ECHO Renewal for the INSPIRE Study Cohort

INSPIRE 研究队列的 ECHO 更新

• 批准号: 10745075
• 负责人: Leonard B Bacharier
• 金额: $ 182.59万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10745075
• 关键词: Address; Adolescence; Age; Allergens; Allergic; Asthma; Biological; Biological Markers; Biological Response Modifier Therapy; Biological Response Modifiers; Biological Specimen Banks; Biology; Birth; Blood specimen; Child; Child Health; Childhood Asthma; Clinical; Cohort Studies; Collection; DNA; Data; Data Collection; Data Element; Development; Diagnosis; Disease; Disease Management; Enrollment; Ensure; Environmental Exposure; Environmental Risk Factor; Ethnic Origin; Exhalation; Funding; Genes; Genetic Transcription; Genotype; Geographic Locations; Geography; Goals; Hypersensitivity skin testing; IgE; Incidence; Individual; Infant; Laboratories; Measures; Mentors; Methodology; Morbidity - disease rate; Nitric Oxide; Nose; Outcome; Participant; Pathway interactions; Phenotype; Population; Population Heterogeneity; Poverty; Prevalence; Prevention strategy; Protocols documentation; Publications; Pulmonary function tests; Race; Research; Respiratory syncytial virus; Risk Factors; Role; Rural Community; Sample Size; Sampling; Science; Serology; Southeastern United States; Technology; Testing; Time; Urban Community; Viral Respiratory Tract Infection; Visit; airway epithelium; asthma prevention; clinical care; clinical practice; clinically relevant; cohort; comparative; comparison group; diagnostic criteria; differential expression; disorder prevention; early life exposure; eosinophil; ethnic diversity; fecal microbiome; follow-up; innovation; middle childhood; multidimensional data; novel; policy implication; population based; protective factors; racial diversity; respiratory; respiratory microbiome; sex; targeted treatment; transcriptomics; treatment strategy; viral detection

ABSTRACT The overarching goals of this proposal are 1) to maintain retention of children in the INSPIRE birth cohort with emphasis on diversity, and implementation of the ECHO Cohort Protocol with high fidelity, and 2) tackle the major limitation in diagnosis and management of childhood asthma - addressing the need to identify asthma phenotypes and endotypes to develop targeted treatment and prevention strategies. The term asthma is an umbrella diagnosis for several disease states with distinct variable clinical presentations (phenotypes) and mechanistic pathways (endotypes). Central to understanding the causal role of environmental exposures in asthma development and to disease management is identifying distinct asthma phenotypes. The scientific aims of this proposal are: 1) Aim 1: to determine the incidence and prevalence of two highly relevant asthma phenotypes, atopic and non-atopic asthma, by age, sex, cohort decade and geographic location, using widely available and harmonized variables and those collected through the ECHO Cohort Protocol. We will also determine the contribution of established environmental risk and protective factors with these specific clinically relevant asthma phenotypes. Lastly, we will calculate comparative estimates of childhood asthma morbidity by asthma phenotypes; 2) Aim 2: to further characterize asthma phenotypes and endotypes into clinically useful entities within the ECHO consortium and expand the findings to clinical practice by utilizing available or to be collected samples to add biomarkers of asthma routinely available in clinical practice, and nasal samples to perform transcriptomic analyses to define asthma endotypes; 3) Aim 3: to facilitate and oversee longitudinal follow-up of the established INSPIRE cohort, and biosample collection to maximize retention of existing participants with emphasis on diversity, and implement the ECHO Cohort Protocol with high fidelity. The INSPIRE birth cohort is a population-based birth cohort study that originally enrolled over 1950 term healthy infants. INSPIRE is unique in including surveillance for infant respiratory viral infection through biweekly active and passive surveillance using PCR for viral detection and respiratory syncytial virus (RSV) serology at age one. The children will be ages 8-10 years when the current ECHO funding period ends, entering adolescence, and will be followed to age 15-17 years during this next funding period. The proposed research is an innovative, novel, multi-faceted and practical approach to move away from viewing “asthma” as a single umbrella disease, and identifying and understanding asthma phenotypes, endotypes, and the influence of risk and protective factors on specific asthma phenotypes. The approach we propose is also practical in moving toward solutions that utilize currently available technologies and laboratory testing to aide in development of diagnostic criteria for childhood asthma sub-types.

抽象的 该提议的总体目标是1）维持儿童在启发出生中的保留 队列重点是多样性，以及具有高保真度的回声队列协议的实施，2） 解决儿童哮喘诊断和管理的主要限制 - 解决识别的需求 哮喘表型和内型，以制定有针对性的治疗和预防策略。 该术语哮喘是几种具有不同临床变化的疾病状态的雨伞诊断 演示（表型）和机械途径（内型）。了解理解因果关系的核心 哮喘发育和疾病管理中的环境暴露正在确定不同的哮喘 表型。该提议的科学目的是：1）目标1：确定事件和流行率 在两种高度相关的哮喘表型中，特应性和非原子性哮喘，按年龄，性别，队列十年以及 地理位置，使用广泛可用和统一的变量以及通过回声收集的变量 队列协议。我们还将确定已建立的环境风险和保护性的贡献 这些特定临床相关的哮喘表型的因素。最后，我们将计算比较 哮喘表型对儿童哮喘发病率的估计； 2）目标2：进一步描述哮喘 表型和内型进入回声财团内的临床有用实体并扩大发现 通过利用可用或收集样品来添加哮喘的生物标志物，以定期添加临床实践 可在临床实践和鼻样样本中进行，以执行转录组分析以定义哮喘 内型； 3）目标3：促进和监督已建立的启发队列的纵向随访，并 生物样品收集以最大程度地提高现有参与者的保留，重点是多样性和实施 具有高保真度的回声队列协议。 Inspire出生队列是一项基于人群的出生队列研究 这最初是在1950年任期健康的婴儿中招收的。 Inspire在包括婴儿的监视方面是独一无二的 通过PCR进行病毒检测和 一岁时呼吸道合胞病毒（RSV）血清学。当前的孩子将年满8-10岁 回声融资期结束，进入青少年，并将在此期间遵循15-17岁 资金期。 拟议的研究是一种创新，新颖，多方面和实用的方法，可以移开 从将“哮喘”视为单伞疾病，并识别和理解哮喘表型， 内型，以及风险和保护因素对特定哮喘表型的影响。我们的方法 提案在朝着利用当前可用技术和实验室的解决方案方面进行实用 在儿童哮喘子类型的诊断标准发展方面的助手测试。