Asthma Research
Research Programs

Our Innovative Integration of Clinical Cohorts, Laboratory Research and Bioinformatics

Our division has crafted a multidisciplinary research design to mechanistically understand the environmental, genetic and biological factors that contribute to allergic diseases and asthma progression. As such, we use samples collected from innovative longitudinal clinical cohorts, laboratory techniques, pre-clinical models and bioinformatic approaches to assess changes in patient microbiome, epigenetic, genetic and transcriptional profiles that contribute to the progression of atopic diseases, from atopic dermatitis to asthma. (see graphic below) Integration of these techniques provide unique translational insights into the pathogenesis of atopic diseases. Furthermore, our research team has contributed to numerous publications and critical new insights into the natural history, epidemiology and mechanistic underpinnings of allergic diseases.

Research Focus

We are focused on understanding the total exposure relevant to asthma from the cell and individual level to the patient, family neighborhood and community level. We aim to identify the factors that contribute to asthma development and symptoms, determine the mechanisms by which these factors contribute to disease, delineate how effects of environmental exposure are modified by genetics and other exposures, and identify biomarkers of exposure and disease activity and severity in an individual. Our current projects include a basic, translational and clinical research that investigates the role of these factors in promoting disease development and activity.

Research Strategy

The division utilizes transdisciplinary approaches integrating human cohorts, in vitro systems, and animal models to address these complex problems. Numerous other factors affect disease outcomes as well, including psychosocial factors, community health perceptions, and health literacy.

Our Cohorts

Under the direction of Dr. Khurana Hershey, the Division of Asthma Research has built and contributed to several innovative longitudinal cohorts over the last 25 years, which provide a tremendous infrastructure for research into the pathogenesis of allergic disorders and enable epidemiologic and mechanistic studies. These cohorts have resulted in numerous publications and critical new insights into the natural history, epidemiology, and mechanistic underpinnings of allergic diseases. These cohorts also provide a tremendous and unique infrastructure for translation of findings from epidemiologic studies to the laboratory and back to human patients.

Programs (5)

Cincinnati Childhood Allergy and Air Pollution Study Birth Cohort (CCAAPS)

The Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS) was created to determine if children exposed to higher levels of diesel are at an increased risk of developing atopy and allergic disease and to evaluate if these effects are magnified in a genetically at-risk population. The National Institute of Environmental Health Sciences originally funded CCAAPS to recruit 762 children born to at least one parent with an allergy/asthma and with/without proximity to major highways. Children were identified from birth records in a seven-county area of the Greater Cincinnati Area between 2001 and 2003. The children were examined for the presence of allergic disease annually at ages one to four and at ages seven and 12, 14-18, and now 18-21 for asthma. Blood and hair samples were collected and skin prick testing performed at each research visit and pulmonary function tests were performed on patients at age seven. These data were used to identify if participants developed asthma, allergic rhinitis, allergen sensitization, or eczema. CCAAPS is a rich resource and provides the infrastructure for several collaborative projects, projects and the data collected as part of CCAAPS has contributed to over 100 peer-reviewed publications.

Environmental Influences on Child Health Outcomes (ECHO)

The Environmental Influences on Child Health Outcomes (ECHO) Program was created with the central goal of identifying and understanding the effects of early environmental exposures on child health and development. The Division of Asthma Research at Cincinnati Children’s has contributed to this goal through the incorporation of CCAAPS in the Children’s Respiratory and Environmental Workgroup (CREW) study population. CREW was developed to better understand how early life environmental exposures and host factors interact to promote the development of specific asthma endotypes.

Greater Cincinnati Pediatric Clinic Repository (GCPCR)

The Greater Cincinnati Pediatric Clinic Repository (GCPCR) was initiated in 1998 by Dr. Khurana Hershey to link and efficiently utilize clinical and epidemiologic data and biospecimens in the aim of delineating phenotypes of asthma and other allergic disorders. Children are invited to participate in the GCPCR upon presentation to a Cincinnati Children's Hospital Medical Center clinic or ED. GCPCR includes over 7,000 participants with asthma, food allergy, and / or allergic rhinitis, as well as non-asthmatic, non-allergic controls. At the time of recruitment, patients are asked to provide a DNA sample. DNA samples from over 1,700 participants have undergone genome wide SNP genotyping. The genetic data collected as a part of this resource have contributed to numerous peer-reviewed manuscripts and grants. This repository serves as a valuable resource, supporting several projects, including funded initiatives for multiple faculty, and providing a foundation for recruiting participants for clinical research studies.

Mechanisms of Progression of Atopic Dermatitis to Asthma in Children (MPAACH)

The Mechanisms of Progression of Atopic Dermatitis (AD) to Asthma in CHildren (MPAACH) cohort is the first US prospective longitudinal early life cohort of AD. MPAACH was designed to define AD phenotypes and endotypes, and to identify novel biomarkers that identify children at risk for the development of asthma and wheezing phenotypes. It is the cornerstone of our NIH U19 Asthma and Allergic Diseases Cooperative Research Center. As part of MPAACH, children complete comprehensive annual visits where we collect blood, skin tape samples, contact plate and nasal samples, hair, stool, and home dust samples. The quality of the skin barrier is assessed through SCORAD and trans-epidermal water loss and the children undergo skin prick testing to 11 aeroallergens and 13 foods. Questionnaires collect data on allergy and asthma symptoms, food allergy, environmental exposures, demographics, quality of life and food insecurity. These samples are used to quantify changes in the skin microbiome, the transcriptome, the epigenome and immune signatures over time, and assess how these alterations drive the progression to food allergies, allergic rhinitis and asthma. MPAACH visits are ongoing and the cohort currently includes over 700 children. MPAACH includes 65% Black children and is one of the only early life cohorts that represents this historically underrepresented and understudied population.

Ohio Pediatric Asthma Repository (OPAR)

The Ohio Pediatric Asthma Repository (OPAR) was initiated and funded by the state of Ohio in an effort to better understand the Ohio childhood asthma epidemic, where one in six children has asthma. The central objective of the Ohio Pediatric Asthma Repository (OPAR) is to build a comprehensive biorepository at the 6 major Ohio children’s linking biosamples with clinical, demographic, adherence, health literacy, environmental, and health outcomes data. This data repository provides an infrastructure for studies aimed at delineating asthma phenotypes and endotypes, as well as identifying the most effective outcome-based care practices across the participating hospitals. OPAR also provides a resource to stimulate collaborative research and grant design focused on asthma. Cincinnati Children’s is proud to lead this endeavor for the state of Ohio.

Faculty Labs

Asthma ResearchResearch Programs