Mechanisms of Upper Gut and Airway Interaction -Program Project Grant

描述(申请人提供)：呼吸系统和消化系统入口处的解剖邻近，以及咽部作为呼吸道和胃肠通道的双重功能，使肺部在吞咽过程中容易发生吸入的危险，并通过食道-咽腔逆行运输胃内容物。大量的肺部和呼吸道疾病，从哮喘、吸入性肺炎和其他肺损伤到喉部和呼吸道的良性炎症性病变，都归因于胃内容物的有害影响或误导到呼吸系统。 因此，该计划项目的中心主题是上呼吸道和呼吸道相互作用的机制，特别强调防止吸入的呼吸道保护。这一主题是在成人和婴儿人类和猫模型中通过系统的方法在4个水平上进行的，a)生理学b)病理生理学c)诊断d)管理。它使用从上一次筹资期间的研究中吸取的经验教训，并得到初步研究的支持。 共有23个假设将在6个具体目标下进行测试。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许多解决方案。目前的提案有三个项目和一个行政核心。 除了该项目领导之间的长期专业关系和研究合作外，每个领导都是一名经验丰富的研究人员，并拥有既定的生产力记录和对各自领域的公认贡献。这些领域包括胃肠生理学、新生儿科学、空气消化生理学、胃肠科学、耳鼻咽喉科学、Gl运动学和内窥镜。三个研究小组的协作程度和凝聚力体现在上一个资助期的公布以及所有各方在制定当前提案及其初步数据方面所作的合作努力上。

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.