Prenatal Fatty Acid Supplementation and Early Childhood Asthma and Atopy in Black American Families

美国黑人家庭产前脂肪酸补充剂与儿童早期哮喘和特应性

基本信息

  • 批准号:
    10586398
  • 负责人:
  • 金额:
    $ 59.55万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2023
  • 资助国家:
    美国
  • 起止时间:
    2023-01-01 至 2026-11-30
  • 项目状态:
    未结题

项目摘要

Project Summary Asthma is a chronic inflammatory lung disease that currently affects an estimated 8.4% of children in the U.S., resulting in over 600,000 emergency department visits and over 75,000 hospitalizations each year (Moorman et al., 2012). For decades the burden of asthma in the U.S. has fallen disproportionately on Black children living in low- resourced communities, for whom the prevalence, morbidity and mortality rates far exceed those for White children. Black children have 2-3 times higher rates of hospitalization and emergency department visits compared with White children, and a nearly 5-fold increase in asthma-related mortality (Volerman, et al., 2019). In some neighborhoods on the South Side of Chicago the rates of asthma among young Black children are over 40% (Gupta et al., 2008). The high rate of asthma and allergy in Black children appears to be in part influenced by prenatal stress exposure. Thus, an intervention designed to improve prenatal stress regulation in Black women may also reduce the risk of asthma in their children. The Nutrition and Pregnancy Study (NAPS) (NCT02647723) is a nearly completed double-blind, randomized controlled study (RCT) of prenatal fatty acid supplementation aiming to improve birth outcomes and infant neurodevelopment via improved prenatal stress regulation. Docosahexaenoic acid (DHA), an omega-3 fatty acid, has been shown to protect against the development of asthma and atopy in controlled animal studies and in observational studies of humans. Results from two small RCTs of infant formula supplementation provide further support for the protective effects of dietary fatty acids against asthma (Birch et al., 2010; Foiles et al., 2016). The NAPS study provides an unprecedented opportunity to test the effects of prenatal DHA levels on childhood asthma and atopic disease, and to further examine how patterns of prenatal stress regulation impact that effect. We propose to conduct clinical assessments of asthma and other atopic outcomes in 130 children at 5-6 years of age whose mothers participated in the NAPS study, and to collect data from medical records and maternal report to test two aims. Aim 1: Test whether prenatal fatty acid levels are associated with asthma and atopic disease in early childhood. We hypothesize that higher prenatal blood levels of DHA will be associated with lower levels of asthma and atopy in the offspring as measured via laboratory assessments of asthma and allergic sensitization at ages 5-6 years, as well as medical record abstraction and maternal report. Aim 2: Test whether prenatal stress regulation impacts the association between prenatal fatty acid levels and asthma and atopic disease in early childhood. Our primary hypothesis is that cortisol and cytokine levels, heart rate variability, and perceived stress during pregnancy will partially mediate the association between prenatal DHA levels and childhood asthma and atopic disease. We will also test whether the association between prenatal DHA levels and early childhood asthma and atopic disease is moderated by prenatal stress regulation at baseline and by changes in stress regulation during pregnancy. To our knowledge, this will be the first test of prenatal fatty acid levels on asthma and allergy in Black children living in low-resourced environments in the U.S.
项目摘要 哮喘是一种慢性炎症性肺部疾病,目前估计影响美国8.4%的儿童, 每年有超过600,000人次急诊就诊和超过75,000人次住院(Moorman等人, 2012年)。几十年来,美国哮喘的负担不成比例地落在生活在低收入国家的黑人儿童身上。 资源丰富的社区,其患病率、发病率和死亡率远远超过白色 孩子黑人儿童的住院率和急诊就诊率是黑人儿童的2 - 3倍, 与白色儿童相比,哮喘相关死亡率增加了近5倍(Volerman,et al.,2019年)。在一些 在芝加哥南部的社区,黑人儿童的哮喘发病率超过40%(Gupta et 例如,2008年)。黑人儿童哮喘和过敏的高发病率似乎部分受到产前压力的影响 exposure.因此,旨在改善黑人妇女产前压力调节的干预措施也可能减少 他们的孩子有哮喘的风险。营养和妊娠研究(NAPS)(NCT 02647723)是一项即将完成的 旨在改善分娩的产前脂肪酸补充的双盲、随机对照研究(RCT) 通过改善产前应激调节,改善妊娠结局和婴儿神经发育。二十二碳六烯酸(DHA), ω-3脂肪酸,已被证明可以防止控制动物的哮喘和特应性的发展 研究和对人类的观察性研究。两项婴儿配方奶粉补充剂小型RCT的结果 为膳食脂肪酸对哮喘的保护作用提供了进一步的支持(Birch等,2010; Foiles et 例如,2016年)。NAPS的研究提供了一个前所未有的机会来测试产前DHA水平对胎儿发育的影响。 儿童哮喘和特应性疾病,并进一步研究产前压力调节模式如何影响, 效果我们建议对130名5 - 6岁的儿童进行哮喘和其他特应性结局的临床评估。 年龄的母亲参加了NAPS研究,并收集数据,从医疗记录和产妇 测试两个目标。目的1:检测产前脂肪酸水平是否与哮喘和特应性疾病相关 在童年早期。我们假设产前血液中较高的DHA水平与较低的 通过实验室评估哮喘和过敏性致敏作用, 5 - 6岁,以及病历摘要和产妇报告。目的2:测试产前压力是否 调节影响产前脂肪酸水平与早期哮喘和特应性疾病之间的关系 童年.我们的主要假设是皮质醇和细胞因子水平、心率变异性和感知压力 怀孕期间的DHA水平将部分介导产前DHA水平和儿童哮喘之间的关联, 特应性疾病我们还将测试产前DHA水平与儿童早期哮喘之间的关系 和特应性疾病是由产前压力调节在基线和压力调节的变化, 怀孕据我们所知,这将是第一次测试产前脂肪酸水平对哮喘和过敏的黑色 生活在美国资源匮乏环境中的儿童

项目成果

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Christina Elizabeth Ciaccio其他文献

Christina Elizabeth Ciaccio的其他文献

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{{ truncateString('Christina Elizabeth Ciaccio', 18)}}的其他基金

IL-6 high phenotype in childhood asthma
儿童哮喘中 IL-6 高表型
  • 批准号:
    10043029
  • 财政年份:
    2020
  • 资助金额:
    $ 59.55万
  • 项目类别:
IL-6 high phenotype in childhood asthma
儿童哮喘中 IL-6 高表型
  • 批准号:
    10215498
  • 财政年份:
    2020
  • 资助金额:
    $ 59.55万
  • 项目类别:

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