ACUTE INTERVENTION MANAGEMENT STRATEGIES (AIMS)

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。临床经验表明，儿童，尤其是6岁以下的儿童，可能患有真正间歇性的哮喘（急性发作之间无症状），但会发生急性发作，特别是在呼吸道病毒季节，通常是严重的，导致前往医生办公室接受紧急护理，急诊科治疗和住院治疗。因此，认为这些患者患有重度间歇性哮喘是合理的。 国家心肺血液研究所（NHLBI）儿童哮喘研究和教育（CARE）网络开发了一项名为“急性干预管理策略（AIMS）”的试验，该研究将评估3种干预策略对12个月大的儿童的影响-59个月，在呼吸道疾病严重程度足以导致既往紧急治疗的情况下反复喘息单位，住院，或紧急访问医生的办公室（即严重间歇性哮喘）。我们将尝试回答以下问题：1.与常规治疗相比，吸入性皮质类固醇或白三烯受体拮抗剂的早期治疗是否改变了研究期间严重间歇性哮喘的病程？2.对任一干预措施的反应是否与表型（嗜酸性粒细胞、IgE、鼻灌洗液中的cysLT、哮喘预测指数阳性/阴性）或基因型（如B2肾上腺素能受体或5-脂加氧酶基因）特征相关？

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. Clinical experience demonstrates that children, especially those under the age of 6 years, may have asthma which is truly intermittent (asymptomatic between exacerbations) and yet experience exacerbations, particularly during the respiratory viral season, that often are severe leading to visits to physician offices for urgent care, emergency department treatment, and hospitalization. Thus, it is plausible to consider these patients to have severe intermittent asthma. The National Heart, Lung and Blood Institute (NHLBI) Childhood Asthma Research and Education (CARE) Network has developed a trial entitled "Acute Intervention Management Strategies (AIMS)", which will evaluate the effect of 3 intervention strategies in children age 12 months - 59 months with recurrent wheezing in the context of respiratory tract illnesses of sufficient severity to have resulted in previous treatment in the emergency unit, hospitalization, or urgent visit to a physician's office (i.e. severe intermittent asthma). We will attempt to answer the following questions: 1. Does early treatment with inhaled corticosteroid or leukotriene receptor antagonist change the course of severe intermittent asthma over the study period compared with conventional therapy? 2. Can the response to either intervention be related to either phenotypic (eosinophils, IgE, cysLT in nasal lavage, asthma predictive index positive/negative) or genotyic (such as B2-adrenergic receptor or 5-lioxygenase gene) features?