Clinical and Immunological Evaluation of Children with Allergic Disease

儿童过敏性疾病的临床和免疫学评估

• 批准号: 7964522
• 负责人: Dean D Metcalfe
• 金额: $ 31.67万
• 依托单位: NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7964522
• 关键词: 2 year old; Allergic; Allergic rhinitis; Asthma; Atopic Dermatitis; Blood; Child; Childhood; Chronic Disease; Clinic; Clinical; Clinical Immunology; Communication; Consultations; Cytokine Signaling; Databases; Diagnostic tests; Diagnostics Research; Disease; Documentation; Eczema; Elasticity; Ethnic Origin; Evaluation; Exercise; Exhalation; Fellowship Program; Food Hypersensitivity; Gender; Health; Health Priorities; Hypersensitivity; IgE; Infant; Inflammatory; Journals; Laboratory Study; Lung; Manuscripts; Measurement; Measures; Medical; Medical Care Costs; Modality; National Heart, Lung, and Blood Institute; National Institute of Allergy and Infectious Disease; Nitric Oxide; Oscillometry; Patch Tests; Patient Care; Patients; Physicians; Publications; Publishing; Pulmonary function tests; Pulmonology; Race; Radioallergosorbent Test; Research; Research Personnel; Resistance; Resources; Respiratory physiology; Serum; Services; Skin; System; Techniques; Testing; Training; Tryptase; United States National Institutes of Health; Urticaria; Visit; Weight; clinical application; experience; longitudinal analysis; mast cell; social

The NIH Pediatric Allergy Clinic has provided residents in the NIAID Allergy and Immunology Clinical Fellowship Program with medical training and continuity clinic experience in pediatric allergic diseases including asthma, allergic rhinitis, food allergy, atopic dermatitis and urticaria. During the past fiscal year, patient care visits exceeded 350, with a total accrual of 260 new patients. The NIH Pediatric Allergy Clinic also provides clinical resources for the study of children with allergic inflammatory disorders. In addition to standard diagnostic testing for allergic diseases, which includes skin prick testing, radioallergosorbent (RAST) testing, patch testing and pulmonary function testing, the clinic has integrated other modalities in the evaluation of children with allergic diseases. To evaluate lung function we have emplotyed impulse oscillometry, a non-invasive, non-effort dependant technique that measures lung resistance and elasticity. This is being used in conjunction with standard pulmonary function testing in older children and by itself in infants as young as two years old. A manuscript reviewing the clinical application of impulse oscillometry in pediatric patients with asthma is being prepared for publication. Through consultation with the NHLBI pulmonology service, exercise challenge pulmonary function testing has been performed. In conjunction with other investigators in the LAD, expired breath condensate and exhaled nitric oxide measurements have been obtained for diagnostic and research purposes. Research blood has been collected for laboratory studies to measure markers of allergic diseases, develop approaches to culture mast cells from blood, and determine cytokine and signaling profiles. In particular, serum tryptase levels were measured in 44 non-atopic and 153 atopic clinic patients. Median and 95% prediction intervals of tryptase levels for non-atopics were 3.44, 0.64-6.77 and 3.56, 0.98-10.80 for atopics. This study, recently published in the Journal of Allergy and Clinical Immunology (9 August 2009 on-line) establishes normative serum reference tryptase values in atopic and non-atopic children. Among atopics, a statistically significant association with tryptase was found for gender and race but not for ethnicity, total IgE levels, weight/weight percentile or eczema status. Patient documentation for communication with referring physicians and for longitudinal analysis is entered into CRIMSON, the NIAID database system.

NIH儿科过敏诊所为NIAID过敏和免疫学临床奖学金计划提供了医学培训和连续性临床临床奖学金计划的居民。在过去的财政年度中，患者护理访问超过350，总应计260名新患者。 NIH儿科过敏诊所还为患有过敏性炎症性疾病的儿童的研究提供了临床资源。 除了对过敏性疾病的标准诊断测试（包括皮肤刺测试，放射性吸血器（RAST）测试，斑块测试和肺功能测试）外，该诊所还将其他方式整合在评估过敏性疾病儿童的情况下。 为了评估肺功能，我们已经构成了脉冲振荡，这是一种无创，非依赖性的技术，可测量肺阻力和弹性。 这与年龄较大的儿童的标准肺功能测试一起使用，并在两岁以下的婴儿中使用。审查脉冲振荡在儿科患者哮喘中的临床应用的手稿正在准备出版。 通过与NHLBI肺科服务的咨询，已经进行了运动挑战肺功能测试。 与LAD中的其他研究人员一起，已获得过期的呼吸冷凝物和呼出的一氧化氮测量值，以诊断和研究目的。 已经收集了研究血液进行实验室研究，以测量过敏性疾病的标志物，开发出血液中培养肥大细胞的方法，并确定细胞因子和信号传导谱。特别是，在44名非原子质和153名特应诊所患者中测量了血清胰蛋白酶水平。非原子化酶水平的中值和95％的预测间隔为3.44、0.64-6.77和3.56、0.98-10.80，用于ATOPICS。 这项研究最近发表在《过敏和临床免疫学杂志》（2009年8月9日）上，在特应性和非特性儿童中建立了规范性血清参考胰蛋白酶值。在Atopics中，发现与胰蛋白酶的统计学意义相关性，但没有针对种族，总IGE水平，体重/体重百分比或湿疹状态。 与参考医生进行沟通和进行纵向分析的患者文档已进入NIAID数据库系统Crimson。