ECHO Renewal for the CANOE Study Cohort

摘要 该应用程序的首要目标是：1）保持范德比尔特CANOE分娩中的儿童保留 队列，重点是多样性和高保真的ECHO队列方案的实施， 进行新的登记，和2）解决该领域的关键问题，其中一个最常见的， 可改变的早期生活环境暴露与哮喘风险显著增加相关， 呼吸道合胞病毒（RSV）感染，描述了严重程度依赖性和年龄依赖性的影响， 呼吸道合胞病毒感染与哮喘风险这一创新项目具有重大的公共卫生影响，因为建立了 RSV和哮喘之间的年龄和严重程度依赖性关系是第一步，也是最重要的一步， 疾病一级预防。我们建议解决该领域尚未回答的关键问题： RSV和哮喘的年龄依赖性关联，以及感染对肺功能的影响。另外我们 将探索SARS-CoV-2大流行对哮喘发病率和控制的广泛影响， 目的，这可能为哮喘预防中的多方面环境改造提供支持， 控制和数据，以告知广泛的公共卫生干预措施的潜在影响。 此应用程序支持的出生队列是范德比尔特CANOE（儿童过敏和新生儿 环境）研究。CANOE是一个出生队列，旨在识别和了解环境因素 改变气道上皮的发育。这项研究包括独特的纵向抽样的 儿童气道在整个生命的第一年，每年。范德比尔特坎诺研究有独特的早期生活 暴露和结局确定，包括RSV监测和新的生物标本储存库， 鼻气道上皮细胞CANOE队列也有纵向发展的重要信息， 气道微生物组和气道上皮。建议的研究是创新和及时的，因为 预计明年将获得多种RSV预防产品的许可（孕产妇疫苗和长期 用于婴儿的单克隆抗体）。拟议的工作代表了一种新颖的，多方面的方法， 识别和了解RSV感染的严重程度和RSV感染的年龄对哮喘的影响 风险和肺功能。这些问题的答案对于制定预防战略至关重要， 告知公众对RSV非药物预防策略的期望，并评估潜在的 疫苗在预防终身慢性呼吸道疾病方面的长期增值效益。这些数据可以 不仅支持RSV疫苗在美国的可接受性和吸收， 评估中低收入国家RSV预防策略的成本效益。

ABSTRACT The overarching goals of this application are to: 1) maintain retention of children in the Vanderbilt CANOE birth cohort with emphasis on diversity and implementation of the ECHO Cohort Protocol with high fidelity and conduct new enrollment, and 2) address key questions in the field about one of the most common and modifiable early life environmental exposures consistently associated with significantly increased asthma risk, respiratory syncytial virus (RSV) infection, delineating the severity-dependent and age-dependent effects of RSV infection on asthma risk. This innovative project has significant public health impact, as establishing the age- and severity-dependent relationship between RSV and asthma is the first and most important step in disease primary prevention. We propose to address key unanswered questions in the field: the severity- and age-dependent association of RSV and asthma, and the impact of infection on lung function. In addition, we will explore the broad impact of the SARS-CoV-2 pandemic on asthma incidence and control in an exploratory aim, which may provide support for multi-faceted environmental modifications in asthma prevention and control, and data to inform the potential impact of broad public health interventions. The birth cohort that this application supports is the Vanderbilt CANOE (Childhood Allergy and the NeOnatal Environment) study. CANOE is a birth cohort designed to identify and understand how environmental factors modify the development of the airway epithelium. The study includes the unique longitudinal sampling of the child airway throughout the first year of life, and annually. The Vanderbilt CANOE study has unique early life exposure and outcomes ascertainment, including surveillance for RSV and a novel biospecimen repository of nasal airway epithelial cells. The CANOE cohort also has important information for longitudinal development of the airway microbiome and the airway epithelium. The proposed research is innovative and timely given the anticipated licensure of multiple RSV prevention products in the coming year (maternal vaccines and long- acting monoclonal antibodies for infants). The proposed work represents a novel, multi-faceted approach to identifying and understanding the influence of severity of RSV infection and age of RSV infection on asthma risk and lung function. The answers to these questions will be critical to developing prevention strategies and informing public health expectations for RSV non-pharmaceutical preventive strategies and evaluating potential long-term value-added benefits of vaccines in preventing lifelong chronic respiratory disease. These data may not only bolster RSV vaccine acceptability and uptake in the US, but will almost certainly be useful in evaluating the cost-effectiveness of RSV prevention strategies in low and middle income countries.