New Jersey ECHO

项目总结/摘要 早期的环境暴露与后来疾病的发展密切相关。早期生活 微生物组为理解整个生命过程中的健康和疾病提供了发展背景。在 在现代，母亲和儿童经常遇到微生物干扰暴露，包括剖腹产 在怀孕期间和孩子出生后的第一年，婴儿配方奶粉和抗生素。令人信服的基本 我们小组和其他人的科学和流行病学研究表明，怀孕前的干扰， 产前和幼儿期的微生物组有助于不利的健康结果。这些连接是 对上呼吸道和下呼吸道的健康特别有利。基于人口的研究记录了 哮喘和早期抗生素暴露，哮喘儿童有不同的微生物组特征， 不受影响的孩子互补的小鼠模型显示了受干扰的微生物群之间的因果关系 和呼吸道疾病。然而，关键的知识差距仍然存在。首先，现有的研究缺乏多样性，往往是 评估微生物群干扰暴露（如药物使用）的程度的能力不足， 剖宫产和婴儿配方奶粉是结果的种族/民族差异的基础， 与白色儿童相比，黑人和西班牙裔儿童的哮喘发病率。其次，很少有研究考察了 微生物组跨越关键时间窗口（孕前，怀孕，分娩，婴儿和幼儿）。 ECHO提供了一个独特的机会来解决这些差距，并研究早期生命的发展作用。 微生物组在一个大型的，多样化的美国队列中的后期健康。我们将招募500名孕妇， 来自新泽西州米德尔塞克斯县的后代，美国最多样化的县之一，加入国家ECHO队列 我们建议的科学重点是早期生命微生物组和暴露于微生物组干扰暴露 （剖宫产，婴儿配方奶粉和药物使用）与上下气道健康的关系。我们的具体 目的是：（1）描述常见微生物组干扰中的社会决定因素和种族/民族差异 ECHO全队列中关键早期生命期的暴露，并评估与纵向 母亲和儿童的微生物组结构;（2）估计微生物组干扰之间的关联 暴露和儿童结局，重点关注上呼吸道和下呼吸道健康;（3）招募500名孕妇， 参与者反映了米德尔塞克斯县，新泽西州的独特多样性;和（4）（探索）检查的程度， 在怀孕前12个月内母体微生物组的扰动与不利的上层代谢有关。 以及儿童气道功能下降。NJ的加入为ECHO财团带来了独特的多样性。 反过来，我们团队在全国范围内的ECHO研究将产生知识，告知临床和公众 促进“健康”微生物组和改善儿童健康的卫生干预措施。

PROJECT SUMMARY/ABSTRACT Early environmental exposures are strongly implicated in the development of later diseases. The early life microbiome provides a developmental context for understanding health and disease across the life course. In the modern era, mothers and children routinely encounter microbiome perturbing exposures including cesarean section, infant formula, and antibiotics during pregnancy and in the child's first year after birth. Compelling basic science and epidemiological research from our group and others shows that perturbation of the pre-conception, prenatal, and early childhood microbiome contributes to adverse health outcomes. These connections are particularly strong for upper and lower airway health. Population-based studies document associations between asthma and early antibiotic exposure, and children with asthma have distinct microbiome signatures from unaffected children. Complementary mouse models show a causal association between perturbed microbiota and airway disease. However, key knowledge gaps remain. First, existing studies lack diversity and are often underpowered to evaluate the extent to which microbiome-perturbing exposures such as medication use, cesarean section, and infant formula underlie racial/ethnic disparities in outcomes such as the higher prevalence of asthma in Black and Hispanic children compared to White children. Second, few studies have examined the microbiome across critical time windows (preconception, pregnancy, delivery, infancy, and early childhood). ECHO provides a unique opportunity to address these gaps and study the developmental role of the early life microbiome in later health in a large, diverse U.S. cohort. We will recruit 500 pregnant people and their resulting offspring from Middlesex County, NJ, one of the most diverse counties in the U.S., into the national ECHO cohort. Our proposed scientific focus is on the early life microbiome and exposure to microbiome-perturbing exposures (cesarean section, infant formula, and medication use) in relation to upper and lower airway health. Our specific aims are to: (1) Characterize social determinants and racial/ethnic disparities in common microbiome-perturbing exposures during critical early life periods in the ECHO-wide cohort and evaluate associations with longitudinal microbiome structures in mothers and children; (2) Estimate associations between microbiome-perturbing exposures and child outcomes, with a focus on upper and lower airway health; (3) Recruit 500 pregnant participants reflecting the unique diversity of Middlesex County, NJ; and (4) (Exploratory) Examine the extent to which maternal microbiome perturbation in the 12 months before conception is associated with adverse upper and lower airway outcomes in children. The addition of NJ contributes unique diversity to the ECHO consortium. In turn, our team's ECHO-wide research at a national scale will yield knowledge that informs clinical and public health interventions that promote a “healthy” microbiome and improve child health.