PATHOGENESIS OF VIRUS-INDUCED ACUTE OTITIS MEDIA: GENETIC AND ENVIRONMENTAL

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者的研究机构。 中耳炎（OM）是儿科实践中最常见的疾病，被认为是一种多因素疾病，具有复杂和相互关联的遗传，环境和感染病因。我们将研究遗传危险因素（如TNF-308和IL- 6-174多态性）使宿主OM易感的机制，以及环境因素是否可以改变遗传易感儿童的OM风险。我们将对300名有和没有TNF-308多态性的婴儿进行一项前瞻性纵向研究，从临近出生到第一次AOM发作长达1岁。将对受试者进行基因多态性筛选;将在出生后第一个月内入组相同数量的多态性和正常婴儿（性别和人种匹配）。前6个月鼻咽部细菌定植的动态变化。将研究生命的时间;将监测症状性URI发作的AOM并发症。将前瞻性收集BF、CSE和日托（DC）出勤率信息，并不断更新。将比较多态性和正常儿童组出生后第一年AOM的发生率（第一年至少发生一次的病例%）;将评估环境风险因素对细菌定植、病毒URI和AOM发生率的影响。我们还将比较IL- 6-174多态性和正常儿童。这项研究对公共卫生很重要，因为它将为设计预防OM的创新方法奠定基础。

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. Otitis media (OM) is the most common disease seen in pediatric practice and is recognized as a multifactorial disease with complex and interrelated genetic, environmental and infectious etiologies. We will study the mechanisms by which genetic risk factors (as represented by TNF -308 and IL- 6-174 polymorphisms) render the host OM susceptible and whether environmental factors could modify OM risks in children with genetic predisposition. We will perform a prospective, longitudinal study of 300 infants with and without TNF -308 polymorphism followed from near birth to the first AOM episode up to 1 year of age. Subjects will be screened for the gene polymorphism; equal number of polymorphic and normal infants (matched for gender and race) will be enrolled into the study within the first month of life. The dynamics of nasopharyngeal bacterial colonization in the first 6 mos. of life will be studied; symptomatic URI episodes will be monitored for AOM complication. Information on BF, CSE, and daycare (DC) attendance will be collected prospectively and updated continuously. Incidence of AOM in the first year of life (% of cases with at least one episode in the first year) will be compared between polymorphic and normal children groups; modifying effects of environmental risk factors on bacterial colonization, incidence of viral URI and AOM will be assessed. We will also compare IL- 6-174 polymorphic and normal children. The study is important to public health as it will lay the ground work for the design of innovative approaches to prevent OM.