? The candidate for this K23 Career Development Award is a pediatric gastroenterologist who specializes in esophageal physiology. The candidate's long-term career goal is to have an academic research career in pediatric gastroenterology that improves the health of children through the study of reflux-related respiratory diseases. Short-term career goals to be achieved with this award include: (1) to obtain formal training in advanced statistics and epidemiology; (2) to gain additional expertise in the use of multi-channel intraluminal impedance (pH-MII), an emerging tool for measuring gastroesophageal reflux (GER); (3) to deepen the candidate's knowledge of the relationship between GER and respiratory disease; and (4) to acquire the valuable mentorship required to ensure the candidate's progress toward becoming a R01-funded clinical investigator. ? The candidate's primary mentor, Dr. David Christiani, has a strong background in pulmonology and epidemiology that forms the basis for his studies of the cause-and-effect relationships between toxins and respiratory disease. The candidate's multidisciplinary mentorship team also includes faculty members with expertise in pediatric pulmonology, otolaryngology, gastroenterology, and statistics. Training activities include coursework in advanced statistics and epidemiology; participation in clinical research conferences; and didactic instruction from mentors. ? This application outlines the first pediatric study to determine the role of non-acid reflux in respiratory disease using two novel technologies: pH-MII and esophageal manometry with impedance. Through cross-sectional and cohort studies of children, the candidate will determine (1) the temporal relationship between non-acid reflux and respiratory symptoms; (2) the strength of association and the dose-response relationship between non-acid reflux and markers of reflux-related respiratory disease; and (3) the strength of association and the dose-response relationship between non-acid reflux and the severity of respiratory disease. Findings from this research may lead to a paradigmatic shift from acid reflux to non-acid reflux as a cause of respiratory disease. Findings from this study also may lead to improved strategies for diagnosing and treating respiratory diseases, which already account for significant morbidity in children. ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DK073713-02
Application #
7342470
Study Section
Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
Program Officer
Podskalny, Judith M,
Project Start
2007-02-01
Project End
2012-01-31
Budget Start
2008-02-01
Budget End
2009-01-31
Support Year
2
Fiscal Year
2008
Total Cost
$128,849
Indirect Cost
Name
Children's Hospital Boston
Department
Type
DUNS #
076593722
City
Boston
State
MA
Country
United States
Zip Code
02115
Rosen, Rachel; Hu, Lan; Amirault, Janine et al. (2015) 16S community profiling identifies proton pump inhibitor related differences in gastric, lung, and oropharyngeal microflora. J Pediatr 166:917-23
Rosen, Rachel; Amirault, Janine; Giligan, Emily et al. (2014) Intraesophageal pressure recording improves the detection of cough during multichannel intraluminal impedance testing in children. J Pediatr Gastroenterol Nutr 58:22-6
Rosen, Rachel; Amirault, Janine; Johnston, Nikki et al. (2014) The utility of endoscopy and multichannel intraluminal impedance testing in children with cough and wheezing. Pediatr Pulmonol 49:1090-6
Rosen, R; Amirault, J; Heinz, N et al. (2014) The sensitivity of acoustic cough recording relative to intraesophageal pressure recording and patient report during reflux testing. Neurogastroenterol Motil 26:1635-41
Rosen, Rachel; Amirault, Janine; Liu, Hongye et al. (2014) Changes in gastric and lung microflora with acid suppression: acid suppression and bacterial growth. JAMA Pediatr 168:932-7
Palm, Kara; Sawicki, Gregory; Rosen, Rachel (2012) The impact of reflux burden on Pseudomonas positivity in children with cystic fibrosis. Pediatr Pulmonol 47:582-7
Rodriguez, Leonel; Rosen, Rachel; Manfredi, Michael et al. (2012) Endoscopic intrapyloric injection of botulinum toxin A in the treatment of children with gastroparesis: a retrospective, open-label study. Gastrointest Endosc 75:302-9
Rosen, R; Johnston, N; Hart, K et al. (2012) The presence of pepsin in the lung and its relationship to pathologic gastro-esophageal reflux. Neurogastroenterol Motil 24:129-33, e84-5
Chiou, Eric; Rosen, Rachel; Nurko, Samuel (2011) Effect of different pH criteria on dual-sensor pH monitoring in the evaluation of supraesophageal gastric reflux in children. J Pediatr Gastroenterol Nutr 52:399-403
Rosen, Rachel; Johnston, Nikki; Hart, Kristen et al. (2011) Higher rate of bronchoalveolar lavage culture positivity in children with nonacid reflux and respiratory disorders. J Pediatr 159:504-6

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