Evaluation of Soluble Fiber as a Strategy to Decrease Asthma Morbidity in Underserved Populations

可溶性纤维作为降低服务不足人群哮喘发病率策略的评估

• 批准号: 10707490
• 负责人: Emily K Cope
• 金额: $ 33.53万
• 依托单位: NORTHERN ARIZONA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-20 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10707490
• 关键词: Accident and Emergency department; Acetates; Address; Adherence; Affect; Area; Arizona; Asthma; Black race; Blood; Butyrates; Carbohydrates; Cells; Child; Childhood Asthma; Chronic; Clinic; Clinical Trials; Colon; Complex; Consumption; County; Dendritic Cells; Development; Diagnosis; Diet; Dietary Fiber; Dietary Intervention; Dietary Practices; Disease; Disparity; Ecology; Economic Burden; Economics; Environmental Exposure; Enzymes; Evaluation; Family; Fermentation; Fiber; Funding; Goals; Health; Healthcare; Hispanic; Homing; Human; Hypersensitivity; Immune; Immune system; In Vitro; Incidence; Individual; Inflammation; Inflammatory; Inflammatory Bowel Diseases; Intake; Intervention; Link; Low Income Population; Lung; Measures; Mediating; Metabolic; Metabolism; Morbidity - disease rate; Mus; Not Hispanic or Latino; Nutritional; Obesity; Outcome; Patients; Pediatric Hospitals; Peripheral; Persons; Phenotype; Physiological; Pilot Projects; Play; Population; Poverty; Prevalence; Preventive; Process; Production; Propionates; Protocols documentation; Public Health; Recommendation; Reducing diet; Reporting; Research; Risk; Risk Factors; Role; Scientist; Site; Small Intestines; Supplementation; T-Lymphocyte; Travel; Underserved Population; Urban Population; Visit; Volatile Fatty Acids; airway inflammation; allergic airway inflammation; asthma exacerbation; asthmatic; asthmatic patient; care burden; cell type; cohort; community partnership; coping; dietary; economic disparity; eosinophil; experience; genetic risk factor; gut microbiome; gut microbiota; health disparity; health equity; host microbiota; host-associated microbial communities; host-microbe interactions; improved; in vivo; low socioeconomic status; metropolitan; microbial; microbial composition; microbiome; microbiome composition; microbiota; microbiota metabolites; migration; minority children; nasal microbiota; patient population; polarized cell; preclinical study; recruit; reduce symptoms; respiratory microbiome; skills; soluble fiber; underserved community; urban area; urban residence; urban underserved

PROJECT SUMMARY Approximately 7.7% of the US population have asthma, and incidence has been increasing since the 1980s. In Arizona, asthma prevalence exceeds the national average, with the majority of asthma diagnoses made in the Phoenix Metropolitan Area. Genetic risk factors have been identified in asthmatics. However, the steady increase in the prevalence of asthma in the US population suggests that environmental exposures or other extrapulmonary factors, such as diet and the gut microbiota, may play a critical role in asthma development. Health disparities in asthma prevalence and morbidity are highlighted in individuals from low-income urban areas where nutritional health disparities are more likely to exist. For example, poor-urban residence is an individual risk factor for reporting an asthma attack and having higher odds for an asthma-related visit to the Emergency Department. Minority children are disproportionately affected by low socioeconomic status. A recent study demonstrated that 31.4% of non-Hispanic Black children, and 25.2% of Hispanic children lived under the poverty threshold compared to 9.4% non-Hispanic white children. Economically disadvantaged urban populations also experience a nutritional health disparity, including a low fiber diet that leads to shifts in the gut microbiome and may explain differences in asthma risk. Dietary fibers are complex carbohydrates that resist metabolism in the small intestine by host enzymes and are fermented in the colon by resident microbes. Gut microbial fermentation of soluble fibers results in production of metabolic by-products such as the short chain fatty acids (SCFAs) acetate, propionate, and butyrate, which are important molecules that act as a link between the microbiota and host immune system. We hypothesize that a low fiber diet is a critical, but understudied, factor in asthma health disparities. The overall goals of this proposal are to determine the effect of a gut microbiome modifier (fiber) on microbial composition and function in an underserved population. In addition, we will determine the effect of soluble fiber supplementation in reducing airway inflammation via the gut microbiome-airway axis. The hypothesis governing this proposal is that gut microbial metabolism of dietary fiber to SCFAs will reduce airway inflammation by altering the phenotype of T cells and eosinophils. We have assembled a strong team of clinicians and scientists, and we draw on our pilot study of fiber intervention in a pediatric asthma cohort to achieve 3 aims. First, we will build on the community partnerships through the PCH Mobile Asthma Clinic (Breathmobile) to assess baseline fiber consumption and gut microbiota across underserved communities in Maricopa County. Second, we will evaluate the effect of a soluble fiber supplement in a pediatric asthma cohort. Finally, we will evaluate the effect of microbial-derived SCFAs on key immune cell populations. Completion of these aims will provide evidence that can guide public health nutritional interventions in low SES populations to improve asthma outcomes and advance health equity.

项目总结 大约7.7%的美国人口患有哮喘，自20世纪80年代以来，发病率一直在上升。在……里面 亚利桑那州的哮喘患病率超过全国平均水平，大多数哮喘诊断是在 凤凰城都会区。已经在哮喘患者中发现了遗传风险因素。然而，稳定的 美国人口中哮喘患病率的增加表明环境暴露或其他 肺外因素，如饮食和肠道微生物区系，可能在哮喘的发展中发挥关键作用。 来自低收入城市的个人在哮喘患病率和发病率方面的健康差异突出。 营养健康差异更有可能存在的地区。例如，贫困城市住宅是一种 报告哮喘发作和与哮喘相关的就诊几率较高的个体危险因素 急诊科。少数族裔儿童受社会经济地位低下的影响不成比例。一个 最近的研究表明，31.4%的非西班牙裔黑人儿童和25.2%的西班牙裔儿童生活在 低于贫困线的儿童比例为9.4%，非西班牙裔白人儿童的比例为9.4%。经济上的弱势群体 城市人口也经历了营养健康差距，包括低纤维饮食导致 肠道微生物群并可能解释哮喘风险的差异。膳食纤维是一种复杂的碳水化合物 抵抗宿主酶在小肠中的新陈代谢，而在结肠中由驻留的微生物发酵。 可溶纤维的肠道微生物发酵会产生代谢副产物，如短纤维 链脂肪酸(SCFA)醋酸酯、丙酸和丁酸，这些都是起纽带作用的重要分子 在微生物区系和宿主免疫系统之间。我们假设低纤维饮食是关键，但 研究不足，哮喘健康差异的因素。这项提案的总体目标是确定效果 肠道微生物组改良剂(纤维)对服务不足人群中微生物组成和功能的影响。在……里面 此外，我们将通过以下途径确定补充可溶性纤维在减少呼吸道炎症方面的效果 肠道微生物群-气道轴。这一建议的假设是，饮食中的肠道微生物代谢 通过改变T细胞和嗜酸性粒细胞的表型，纤维连接到单链脂肪酸可减轻呼吸道炎症。我们有 组建了一支强大的临床医生和科学家团队，我们利用了我们在 儿童哮喘队列要达到3个目标。首先，我们会透过公共卫生署与社区建立伙伴关系 流动哮喘诊所(Breathmobile)评估基线纤维消耗和肠道微生物区系 马里科帕县服务不足的社区。其次，我们将评估一种可溶性纤维的效果 儿童哮喘队列中的补充剂。最后，我们将评估微生物来源的单链脂肪酸对关键 免疫细胞群。这些目标的实现将为指导公共卫生提供证据 对低SES人群进行营养干预以改善哮喘结果并促进健康公平。