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.

项目概要 特应性疾病是一个主要的公共卫生问题，影响着世界上多达 20% 的人口，并且患病率不断上升 近几十年来，它的流行与致命反应（食物过敏）有关，并且与显着相关。 环境和子宫内暴露对儿童和家庭造成的社会心理和经济负担是已知的。 风险因素，但人们对暴露可能带来风险的机制知之甚少。 已知的暴露因素是产妇产前焦虑，这与孕产妇产前焦虑标志物升高有关。 过敏风险（例如免疫球蛋白 E (IgE) 水平）和儿童特应性诊断。 产前焦虑也与母亲和儿童的免疫失调有关，并且升高 儿童出生时的先天免疫活动可能是未来过敏风险的关键标志——但尚无研究表明 试图将母婴二元免疫失调与同一母子的过敏风险联系起来 在这项前瞻性、纵向、观察性研究中，我们建议跟踪 200 对母子（132 对）。 临床上显着焦虑的风险和 68 名健康对照者）从妊娠中期直至 我们认为，患有临床显着产前焦虑的婴儿会出现 12 个月大的情况。 与健康对照相比，显示出更高的免疫活性，刺激细胞和基因表达 这些怀孕期间脐带血中的抗体同样会显示出免疫活性增加的证据，并且 母婴免疫活动将与儿童过敏风险标志物相关。 测量母亲和儿童受刺激细胞产生的免疫细胞群和细胞因子； 对儿童脐带血中的免疫相关基因进行甲基化分析（重点关注已知的 将测量儿童特应性皮炎；并将测量常见的 IgE； 过敏原和母婴食物过敏反应的报告 此外，我们还会观察母子关系。 围绕喂养的相互作用，以考虑可能有助于 我们彻底而严格的实验计划将有助于阐明儿童过敏风险升高的途径。 有助于母亲产前焦虑与儿童过敏风险之间的关联，并可能导致新的 拦截以改善母亲和孩子的症状和风险。