Recognizing that asthma severity in inner-city children is disproportionately high, NIAID has sponsored research to reduce the public health burden that asthma presents in inner-city populations. Beginning in 1991, NIAID has supported three consecutive inner-city asthma research programs, which have been successful in reducing asthma severity in children.
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The goal of NCICAS was to identify the environmental factors responsible for asthma in inner-city children and then to develop an intervention strategy based on the findings. NCICAS researchers determined that cockroach allergen in the inner city was directly related to asthma severity. Asthma counselors educated the family on how to reduce this allergen in the home, which helped to reduce the child’s asthma symptoms.
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The goal of ICAS was to design and conduct an environmental intervention study to reduce the exposure of children with asthma to house dust mites, second-hand smoke, cockroaches, pets, rodents, and mold. The study showed that by reducing environmental allergens, especially in the bedroom, there was a significant reduction in asthma morbidity in at-risk children.
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The goals of ICAC are to design and implement immune-based therapies for asthma and to conduct studies to define the disease in inner-city children.
Two clinical trials initiated during phase I of ICAC have yielded important results and insights:
Szefler SJ, Mitchell H, Sorkness CA, Gergen PJ, O'Connor GT, Morgan WJ, Kattan M, Pongracic JA, Teach SJ, Bloomberg GR, Eggleston PA, Gruchalla RS, Kercsmar CM, Liu AH, Wildfire JJ, Curry MD, Busse WW. Management of asthma based on exhaled nitric oxide in addition to guideline-based treatment for inner-city adolescents and young adults: a randomised controlled trial. Lancet. 372(9643):1065-72 (2008).
Busse WW, Morgan WJ, Gergen PJ, Mitchell HE, Gern JE, Liu AH, Gruchalla RS, Kattan M, Teach SJ, Pongracic JA, Chmiel JF, Steinbach SF, Calatroni A, Togias A, Thompson KM, Szefler SJ, Sorkness CA. Randomized trial of omalizumab (anti-IgE) for asthma in inner-city children. N Engl J Med. 364(11):1005-15 (2011).
William Busse, M.D., the principal investigator of ICAC I and II, provides an overview of the contributions of NCICAS, ICAS, and ICAC I to the study of asthma in the inner city and looks ahead to the projects planned under ICAC II.
Busse WW. The National Institutes of Allergy and Infectious Diseases networks on asthma in inner-city children: an approach to improved care. J Allergy Clin Immunol. 125(3):529-37 (2010).
ICAC investigators are currently conducting several projects focused on improving asthma treatment, including the following:
ICAC is composed of nine clinical and two basic research sites under the leadership of William Busse, M.D., of the University of Wisconsin-Madison. The nine clinical sites and principal investigators include
The two basic research sites and principal investigators include
Rho, Inc., in Chapel Hill, North Carolina, led by Herman Mitchell, Ph.D., is the statistical and data coordinating center that supports the efforts of the ICAC program.
Last Updated July 20, 2011
Last Reviewed March 30, 2011