Vitamin D and Susceptibility to Inhaled Pollutants in Urban Children with Asthma

城市哮喘儿童维生素 D 与吸入污染物的易感性

• 批准号: 8003019
• 负责人: Sonali Bose
• 金额: $ 5.96万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8003019
• 关键词: Accounting; Affect; African American; Age; Air Pollution; Allergens; Antioxidants; Asthma; Attention; Baltimore; Biological Markers; Blood; Breathing; Child; Childhood; Childhood Asthma; Clinical; Clinical Research; Cross-Sectional Studies; Diet; Dietary intake; Disadvantaged; Disease; Economics; Environment; Environmental Pollutants; Epidemiologic Studies; Exposure to; Extrinsic asthma; Future; Goals; Grant; Health; Immune; Inflammation; Inflammatory Response; Investigation; Lead; Lung Inflammation; Measures; Mentorship; Minority; Monitor; Morbidity - disease rate; Nasal Lavage Fluid; Oxidative Stress; Particulate Matter; Pharmaceutical Preparations; Population; Poverty; Predisposition; Preparation; Public Health; Recruitment Activity; Research; Research Proposals; Respiratory physiology; Risk; Role; Seasons; Serum; Skin; Sun Exposure; Symptoms; Training; United States; Urine; Vitamin D; Vulnerable Populations; burden of illness; cost; environmental particulate; experience; improved; inner city; novel; pollutant; protective effect; public health relevance; skills; social

DESCRIPTION (provided by applicant): The proposed project promises to be a rich training experience that will allow me to develop the skills necessary for clinical research. It achieves this through a combination of a rigorous research plan, relevant coursework, and supervised dedicated mentorship. Below is a summary of the research proposal. The urban minority pediatric population in the United States has a disproportionate burden of asthma. Several factors may contribute to this disparity, including high exposure to environmental pollutants and allergens, a poor diet, and other disadvantages of poverty. Recent attention has focused on the antioxidant and immune-modulatory role of vitamin D which may confer a protective effect on disease morbidity, and several clinical observational and cross-sectional studies support that low vitamin D levels may lead to greater allergic and asthma manifestations. Epidemiological studies, including our own preliminary investigations in Baltimore, have discovered that a significant proportion of African-American inner-city children with asthma have well below the recommended levels of serum vitamin D, and that, in these same children, indoor particulate matter (PM) is a significant cause of asthma morbidity. We therefore propose to determine whether lowerlevels of vitamin D, in such a highly-affected and vulnerable population, may increase their susceptibility to inhaled pollutants. To achieve this goal, we will nest this proposed study within an existing grant (The Center for Childhood Asthma in the Urban Environment DISCOVER # 1P50ES015903), which is currently recruiting 130 predominantly-black children with asthma, ages 5-12 years, in urban Baltimore to study the mechanisms by which air pollution induces lung inflammation and oxidative stress. This project proposal has three novel aims. First, to better understand the relationship between vitamin D levels and asthma health, we will be repeatedly measuring each subject' s serum vitamin D levels, daily asthma symptoms and medication use, and twice-daily lung function during 4 one-week periods in each season of the year. Second, to determine if varying levels of vitamin D modify the inflammatory response to air pollution, we will also be monitoring each child' s personal exposure to environmental PM throughout the day and simultaneously be measuring biomarkers of oxidative stress and inflammation present in blood, urine, and nasal lavage fluid. Finally, we will be collecting information regarding sun exposure, skin type, and dietary intake in order to assess the determinants of vitamin D status in this chronically low population, in preparation for future public health strategies directed towards improving asthma health. PUBLIC HEALTH RELEVANCE: Asthma attacks are particularly severe among urban African-American children and account for significant personal, economic, and social costs. Recent studies show that the majority of these children have low blood levels of vitamin D, and that the lower their levels, the worse their asthma symptoms seem to be. We would like to understand if low vitamin D levels put children at increased risk to be affected by common environmental triggers; if true, then improving their vitamin D status may ultimately protect urban minority children from a high burden of disease.

描述（由申请人提供）：拟议的项目有望成为丰富的培训经验，使我能够发展临床研究所需的技能。它通过严格的研究计划，相关课程和受监督的专门指导来实现这一目标。以下是研究建议的摘要。美国城市少数小儿人口的哮喘负担不成比例。几个因素可能导致这种差异，包括高暴露于环境污染物和过敏原，饮食不良以及其他贫困的缺点。最近的注意力集中在维生素D的抗氧化剂和免疫调节作用上，这可能赋予对疾病发病率的保护作用，几项临床观察和横断面研究支持低维生素D水平可能导致更大的过敏和哮喘表现。流行病学研究，包括我们自己在巴尔的摩的初步研究，发现哮喘患有哮喘的非裔美国人内城儿童中有很大一部分远低于推荐水平的血清维生素D水平，并且在这些儿童中，室内颗粒物（PM）的重要原因是哮喘的重要原因。因此，我们建议确定在如此高度影响和脆弱的人群中，维生素D的下层是否可能增加其对吸入污染物的敏感性。为了实现这一目标，我们将在现有的赠款（城市环境中的童年哮喘中心发现＃1P50ES015903中的童年哮喘中心）中嵌套，该研究目前正在招募130名主要是5至12岁的哮喘儿童，年龄在Baltimore的哮喘儿童中，在Baltimore中，在其空气污染的机制中，通过lung lung ingucative and lung ingentive and lung ingentive and lung ingentive and conterative and conterative and conterative and conterative and conterative and lung inge anditagety and氧化。该项目提案有三个新颖的目标。首先，为了更好地了解维生素D水平与哮喘健康之间的关系，我们将反复测量每个受试者的血清维生素D水平，每天的哮喘症状和药物使用，以及每年4个周期的每日肺功能两次。其次，为了确定维生素D的不同水平是否改变了对空气污染的炎症反应，我们还将监测每个孩子全天对环境PM的个人暴露，同时测量血液，尿液，尿液和鼻腔灌洗液中氧化应激和炎症的生物标志物。最后，我们将收集有关阳光暴露，皮肤类型和饮食摄入量的信息，以评估这种慢性人口中维生素D状况的决定因素，以准备未来针对改善哮喘健康的公共卫生策略。 公共卫生相关性：在非裔美国人儿童中，哮喘攻击尤其严重，造成了巨大的个人，经济和社会成本。最近的研究表明，这些儿童中的大多数维生素D的血液水平较低，其水平越低，其哮喘症状似乎越糟。我们想了解，低维生素D水平是否会使儿童面临更大的风险受到常见环境触发因素的影响；如果是真的，那么改善其维生素D状态可能最终可以保护城市少数民族儿童免受疾病的高负担。