Asthma and obesity are public health crises that have concurrently arisen over the past decades, affecting millions of children in the US and disproportionately affecting low-income minority children in urban areas. The same children at highest risk for asthma and obesity also have greater exposure to pollution. Emerging evidence suggests that these three factors ?asthma, obesity, and pollution? may be causally linked. Recent observational studies have found that obesity confers susceptibility to pulmonary effects of particulate matter (PM), including our own showing overweight Baltimore children with asthma have greater respiratory response to indoor PM versus lean children. There is a need to confirm these observational findings with causal-level evidence, including experimental evidence of the effect of being overweight on PM susceptibility and identification of plausible mediators of this effect. To provide experimental evidence, project 1 will conduct a randomized, clinical trial of an air purifier intervention to address our overarching hypothesize that overweight children are more susceptible to PM compared to lean children. Portable air purifiers have been used successfully in clinical trials of inner-city children, reduce indoor PM by ?50%, and reduce asthma symptoms. Moreover, air purifiers are a highly feasible, inexpensive intervention that can be implemented immediately to modify indoor environments. To define plausible mediators of effect, we will investigate four leading hypotheses that increases in 1) tidal volume and thereby increases in particulate dose to the lungs 2) systemic inflammation and oxidative stress that may result in exaggerated responses to pro-inflammatory PM exposure 3) glucocorticoid resistance which may dampen the protective effect of inhaled steroids 4) risk of obstructive sleep apnea (OSA), a comorbidity recently linked to PM exposure that is also associated with worsening of asthma symptoms, enhance susceptibility to PM among overweight versus lean children. The study findings will be critical to future revisions of air quality standards and have high potential to impact policy by defining a new sensitive population to pollution health effects. Further, our findings will immediately impact asthma clinical practice guidelines by providing evidence to support a highly feasible intervention for the highest risk subpopulation of children with asthma, a population easily identifiable by height and weight measurements. Moreover, as our target population is low-income, minority children, our findings will have implications for those most affected by both obesity and asthma.

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National Institute of Environmental Health Sciences (NIEHS)
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Johns Hopkins University
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Javaheri, Shahrokh; Barbe, Ferran; Campos-Rodriguez, Francisco et al. (2017) Sleep Apnea: Types, Mechanisms, and Clinical Cardiovascular Consequences. J Am Coll Cardiol 69:841-858
Nnodum, Benedicta Nneoma; McCormack, Meredith C; Putcha, Nirupama et al. (2017) Impact of Physical Activity on Reporting of Childhood Asthma Symptoms. Lung 195:693-698
Gu, Chenjuan; Younas, Haris; Jun, Jonathan C (2017) Sleep apnea: An overlooked cause of lipotoxicity? Med Hypotheses 108:161-165
Jun, Jonathan C; Devera, Ronald; Unnikrishnan, Dileep et al. (2017) Adipose HIF-1? causes obesity by suppressing brown adipose tissue thermogenesis. J Mol Med (Berl) 95:287-297
Peters, Kamau O; Williams, D' Ann L; Abubaker, Salahadin et al. (2017) Predictors of polycyclic aromatic hydrocarbon exposure and internal dose in inner city Baltimore children. J Expo Sci Environ Epidemiol 27:290-298
Shin, Mi-Kyung; Han, Woobum; Joo, Hoon et al. (2017) Effect of adrenal medullectomy on metabolic responses to chronic intermittent hypoxia in the frequently sampled intravenous glucose tolerance test. J Appl Physiol (1985) 122:767-774
Fleury Curado, Thomaz; Fishbein, Kenneth; Pho, Huy et al. (2017) Chemogenetic stimulation of the hypoglossal neurons improves upper airway patency. Sci Rep 7:44392
McCormack, Meredith C; Belli, Andrew J; Waugh, Darryn et al. (2016) Respiratory Effects of Indoor Heat and the Interaction with Air Pollution in Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc 13:2125-2131
Belli, Andrew J; Bose, Sonali; Aggarwal, Neil et al. (2016) Indoor particulate matter exposure is associated with increased black carbon content in airway macrophages of former smokers with COPD. Environ Res 150:398-402
Lu, Kim D; Phipatanakul, Wanda; Perzanowski, Matthew S et al. (2016) Atopy, but not obesity is associated with asthma severity among children with persistent asthma. J Asthma 53:1033-44

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