Phthalate Exposure and Inner City Pediatric Asthma

邻苯二甲酸盐接触与内城小儿哮喘

• 批准号: 7496166
• 负责人: Robin Marjorie Whyatt
• 金额: $ 59.32万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-15 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7496166
• 关键词: 5 year old; Accident and Emergency department; Adult; African American; Age; Air; Allergens; Allergic; Antibodies; Asthma; Biological Markers; Birth; Blood; Caring; Child; Childhood; Childhood Asthma; Cohort Studies; Collection; Communities; Data; Development; Diagnosis; Dibutyl Phthalate; Diethylhexyl Phthalate; Dominican; Dose; Dust; Eczema; Enrollment; Environmental Health; Environmental Monitoring; Epidemiologic Studies; Exhalation; Exposure to; Funding; Goals; Grant; Health; Home environment; Hospitals; House Dust; Hypersensitivity; IgE; Immunoglobulins; Infant; International; Maternal Age; Measurement; Measures; Methods; Minority; Mothers; New York; New York City; Nitric Oxide; Outcome; Outcome Measure; Parents; Pediatric Hospitals; Pharmaceutical Preparations; Play; Pregnancy; Pregnancy Trimesters; Presbyterian Church; Production; Pulmonary function tests; Questionnaires; Rate; Recording of previous events; Reporting; Research; Respiratory physiology; Rhinitis; Risk Factors; Role; Sampling; Sweden; Symptoms; Testing; Urine; Visit; Wheezing; air sampling; airway inflammation; atopy; base; butylbenzyl phthalate; cohort; cost; cost effective; diethylphthalate; early childhood; experience; falls; inner city; phthalate; phthalates; postnatal; prenatal; respiratory; response

DESCRIPTION (provided by applicant): The proposed study will determine whether early childhood exposures to phthalates are associated with the development of current asthma and proallergic immunoglobulin (Ig) E production at ages five to seven and whether current exposures to phthalates are associated with augmented airway inflammation and diminished lung function at ages five to seven. The research will confirm or refute recent epidemiologic findings of associations between phthalate exposures and childhood asthma, atopy and reduced lung function. This prior research is limited by incomplete exposure and outcome measures. However, results from a pilot undertaken for the proposed study also support the hypothesis that phthalate exposures are risk factors in the development of asthma. The proposed study will be conducted among a cohort of 400 children who reside in minority communities in New York City. These communities experience some of the highest childhood asthma rates in the world. Phthalate exposures are also widespread. The research will be performed within the ongoing longitudinal birth cohort study being conducted by the Columbia Center for Children's Environmental Health (CCCEH). The CCCEH is evaluating the contribution of prenatal and postnatal exposures in the development of asthma and other health outcomes. Children are followed from pregnancy through age seven years. The proposed research is cost effective in that many of the required exposure and outcome measurements are already being gathered within the CCCEH cohort. These include detailed history of respiratory and allergic symptoms, asthma treatment and emergency room visits; lung function testing at age six; allergen levels in house dust samples collected from pregnancy through age five; and measurement of allergic sensitization (total and specific IgE measured at ages two, three, and five years). The phthalates will be measured in stored urine samples collected from the mother during pregnancy and from children at ages three and five years and in newly collected indoor air and urine samples at ages five to seven. Also at age five to seven years, exhaled nitric oxide will be measured as an indicator of airway inflammation and total and allergen-specific IgE levels will be determined. The case ascertainment of current asthma at ages five to seven will be made by a designated board- certified pediatric pulmonologist at the Morgan Stanley Children's Hospital of New York Presbyterian Hospital. Hypotheses to be tested are: (1) that early childhood exposures to the phthalates, as measured by metabolite levels in urine samples collected during pregnancy and at ages three and five years, predict current asthma at ages five to seven and production of IgE antibodies at age seven; and (2) after correcting for early phthalate exposure, current exposure as measured by levels of the parent compounds in indoor air samples and metabolites in urine samples collected at ages five to seven years, will be associated inversely with lung function and positively with airway inflammation at ages five to seven years.

描述（由申请人提供）：拟议的研究将确定儿童早期接触邻苯二甲酸盐是否与当前哮喘的发展和 5 至 7 岁时促过敏性免疫球蛋白 (Ig) E 的产生有关，以及当前接触邻苯二甲酸盐是否与 5 至 7 岁时气道炎症加剧和肺功能下降有关。该研究将证实或反驳最近的流行病学发现，即邻苯二甲酸盐暴露与儿童哮喘、特应性和肺功能下降之间存在关联。这项先前的研究受到不完整的暴露和结果测量的限制。然而，为拟议研究进行的试点结果也支持邻苯二甲酸盐暴露是哮喘发生的危险因素的假设。拟议的研究将在居住在纽约市少数族裔社区的 400 名儿童中进行。这些社区的儿童哮喘发病率是世界上最高的。邻苯二甲酸盐的暴露也很普遍。该研究将在哥伦比亚儿童环境健康中心 (CCCEH) 正在进行的纵向出生队列研究中进行。 CCCEH 正在评估产前和产后接触对哮喘和其他健康结果的影响。对儿童从怀孕到七岁进行跟踪。拟议的研究具有成本效益，因为许多所需的暴露和结果测量已经在 CCCEH 队列中收集。其中包括呼吸道和过敏症状的详细病史、哮喘治疗和急诊室就诊；六岁时进行肺功能测试；从怀孕到五岁收集的室内灰尘样本中的过敏原水平；过敏反应的测量（在两岁、三岁和五岁时测量总 IgE 和特异性 IgE）。将从怀孕期间的母亲以及三岁和五岁的儿童收集的储存尿液样本以及新收集的五岁至七岁的室内空气和尿液样本中测量邻苯二甲酸盐。此外，在五到七岁时，将测量呼出的一氧化氮作为气道炎症的指标，并确定总 IgE 水平和过敏原特异性 IgE 水平。纽约长老会医院摩根士丹利儿童医院指定的经过委员会认证的儿科肺科医师将对五至七岁儿童当前患有哮喘的病例进行确定。需要检验的假设是：(1) 儿童早期接触邻苯二甲酸盐（通过在怀孕期间以及三岁和五岁时收集的尿液样本中的代谢物水平进行测量）可以预测五岁至七岁时当前的哮喘以及七岁时产生的 IgE 抗体； (2) 在校正早期邻苯二甲酸盐暴露后，通过五至七岁时收集的室内空气样本中的母体化合物和尿液样本中的代谢物水平来测量当前的邻苯二甲酸盐暴露水平，将与五至七岁时的肺功能呈负相关，与气道炎症呈正相关。