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Your Environment. Your Health.

National Jewish Health

Environmental Determinants of Airway Disease in Children

David A. Schwartz, M.D.

Child Health Specialist: Stanley Szefler, M.D.
Pediatric asthma


Environmental Exposures

Air pollutants (ozone) and ambient bacterial endotoxin

Primary Health Outcomes

Asthma and immune system function

The Denver Children’s Environmental Health Center explores possible causes of asthma and other airway diseases, which are the most common chronic childhood illnesses. Center researchers are building on a study of children with asthma called the Childhood Asthma Management Program (CAMP) study. They are studying ozone, an air pollutant and component of smog, as well as endotoxins, which are released into the air when certain bacteria die. Scientists believe that inhaling these contaminants could make a child more susceptible to airway disease by changing the response of the developing immune system.

Findings from this center are expected to enhance the understanding of airway disease in children and to inform the design of programs that identify, treat, and ultimately prevent respiratory diseases in children. Findings will also be combined with education and intervention programs to improve children’s health.

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Project 1: Endotoxin exposure and asthma in children

Project leader: Andrew H. Liu, M.D.

Researchers are exploring how endotoxin interacts with other potentially toxic exposures and genetic differences in a susceptible child to cause persistent asthma. Exposure to endotoxin can affect the immune system, but scientists don’t know if it can cause asthma or affect children who already have asthma. This work builds on the CAMP study of children with asthma. The research results will help determine the levels of endotoxin exposure likely to be problematic for children and will provide information important for developing environmental educational and intervention programs that improve health.

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Project 2: Environmental determinants of early host response to RSV

Project leaders: Azzeddine Dakhama, Ph.D., Carl W. White, M.D. ,

Inhaled air pollutants such as ozone can exacerbate asthma and could play a role in the development of airway disease in early life. For this project, researchers investigate whether exposure to ozone in the first weeks after birth alters lung development and modifies a child’s immune response to allergens and to early-life infections of respiratory syncytial virus (RSV). These early changes could contribute to the development of reactive airway disease.

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Project 3: Environmental determinants of host defense

Project leaders: David A. Schwartz, M.D., Ivana V. Yang, Ph.D. ,

This project uses animal models and cell studies to understand how and why air pollution alters the immune system response in the lungs. Researchers investigate whether a person’s genetics and environmental factors influence the activation of toll-like receptors in the lungs. Toll-like receptors are proteins related to lung infection and allergies. Investigators collaborate with a federally sponsored inner-city home environment intervention study to determine how to reduce bacterial endotoxin levels in the home and potentially improve asthma outcomes.

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Community Outreach and Translation Core

Core Leader: Stanley Szefler, M.D.

The Community Outreach and Translation Core (COTC) serves as a forum for exchanging ideas, thoughts, and information to evaluate the impact of environmental exposures, such as air pollution and endotoxin, on responses to viral infection and allergen exposure in children in urban and rural Colorado. The Core is a bridge between scientific investigators and community stakeholders for organizing approaches and strategies for translation and uptake by community members. The COTC also assimilates the available research evidence while informing the CEHC research investigators of the need for responsive research to the community.

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