URBAN ENVIRONMENT AND CHILDHOOD ASTHMA (URECA)

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所在的机构。 URECA研究将是一项从出生开始为期三年的纵向前瞻性评价。 本研究的主要目的是在36个月大的城市儿童中确定反复喘息的免疫学原因。 第二个目标是确定与城市儿童特应性发展相关的免疫学发展模式。 其他次要目标是确定与内城生活相关的环境暴露，这些暴露改变免疫发育，并最终改变上述特应性和复发性喘息的发展。 虽然最初的研究将涉及对研究参与者进行为期三年的随访，但样本量（该研究中心的125名参与者）将足够大，因此，如果研究的初始阶段成功，可以对儿童进行随访至6岁，以评估真正的儿童哮喘的发展。 父母有过敏性疾病或哮喘阳性病史的家庭将在出生前入组。 将在产前评估母体压力和其他环境暴露。 从出生开始并持续到生命的前三年，将对儿童的血细胞细胞因子反应、可能影响细胞因子反应发展的出生后环境影响（感染、过敏原和微生物暴露、应激、室内污染物）以及过敏和哮喘的临床表现（反复喘息）进行纵向评价。 将定期进行门诊访视，进行体格检查，以跟踪显著下呼吸道症状的发展和持续时间。 计划访视将与家庭访视（三个月大）相对应，以进行环境评估和灰尘收集，并从一岁开始每年进行一次诊所访视。 最后，将从研究参与者及其母亲中获得DNA，以评估与喘息性疾病和哮喘相关的免疫发育模式的遗传相关性。 假设： + 出生时IFN-g应答与3岁时喘息复发风险呈负相关。 + 反复喘息与IL-13反应的异常模式有关：IL-13反应在出生时较低，然后在3岁时升高。

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 URECA study will be a longitudinal prospective evaluation over a three-year time period, beginning at birth. The primary objective of the study is to establish in inner city children the immunologic causes for the development of recurrent wheezing by 36 months of age. The secondary objective is to identify patterns of immunologic development associated with the development of atopy in inner city children. Other secondary objectives are to identify environmental exposures associated with inner city life that modify immune development, and ultimately, the development of atopy and recurrent wheezing as defined above. Although the initial study will involve a three-year follow-up of study participants, the sample size (125 participants at this site) will be large enough so that, if the initial phases of the study are successful, the children could be followed to the age of six years to assess the development of bona fide childhood asthma. Families with a positive parental history of allergic diseases or asthma will be enrolled prior to birth. Maternal stress and other environmental exposures will be assessed prenatally. Beginning at birth and continuing for the first three years of life, the children will be evaluated longitudinally for blood cell cytokine responses, and for postnatal environmental influences (infections, allergen and microbial exposure, stress, indoor pollutants) that could affect the development of cytokine responses, and for clinical manifestations of allergy and asthma (recurrent wheeze). Periodic clinic visits will occur to perform physical examinations in order to track the development and persistence of significant lower respiratory tract symptoms. Scheduled visits will correspond with the home visit (age three months) for environmental assessment and dust collection, and yearly clinic visits beginning at age one year. Finally, DNA will be obtained from study participants and their mothers to evaluate genetic correlates to the observed patterns of immune development as they relate to wheezing diseases and asthma. Hypotheses: + IFN-g responses at birth will be inversely related to the risk of recurrent wheeze at 3 years of age. + Recurrent wheeze will be associated with an abnormal pattern in the development of IL-13 responses: IL-13 responses will be low at birth, and then elevated by three years of age.