NIAID, NIEHS, NHLBI, and MCAN Workshop Report: The indoor environment and childhood asthma-implications for home environmental intervention in asthma prevention and management

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:140

Article

Gold, Diane R.¹  Adamkiewicz, Gary²  Arshad, Syed Hasan^3,4  Celedon, Juan C.⁵  Chapman, Martin D.⁶  Chew, Ginger L.⁷  Cook, Donald N.⁸  Custovic, Adnan^11,12  Gehring, Ulrike¹³  Gern, James E.^14,15  Johnson, Christine C.¹⁶  Kennedy, Suzanne¹⁷  Koutrakis, Petros²  Leaderer, Brian¹⁸  Mitchell, Herman¹⁹  Litonjua, Augusto A.¹  Mueller, Geoffrey A.⁹  O'Connor, George T.²⁰  Ownby, Dennis²¹  Phipatanakul, Wanda²²  Persky, Victoria²³  Perzanowski, Matthew S.²⁴  Ramsey, Clare D.^25,26  Salo, Paivi M.¹⁰  Schwaninger, Julie M.²⁷  Sordillo, Joanne E.¹  Spira, Avrum²⁸  Suglia, Shakira F.²⁹  Togias, Alkis²⁷  Zeldin, Darryl C.¹⁰  Matsui, Elizabeth C.³⁰ 

[1] Harvard Med Sch, Brigham & Womens Hosp, Channing Div Network Med, Boston, MA USA

[2] Harvard TH Chan Sch Publ Hlth, Dept Environm Hlth, Boston, MA USA

[3] David Hide Asthma & Allergy Res Ctr, Isle Of Wight, England

[4] Univ Southampton, Fac Med, Clin & Expt Sci, Southampton, Hants, England

[5] Univ Pittsburgh, Med Ctr, Childrens Hosp Pittsburgh, Div Pulm Med Allergy & Immunol, Pittsburgh, PA USA

[6] Indoor Biotechnol, Charlottesville, VA USA

[7] Air Pollut & Resp Hlth Branch, Div Environm Hazards & Hlth Effects, Natl Ctr Environm Hlth, Ctr Dis Control & Prevent CDC, Atlanta, GA USA

[8] NIEHS, Immun Inflammat & Dis Lab, NIH, POB 12233, Res Triangle Pk, NC 27709 USA

[9] NIEHS, Genome Integr & Struct Biol Lab, NIH, POB 12233, Res Triangle Pk, NC 27709 USA

[10] NIEHS, Div Intramural Res, NIH, POB 12233, Res Triangle Pk, NC 27709 USA

[11] Imperial Coll London, Sect Paediat, London, England

[12] Imperial Coll London, MRC & Asthma UK Ctr Allerg Mech Asthma, London, England

[13] Univ Utrecht, Inst Risk Assessment Sci, Utrecht, Netherlands

[14] Univ Wisconsin, Sch Med & Publ Hlth, Dept Pediat, Madison, WI 53706 USA

[15] Univ Wisconsin, Sch Med & Publ Hlth, Dept Med, Madison, WI 53706 USA

[16] Henry Ford Hosp & Hlth Syst, Dept Publ Hlth Sci, Detroit, MI USA

[17] Univ N Carolina, Dept Pediat, NC Childrens Hosp, Chapel Hill, NC USA

[18] Yale Sch Med, Yale Sch Forestry & Environm Studies, Yale Sch Publ Hlth, Ctr Perinatal Pediat & Environm Epidemiol CPPEE, New Haven, CT USA

[19] Rho Inc, Rho Fed Syst Div, Chapel Hill, NC USA

[20] Boston Univ, Sch Med, Ctr Pulm, Boston, MA 02118 USA

[21] Augusta Univ, Dept Pediat, Div Allergy Immunol & Rheumatol, Augusta, GA USA

[22] Harvard Med Sch, Boston Childrens Hosp, Asthma Allergy & Immunol, Boston, MA USA

[23] Univ Illinois, Sch Publ Hlth, Div Epidemiol & Biostat, Chicago, IL USA

[24] Columbia Univ, Dept Environm Hlth Sci, Mailman Sch Publ Hlth, New York, NY USA

[25] Univ Manitoba, Rady Fac Hlth Sci, Dept Med, Winnipeg, MB, Canada

[26] Univ Manitoba, Rady Fac Hlth Sci, Dept Community Hlth Sci, Winnipeg, MB, Canada

[27] NIAID, Div Allergy Immunol & Transplantat, NIH, Rockville, MD USA

[28] Boston Univ, Dept Med, Div Computat Biomed, Boston, MA USA

[29] Emory Univ, Rollins Sch Publ Hlth, Dept Epidemiol, Atlanta, GA 30322 USA

[30] Johns Hopkins Univ, Div Pediat Allergy Immunol, Baltimore, MD USA

关键词: Asthma;    allergy;    child health;    indoor allergens;    pollutants;    environmental intervention;    clinical trials;   

DOI  :  10.1016/j.jaci.2017.04.024

来源: Elsevier

【 摘 要 】

Environmental exposures have been recognized as critical in the initiation and exacerbation of asthma, one of the most common chronic childhood diseases. The National Institute of Allergy and Infectious Diseases; National Institute of Environmental Health Sciences; National Heart, Lung, and Blood Institute; and Merck Childhood Asthma Network sponsored a joint workshop to discuss the current state of science with respect to the indoor environment and its effects on the development and morbidity of childhood asthma. The workshop included US and international experts with backgrounds in allergy/allergens, immunology, asthma, environmental health, environmental exposures and pollutants, epidemiology, public health, and bioinformatics. Workshop participants provided new insights into the biologic properties of indoor exposures, indoor exposure assessment, and exposure reduction techniques. This informed a primary focus of the workshop: to critically review trials and research relevant to the prevention or control of asthma through environmental intervention. The participants identified important limitations and gaps in scientific methodologies and knowledge and proposed and prioritized areas for future research. The group reviewed socioeconomic and structural challenges to changing environmental exposure and offered recommendations for creative study design to overcome these challenges in trials to improve asthma management. The recommendations of this workshop can serve as guidance for future research in the study of the indoor environment and on environmental interventions as they pertain to the prevention and management of asthma and airway allergies.

【 授权许可】

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