Childhood Allergy and the NeOnatal Environment in St Louis (CANOE-STL) and the Impact of Wheezing Illnesses on Neurocognitive Development of Preschool Children

项目摘要 学龄前几年的喘息是一种常见的情况[1]，造成巨大的医疗负担[2]。 频繁的计划外就诊、急诊室就诊、住院治疗以及吸入和全身治疗 皮质类固醇和其他药物。反复喘息通常是哮喘的前驱症状，哮喘是 儿童时期最常见的慢性病。尽管有证据表明有严重的神经认知问题 在患有其他慢性健康状况的儿童中，如肿瘤疾病、糖尿病、心脏病、镰状细胞、 和创伤性脑损伤[3]，反复喘息性疾病和相关治疗对 婴幼儿神经认知和情绪发育尚未完全完成 特色化的。ECHO队列研究一直在收集儿童在 学龄前后期；然而，关键的神经发育轨迹发生在婴儿早期[4]。数据显示 这些轨迹可能会受到产前条件、社会经济地位、压力、疾病严重性、 和/或药物使用。最近的一项研究表明，在非哮喘患者中，使用全身性 皮质类固醇是一种经常用于治疗喘息性疾病的药物，它与大脑的变化有关 结构[5]。在这些发现的基础上，我们的主要研究目标是了解两者之间的联系 反复喘息性疾病及其相关治疗对神经认知和情绪的影响 婴幼儿和学龄前儿童的发育。

Project Summary Wheezing during preschool years is a common occurrence [1] causing significant healthcare burden [2] with frequent unscheduled physician visits, ED visits, hospitalizations, and treatment with inhaled and systemic corticosteroids along with other medications. Recurrent wheezing is often the antecedent to asthma, one of the most common chronic diseases of childhood. Though there is evidence of significant neurocognitive problems in children with other chronic health conditions such as oncological diseases, diabetes, heart disease, sickle cell, and traumatic brain injury [3], the impact of recurrent wheezing illnesses and associated treatment on the neurocognitive and emotional development of infants and preschool children has not been fully characterized. The ECHO cohort study has been collecting neurodevelopmental measures in children after the late preschool years; however, critical neurodevelopmental trajectories occur in early infancy [4]. Data suggest that these trajectories can be affected by pre-natal conditions, socioeconomic status, stress, disease severity, and/or medication use. A recent study, in non-asthmatic patients, showed that the use of systemic corticosteroids, a frequently administered treatment for wheezing illnesses, was associated with changes in brain structure [5]. Building on these findings, our overarching study objective is to understand the association of recurrent wheezing illnesses and its associated treatment on the neurocognitive and emotional development of infants and preschool children.