Early Environmental Hygiene and Pediatric Asthma

早期环境卫生与小儿哮喘

• 批准号: 7837485
• 负责人: Christine C Johnson
• 金额: $ 74.42万
• 依托单位: HENRY FORD HEALTH SYSTEM
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-14 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7837485
• 关键词: 6 year old; Accounting; Affect; Africa; Age; Age-Years; Allergens; American; Animals; Asthma; Behavioral; Biological Assay; Biological Markers; Birth; Birth Order; Black race; Blood specimen; CD14 gene; Cells; Centers for Disease Control and Prevention (U.S.); Characteristics; Child; Childhood; Childhood Asthma; Cities; Clinical; Country; County; Data; Developed Countries; Developing Countries; Development; Endotoxins; Environment; Environmental Exposure; Environmental Risk Factor; Environmental Tobacco Smoke; Epidemiology; Equilibrium; European Union; Exposure to; Family history of; Freezing; Genetic; Genotype; Grant; Health; Health Surveys; Household; Human; Hygiene; Hypersensitivity; IL2 gene; IL4 gene; IL5 gene; IgE; Immune; Immune response; Immune system; Immunologics; Incidence; Inherited; Intention; Interferons; Interleukin-10; Interleukin-12; Interleukin-13; International; Intervention; Investigation; Life; Link; Longitudinal Studies; Measurement; Measures; Minority; Minority Groups; Modification; Morbidity - disease rate; Outcome; Pattern; Persons; Phenotype; Plasma; Play; Population Study; Predisposition; Pregnant Women; Prevalence; Production; Prospective Studies; Public Health; Recruitment Activity; Research; Research Personnel; Research Project Grants; Risk; Risk Factors; Role; Sahara; Sampling; Socioeconomic Status; Stimulus; Study Subject; Suburbanization; T-Lymphocyte; TNF gene; Technology; Testing; Time; Urbanization; Variant; Whole Blood; atopy; base; clinically relevant; clinically significant; cohort; cost; cytokine; exposed human population; extracellular; follow-up; genetic variant; high risk; infancy; modifiable risk; mortality; pet animal; respiratory; response; sex; social; theories

The prevalence of asthma has increased over the 20th century in most, if not all, developed countries of the world. Major findings from the European Community Respiratory Health Survey and the International Study of Asthma and Allergies in Childhood were that asthma prevalence is increasing worldwide; is generally more common in Western countries; more prevalent in English-speaking countries; and increasing in developing countries as they become more Westernized or become urbanized. CDC estimated that from January to March of 2006 more than 22 million Americans (8.0%) suffered from asthma, an increase from 7.8% in 2005. While many studies have demonstrated strong inherited influences on the development of asthma, these changes have been too rapid to be explained solely by genetics, and it has been widely hypothesized that early life exposures influence an infant¿s susceptibility to asthma. In the US, asthma morbidity and mortality are highest among persons who are of minority status. One approach to reducing racial disparities involves targeting reductions in asthma incidence through modification of risk factors. The objective of this proposal is the epidemiological investigation of early life environmental factors, focusing on pet exposure and endotoxin, that may alter immunologic development, based on the premise that variations in the early immune response to environmental stimuli affects risk for asthma.The level of exposure of humans to animals (and presumably endotoxin) has declined over the last 100 years through urbanization and suburbanization, although humans have evolved with close contact with animals. As part of an ongoing study, the Wayne County Health, Environment, Allergy & Asthma Longitudinal Study (WHEALS), a multi-ethnic cohort of pregnant women has been recruited for prospective study of their children. With this renewal, we will extend follow-up to 5-6 years of age for the 1248 children of varied racial backgrounds (60% Black). We will use the WHEALS cohort to 1) evaluate whether pet contact and household endotoxin levels affect total and allergen-specific IgE and extracellular cytokine (IL4, IL5, IL13, IFN?, IL2, IL12, TNF and IL10 production by stimulated T-cells) patterns measured at 4 points in time during infancy (birth, 6 months, 12 months and 2 years) and 2) how these exposures and immunological patterns are related to the prevalence of clinical asthma at age 5-6 years. Finally, the data will be analyzed to evaluate the role that Black race plays in the relationship between early environmental exposures and immunological biomarkers and asthma, after accounting for other non-modifiable and modifiable risk factors including CD14 genotype, family history, child sex, birth order, birth characteristics, socioeconomic status, and other social, behavioral and environmental variables. If factors associated with animal or endotoxin contact are related to asthma risk, such factors would likely lend themselves to public health interventions.

20 世纪以来，在大多数（如果不是全部）发达国家，哮喘的患病率有所增加。 欧洲共同体呼吸健康调查和国际研究的主要发现 哮喘和儿童过敏的研究表明，全球范围内哮喘患病率总体上呈上升趋势； 在西方国家很常见；在英语国家更为普遍，并且在发展中国家有所增加； CDC 估计，从 1 月到 3 月，这些国家变得更加西化或城市化。 2006 年，超过 2200 万美国人（8.0%）患有哮喘，比 2005 年的 7.8% 有所增加。 许多研究表明遗传因素对哮喘的发展有很强的影响，这些变化 进化速度太快，无法仅用遗传学来解释，并且早期生命已经广泛进化 暴露会影响婴儿?? s 易患哮喘。 在美国，少数民族人群的哮喘发病率和死亡率最高。 减少种族差异的方法包括通过修改来减少哮喘发病率 该提案的目的是对早期生命环境进行流行病学调查。 因素，重点是宠物暴露和内毒素，可能会改变免疫发育，基于 前提是对环境刺激的早期免疫反应的变化会影响哮喘的风险。 过去 100 年来，人类接触动物（大概还有内毒素）的数量有所下降 城市化和郊区化，尽管人类是在与动物密切接触的情况下进化的。 作为正在进行的研究的一部分，韦恩县健康、环境、过敏和哮喘纵向调查 研究（WHEALS），招募了一组多种族孕妇进行前瞻性研究 通过此次更新，我们将把 1248 名不同种族的儿童的随访范围扩大到 5-6 岁。 我们将使用 WHEALS 队列来 1) 评估是否有宠物接触和家庭。 内毒素水平影响总的和过敏原特异性的 IgE 和细胞外细胞因子（IL4、IL5、IL13、IFN？、IL2、IL12、 在婴儿期的 4 个时间点（出生、6 个月、12 个月和 2 年）以及 2）这些暴露和免疫学模式与 最后，我们将分析数据以评估 Black 的作用。 种族在早期环境暴露和免疫生物标志物之间的关系中发挥着作用 哮喘，在考虑了其他不可改变和可改变的危险因素（包括 CD14 基因型、家庭）后 历史、儿童性别、出生顺序、出生特征、社会地位以及其他社会、行为和 如果与动物或内毒素接触相关的因素与哮喘风险相关，例如 这些因素可能有助于公共卫生干预措施。