The candidate is a physician-epidemiologist who focuses on the interaction of environmental factors, specifically viral infections in early childhood, and how they contribute to the development of asthma. The candidate will increase her knowledge of asthma, atopy, and epidemiology by attending courses in immunology, microbiology and epidemiology, and by attending clinical conferences. The candidate will conduct the proposed research under the guidance of mentors and an advisory committee who have expertise in all areas related to the project. The goals of this proposal are to train the candidate to do prospective and retrospective epidemiologic investigations, and specifically to investigate the role of bronchiolitis during infancy and the development of asthma. Observational studies have reported that over 30% of hospitalized infants with Respiratory Syncytial Virus (RSV) bronchiolitis subsequently develop asthma. However, it is not known whether the severity or viral etiology of bronchiolitis is associated with increased asthma risk. Neither is it known how two risk factors for asthma, familial predisposition to develop asthma and environmental tobacco smoke [ETS], interact with bronchiolitis to affect asthma risk. The candidate will test the hypothesis that (a) clinically significant bronchiolitis of any severity is associated with increased risk of developing asthma, with more severe bronchiolitis associated with greater asthma risk and that (b) RSV vs. non-RSV respiratory viruses confer different risks on the development of childhood asthma, and that (c) familial-environment interactions modify the risk of developing asthma.
In Specific Aim #1, the candidate will conduct a retrospective population-based cohort study using Tennessee Medicaid data to determine the association of bronchiolitis of RSV and non-RSV etiology, including inpatient and outpatient care, with asthma at age 5 years.
In Specific Aim #2, the candidate will extend follow-up to age 5 years of an ongoing prospective cohort (Atopy-Bronchiolitis Cohort) of infants with either a hospitalization or outpatient visit for bronchiolitis during infancy to determine whether viral etiology and bronchiolitis severity are independently associated with asthma development. Findings will identify infants who are at the greatest risk for developing asthma, what modifiable factors interact with bronchiolitis to increase the risk, and thus guide the future application and evaluation of preventive or treatment measures during infancy.
|Wu, Pingsheng; Larkin, Emma K; Reiss, Sara S et al. (2015) ?2-Adrenergic receptor promoter haplotype influences the severity of acute viral respiratory tract infection during infancy: a prospective cohort study. BMC Med Genet 16:82|
|Vereen, Shanda; Gebretsadik, Tebeb; Hartert, Tina V et al. (2014) Association between breast-feeding and severity of acute viral respiratory tract infection. Pediatr Infect Dis J 33:986-8|
|Miller, E Kathryn; Gebretsadik, Tebeb; Carroll, Kecia N et al. (2013) Viral etiologies of infant bronchiolitis, croup and upper respiratory illness during 4 consecutive years. Pediatr Infect Dis J 32:950-5|
|Lemke, Meghan; Hartert, Tina V; Gebretsadik, Tebeb et al. (2013) Relationship of secondhand smoke and infant lower respiratory tract infection severity by familial atopy status. Ann Allergy Asthma Immunol 110:433-7|
|Carroll, Kecia N; Gebretsadik, Tebeb; Minton, Patricia et al. (2012) Influence of maternal asthma on the cause and severity of infant acute respiratory tract infections. J Allergy Clin Immunol 129:1236-42|
|Wu, Pingsheng; Carroll, Kecia N; Gebretsadik, Tebeb et al. (2012) The developmental trajectory of pediatric asthma in 3- to-10-year-olds. J Allergy Clin Immunol 129:1397-8|
|Miller, E Kathryn; Williams, John V; Gebretsadik, Tebeb et al. (2011) Host and viral factors associated with severity of human rhinovirus-associated infant respiratory tract illness. J Allergy Clin Immunol 127:883-91|
|Carroll, Kecia N; Gebretsadik, Tebeb; Larkin, Emma K et al. (2011) Relationship of maternal vitamin D level with maternal and infant respiratory disease. Am J Obstet Gynecol 205:215.e1-7|
|Valet, Robert S; Gebretsadik, Tebeb; Carroll, Kecia N et al. (2011) High asthma prevalence and increased morbidity among rural children in a Medicaid cohort. Ann Allergy Asthma Immunol 106:467-73|
|Hartert, Tina V; Carroll, Kecia; Gebretsadik, Tebeb et al. (2010) The Tennessee Children's Respiratory Initiative: Objectives, design and recruitment results of a prospective cohort study investigating infant viral respiratory illness and the development of asthma and allergic diseases. Respirology 15:691-9|
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