Symptom clusters in children with exacerbation-prone asthma

哮喘易加重儿童的症状群

• 批准号: 10838820
• 负责人: Anne Mentro Fitzpatrick
• 金额: $ 46.54万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-10 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10838820
• 关键词: Acceleration; Address; Administrative Supplement; Air; Air Pollution; Allergens; Aromatic Polycyclic Hydrocarbons; Asthma; Award; Biological; Black race; Blood Cells; Cells; Cessation of life; Child; Climate; Clinical; Collaborations; Crime; Data; Enrollment; Eosinophilia; Epigenetic Process; Epithelium; Exposure to; Filtration; Fright; Future; Genes; Grain; Green space; Health; Heavy Metals; Hispanic; Home; Hospitalization; Host Defense; Housing; Human Resources; Humidity; Immune; Impairment; Infiltration; Inflammation; Inflammatory; Inhalation; Intervention Studies; Investigation; Longitudinal Studies; Lung; Measures; Mediating; Mediation; Metabolic; Metabolic Pathway; Modification; Neighborhoods; Nitrates; Obstruction; Outcome; Oxidative Stress; Ozone; Parents; Particulate; Patient Outcomes Assessments; Patients; Phenotype; Plasma; Pollen; Population; Predisposition; Production; Public Health; Quality of life; Recreation; Reporting; Research; Research Personnel; Respiratory Signs and Symptoms; Risk; Safety; Sampling; School-Age Population; Seasons; Structural Racism; Sulfur; Surface; Symptoms; Temperature; Testing; Volatilization; Vulnerable Populations; absorption; advanced system; airborne allergen; asthma exacerbation; climate change; climate impact; climate-related health; cytokine; differential expression; eosinophil; experience; experimental study; extreme heat; fine particles; follow-up; health equity; metabolomics; multiple omics; pollutant; programs; respiratory; respiratory health; skills; social vulnerability; symptom cluster; timeline; toxicant; transcriptome sequencing; transcriptomics; ventilation

PROJECT SUMMARY/ABSTRACT Climate change poses a significant threat to respiratory health in patients with asthma through synergistic disturbances in air quality and airborne allergens. However, the effects of climate change and air pollution are not equal and are substantially greater in socially vulnerable populations of children. For example, Black and Hispanic children are more likely to live in lower opportunity neighborhoods due to systemic structural racism and historic red lining practices, are exposed to more pollutants, and have more severe asthma exacerbations attributable to air pollution. This is a public health crisis since asthma exacerbations are a primary predictor of future hospital admission and significantly increase the risk of asthma-related death. Dr. Fitzpatrick has built an extensive research program focused on socially vulnerable populations of children with asthma. Her current R01, Symptom Clusters in Children with Exacerbation-Prone Asthma (R01NR018666), is a 12-month longitudinal study of school-age children with a recent asthma exacerbation who are clustered into separate groups based on a battery of patient-reported outcome (symptom) measures. Clinical outcomes and inflammatory and metabolic pathways are then compared between cluster groups. However, climate and air quality are not assessed. This administrative supplement will utilize previously collected data and samples from the parent R01 and will add new assessments (characterization of social vulnerability and air quality), new experiments (transcriptomics and multi-omic associations), and additional personnel with expertise to pursue Climate Change and Health (CCH) initiatives. The central hypothesis is that climate change-induced disruptions in air quality worsen asthma inflammation, symptoms, and longitudinal outcomes in school-age children with asthma and that these effects are mediated by social vulnerability. Specific aims are to: 1) determine associations between climate, air quality, symptoms, and outcomes in children with exacerbation- prone asthma during two climate seasons, and 2) determine the biological impact of climate and pollutants in children with exacerbation prone asthma. This administrative supplement addresses two Core Pillars of the CCH Initiative: Health Effects Research, investigation of the influences of climate change on health outcomes and biological mechanisms, and Health Equity, recognizing and responding to the needs of populations most at risk. The timeline for completion is one year. The results are expected to advance systems-level understanding of the impact of climate change-associated air pollution on vulnerable children with asthma and provide key preliminary data for an R01 interventional study in this field.

项目摘要/摘要 气候变化通过协同作用对哮喘患者的呼吸健康构成重大威胁 空气质量的紊乱和空气中的过敏原。然而，气候变化和空气污染的影响是 不平等，在社会弱势儿童群体中的比例大大增加。例如，Black和 由于系统性的结构性种族主义，拉美裔儿童更有可能生活在机会较低的社区 和历史性的红线做法，暴露在更多的污染物中，并有更严重的哮喘恶化 可归因于空气污染。这是一场公共卫生危机，因为哮喘恶化是 未来入院并显著增加与哮喘相关的死亡风险。菲茨帕特里克博士建立了一个 广泛的研究计划侧重于哮喘儿童的社会弱势群体。她目前的情况 R01，易加重哮喘儿童的症状群(R01NR018666)，为期12个月 对最近哮喘加重的学龄儿童的纵向研究，这些儿童被分成独立的 根据患者报告的一系列结果(症状)测量进行分组。临床结果和 然后比较不同聚类组之间的炎症和代谢途径。然而，气候和空气 没有对质量进行评估。本行政副刊将利用以前从以下方面收集的数据和样本 母公司R01，并将增加新的评估(社会脆弱性和空气质量的特征)，新 实验(转录组和多组体关联)，以及更多具有专业知识的人员 气候变化与健康(CCH)倡议。中心假设是气候变化导致的 空气质量的破坏会加重学龄儿童的哮喘炎症、症状和纵向结局 儿童哮喘，这些影响是由社会脆弱性所调节的。具体目标是：1) 确定气候、空气质量、症状和恶化儿童预后之间的关系- 在两个气候季节易发哮喘，以及2)确定气候和污染物在 易加重哮喘的儿童。这份行政副刊阐述了 CCH倡议：健康影响研究，调查气候变化对健康结果的影响 和生物机制，以及健康公平，认识到并最大限度地响应人口的需求 处于危险之中。完成的时间是一年。预计结果将推动系统层面的发展 了解与气候变化相关的空气污染对易受影响的哮喘儿童和 为该领域的R01介入研究提供关键的初步数据。