Mentoring in Patient-Oriented Research on Asthma and the Indoor Environment

指导以患者为中心的哮喘和室内环境研究

• 批准号: 10362735
• 负责人: Elizabeth C. Matsui
• 金额: $ 18.9万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-02-01 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10362735
• 关键词: Adult; Air; Allergens; Area; Asthma; Baltimore; Biological; Biology; Black race; Child; Childhood; Chronic Obstructive Pulmonary Disease; County; Cross-Sectional Studies; Data; Discrimination; Enrollment; Environment; Environmental Exposure; Eosinophilia; Housing; Immunologics; Individual; Indoor environment; Inflammatory; Lead; Link; Low income; Lung; Measures; Mediating; Mentors; Neighborhoods; Nitrogen Dioxide; Obstruction; Outcome; Particulate Matter; Pathway interactions; Pattern; Persons; Phenotype; Physiology; Pollution; Population; Poverty; Prospective cohort study; Race; Reporting; Research Personnel; Risk; Sampling; Science; Shapes; Testing; Texas; Time; Work; asthmatic; austin; ethnic diversity; ethnic minority; health disparity; improved; lung health; metropolitan; patient oriented research; pollutant; pulmonary function; racial and ethnic; racial and ethnic disparities; racial minority; socioeconomic disparity; training opportunity

Emerging data suggest that a significant proportion of racial and ethnic asthma disparities may be attributable to non-biologic factors. Importantly, racial and ethnic asthma disparities are explained to a significant extent by socioeconomic disparities. Because of longstanding housing discrimination, racial and ethnic minorities are concentrated in poor neighborhoods, and asthma-associated indoor and outdoor exposures likely vary by neighborhood poverty. These exposure differences could lead to phenotypic differences in asthma among residents of high- vs low-poverty neighborhoods. We therefore hypothesize that both environmental exposures and asthma phenotypes covary with neighborhood poverty, and that differences in exposure profiles between high- and low-poverty neighborhoods explain, at least in part, differences in asthma phenotypes. To test this hypothesis, we will (1) examine changes in environmental exposures and asthma phenotypes among an established prospective cohort study of low-income, Black children with asthma who move from high- to low-poverty neighborhoods in the Baltimore metropolitan area (Mobility Asthma Project (MAP)); and (2) conduct a cross-sectional study of 300 ethnically diverse children with asthma who live in high- and low-poverty neighborhoods in Austin-Travis County, TX. Our specific aims are: (1) To determine the effects of (1) moving from a high- to a low-poverty neighborhood and (2) changes in indoor and outdoor exposures on asthma phenotypes in MAP, and (2) To determine whether (1) indoor and outdoor exposures and (2) asthma phenotypes vary by neighborhood poverty in Central Texas. We will enroll 300 children with asthma sampled from high- and low-poverty neighborhoods across Austin-Travis County in the Austin-Travis County Asthma Study (ATX-AS). Establishing neighborhood differences in exposures and asthma phenotypes would support the pursuit of population-level strategies to reduce exposures, potentially resulting in long-term benefits at the population level and reductions in asthma disparities. At the individual level, should improvements in environmental exposures result in a shift to a less severe asthma phenotype, then targeting indoor and outdoor exposures could mitigate the long-term risks of fixed obstruction and chronic obstructive pulmonary disease. These proposed studies will offer outstanding training opportunities for junior clinician investigators as well as an opportunity for the PI to expand her expertise to include outdoor pollution exposure and health disparities science.

新的数据表明，很大比例的种族和民族哮喘差异可能归因于 非生物因素。重要的是，种族和民族哮喘差异在很大程度上可以解释为 社会经济差距。由于长期存在的住房歧视，少数种族和族裔 集中在贫困社区，与哮喘相关的室内和室外暴露可能会因 邻里贫困。这些暴露差异可能导致哮喘的表型差异， 高贫困社区和低贫困社区的居民。因此，我们假设， 暴露和哮喘表型与社区贫困程度相关， 高贫困社区和低贫困社区之间的暴露概况至少部分解释了 哮喘表型为了验证这一假设，我们将（1）检查环境暴露的变化， 低收入黑人哮喘儿童中哮喘表型的前瞻性队列研究 从巴尔的摩大都市区的高贫困社区搬到低贫困社区的人（流动性哮喘项目 （MAP））;（2）对300名不同种族的哮喘儿童进行横断面研究，这些儿童居住在高海拔地区， 和德克萨斯州奥斯汀-特拉维斯县的低贫困社区。具体目标是：（1）确定 （1）从高贫困社区搬到低贫困社区，（2）室内和室外环境的变化 暴露对MAP中哮喘表型的影响，以及（2）确定（1）室内和室外暴露是否 和（2）在德克萨斯州中部，哮喘表型因社区贫困而异。我们将招收300名儿童， 从奥斯汀-特拉维斯县的高贫困和低贫困社区取样的哮喘样本 县哮喘研究（ATX-AS）。建立暴露和哮喘表型的邻里差异 将支持追求人口水平的战略，以减少暴露，可能导致长期的 在人口水平上的好处和减少哮喘的差距。在个人层面， 环境暴露的改善导致向不太严重的哮喘表型转变， 室内和室外暴露可以减轻固定性梗阻和慢性梗阻性疾病的长期风险。 肺部疾病这些拟议的研究将为初级临床医生提供出色的培训机会 调查人员以及PI有机会扩展她的专业知识，包括户外污染暴露 和健康差异科学。