Friday, April 25, 2025
4/25/2025
Factors Influencing Pediatric Asthma into Adulthood (FIPA2) - A. Summary of Funded Parent Grant: Factors Influencing Pediatric Asthma into Adulthood (R01MD019027) The prevalence of asthma among American Indian (AI) children is 9.3% as compared to 5.5% in non- Hispanic White children. Asthma disparities become even more pronounced into adulthood, with AI adults having the highest prevalence of asthma as compared to all other racial/ethnic groups in the US, with 60% uncontrolled. Asthma is influenced by social and environmental factors (SEF) including adverse childhood events (ACEs), tobacco smoke, and everyday life stressors that may alter immunological state. ACEs in particular, including abuse, neglect, and household challenges have been associated with immune dysregulation, may have implications for clinical outcomes of respiratory viral infections in children that have been linked to asthma and persistent respiratory symptoms. For example, Infants who develop severe RSV bronchiolitis in the first year of life are more likely to develop asthma, and children with asthma are at increased risk of experiencing complications from respiratory viral infections due to SARS-CoV-2, respiratory syncytial virus (RSV), influenza, and rhinovirus C. In the Factors Influencing Pediatric Asthma (FIPA) study including children from a Northern Plains American Indian community, we found children with asthma experienced an increased clinical burden from RSV infection and had lower levels of serum RSV-specific Immunoglobulin G (IgG) than children without asthma, indicative of immune suppression or dysfunction. However, the complex interplay between social, environmental and immunological response to viral respiratory infections remains largely unknown, and these factors have not been investigated among AI children with respect to their influence on immunological response and asthma development and control of asthma symptoms. In this continued AI community-focused study, we will test the hypothesis that social and environmental factors contribute to asthma susceptibility through stress-induced immune dysregulation, including the alteration of immunological response to viral respiratory infections. We will also investigate the role of viral respiratory infections and SEF on asthma control, including frequency of symptoms, exacerbations, ER visits/hospitalizations, and use of asthma medications. Aim 1: Identify social and environmental factors (SEF) that contribute to asthma susceptibility, asthma control, and long-term respiratory health in American Indian children. We will follow-up on our previously NIMHD-funded case/control study of 324 children recruited between the ages of 6-17 from 2013- 2017 as they transition into adulthood (now ages 11-27). We will recontact original study participants, evaluating their current asthma status to investigate the role of age and gender on long-term respiratory health including current asthma and asthma control. We will also expand our study to 400 new participants with and without asthma between the ages of 6-17, including Tribal members living in Rapid City, SD, and offspring of original study participants (~30% of original study participants have since become parents). We will obtain detailed measures of SEF, and retrospective information on adverse childhood events (ACE) using an established screener to evaluate their role in asthma susceptibility and asthma control, including comparisons between urban vs. rural and multi-generational effects in this community-engaged study. We hypothesize that domains of biological and behavioral influences acting on the individual and interpersonal levels generate social stress and have an impact on asthma development and control. Aim 2: Investigate the role of SEF on immunological response to viral respiratory infections (VRIs) in AI children with and without asthma. We will investigate the impact of social and environmental factors measured using validated and Tribally-developed surveys on the immune system of AI children with
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