PREVENTION OF EARLY ASTHMA IN KIDS (PEAK)

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。长期随访研究表明，在3岁之前开始出现哮喘样症状的儿童，在以后的生活中会发展为哮喘，与较差的预后和较大的肺功能缺陷有关。慢性气道炎症和随之而来的气道高反应性的发展可能在早发性哮喘的自我延续中起关键作用。这表明，早期针对减少气道炎症的治疗制度可能会改变哮喘的自然病程。我们提出了一项研究，旨在确定一个2-4岁的儿童亚组，他们在生命早期有喘息，随后发展为哮喘的风险最大。在一个月的磨合期后，儿童将被随机分配到吸入皮质类固醇（氟替卡松）或匹配安慰剂的双盲安慰剂对照试验中，每天两次，持续两年。然后，这些儿童将被观察停用研究药物1年，以观察哮喘症状的发展。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Long-term follow-up studies suggest that initiation of asthma-like symptoms before age 3 in children who will go on to develop asthma is associated with a worse prognosis and larger deficits in lung function later in life. It is likely that chronic airway inflammation and the consequent development of airway hyperresponsiveness may play a crucial role in the self-perpetuation of early-onset asthma. This suggests that the early institution of therapy directed at decreasing airway inflammation may alter the natural course of asthma. We propose a study aimed at the identification of a subgroup of children aged 2-4 years who have wheezed during early life and are at greatest risk for the subsequent development of asthma. After a one month run-in period, children will then be randomized into a double-blind placebo-controlled trial of inhaled corticosteroid (fluticasone proprionate) or matching placebo administered twice daily for two years. These children will then be observed off study medication for 1 year for the development of asthma symptoms.