Pediatric Asthma Disparities: The Role of Sleep and Immune Balance

小儿哮喘差异：睡眠和免疫平衡的作用

基本信息

批准号：
9207483
负责人：
Daphne Koinis Mitchell
金额：
$ 10.15万
依托单位：
RHODE ISLAND HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-02-01 至 2021-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9207483
关键词：
10 year old Address Adherence Adult Affect Age Area Asthma Beds Behavior Behavior Therapy Behavior assessment Biological Biological Markers Caregivers Child Childhood Childhood Asthma Chronic Clinical Clinical Immunology Crowding Data Development Disease Drowsiness Eligibility Determination Equilibrium Ethics Evaluation Experimental Designs Extrinsic asthma Faculty Fellowship Program Funding Goals Grant Growth and Development function Home environment Human Immune Immunologic Markers Inflammation Inflammatory Interferon-alpha Interleukin-13 Interleukin-4 Interleukin-5 Interleukin-6 Interleukins Intervention Intervention Studies Investigation K-Series Research Career Programs Knowledge Link Longitudinal Studies Mentors Mentorship Methods Minority Nocturnal Asthma Outcome Performance Physiology Plasma Polysomnography Postdoctoral Fellow Process Protocols documentation Psychiatry Pulmonary Function Test/Forced Expiratory Volume 1 Recording of previous events Recruitment Activity Reporting Research Research Design Research Infrastructure Research Project Grants Resources Respiratory physiology Risk Role Schedule Schools Sleep Sleep Fragmentations Sleep disturbances Spirometry Symptoms Testing Time Training Training Activity Universities Work actigraphy base career cytokine elementary school ethnic diversity health disparity improved innovation interest medical schools mid-career faculty minority children patient oriented research phenomenological models primary caregiver programs public health relevance statistics training opportunity treatment response urban children urban poverty vigilance

项目摘要

DESCRIPTION (provided by applicant): This K24 application proposes a mentorship program in patient-oriented research in multi-level contributors to pediatric asthma health disparities, wih a focus on sleep and immune balance. The K24 Candidate is an Associate Professor (Research) in the Department of Psychiatry and Human Behavior of the Warren Alpert Medical School at Brown University, with a history of funding in behavioral interventions and longitudinal research aimed at improving asthma outcomes in urban children and addressing health disparities in pediatric asthma. Training Plan: The candidate will obtain additional training in asthma clinical immunology and sleep physiology, including state-of the art methods to assess immune biomarkers relevant to asthma and sleep, and in-lab methods to assess sleep phenomenology through experimental approaches. Research Plan: The research proposed involves an innovative investigation of the effects of experimental sleep disruption on immune balance (Th1/Th2 cytokine ratio-Th1/Th2R; plasma IL-6 -pIL-6), and associated changes in asthma- related lung function (FEV1 by spirometry) and daytime performance in urban children with persistent asthma (8-10 years old). Forty children and their primary caregiver will each participate in a within-subjects protocol, with two experimental sleep conditions: baseline sleep (1 overnight, in-lab polysomnographic (PSG) sleep study), followed by sleep fragmentation (1 overnight, in-lab PSG). Prior to each condition, children will follow a 6-day sleep stabilization schedule at home. We will monitor sleep and lung function (FEV1 by spirometry) daily to confirm eligibility and adherence to sleep criteria, and assess asthma status. We include assessments of immune biomarkers and daytime performance following each condition. Results from this study ultimately will support the development of asthma and sleep interventions for urban and ethnically diverse children. Our data will elucidate how immune biomarkers relevant to asthma and sleep operate in relation to sleep disruption, and clinical indicators of worsening asthma (lung function), to identify those most at risk, prioritize intervention targets, and improve treatment response. Mentoring Plan: The proposed mentoring plan offers opportunities for mentorship of postdoctoral fellows, residents and junior faculty with interests in POR. Mentees will be involved in ongoing longitudinal and intervention studies on pediatric asthma disparities, including the proposed research, which will focus on biological-based processes that contribute to asthma and sleep in urban children. A strong emphasis is placed on the recruitment and selection of minority mentees. This overall plan capitalizes on the rich resources and training opportunities available to postdoctoral fellows, residents and junior faculty at Brown Medical School, including several T32 fellowship programs, numerous junior faculty with K awards and small grants, a commitment to diversity in training, seminars in research design, ethics, and statistics, and an established infrastructure for evaluation.

描述（由应用程序提供）：这项K24应用程序提案是针对儿科哮喘健康差异的多层次贡献者研究的心态计划，关注睡眠和免疫平衡。 K24候选人是布朗大学沃伦·阿尔珀特医学院精神病学和人类行为的副教授（研究），其行为干预和纵向研究的资金历史旨在改善城市儿童哮喘的成果，并解决儿童健康差异。培训计划：候选人将获得有关哮喘临床免疫学和睡眠生理学的额外培训，包括评估与哮喘和睡眠相关的免疫生物标志物的最先进方法，以及通过实验方法评估睡眠现象学评估睡眠现象学的实验室方法。研究计划：提出的研究涉及对实验睡眠破坏对免疫平衡的影响的创新投资（Th1/Th2细胞因子比率-TH1/TH2R； Plasma IL-6-PIL-6）以及哮喘相关的肺功能（FEV1）的相关变化（supermetry）和白天的表现，以及在URBAN CHICVESS cORSISTERSENT ASSISTENTSTMASTMASTMASSMASSMA（8-10）（8-10岁）。四十个儿童及其主要护理人员将分别参与受试者内部方案，具有两个实验性睡眠条件：基线睡眠（1个过夜，实验室内多个学术摄影（PSG）睡眠研究），然后进行睡眠片段化（1个过夜，LAB PSG）。在每种情况之前，孩子们将遵循家庭中为期6天的睡眠稳定时间表。我们将每天监测睡眠和肺功能（FEV1），以确认对睡眠标准的资格和遵守性和评估哮喘状态。我们包括对免疫生物标志物的评估和每种条件下的白天性能。这项研究的结果最终将支持城市和富有多元化儿童的哮喘和睡眠干预措施的发展。我们的数据将阐明与哮喘和睡眠干扰有关的免疫生物标志物与哮喘和睡眠操作相关，以及担心哮喘（肺功能）的临床指标，以确定最风险的人，优先考虑干预目标并改善治疗反应。指导计划：拟议的心理计划为博士后研究员，居民和初级教师的心态提供了机会。受训者将参与有关小儿哮喘差异的持续纵向和干预研究，包括拟议的研究，该研究将着重于基于生物学的过程，这些过程有助于城市儿童的哮喘和睡眠。非常重视少数群体的招募和选择。该总体计划利用了布朗医学院的博士后研究员，居民和初级教职员工的丰富资源和培训机会，包括几个T32奖学金计划，众多具有K奖项的初级教师和小额赠款，对培训的多样性，对研究设计，素养和统计学的半人选，以及用于评估的基础。