Asthma disproportionately affects inner-city children. Asthma morbidity in the inner-city is likely multifactorial with environmental exposures playing a critical role. Inner city populations are vulnerable to sleep disturbances;however, the relationship between sleep disordered breathing (SDB) and asthma morbidity has not been thoroughly investigated in inner city asthmatics. The primary objective of this study is to investigate the effect of SDB on asthma morbidity. We hypothesize that SDB will be independently related to increased asthma morbidity. The secondary objective of this study is to determine the differential effect of home and school environmental exposures (including common aeroallergens [dust mite, cat, dog, mouse, cockroach, and mold], endotoxin, and air pollution [black carbon and nitrogen dioxide]) on SDB and asthma morbidity. There is a paucity of studies that have examined the role of environmental exposures on the complex associations of SDB and asthma morbidity. We hypothesize that school based exposures will independently contribute to SDB and asthma morbidity. This study is unique because we will be among the first to examine the effect of school/classroom specific environmental exposures on SDB and asthma morbidity. To test these hypotheses, we will evaluate the children enrolled in an established cohort, the Allergens in Inner-City Schools and Childhood Asthma (Dr. Wanda Phipatanakul, PI, NIAID R-01-AI-073964), for SDB (using wrist actigraphy and pulse oximetry). This proposal details a one year project to provide Dr. Wright with training and expertise in the assessment of environmental exposures and its effects on SDB and asthma morbidity with a specific focus on the school environment of inner city asthmatics. Dr. Wright will work under the mentorship of Dr. Phipatanakul, an expert in asthma and environmental epidemiology, in addition to an extraordinary team of researchers, including Drs. Joshua Boyce (with expertise in asthma), Susan Redline (with expertise in sleep medicine), and Brent Coull (with expertise in environmental statistical modeling), who have committed their time and resources to facilitate Dr. Wright's career development and the successful completion of the proposed project. As part of the research training program, Dr. Wright will complete a Master of Public Health with a concentration in environmental health in order to acquire the necessary epidemiologic and bio-statistical skills to become a successful independent junior investigator.

Public Health Relevance

Asthma disproportionately affects children in the inner-city. Environmental exposures specific to the inner-city are known to play a critical role in triggering asthma in the home;however, little is known about the home. Inner-city populations are also vulnerable to sleep disturbances. However, the relationship between sleep disordered breathing and asthma is poorly understood. The purpose of this study is to determine the differential effect of home and school/classroom environmental exposures on sleep disordered breathing and asthma morbidity in an inner-city school aged cohort. This research will provide important information that may be used in designing public health intervention trials or shape public policy to improve the health of inner city children with asthma.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Postdoctoral Individual National Research Service Award (F32)
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Special Emphasis Panel (ZRG1)
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Tigno, Xenia
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Brigham and Women's Hospital
United States
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Wright, Lakiea S; Phipatanakul, Wanda (2016) Treatment of moderate to severe pediatric asthma: Omalizumab and potential future use of monoclonal antibodies. Ann Allergy Asthma Immunol 117:17-20