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的居民提供儿科过敏性疾病（包括哮喘、过敏性鼻炎、食物过敏、特应性皮炎和荨麻疹）的医疗培训和连续性诊所经验。在上一个财政年度，病人护理访问超过350次，共增加260名新病人。美国国立卫生研究院小儿过敏症诊所也为儿童过敏性炎症性疾病的研究提供临床资源。 除了过敏性疾病的标准诊断测试（包括皮肤点刺测试、放射性过敏吸附剂（RAST）测试、斑贴测试和肺功能测试）外，该诊所还整合了其他模式来评估患有过敏性疾病的儿童。 为了评估肺功能，我们采用了脉冲阻力测定法，这是一种测量肺阻力和弹性的非侵入性、非努力依赖性技术。 这是与标准肺功能测试结合使用，在年龄较大的儿童和本身在婴儿为两岁。一篇综述脉冲多普勒超声心动图在儿童哮喘患者中临床应用的论文正在准备发表。 通过咨询NHLBI肺病服务，进行了运动挑战肺功能测试。 与LAD的其他研究人员一起，已获得呼气冷凝液和呼出一氧化氮测量值，用于诊断和研究目的。 研究血液已被收集用于实验室研究，以测量过敏性疾病的标志物，开发从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，血清类胰蛋白酶水平测定44非特应性和153特应性临床患者。类胰蛋白酶水平的中位数和95%预测区间为3.44，0.64-6.77和3.56，0.98-10.80的特应性。 这项研究最近发表在《变态反应和临床免疫学杂志》（2009年8月9日在线）上，建立了特应性和非特应性儿童的标准血清参考类胰蛋白酶值。在特应性疾病中，性别和种族与类胰蛋白酶有统计学显著相关性，但种族、总IgE水平、体重/体重百分位数或湿疹状态与类胰蛋白酶无统计学显著相关性。 将用于与转诊医生沟通和纵向分析的患者文档输入NIAID数据库系统CRIMSON。