Investigators supported by the National Institute of Allergy and Infectious Diseases (NIAID) and the National Institute of Environmental Health Sciences (NIEHS) are recruiting children with moderate to severe asthma for a large nationwide multicenter study.

The study, in seven sites in inner cities across the United States, aims to reduce the severity of asthma among low-income children. Participating research institutions are located in Boston, Mass.; Chicago, Ill.; Dallas, Texas; New York, N.Y. (Bronx and Manhattan); Seattle, Wash.; and Tucson, Ariz.

Asthma has been increasing in the United States over several decades. This increase is most apparent among children, especially those living in inner cities. Approximately 15 million Americans suffer from asthma. Annually, in the United States about 500,000 asthma-related hospitalizations occur and 5,000 people die.

Anthony S. Fauci, M.D., NIAID director, says, "This study affirms our commitment to learn more about how to reduce asthma in our inner-city pediatric populations, children primarily of African American and Hispanic heritage. Our goal is to aid children and their families by providing valuable insights on managing a child’s asthma through education, environmental controls and behavior modification."

NIEHS Director Kenneth Olden, Ph.D., adds, "We want to enable inner-city families to help their kids avoid asthma attacks by modifying their environment. That means reducing the allergens – the things the youngsters are allergic to – with such things as plastic covers on their pillows and mattresses, air filters, and the elimination of mold and insects."

Focusing on more than 1,000 children between the ages of 4 and 12 with moderate to severe asthma, the study will test the effectiveness of two interventions. One intervention entails a novel communication/physician education system in which patient information on asthma severity, medication use and health care utilization, obtained through bimonthly phone interviews, will be interpreted according to the asthma care guidelines developed by the National Asthma Education and Prevention Program. This information will be provided to the asthma patients’ primary care physicians, and the study will evaluate the value of this exchange in improving medical care.

The other intervention involves educating families about reducing indoor allergens and passive cigarette smoke, which may trigger asthma attacks. In addition, extensive allergen reduction measures will be undertaken at no cost to participating families. These measures will include professional cockroach extermination; extensive and repeated cleaning; repair of cracks and pest entry points; encasing of mattresses and pillows in dust-proof or allergen-proof covers (zippered plastic); and using air filters to reduce airborne allergens, including allergens from household pets (such as cats and dogs) and fungal allergens. Follow-up home evaluations will assess the impact of the intervention on the levels of indoor allergens. The effectiveness of the intervention will be assessed by its capacity to reduce the severity of asthma in these children.

In addition to NIAID and NIEHS, this study is supported by the National Institutes of Health (NIH) Pediatric Research Initiative. NIH is an agency of the U.S. Department of Health and Human Services.

NIAID, a component of NIH located in Bethesda, Md., conducts and supports research aimed at preventing, diagnosing and treating illnesses such as AIDS and other sexually transmitted diseases, tuberculosis, asthma and allergies.

NIEHS, another component of NIH in Research Triangle Park, N.C., conducts and supports research to understand the impact of the environment on human diseases such as asthma, translates this research into strategies to prevent disease and promote health, and communicates this information to the public.

The NIH Pediatric Research Initiative is a continuing effort to strengthen the pediatric biomedical research portfolio, encourage collaborative efforts across institutes in high priority areas, and to assure expanding opportunities for advancement in scientific investigations involving children.

NIAID/NIEHS National Cooperative Inner-City Asthma Study

Those interested in participating in the study should contact the institution in their local community.

• Ellen Crain, M.D., Ph.D.
  Pediatric Emergency Medicine
  Albert Einstein College of Medicine
  1300 Morris Park Avenue
  Bronx, NY 10461
  718/918-4395

• George T. O'Connor, M.D.
  Pulmonary Center
  Boston University School of Medicine
  80 E. Concord Street, K603
  Boston, MA 02118
  617/636-4860

• Richard Evans III, M.D., M.P.H.
  Department of Pediatrics
  Division of Allergy
  Children's Memorial Hospital
  990 W. Fullerton
  Suite 200
  Chicago, IL 60614
  773/404-4678

• Meyer Kattan, M.D.
  Department of Pediatrics
  Mount Sinai School of Medicine
  Box 1202
  One Gustave L. Levy Place
  New York, NY 10029
  212/241-7788

• James W. Stout, M.D., M.P.H.
  Odessa Brown Children's Clinic
  2101 E. Yesler Way
  Seattle, WA 98112
  206/527-1200

• Wayne Morgan, M.D.
  University of Arizona Health Sciences Center
  1501 N. Campbell Avenue
  Tucson, AZ 85724
  520/626-7780

• Rebecca Gruchalla, M.D., Ph.D.
  Department of Internal Medicine
  Division of Allergy and Immunology
  University of Texas Southwestern Medical Center
  5323 Harry Hines Blvd.
  Dallas, TX 75235-8859
  214/648-5436

• (Data Coordinating Center)
  Herman E. Mitchell, Ph.D.
  Rho, Inc.
  121 S. Estes Drive, Suite 100
  Chapel Hill, NC 27514
  910/932-6500 ext. 223

NIAID is a component of the National Institutes of Health (NIH). NIAID conducts and supports research to prevent, diagnose and treat illnesses such as HIV disease and other sexually transmitted diseases, tuberculosis, malaria, asthma and allergies. NIH is an agency of the U.S. Department of Health and Human Services.

Press releases, fact sheets and other NIAID-related materials are available on the Internet via the NIAID Web site at http://www.niaid.nih.gov.