Project 1: Urban Dietary Effects on the Asthmatic Response to Pollutants

哮喘是一种常见而复杂的疾病。在美国，哮喘的负担是巨大的， 对弱势群体的不成比例的影响，包括幼儿、非裔美国人和那些生活在 在市中心。这些最脆弱的人往往生活在污染严重的环境中。 水平，包括室内污染物和过敏原的高水平。此外，低收入者的饮食，内部 城市非裔美国人明显不符合国家营养指南，并有一种模式 可能会使他们特别容易受到吸入污染物和过敏原的影响。要解决这个问题 饮食摄入量和室内环境对儿童哮喘的关键问题，我们建议 一项对生活在非裔美国人和低收入城市社区的儿童的小组研究 参与者。我们已经证明，在拟议的研究参与者所在的社区， 污染物水平，包括颗粒物(PM)和二氧化氮(NO2)，远远超过 室外水平和郊区室内水平，这些室内污染物是独立相关的 随着哮喘发病率的增加。此外，我们已经证明，在这种高风险的饮食 人口是贫穷的，其模式与已被证明的饮食模式不一致 预防哮喘。我们计划研究贫穷的“市中心”饮食对糖尿病易感性的影响。 哮喘儿童接触家庭污染物(PM和NO2)(目标1)，并确定障碍和 在市中心儿童之家实施饮食和环境调整的有利因素 哮喘患者(目标2)。为了实现这些目标，将计划在#年招募200名5-12岁的哮喘儿童 巴尔的摩市中心，每个人将接受3个为期7天的监测期(基线、3个月和 6个月)，在那里他们将接受室内空气监测、饮食和呼吸评估、鼻腔 灌洗、呼出的一氧化氮测量、尿液采集和抽血以确定炎症标志物 和氧化应激。重要的是，这个应用程序的目标建立在良好的基础设施之上 由一群经验丰富的调查人员组成，他们拥有不同但高度整合的专业领域。这个真实的世界 现场研究将通过展示临床研究来补充项目2和项目3的结果 饮食对室内污染物反应的影响，并通过提供氧化的佐证 他们可能通过的应激和炎症途径。项目2和项目3将类似地检查 饮食对污染物反应的影响，但在受控环境中使用人类受试者和动物。

Asthma is a common and complex disorder. In the U.S., the burden of asthma is enormous, with a disproportionate impact on vulnerable groups including young children, African-Americans and those living in the inner city. These most vulnerable people often inhabit an environment that has excessive pollution levels, including high levels of indoor pollutants and allergens. Furthermore, the diet of low-income, inner city African-Americans is markedly inconsistent with national nutritional guidelines, and has a pattern that may leave them especially vulnerable to the effects of inhaled pollutants and allergens. To address the critical questions of the role of dietary intake and the indoor environment on childhood asthma, we propose a panel study of children living in urban neighborhoods enriched with African-American and lower income participants. We have already shown that in the neighborhoods of the proposed study participants that in-home pollutant levels, including particulate matter (PM) and nitrogen dioxide (NO2), greatly exceed the outdoor levels and suburban indoor levels and that these in-home pollutants are independently associated with increased asthma morbidity. Furthermore, we have already demonstrated that the diet in this high-risk population is poor and is of a pattern that is inconsistent with dietary patterns that have been shown to protect against asthma. We plan to examine the effect of the poor "inner city" diet on susceptibility of asthmatic children to in-home pollutant (PM and NO2) exposure (Aim 1), and to identify barriers and enabling factors to implementing dietary and environmental modifications in inner city homes of children with asthma (Aim 2). To address these aims will plan to recruit 200 children with asthma, ages 5-12, in inner city Baltimore, each of whom will undergo 3 seven-day monitoring periods (at baseline, 3 months and 6 months) where they will undergo indoor air monitoring, dietary and respiratory assessments, nasal lavage, exhaled nitric oxide measurements, urine collection and blood draw for markers of inflammation and oxidative stress. Importantly, the aims in this application build upon the well-established infrastructure of a group of experienced investigators with diverse but highly integrated areas of expertise. This real-world field-based study will complement the findings from Projects 2 and 3 by demonstrating the clinical effect of diet on response to indoor pollutants, and by providing corroborative evidence of the oxidative stress and inflammatory pathways by which they may act. Projects 2 and 3 will similarly examine the effects of diet on response to pollutants, but in controlled settings using human subjects and animal.