Antenatal Anxiety and Dyadic Immune Risk(ADIR Study)

产前焦虑和二元免疫风险（ADIR 研究）

• 批准号: 10561867
• 负责人: Lauren M Osborne
• 金额: $ 72.88万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10561867
• 关键词: Accounting; Affect; Age Months; Allergens; Allergic; Allergic Reaction; Anxiety; Asthma; Atopic Dermatitis; Biological; Biological Markers; Birth; Bronchiolitis; Cells; Child; Child Mortality; Child Rearing; Clinical; DNA Methylation; Data; Development; Diagnosis; Dietary Factors; Disease; Economic Burden; Elements; Environment; Environmental Exposure; Family; Financial Hardship; Food; Food Hypersensitivity; Frequencies; Future; Gene Expression; Genes; Genetic Risk; Goals; Hydrocortisone; Hypersensitivity; Immune; Immune system; Immunologic Markers; Immunologic Stimulation; Immunologics; Infant; Inflammatory; Interleukin-1 beta; Interleukin-6; Intervention; Link; Longitudinal, observational study; Measures; Mediating; Methylation; Mitogen-Activated Protein Kinases; Morbidity - disease rate; Mother-Child Relations; Mothers; Natural Immunity; Neonatal; Newborn Infant; Pathway interactions; Perinatal; Population; Pregnancy; Pregnant Women; Prevalence; Production; Public Health; Quality of life; Questionnaires; Reaction; Regulatory T-Lymphocyte; Reporting; Risk; Risk Factors; Second Pregnancy Trimester; Signal Transduction; TNF gene; Th1 Cells; Third Pregnancy Trimester; Umbilical Cord Blood; Woman; Work; adaptive immunity; antenatal; anxiety symptoms; anxious; atopy; cigarette smoking; clinical risk; clinically significant; cytokine; early childhood; epigenetic marker; feeding; fetal; immune activation; immune function; in utero; infancy; innovation; mast cell; maternal anxiety; monocyte; novel; obstetrical complication; postnatal; prenatal exposure; prospective; psychologic; psychosocial; recruit; reduce symptoms; symptomatology

PROJECT SUMMARY Atopic disease is a major public health problem affecting up to 20% of the world’s population, with rising prevalence in recent decades. It is associated with fatal reactions (food allergy), and with significant psychosocial and financial burden for children and families. Environmental and in utero exposures are known risk factors, but little is known about the mechanisms through which exposures may confer risk. One of these known exposures is maternal antenatal anxiety, which has been associated both with elevated markers of allergy risk (such as levels of Immunoglobluin E (IgE)) and with atopic diagnosis in children. Maternal antenatal anxiety has also been linked to immune dysregulation in both mothers and children, and elevated innate immune activity in children at birth may be a key marker of future allergic risk – yet no study has attempted to link dyadic maternal and neonatal immune dysregulation to allergy risk in the same mother-child pairs. In this prospective, longitudinal, observational study, we propose to follow 200 mother-child pairs (132 at risk for clinically significant anxiety and 68 healthy controls) from the second trimester of pregnancy until infants reach 12 months of age. We hypothesize that women with clinically significant antenatal anxiety will demonstrate elevated immune activity compared to healthy controls, that stimulated cells and gene expression from umbilical cord blood in these pregnancies will similarly show evidence of increased immune activity, and that maternal and child immune activity will be associated with markers of allergy risk in children. We will measure immune cell populations and cytokines produced by stimulated cells in mothers and children; will conduct methylation analyses of immune-related genes in the cord blood of children (focusing on known biomarkers of future allergic risk); will measure atopic dermatitis in children; and will measure IgE to common allergens and maternal report of food allergic reactions in children. In addition, we will observe mother-child interactions surrounding feeding to account for elements of the postnatal environment that may contribute to elevated child allergic risk. Our thorough and rigorous experimental plan will help to illuminate pathways that contribute to the association between maternal antenatal anxiety and child allergy risk, and may lead to novel interventions to ameliorate symptoms and risk in both mother and child.

项目摘要 特应性疾病是一个主要的公共卫生问题，影响了世界人口的20％，随着增加 近几十年以来的流行。它与致命的反应（食物过敏）有关 儿童和家庭的社会心理和经济燃烧。环境和子宫暴露是已知的 风险因素，但对暴露可能会导致风险的机制知之甚少。其中之一 已知暴露是Mater焦虑，这两者都与升高的标记相关联 过敏风险（例如免疫蛋白E（IgE）水平）和儿童特有诊断。母亲 产前动画也与母亲和儿童的免疫失调有关，并升高 出生时儿童的先天免疫活动可能是未来过敏风险的关键标志 - 但没有研究 试图将二元材料和新生儿免疫失调与同一母亲的过敏风险联系起来 成对。在这项前瞻性，纵向，观察性研究中，我们建议遵循200个母子对（132位 从怀孕的第二月开始，才有临床意义的动画和68个健康对照的风险 婴儿达到12个月大。我们假设具有临床意义的天线动画的女性将 与健康对照组相比，免疫活性升高，刺激细胞和基因表达 这些妊娠中的脐带血中，同样会显示出免疫反应性升高的证据，并且 婴儿免疫活动将与儿童过敏风险的标记有关。我们将 测量母亲和儿童刺激细胞产生的免疫细胞群体和细胞因子；将要 对儿童脐带血中的免疫相关基因进行甲基化分析（重点是已知） 未来过敏风险的生物标志物）；将测量儿童特应性皮炎；并将测量IgE 过敏原和孕产妇报告儿童食物过敏反应。此外，我们将观察母子 围绕进食的相互作用，以说明产后环境的要素可能有助于 升高儿童过敏风险。我们诚实而严格的实验计划将有助于阐明 有助于孕产妇的静脉焦虑与儿童过敏风险之间的关联，并可能导致新颖 改善母亲和儿童症状和风险的干预措施。