INNER CITY ASTHMA CONSORTIUM, ASTHMA CONTROL EVALUATION (ACE)

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。国家过敏和传染病研究所内城哮喘联盟（ICAC）的目标是(1)确定免疫疗法的形式，以促进哮喘的控制和预防，(2)设计方案，评估免疫疗法治疗低收入内城儿童哮喘的效果。(3)通过与治疗方案并行的机制研究，确定免疫治疗的机制和低收入城市儿童哮喘发病的潜在独特机制。随着对哮喘发病机制的进一步了解，包括免疫调节剂（如抗ige）在内的新药物的引入，以及生物标志物和药物遗传学在哮喘临床管理中的潜在应用，国家哮喘教育和预防计划（NAEPP）哮喘指南将发生变化。本研究中提出的另一项措施是使用生物标志物，特别是使用Aerocrine NIOX装置测量呼出的一氧化氮（eNO）。eNO可以在不到15分钟的时间内轻松测量。预计除了使用NAEPP指南外，使用eNO测量将提高哮喘评估水平，指导用药方案，并改善整体哮喘控制。研究支持eNO在哮喘临床治疗中的作用，作为改善哮喘控制的一种附加方法。呼出的一氧化氮可以作为哮喘控制不良的监测指标，因为症状识别不佳、药物依从性差和持续炎症。该研究结果可能会改变对持续性哮喘儿童的管理模式，这可能对市中心哮喘儿童特别有益，因为那里似乎有独特的特征，如过敏原暴露和治疗依从性差，导致持续炎症。

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. The objectives of the National Institute of Allergy and Infectious Diseases Inner City Asthma Consortium (ICAC) are (1) to identify forms of immune-based therapy to promote control and prevention of asthma, (2) to design protocols to evaluate immune-based therapies in the treatment of asthma in low-income inner-city children, and (3) to determine mechanisms of immune-based therapies and the potential unique mechanisms of asthma pathogenesis in low-income inner-city children by the conduct of parallel mechanistic investigations with the therapeutic protocols.The National Asthma Education and Prevention Program (NAEPP) asthma guidelines will change with further understanding of the pathogenesis of asthma, the introduction of new medications including immunomodulators, such as anti-IgE, and the potential application of biomarkers and pharmacogenetics in the clinical management of asthma. One of the additional measures proposed in this study is the use of biomarkers, specifically the measurement of exhaled nitric oxide (eNO) using the Aerocrine NIOX device. eNO can easily be measured in less than 15 minutes. It is anticipated that using eNO measurements in addition to using the NAEPP guidelines will enhance the level of assessment of asthma, guide medication regimens, and improve overall asthma control. Studies support the role of eNO in the clinical treatment of asthma, as an added approach to improve asthma control. Exhaled nitric oxide could serve as a monitor of poor asthma control due to poor symptom recognition, poor medication adherence, and persistent inflammation. The study results may change the paradigm of management for children with persistent asthma, which could be particularly beneficial for inner city asthma children where there appear to be unique characteristics, such as allergen exposure and poor adherence to therapy, that result in persistent inflammation.