New Jersey ECHO

项目摘要/摘要 早期的环境暴露与后来的疾病的发展密切相关。早期的生活 微生物组为了解生命过程中的健康和疾病提供了一个发展背景。在……里面 在现代，母亲和孩子经常会遇到微生物群干扰的暴露，包括剖腹产 在怀孕期间和孩子出生后的第一年，使用婴儿配方奶粉和抗生素。引人入胜的基本知识 我们小组和其他人的科学和流行病学研究表明，对预先受孕的扰动， 产前和儿童早期的微生物群会造成不良的健康后果。这些连接是 对上呼吸道和下呼吸道健康特别有效。以人口为基础的研究记录了 哮喘和早期抗生素暴露，哮喘儿童有明显的微生物组特征 未受影响的儿童。互补的小鼠模型显示扰动的微生物区系之间存在因果关系 和呼吸道疾病。然而，关键的知识差距仍然存在。首先，现有的研究缺乏多样性，而且往往 无力评估微生物群扰动暴露的程度，如药物使用， 剖腹产和婴儿配方奶粉是导致种族/民族差异的根本原因，例如更高的患病率 与白人儿童相比，黑人和西班牙裔儿童的哮喘发病率更高。其次，很少有研究研究 跨越关键时间窗口(未孕、怀孕、分娩、婴儿期和儿童早期)的微生物群。 Echo为解决这些差距和研究早期生命的发展作用提供了一个独特的机会 在一个庞大的、多样化的美国队列中，微生物群在后来的健康中。我们将招募500名孕妇和他们由此产生的 来自新泽西州米德尔塞克斯县的后代进入了全国回声队列。米德尔塞克斯县是美国最多样化的县之一。 我们建议的科学重点是早期生命微生物群和暴露于微生物群-扰乱暴露 (剖腹产、婴儿配方奶粉和药物使用)与上呼吸道和下呼吸道健康有关。我们的特定 目的是：(1)表征社会决定因素和常见微生物群中的种族/民族差异-扰乱 在全回声队列中的关键早期生命时期的暴露，并评估与纵向 母亲和孩子的微生物组结构；(2)估计微生物组扰动之间的关系 暴露和儿童结局，重点关注上呼吸道和下呼吸道健康；(3)招募500名孕妇 参与者反映了新泽西州米德尔塞克斯县的独特多样性；和(4)(探索性)审查了 在怀孕前12个月内，哪种母体微生物群的紊乱与上腹部不良有关 和较低的儿童呼吸道结局。新泽西州的加入为ECHO财团贡献了独特的多样性。 反过来，我们团队在全国范围内进行的回声范围的研究将产生为临床和公众提供信息的知识 促进“健康”微生物群和改善儿童健康的健康干预措施。

PROJECT SUMMARY/ABSTRACT Early environmental exposures are strongly implicated in the development of later diseases. The early life microbiome provides a developmental context for understanding health and disease across the life course. In the modern era, mothers and children routinely encounter microbiome perturbing exposures including cesarean section, infant formula, and antibiotics during pregnancy and in the child's first year after birth. Compelling basic science and epidemiological research from our group and others shows that perturbation of the pre-conception, prenatal, and early childhood microbiome contributes to adverse health outcomes. These connections are particularly strong for upper and lower airway health. Population-based studies document associations between asthma and early antibiotic exposure, and children with asthma have distinct microbiome signatures from unaffected children. Complementary mouse models show a causal association between perturbed microbiota and airway disease. However, key knowledge gaps remain. First, existing studies lack diversity and are often underpowered to evaluate the extent to which microbiome-perturbing exposures such as medication use, cesarean section, and infant formula underlie racial/ethnic disparities in outcomes such as the higher prevalence of asthma in Black and Hispanic children compared to White children. Second, few studies have examined the microbiome across critical time windows (preconception, pregnancy, delivery, infancy, and early childhood). ECHO provides a unique opportunity to address these gaps and study the developmental role of the early life microbiome in later health in a large, diverse U.S. cohort. We will recruit 500 pregnant people and their resulting offspring from Middlesex County, NJ, one of the most diverse counties in the U.S., into the national ECHO cohort. Our proposed scientific focus is on the early life microbiome and exposure to microbiome-perturbing exposures (cesarean section, infant formula, and medication use) in relation to upper and lower airway health. Our specific aims are to: (1) Characterize social determinants and racial/ethnic disparities in common microbiome-perturbing exposures during critical early life periods in the ECHO-wide cohort and evaluate associations with longitudinal microbiome structures in mothers and children; (2) Estimate associations between microbiome-perturbing exposures and child outcomes, with a focus on upper and lower airway health; (3) Recruit 500 pregnant participants reflecting the unique diversity of Middlesex County, NJ; and (4) (Exploratory) Examine the extent to which maternal microbiome perturbation in the 12 months before conception is associated with adverse upper and lower airway outcomes in children. The addition of NJ contributes unique diversity to the ECHO consortium. In turn, our team's ECHO-wide research at a national scale will yield knowledge that informs clinical and public health interventions that promote a “healthy” microbiome and improve child health.