Evaluation of Soluble Fiber as a Strategy to Decrease Asthma Morbidity in Underserved Populations

可溶性纤维作为降低服务不足人群哮喘发病率策略的评估

基本信息

批准号：
10707490
负责人：
Emily K Cope
金额：
$ 33.53万
依托单位：
NORTHERN ARIZONA UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-20 至 2027-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10707490
关键词：
Accident and Emergency department Acetates Address Adherence Affect Area Arizona Asthma Black race Blood Butyrates Carbohydrates Cells Child Childhood Asthma Chronic Clinic Clinical Trials Colon Complex Consumption County Dendritic Cells Development Diagnosis Diet Dietary Fiber Dietary Intervention Dietary Practices Disease Disparity Ecology Economic Burden Economics Environmental Exposure Enzymes Evaluation Family Fermentation Fiber Funding Goals Health Healthcare Hispanic Homing Human Hypersensitivity Immune Immune system In Vitro Incidence Individual Inflammation Inflammatory Inflammatory Bowel Diseases Intake Intervention Link Low Income Population Lung Measures Mediating Metabolic Metabolism Morbidity - disease rate Mus Not Hispanic or Latino Nutritional Obesity Outcome Patients Pediatric Hospitals Peripheral Persons Phenotype Physiological Pilot Projects Play Population Poverty Prevalence Preventive Process Production Propionates Protocols documentation Public Health Recommendation Reducing diet Reporting Research Risk Risk Factors Role Scientist Site Small Intestines Supplementation T-Lymphocyte Travel Underserved Population Urban Population Visit Volatile Fatty Acids airway inflammation allergic airway inflammation asthma exacerbation asthmatic asthmatic patient care burden cell type cohort community partnership coping dietary economic disparity eosinophil experience genetic risk factor gut microbiome gut microbiota health disparity health equity host microbiota host-associated microbial communities host-microbe interactions improved in vivo low socioeconomic status metropolitan microbial microbial composition microbiome microbiome composition microbiota microbiota metabolites migration minority children nasal microbiota patient population polarized cell preclinical study recruit reduce symptoms respiratory microbiome skills soluble fiber underserved community urban area urban residence urban underserved

项目摘要

PROJECT SUMMARY Approximately 7.7% of the US population have asthma, and incidence has been increasing since the 1980s. In Arizona, asthma prevalence exceeds the national average, with the majority of asthma diagnoses made in the Phoenix Metropolitan Area. Genetic risk factors have been identified in asthmatics. However, the steady increase in the prevalence of asthma in the US population suggests that environmental exposures or other extrapulmonary factors, such as diet and the gut microbiota, may play a critical role in asthma development. Health disparities in asthma prevalence and morbidity are highlighted in individuals from low-income urban areas where nutritional health disparities are more likely to exist. For example, poor-urban residence is an individual risk factor for reporting an asthma attack and having higher odds for an asthma-related visit to the Emergency Department. Minority children are disproportionately affected by low socioeconomic status. A recent study demonstrated that 31.4% of non-Hispanic Black children, and 25.2% of Hispanic children lived under the poverty threshold compared to 9.4% non-Hispanic white children. Economically disadvantaged urban populations also experience a nutritional health disparity, including a low fiber diet that leads to shifts in the gut microbiome and may explain differences in asthma risk. Dietary fibers are complex carbohydrates that resist metabolism in the small intestine by host enzymes and are fermented in the colon by resident microbes. Gut microbial fermentation of soluble fibers results in production of metabolic by-products such as the short chain fatty acids (SCFAs) acetate, propionate, and butyrate, which are important molecules that act as a link between the microbiota and host immune system. We hypothesize that a low fiber diet is a critical, but understudied, factor in asthma health disparities. The overall goals of this proposal are to determine the effect of a gut microbiome modifier (fiber) on microbial composition and function in an underserved population. In addition, we will determine the effect of soluble fiber supplementation in reducing airway inflammation via the gut microbiome-airway axis. The hypothesis governing this proposal is that gut microbial metabolism of dietary fiber to SCFAs will reduce airway inflammation by altering the phenotype of T cells and eosinophils. We have assembled a strong team of clinicians and scientists, and we draw on our pilot study of fiber intervention in a pediatric asthma cohort to achieve 3 aims. First, we will build on the community partnerships through the PCH Mobile Asthma Clinic (Breathmobile) to assess baseline fiber consumption and gut microbiota across underserved communities in Maricopa County. Second, we will evaluate the effect of a soluble fiber supplement in a pediatric asthma cohort. Finally, we will evaluate the effect of microbial-derived SCFAs on key immune cell populations. Completion of these aims will provide evidence that can guide public health nutritional interventions in low SES populations to improve asthma outcomes and advance health equity.

项目概要大约 7.7% 的美国人患有哮喘，且发病率自 20 世纪 80 年代以来一直在增加。在亚利桑那州的哮喘患病率超过全国平均水平，大多数哮喘诊断是在该州进行的凤凰城都会区。哮喘病的遗传危险因素已被确定。然而，稳定的美国人口中哮喘患病率的增加表明，环境暴露或其他因素饮食和肠道微生物群等肺外因素可能在哮喘发展中发挥关键作用。低收入城市人群中哮喘患病率和发病率的健康差异凸显更有可能存在营养健康差异的地区。例如，城市贫困人口的居住是报告哮喘发作以及因哮喘相关就诊的可能性较高的个人风险因素急诊科。少数民族儿童受到社会经济地位低下的影响尤为严重。一个最近的研究表明，31.4% 的非西班牙裔黑人儿童和 25.2% 的西班牙裔儿童居住在与 9.4% 的非西班牙裔白人儿童相比，该比例低于贫困线。经济困难城市人口还面临着营养健康方面的差异，包括低纤维饮食，导致生活方式发生变化肠道微生物组可能解释哮喘风险的差异。膳食纤维是复杂的碳水化合物，抵抗小肠中宿主酶的代谢，并在结肠中被常驻微生物发酵。可溶性纤维的肠道微生物发酵会产生代谢副产物，例如短纤维链脂肪酸 (SCFA) 乙酸盐、丙酸盐和丁酸盐，它们是充当纽带的重要分子微生物群和宿主免疫系统之间的关系。我们假设低纤维饮食至关重要，但是哮喘健康差异的因素尚未得到充分研究。该提案的总体目标是确定效果肠道微生物组修饰剂（纤维）对服务不足人群的微生物组成和功能的影响。在此外，我们将通过以下方式确定补充可溶性纤维在减少气道炎症方面的效果：肠道微生物组-气道轴。控制这一提议的假设是肠道微生物代谢饮食将纤维转化为 SCFA 将通过改变 T 细胞和嗜酸性粒细胞的表型来减少气道炎症。我们有我们组建了一支由临床医生和科学家组成的强大团队，我们利用纤维干预的试点研究小儿哮喘队列旨在实现 3 个目标。首先，我们将通过 PCH 建立社区伙伴关系移动哮喘诊所（Breathmobile）评估基线纤维消耗和肠道微生物群马里科帕县服务不足的社区。其次，我们将评估可溶性纤维的效果儿科哮喘队列中的补充剂。最后，我们将评估微生物衍生的 SCFA 对关键的影响免疫细胞群。完成这些目标将为指导公共卫生提供证据对低社会经济地位人群进行营养干预，以改善哮喘结果并促进健康公平。