The NIAID/LAD Pediatric Allergy Clinic and associated protocol was initiated primarily to provide residents in the NIAID Allergy and Immunology Clinical Fellowship Program with medical training and continuity clinic experience in pediatric allergic diseases to fulfill the requirements set forth by the ACGME for training standards and program accreditation. The allergic diseases studied included asthma, allergic rhinitis, food allergy, atopic dermatitis and urticaria. During the past fiscal year, approximately 100 patient care visits were logged. Research blood was obtained to evaluate markers of allergic disease. In particular, serum tryptase levels were measured in 197 (44 non-atopic and 153 atopic) clinic patients and used to establish normative serum reference tryptase values in children. The data derived from the comprehensive evaluation of children with atopic disease may be used in the future for longitudinal analysis to make disease-associated correlations that could be shared with the medical community and thus generate a foundation of ideas for conducting focused intervention studies. In addition to standard diagnostic testing for allergic diseases, which includes skin prick testing, radioallergosorbent (RAST) testing, patch testing and pulmonary function testing, the clinic has integrated other modalities in the evaluation of children with allergic diseases. To evaluate lung function we have employed impulse oscillometry, a non-invasive, non-effort dependant technique that measures lung resistance and elasticity. This is being used in conjunction with standard pulmonary function testing in older children and by itself in infants as young as two years old. A manuscript reviewing the clinical application of impulse oscillometry in pediatric patients with asthma has been submitted for publication. In addition, a manuscript comparing the utility of spirometry and impulse oscillometry in the evaluation of children with asthma is being prepared for submission. Due to changes in both LAD staff and training opportunities at off-site locations for the A&I program fellows that meet the ACGME requirements, as well as decreasing accrual numbers, it was decided that the protocol supporting the NIAID/LAD Pediatric Allergy Clinic should be terminated. The protocol was officially closed in August of this year and this project will be terminated in the Annual Reports system next fiscal year.
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