Development of an Asthma Research Core Center

描述(申请人提供)：哮喘是一种慢性呼吸道炎症性疾病，据世界卫生组织估计，全球有1.5亿人受到影响，其全球药物治疗费用每年超过50亿美元。辛辛那提儿童医院医疗中心(CCHMC)在初级保健和专科诊所为7000名哮喘儿童提供临床护理。去年，超过3000名儿童在CCHMC急诊科接受初步诊断为急性哮喘恶化的治疗，885名患者(29.5%)因急性哮喘恶化而入院治疗。CCHMC投入了大量资源来促进哮喘研究，包括成立了哮喘研究部，该部门与哮喘中心合作创建了一个全面的哮喘项目，该项目现在为CCHMC的哮喘临床和研究活动提供了一个中央基础。哮喘患者具有相似的临床症状，但疾病在表型和自然病史3、4方面是异质性的，这种异质性造成了哮喘研究和治疗的困难。人们对哮喘的异质性知之甚少，遗传和环境影响影响哮喘发展和哮喘疾病表达的机制在很大程度上也不清楚。因此，拟议的哮喘研究核心的中心目标是提高对哮喘异质性的理解。为了实现这一目标，我们提出了两个目标：目标1：招募或提拔一名新的教师进入终身教职轨道，以制定一项研究计划，重点是阐明导致哮喘异质性的机制。目标2：开发哮喘研究的试点研究计划，在上述领域支持终身教职的新教师。 由于多种遗传和环境影响导致哮喘表型的内在异质性，哮喘治疗无效或不完全有效的比率高达70%。这项建议的中心目标是提高对哮喘异质性的理解。对哮喘表型的更好理解将使知情的个性化治疗计划成为可能，并可能导致哮喘支出的大幅减少。

DESCRIPTION (provided by applicant): Asthma, a chronic inflammatory disorder of the airways, is estimated by the World Health Organization to affect 150 million people worldwide and its global pharmacotherapeutic costs exceed $5 billion per year. Cincinnati Children's Hospital Medical Center (CCHMC) provides clinical care to -7000 asthmatic children in the primary care and specialty clinics. Last year, over 3000 children were treated in the CCHMC Emergency Department with the primary diagnosis of an acute asthma exacerbation, and 885 patients (29.5%) were admitted to the hospital for management of acute asthma exacerbations. CCHMC has invested considerable resources to promote asthma research including the establishment of the Division of Asthma Research, which has partnered with the Asthma Center to create a comprehensive Asthma Program, which now provides a central base for the clinical and research activities for asthma at CCHMC. Patients suffering from asthma share similar clinical symptoms, but the disease is heterogenous in terms of phenotypes and natural history 3, 4. This heterogeneity contributes to the difficulty in both studying and treating asthma. The heterogeneity in asthma is poorly understood and the mechanisms by which genetic and environmental influences impact asthma development and asthma disease expression are largely unknown. As such, the proposed Asthma Research Core has the central goal of improving the understanding of the heterogeneity in asthma. In order to accomplish this goal, we propose 2 aims: Aim #1: To recruit or promote a new faculty member into the tenure track to develop a research program focused a topic relevant to elucidating the mechanisms contributing to asthma heterogeneity. Aim #2: To develop a pilot research program in Asthma Research to support new faculty in the tenure track in the areas outlined above. The frequency of absent or incomplete efficacy in asthma treatment is as high as 70%, due to the inherent heterogeneity in asthma phenotypes caused by multiple genetic and environmental influences. The central goal of this proposal is to improve the understanding of the heterogeneity in asthma. Improved understanding of asthma phenotypes will enable informed personalized treatment plans and likely will result in substantial reduction in asthma expenditures.