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.

Agency
National Institute of Health (NIH)
Institute
National Institute of Environmental Health Sciences (NIEHS)
Type
Specialized Center (P50)
Project #
2P50ES018176-06
Application #
8989736
Study Section
Special Emphasis Panel (ZES1)
Project Start
Project End
Budget Start
2015-09-30
Budget End
2016-06-30
Support Year
6
Fiscal Year
2015
Total Cost
Indirect Cost
Name
Johns Hopkins University
Department
Type
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21205
Fricke, Kathrin; Vieira, Marcela; Younas, Haris et al. (2018) High fat diet induces airway hyperresponsiveness in mice. Sci Rep 8:6404
Levy, Jonathan I; Quirós-Alcalá, Lesliam; Fabian, M Patricia et al. (2018) Established and Emerging Environmental Contributors to Disparities in Asthma and Chronic Obstructive Pulmonary Disease. Curr Epidemiol Rep 5:114-124
Galiatsatos, Panagis; Kineza, Cynthia; Hwang, Seungyoun et al. (2018) Neighbourhood characteristics and health outcomes: evaluating the association between socioeconomic status, tobacco store density and health outcomes in Baltimore City. Tob Control 27:e19-e24
Wu, Tianshi David; Eakin, Michelle N; Rand, Cynthia S et al. (2018) In-Home Secondhand Smoke Exposure Among Urban Children With Asthma: Contrasting Households With and Without Residential Smokers. J Public Health Manag Pract :
Brigham, Emily P; Steffen, Lyn M; London, Stephanie J et al. (2018) Diet Pattern and Respiratory Morbidity in the Atherosclerosis Risk in Communities Study. Ann Am Thorac Soc 15:675-682
Rice, Jessica L; Brigham, Emily; Dineen, Rebecca et al. (2018) The feasibility of an air purifier and secondhand smoke education intervention in homes of inner city pregnant women and infants living with a smoker. Environ Res 160:524-530
Wu, Tianshi David; Brigham, Emily P; Peng, Roger et al. (2018) Overweight/obesity enhances associations between secondhand smoke exposure and asthma morbidity in children. J Allergy Clin Immunol Pract 6:2157-2159.e5
Davis, Meghan F; Ludwig, Shanna; Brigham, Emily P et al. (2018) Effect of home exposure to Staphylococcus aureus on asthma in adolescents. J Allergy Clin Immunol 141:402-405.e10
Pham, Luu V; Miele, Catherine H; Schwartz, Noah G et al. (2017) Cardiometabolic correlates of sleep disordered breathing in Andean highlanders. Eur Respir J 49:
Pham, Luu V; Meinzen, Christopher; Arias, Rafael S et al. (2017) Cross-Sectional Comparison of Sleep-Disordered Breathing in Native Peruvian Highlanders and Lowlanders. High Alt Med Biol 18:11-19

Showing the most recent 10 out of 38 publications