Goal 2: Reduce Human Disease

Redefining asthma: origins of obstructive airways disease

Can detailed longitudinal study of lung disease in infancy/early childhood improve our understanding of the origins of obstructive airways disease, and the variation seen in asthma phenotypes and severity?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

Asthma is, to some extent, an umbrella term that encompasses a broadly heterogenous (in severity, symptoms, and pathophysiology) group of obstructive lung diseases. This is even more true if we examine the "wheezy infant," a population defined almost exclusively by the presence of wheeze, cough, or noisy breathing with very little understanding of disease mechanism or pathophysiology, and few evidence-based treatment options. Improving our understanding of the pathophysiology of wheeze and recurrent cough in early childhood, and how these evolve into various phenotypes of "asthma," through comprehensive longitudinal study of infants and young children may lead to better endotyping of disease and improved therapeutic options, as well as the possibility of disease prevention.

Feasibility and challenges of addressing this CQ or CC

We lack adequate biomarkers (of inflammation, structural and functional lung disease, microbiome, nutrition, etc) to investigate lung disease in infancy and early childhood. Identifying biomarkers with adequate sensitivity, and with a safety profile that allows for repeated measures in large groups of children, will be key to identifying the early childhood origins of all lung diseases.

Name of idea submitter and other team members who worked on this idea Jessica Pittman

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Idea No. 647