AIRFLOW OBSTRUCTION AND BIOMARKERS OF AIRWAY DURING AND FOLLOWING OF ASTHMA

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This is a longitudinal single-center pilot study designed to describe changes in lung function and levels of noninvasive biomarkers of airway inflammation in children ages 6-18 years over two months following hospitalization for status asthmaticus. Forty children ages 6-18 years with asthma, admitted to Children's Hospital (GCRC) for an asthma exacerbation will be enrolled, completing a study visit prior to discharge. Subjects will undergo a clinical assessment, perform spirometry to measure lung function, measure exhaled nitric oxide (eNO), collect exhaled breath condensate (eBC), collect urine for cotinine level (nicotine exposure, repeated at visit 4). Nasal wash and brushings for viral PCR and epithelial cell culture will also be done and repeated at visit 5. eBC will be analyzed for cysteinyl leukotrienes (CysLT), an important mediator of airway inflammation. These subjects will return to the GCRC for four follow-up visits over eight weeks. A questionnaire will be administered regarding symptoms and medication use between study visits. Subjects will repeat all procedures at visits 2-5. A cold, dry air challenge (to measure airway twitchiness) will be done at visit 4. Forty healthy control subjects ages 6-18 years without asthma or allergies will also participate. Control subjects will complete a single study visit at the CGRC pediatric satellite at CHRMC. During the study visit a demographic and medical history questionnaire will be administered and a physical exam performed. Control subjects will complete spirometry, a measurement of eNO will be performed, and eBC collected during 20 minutes of tidal breathing for CysLT analysis.