Vitamin D, Steroids, and Asthma in African American Youth

非裔美国青年的维生素 D、类固醇和哮喘

基本信息

批准号：
8607477
负责人：
Robert J Freishtat
金额：
$ 43万
依托单位：
CHILDREN'S RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-04-01 至 2017-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8607477
关键词：
25-hydroxyvitamin D Accident and Emergency department Acute Address Affect African American Asthma Caring Cells Chronic Detection Dexamethasone Disadvantaged District of Columbia Dose Enrollment Environment Environmental Risk Factor Epidemiology Epithelial Cells Ethnic Origin Ethnic group Exposure to Glucocorticoids Goals Healthy People 2010 Heterogeneity In Vitro Individual Inflammation Mediators Inflammatory Interleukin-1 Interleukin-10 Intervention Trial Knowledge Link Measures Messenger RNA Methods Minority Mitogen-Activated Protein Kinases Modeling Molecular Nose Obesity Outcome Participant Phosphoric Monoester Hydrolases Population Prevalence Proteins Race Randomized Clinical Trials Regulation Research Respiratory Tract Infections Risk Role Sampling Serum Severities Steroids Structure of parenchyma of lung Supplementation Techniques Testing Time Transforming Growth Factors Translations Visit Vitamin D Vitamin D Deficiency Youth abstracting airway epithelium asthmatic airway clinical research site cohort cytokine experience health disparity insight novel prospective racial and ethnic research study respiratory response urban area

项目摘要

Abstract Further studies are urgently needed in order to identify effective and sustainable strategies for reducing the dramatic health disparities experienced by disadvantaged, urban, and minority youth with asthma. Vitamin D deficiency is more common among African American (AA) individuals, especially those from urban environments or with obesity. We and others have contributed to increasing evidence that vitamin D insufficiency may contribute to more severe asthma through increased risk of respiratory infection and decreased glucocorticoid sensitivity. Indeed, low vitamin D levels were recently linked with the need for exogenous glucocorticoids and increased asthma severity. Particularly relevant to health disparities, we showed a strong association between vitamin D insufficiency and asthma in urban African American (AA) youth. Because AA youth residing in urban Washington, DC have markedly worse asthma than other racial/ethnic groups (e.g. prevalence rate 20% higher than the national rate 15 and emergency department utilization rates up to 5 times the national rates and nearly 10 times the Healthy People 2010 target rate), we will utilize our access to this population at the extreme of asthma disparities to examine the contribution of vitamin D to disparities in the chronic control and acute severity of asthma. The overall goal of this application is to provide critical epidemiological/molecular information that will inform the interpretation of ongoing and impending randomized clinical trials of vitamin D supplementation in asthma, especially with regard to urban AA youth with asthma. The knowledge generated by the experiments in this application will be crucial to translation of this inexpensive, easily-accessible potential therapy for asthma. We hypothesize that low serum 25-hydroxyvitamin D [25(OH)D] levels are associated with poor chronic asthma control, worse acute asthma severity, and glucocorticoid insensitivity. AIM 1. Define asthma phenotypic clusters and determine cross- sectional inter- and intra-cluster associations with serum 25(OH)D levels within and between AA and non-AA youth. AIM 2. Determine prospective associations among serum 25(OH)D levels and: (a) chronic asthma control and (b) acute asthma severity within and between AA and non-AA youth. AIM 3. Show the effect of vitamin D on glucorticoid regulation of inflammatory mediators in asthmatic airway epithelial cells.

抽象的迫切需要进一步研究，以确定有效和可持续的战略来减少患有哮喘的弱势群体、城市和少数民族青年所经历的巨大健康差异。维他命 D 缺乏症在非裔美国人 (AA) 中更为常见，尤其是来自城市的人环境或肥胖。我们和其他人为越来越多的证据做出了贡献，表明维生素 D 不足可能会增加呼吸道感染的风险，从而导致更严重的哮喘糖皮质激素敏感性降低。事实上，低维生素 D 水平最近与维生素 D 的需求有关。外源性糖皮质激素和哮喘严重程度增加。特别是与健康差异相关，我们研究表明，城市非裔美国人 (AA) 中维生素 D 不足与哮喘之间存在密切关联青年。因为居住在华盛顿特区市区的 AA 青少年的哮喘症状明显比其他青少年严重种族/族裔群体（例如患病率比全国患病率高 20% 15 和急诊科利用率高达全国利用率的 5 倍和 2010 年健康人民目标率的近 10 倍），我们将利用我们对哮喘差异极端的人群的接触来检查维生素 D 对哮喘慢性控制和急性严重程度的影响。该应用程序的总体目标是提供关键的流行病学/分子信息，为解释正在进行的和即将开展的补充维生素 D 治疗哮喘的随机临床试验，特别是针对城市人群患有哮喘的 AA 青年。本应用中的实验产生的知识对于这种廉价、容易获得的潜在哮喘疗法的翻译。我们假设低血清 25-羟基维生素 D [25(OH)D] 水平与慢性哮喘控制不佳、急性哮喘恶化有关严重程度和糖皮质激素不敏感。目标 1. 定义哮喘表型簇并确定交叉 AA 和非 AA 内以及之间的血清 25(OH)D 水平的部分簇间和簇内关联青年。目标 2. 确定血清 25(OH)D 水平与 (a) 慢性哮喘之间的前瞻性关联 (b) AA 和非 AA 青少年内部以及之间的急性哮喘严重程度。目标3.展示效果维生素 D 对哮喘气道上皮细胞炎症介质糖皮质激素的调节作用。