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，包括幼儿，非洲裔美国人和那些生活 在市中心这些最脆弱的人通常居住在污染过度的环境中 水平，包括高水平的室内污染物和过敏原。此外，低收入、国内 城市非洲裔美国人明显不符合国家营养指南，并且有一种模式， 可能使他们特别容易受到吸入污染物和过敏原的影响。解决 关于饮食摄入和室内环境对儿童哮喘的作用，我们提出了一些关键问题， 一项针对生活在非洲裔美国人和低收入人群聚集的城市社区儿童的小组研究 参与者我们已经表明，在拟议的研究参与者的社区， 污染物水平，包括颗粒物（PM）和二氧化氮（NO2），大大超过了 室外水平和郊区室内水平，这些室内污染物是独立相关的 哮喘发病率增加。此外，我们已经证明，在这种高风险的饮食 人口贫穷，其模式与已被证明 预防哮喘。我们计划研究贫穷的“内城”饮食对易感性的影响， 哮喘儿童在家中污染物（PM和NO2）暴露（目标1），并确定障碍， 在市中心儿童家庭实施饮食和环境改变的有利因素 哮喘（Aim 2）为了实现这些目标，将计划招募200名5-12岁的哮喘儿童， 巴尔的摩市中心，每位受试者将接受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 灌洗、呼出的一氧化氮测量、尿液收集和用于炎症标志物的抽血 和氧化应激。重要的是，此应用程序中的目标建立在完善的基础设施之上 一组经验丰富的调查员，具有不同但高度综合的专业知识领域。这个现实世界 一项基于实地的研究将通过证明临床 饮食对室内污染物反应的影响，并通过提供氧化的确证证据， 压力和炎症途径，他们可能会采取行动。项目2和项目3将同样审查 饮食对污染物反应的影响，但在受控环境中使用人类和动物。

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.