Mechanisms of Upper Gut and Airway Interaction -Program Project Grant

描述（由申请人提供）：呼吸系统和消化系统入口的解剖学接近，沿着咽作为气道和胃肠道通道的双重功能，使肺易于在吞咽和胃内容物通过食管-咽腔逆行转运期间发生误吸的危险。大量的肺部和呼吸消化道疾病，从哮喘、吸入性肺炎和其他肺损伤到喉和呼吸消化道的良性炎性病变，都归因于胃内容物的有害作用或其错误进入呼吸系统 因此，该项目的中心主题是上消化道和气道相互作用的机制，特别强调气道对误吸的保护。通过系统方法在4个水平a）生理学B）病理生理学c）诊断d）管理中对成人和婴儿以及猫模型进行了研究。它利用了从上一个供资期的研究中吸取的经验教训，并得到了初步研究的支持 将在6个具体目标中测试总共23个假设。它们系统地解决了中心主题的不同方面，回答了不同的问题，并为各种重要的未解决的临床不确定性提供了一些解决方案。目前的提案有三个项目和一个行政核心。 除了本项目领导层之间的长期专业关系和研究合作外，每个领导者都是经验丰富的研究人员，并在各自领域的生产力和公认的贡献方面有着既定的记录。这些领域包括胃肠道生理学、消化病学、呼吸消化生理学、胃肠病学、耳鼻喉科、GI运动和内窥镜检查。三个研究小组的合作和凝聚力程度，从上一个资助期的公布和所有人在制定目前的建议及其初步数据时所付出的合作努力中可以看出。

DESCRIPTION (provided by applicant): Anatomical proximity of the inlet of the respiratory and digestive systems, along with the dual function of the pharynx as both airway and gastrointestinal passage, predisposes the lung to the dangers of aspiration during swallowing and retrograde transit of gastric content through the esophago-pharyngeal lumen. A large number of pulmonary and aerodigestive tract disorders, ranging from asthma, aspiration pneumonia, and other lung injuries to benign inflammatory lesions of the larynx and aerodigestive tract are attributed to the deleterious effects of the gastric content or its misdirection into the respiratory system The central theme of this program project therefore is mechanisms of upper gut and airway interaction with special emphasis on airway protection against aspiration. This theme is pursued in adult and infant humans and a feline model by systematic approach at 4 levels a) physiology b) pathophysiology c) diagnosis d) management. It uses the lessons learned from the studies of last funding period and is supported by the preliminary studies A total of 23 hypotheses will be tested in 6 specific aims. They systematically address different aspects of the central theme, answering different questions and providing a number of resolutions to a variety of important unresolved clinical uncertainties. The current proposal has three projects and an administrative core. In addition to long term professional relationship and research collaborations among the leadership of this project, each leader is an experienced investigator and has an established record of productivity and acknowledged contribution to their respective field. These fields include gastrointestinal physiology, neonatalogy, aerodigestive physiology, gastroenterology, otolaryngology, Gl motility and endoscopy. The degree of collaboration and cohesiveness of the three research teams is evidenced by the publication of the last funding period and the collaborative effort rendered by all in developing the current proposal and its preliminary data.