This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.The prevalence of asthma has increased in many parts of the world. Evidence exists that children living in the inner cities of the United States, and living under economic disadvantages, constitute a unique and special at-risk population for asthma, which is characterized by increased morbidity and morality (Akinbami et al, 2002; Cloutier et al, 2002).The objectives of the National Institutes of Allergy and Infectious Diseases Inner City Asthma Consortium (ICAC) are (1) to identify forms of immune-based therapy that are likely to promote control and prevention of asthma, (2) to design protocols that will evaluate immune-based therapies in the treatment of asthma in low-income inner-city adolescents, and (3) to determine both the mechanisms of immune-based therapies and the potential unique mechanisms associated with the pathogenesis of asthma in low-income inner-city adolescents by the conduct of parallel mechanistic investigations with the therapeutic protocols.The availability of biomarkers in the clinical management of asthma presents presents an opportunity to apply this measurement to a specific subpopulation of patients who remain refractory to the conventional approach to asthma management. The population of urban, inner-city adolescents with asthma is a particularly susceptible group who are subject to a severe degree of morbidity. The potential application of biomarker measurement in the form of exhaled nitric oxide presents an opportunity to manage and control asthma as an adjunct to NAEPP guidelines. The ICAC therefore has conducted a randomized, prospective, double-blind parallel group trial involving inner city adolescents, ages 12-20 years, with persistent asthma.
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