The National Institutes of Health (NIH) recently announced it will provide $157 million in awards to launch a multi-center, seven-year initiative that will investigate how exposure to environmental factors in early development — from conception through early childhood — influences the health of children and adolescents.
Vanderbilt is among a consortium of study centers involved in the initiative known as Environmental influences on Child Health Outcomes (ECHO), which will focus on four major health areas: asthma, neurodevelopment, obesity and perinatal outcomes.
“Every baby should have the best opportunity to remain healthy and thrive throughout childhood,” said NIH Director Francis S. Collins, M.D., Ph.D., in an NIH press release. “ECHO will help us better understand the factors that contribute to optimal health in children.”
Three Vanderbilt investigators will receive funding from ECHO to build on existing asthma, prematurity and cognitive development studies.
Tina Hartert, M.D, MPH, will serve as Vanderbilt’s principal investigator on the Children’s Respiratory Research and Environment Workgroup (CREW), a national consortium of asthma investigators that will study how genetics interact with environmental exposures during the prenatal and early childhood years to cause specific subtypes of childhood asthma and determine their distinct functional or biologic mechanism. James Gern, M.D., is the lead principal investigator at the University of Wisconsin, which is the coordinating site.
Hartert, professor of Medicine, is the principal investigator for the NIH-funded INSPIRE study, the largest of the contributing study populations made possible by the collaboration with pediatric practices in the Middle Tennessee region. The INSPIRE study includes more than 1,900 families and is designed to understand how the early life environment affects future childhood health.
“Asthma is really a syndrome with marked variability that remains notoriously difficult to define, so that has limited us in developing targeted prevention and therapies. The goal of the ECHO grant is to define specific asthma diseases or groups so we can tailor preventive efforts and treatments,” said Hartert, director of the Center for Asthma Research.
“One of the most exciting elements of the CREW consortium is the unprecedented opportunity to bring together highly accomplished childhood asthma researchers from nine different U.S. centers with unparalleled collective expertise in studying and advancing our understanding of asthma. Usual NIH funding mechanisms have not historically provided the financial support to create a study of this magnitude.”
Paul Moore, M.D., is the Vanderbilt principal investigator for the Developmental Impact of NICU Exposures (DINE) cohort, while Children’s Hospital at Montefiore will be the lead site.
Vanderbilt’s cohort is the largest group of premature infants included of the 15 DINE sites.
“In the Vanderbilt Neonatal Intensive Care Unit (NICU), our research team enrolled more than 200 of the most premature infants, born at 24-28 weeks gestation, in the NIH-funded Premature and Respiratory Outcomes Program (PROP),” said Moore, associate professor of Pediatrics and Pharmacology.
“ECHO will allow the PROP investigators to extend follow up of this cohort into childhood and examine how children’s lung function and cognitive development are impacted due to environmental exposures in the NICU.
Kecia Carroll, M.D, MPH, associate professor of Pediatrics, is a co-investigator on the third Vanderbilt study, Prenatal and Early Childhood Pathways to Health, known as PATHWAYS, for which the University of Washington is the lead site. PATHWAYS includes three cohorts of mothers and children that have been followed since pregnancy.
Carroll has led characterization of asthma and allergic disease outcomes in the University of Tennessee Health Sciences Center-based Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE), one of the three PATHWAYS cohorts that enrolled about 1,500 women in the second trimester. Carroll and Moore will provide leadership in asthma characterization for the entire PATHWAYS cohort.
“We have followed the children in CANDLE through age 6 years, and participation in ECHO will extend follow-up and allow us to better understand the impact of chemical exposures, such as air pollution and phthalates, and non-chemical stressors, such as stress, on the developing fetus and subsequent asthma and neurodevelopment outcomes through school age,” Carroll said.
“I’m very excited to work with many of our nation’s best scientists to tackle vital unanswered questions about child health and development,” said ECHO Program Director Matthew Gillman, M.D. “I believe we have the right formula of cohorts, clinical trials and supporting resources, including a range of new tools and measures, to help figure out which factors may allow children to achieve the best health outcomes over their lifetimes.”
