Childhood asthma, particularly in urban environments, is a source of significant morbidity. Children spend the majority of their day in school. The immediate goal of this project is to determine the role of changes in school- specific environmental exposures and molecular biomarkers and asthma morbidity. The Candidate/PI is a physician scientist with expertise in patient oriented research and runs a fully NIH funded asthma/allergy clinical research center. Since this K-24 was awarded 4 years ago she has been extremely successful in mentoring by supporting 5 funded K-23 awards and expanding her program with her role as PI on 2 new U01s and 1 R01 with multiple other NIH funded clinical collaborations. This renewal is critical to maintaining this level of productivity and mentoring of the next generation of patient-oriented researchers. Her environment includes unparalleled community relationships, infrastructure, resources, and collaborators. Career Development Goals are to ensure that the candidate will be provided sufficient time for mentoring and patient oriented clinical research activities. The award will also allow her to further her education in statistical methods, study design, molecular biology, phenotype and endotype driven biomarker precision medicine, and environment interactions to help her expand her patient oriented research program. This will allow us to move towards our overall goal of further our understanding of molecular underpinnings in predicting treatment response and disease pathophysiology, which will allow her to develop and design interventions to reduce the severity and incidence of childhood asthma. The research hypothesis is that changes in classroom/school specific allergen/pollution levels will be associated with molecular extracellular vesicle (EV) changes and asthma morbidity. We will use a two stage validation approach to compare number, size, and miRNA cargo in saliva are associated with classroom levels of allergens and particulate pollutants and modified by the NIAID SICAS-2 school/classroom based environmental intervention and asthma health outcomes and compare them with data archived from SICAS-1 (our NIAID observational cohort). We will also compare these results in a subset of age/gender matched students without asthma as controls (the NHLBI funded EASY cohort) attending the same classrooms to further the interpretation of our findings utilizing state of the art techniques. The impact of this research may result in novel biomarkers that could inform us about the efficacy of school-based interventions against environmental exposures important to childhood asthma and its immune modulation, addressing a critical public health problem.

Public Health Relevance

/ Public Health Relevance Statement We aim to determine the role of changes in school-specific environmental exposures and genetic/epigenetic and other molecular biology factors and asthma morbidity. By furthering our understanding of mechanisms behind modifiable epigenetic/environmental risk factors, we may be able to design and implement more cost and time efficient school-based environmental interventions that may potentially help a community of children with asthma, allergic diseases, and its associated morbidity.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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Allergy, Immunology, and Transplantation Research Committee (AITC)
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Gondre-Lewis, Timothy A
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Boston Children's Hospital
United States
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Kantor, David B; Petty, Carter R; Phipatanakul, Wanda et al. (2018) Transcutaneous CO-oximetry differentiates asthma exacerbation and convalescence in children. J Allergy Clin Immunol 142:676-678.e5
Lai, Peggy S; Kolde, Raivo; Franzosa, Eric A et al. (2018) The classroom microbiome and asthma morbidity in children attending 3 inner-city schools. J Allergy Clin Immunol 141:2311-2313
Permaul, Perdita; Phipatanakul, Wanda (2018) School Environmental Intervention Programs. J Allergy Clin Immunol Pract 6:22-29
Lai, Peggy S; Massoud, Amir H; Xia, Mingcan et al. (2018) Gene-environment interaction between an IL4R variant and school endotoxin exposure contributes to asthma symptoms in inner-city children. J Allergy Clin Immunol 141:794-796.e3
Naja, Ahmad Salaheddine; Permaul, Perdita; Phipatanakul, Wanda (2018) Taming Asthma in School-Aged Children: A Comprehensive Review. J Allergy Clin Immunol Pract 6:726-735
Esty, Brittany; Phipatanakul, Wanda (2018) School exposure and asthma. Ann Allergy Asthma Immunol 120:482-487
Kantor, David B; Phipatanakul, Wanda; Hirschhorn, Joel N (2018) Gene-Environment Interactions Associated with the Severity of Acute Asthma Exacerbation in Children. Am J Respir Crit Care Med 197:545-547
Cardet, Juan Carlos; Louisias, Margee; King, Tonya S et al. (2018) Income is an independent risk factor for worse asthma outcomes. J Allergy Clin Immunol 141:754-760.e3
Louisias, Margee; Wright, Lakiea; Phipatanakul, Wanda (2018) Asthma in the melting pot. Ann Allergy Asthma Immunol :
Kantor, David B; Hirshberg, Eliotte L; McDonald, Molly C et al. (2018) Fluid Balance Is Associated with Clinical Outcomes and Extravascular Lung Water in Children with Acute Asthma Exacerbation. Am J Respir Crit Care Med 197:1128-1135

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