Childhood Asthma in Urban Settings Clinical Research Network - Leadership Center

城市环境中的儿童哮喘临床研究网络 - 领导中心

• 批准号: 10608089
• 负责人: James E. Gern
• 金额: $ 676.71万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-12 至 2028-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10608089
• 关键词: 17 year old; Accident and Emergency department; Address; Affect; Air; Allergens; Allergic; Asthma; Bacteria; Birth; Caring; Cells; Child; Childhood Asthma; Clinical Research; Clinical Trials; Development; Dictyoptera; Dietary Intervention; Disease; Disease Progression; Double-Blind Method; Emergency department visit; Enrollment; Environmental Risk Factor; Evaluation; Event; Exposure to; Extrinsic asthma; Family history of; Genetic Transcription; Goals; Guidelines; Healthcare; Hospitalization; Hospitals; Hypersensitivity; Immune; Immunotherapy; Infant; Infection prevention; Inflammation; Intervention; Intervention Trial; Leadership; Life; Microbe; Modification; Molecular; Morbidity - disease rate; National Institute of Allergy and Infectious Disease; Observational Study; Outpatients; Pathogenesis; Pathway interactions; Patients; Pattern; Phase; Phenotype; Placebo Control; Pollution; Prevention; Protocols documentation; Recurrence; Research; Respiratory Disease; Respiratory Mucosa; Rhinitis; Risk; Risk Factors; Role; Self Care; Severities; Stress; Supplementation; Testing; United States; Urban Community; Vision; Wheezing; airway immune response; asthma exacerbation; care burden; common treatment; disorder control; disorder prevention; double-blind placebo controlled trial; effective therapy; expectation; gut microbiome; high risk; immunoregulation; improved; infancy; insight; longitudinal analysis; lower income families; microbial; microbial colonization; microbiome; multiple omics; novel; novel strategies; omalizumab; prevent; programs; respiratory health; subcutaneous; urban children; urban setting

PROJECT SUMMARY/ABSTRACT The overall goals of our Childhood Asthma in Urban Settings (CAUSE)-Leadership Center proposal are to provide administrative leadership and support to develop and conduct collaborative research to address high priority unmet needs for childhood asthma in urban communities, including: a) developing strategies to prevent asthma, b) improving treatment and inhibiting progression, c) reducing severe exacerbations, and d) defining endotypes of respiratory health and disease. Four hypotheses are proposed to accomplish these goals. First, supplementation with immune modulating bacteria in infancy will prevent the early life perturbations in the gut microbiome that have been associated with risk for the development of allergic sensitization and asthma, and will promote airway mucosal immune development. Second, given the importance of cockroach (CR) allergy and exposure to asthma morbidity in urban children, CR immunotherapy will improve asthma control and reduce disease progression. Third, we propose that transcriptional analysis of airway cells will define T2-low mechanisms that contribute to both non-atopic and atopic asthma and provide new insights into treatment. Finally, multi-omics evaluation of airway cells and secretions obtained during severe exacerbations leading to ED visits and hospitalizations will reveal novel mechanistic pathways to inform improved treatment and prevention. We propose five protocols to test these hypotheses: 1. Urban Environment and Childhood Asthma study (URECA) 2. Effects of a Microbial Supplement (STMC-103H) on Microbial Colonization and Immune Development 3. Cockroach (CR) Immunotherapy (IT) in Urban Children with Moderate-Severe Asthma Protected by Omalizumab 4. Pathogenesis and Mechanisms of T2-low (Non-Atopic) Asthma 5. Severe Asthma Exacerbations in the Emergency Department (ED) and Hospital: Identifying Targets for Prevention and Treatment It is our expectation that our proposed CAUSE research program will provide critical information needed to recognize asthma phenotypes and endotypes in urban children, improve treatment of asthma and establish direction for prevention. Collectively, these studies will continue the rigorous programmatic approach of the NIAID Asthma Networks towards achieving the long-term goals of disease modification and prevention of disease in high-risk children of low-income families living in urban communities.

项目总结/文摘