Epidemiology of asthma: risk and prognosis in a cohort from birth to adolescence

哮喘流行病学：从出生到青春期队列的风险和预后

• 批准号: 7478512
• 负责人: Syed HASAN Arshad
• 金额: $ 46.98万
• 依托单位: ST. MARY'S HOSPITAL NEWPORT
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-01 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7478512
• 关键词: Address; Adolescence; Adolescent; Adult; Affect; Age; Age-Years; Agriculture; Allergic; Allergy and Immunology; Animals; Asthma; Automobile Driving; Biometry; Birth; Birth Weight; Body mass index; Breast Feeding; Bronchial Provocation Tests; Child; Childhood; Childhood Asthma; Clinical; Clinical Data; Clinical Markers; Clinical Medicine; Collaborations; Data; Development; Diagnosis; Diet; Disease; Disease regression; Disease remission; England; Environmental Exposure; Environmental Risk Factor; Environmental Tobacco Smoke; Epidemiologic Studies; Epidemiology; Exhalation; Exposure to; Family history of; Farming environment; Female; Gender; Genotype; Home environment; Hypersensitivity; IgE; Infant; Interdisciplinary Study; Intervention; Island; Leptin; Life; Link; Low Birth Weight Infant; Mediating; Medicine; Michigan; Modeling; Morbidity - disease rate; Nitric Oxide; Obesity; Outcome; Participant; Personal Satisfaction; Phase Transition; Phenotype; Physical Examination; Pollution; Population; Prevalence; Prevention; Prevention strategy; Probability; Prognostic Factor; Puberty; Public Health; Questionnaires; Rate; Recording of previous events; Recruitment Activity; Recurrence; Research; Research Personnel; Respiratory physiology; Risk; Risk Factors; Science; Score; Serum; Site; Skin; Smoking; Societies; South Carolina; Spirometry; Sputum; Symptoms; Testing; Time; Tobacco smoke; Training; Universities; Work; airway inflammation; base; boys; cigarette smoking; cohort; early onset; experience; follow-up; genetic epidemiology; girls; indexing; leptin receptor; male; mortality; outcome forecast; pollutant; predictive modeling; prevent; programs; respiratory; sex

DESCRIPTION (provided by applicant): Asthma has shown dramatic increase worldwide. The disorder is diagnosed in 7-15 percent of U.S. children and is more prevalent in boys throughout childhood; however, during puberty a gender reversal occurs. We do not know if asthma persists in girls and remits in boys or there is new onset asthma in girls. In addition, we do not understand factors driving these changes in asthma occurrence, but they seem to be related to gender- specific developments during puberty. We propose to test the following hypotheses: (1) Gender reversal of asthma is due to new onset in girls and higher rates of clinical remission in boys. (2) Risk factors include early onset of puberty, obesity, pollutants, and early life factors such as parental smoking and lack of breastfeeding. (3) Identification of prognostic factors will allow for targeted interventions to prevent persistence and recurrence of asthma in adulthood. In 1989, we recruited a population birth cohort (1,456 children) on the Isle of Wight, an island one mile off the south coast of England with a population of 130,000. This cohort has been extensively phenotyped for asthma and other allergic diseases at 1, 2, 4 and 10 years of age. High follow up proportions (80-95 percent) have been achieved at each age. A wealth of information is available from prior examinations of the cohort. Participants are now adolescents. Therefore, this cohort is uniquely suited to address the above hypotheses. We propose to study these children at the age of 18 years and anticipate that 1,200 will participate. We will assess symptoms, lung function, airway inflammation, and atopic markers using questionnaire, physical examination, spirometry, bronchial provocation, exhaled nitric oxide, sputum induction, skin prick test, and total IgE. Using regression models with clinical markers as outcomes, we will determine the impact of pubertal factors, obesity-related factors (body mass index, serum leptin levels, genotypes for leptin and leptin receptor), and environmental risk factors (including, breastfeeding, tobacco smoke exposure, markers of pollution and agriculture exposure). Using all available information, we will determine a predictive model to identify children who are at high risk of persistent or recurrent asthma in adult life. These results will facilitate prevention of asthma persistence and recurrence. Our work brings together a multidisciplinary research team with a proven record of collaboration and expertise in respiratory medicine, allergy and immunology, epidemiology, genetics, and biostatistics.

描述（由申请人提供）：哮喘在全球范围内显示出急剧增加。该疾病在7-15％的美国儿童中被诊断出来，整个童年的男孩更为普遍。但是，在青春期发生性别逆转。我们不知道哮喘是否持续到女孩中，男孩中的疾病或女孩的哮喘发作是新的。此外，我们不理解推动哮喘发生这些变化的因素，但它们似乎与青春期期间的性别发展有关。我们建议检验以下假设：（1）哮喘性别逆转是由于女孩的新发作和男孩的临床缓解率较高。 （2）风险因素包括青春期，肥胖症，污染物和早期生活因素的早期发作，例如父母吸烟和缺乏母乳喂养。 （3）鉴定预后因素将允许采取有针对性的干预措施，以防止成年后哮喘的持久性和复发。 1989年，我们在怀特岛（Isle of Wight）招募了一个人口出生队列（1,456名儿童），该岛距离英格兰南海岸一英里处，人口为130,000。该队列已在1、2、4和10岁的哮喘和其他过敏性疾病中广泛表型。每个年龄段都达到了较高的随访比例（80-95％）。从同类的事先考试中可以提供大量信息。参与者现在是青少年。因此，该队列非常适合解决上述假设。我们建议在18岁时研究这些孩子，并预计将有1200名参加。我们将使用问卷，身体检查，肺活量测定法，支气管挑衅，呼出的一氧化氮，痰诱导，皮肤刺测试和全部IGE来评估症状，肺功能，气道炎症和特应标记。使用以临床标记为结果的回归模型，我们将确定青春期因素，与肥胖相关因素（体重指数，血清瘦素水平，瘦素和瘦素受体的基因型）的影响以及环境风险因素（包括，乳腺癌，乳房烟雾烟雾，烟草烟雾暴露，污染和农业的标志和农业的标志）。使用所有可用信息，我们将确定一个预测模型，以识别成人生活中持续或经常性哮喘高风险的儿童。这些结果将有助于预防哮喘持久性和复发。我们的工作汇集了一个跨学科研究团队，具有良好的合作和专业知识，在呼吸医学，过敏和免疫学，流行病学，遗传学和生物统计学方面具有良好的记录。