UChicago among institutions nationwide to get $157 million in NIH awards

Project will investigate exposures from conception through early childhood

The National Institutes of Health today announced $157 million in awards in fiscal year 2016 to launch a seven-year initiative called Environmental influences on Child Health Outcomes (ECHO). About $5 million will go to researchers at the University of Chicago during the first two years of this project.

The ECHO program will investigate how exposure to a range of environmental factors in early development - from conception through early childhood - influences the health of children and adolescents. These exposures range from air pollution and chemicals in our neighborhoods, to societal factors such as stress, to individual behaviors such as sleep and diet.

ECHO will follow more than 50,000 children from diverse racial, geographic and socioeconomic backgrounds and will focus on four disease areas: neurodevelopment, including diseases such as autism; prenatal and postnatal outcomes, such as birth defects; airway conditions such as asthma and allergies; and obesity.

ECHO is designed to capitalize on existing participant populations, extending and expanding ongoing studies of mothers and their children. It will support approaches that can evolve with the science and take advantage of the growing number of clinical research networks and technological advances.

"Every baby should have the best opportunity to remain healthy and thrive throughout childhood," said Francis S. Collins, MD, PhD, Director of the National Institutes of Health. "ECHO will help us better understand the factors that contribute to optimal health in children."

Leaders of participating cohorts will spend much of the first two years harmonizing existing data. Those who meet certain milestones will gather new data for another five years.

Neonatologist Erika Claud, MD, associate professor of pediatrics, will head one of the ECHO pediatric cohorts, which includes NorthShore University Health Services, Evanston, Ill.; Beth Israel Deaconess Medical Center, Boston; the University of California at San Diego; and the University of South Florida, Tampa.

Her team will investigate the effects of the environment on the bacterial communities of the human body, now known as the microbiome. They will study how these communities influence neurodevelopment of preterm infants all the way from birth to school readiness. The goal is to understand the many environmental factors, including hospital course, diet, housing, family interactions and socio-economic status, that influence the microbiome and how changes in the microbiome affect a child's outcomes.

"I am excited to lead this project that capitalizes on unique established strengths of the University of Chicago," Claud said, "ranging from excellent clinical neonatal care, pioneering work on the microbiome, an intensive focus on follow-up care of preterm infants after discharge, as well as expertise in the study of economics and health outcomes."

"We hope to identify factors associated with the microbiome that could be modified to improve outcomes of these extremely vulnerable children," she added. "We believe that understanding and promoting alterations in the microbiome associated with the home environment, could lead to improved understanding of health disparities and enable interventions to shift infant neurodevelopmental trajectories in innovative ways."

Kate Keenan, PhD, professor of psychiatry and behavioral neuroscience at the University of Chicago, will work with colleagues at the University of Pittsburgh to understand how exposure to environmental stress prior to conception might alter the mother's capacity to regulate stress during pregnancy, leading to deficits in the neurodevelopment of her children.

The team will follow participants in the Pittsburgh Girls Study, which has enrolled 2,450 urban-living young women who have faced multiple stress exposures.

"Our goal is to understand how to optimize prenatal health, child growth and development among those living in stressful environments," she said.

"We are excited to be selected to participate in the ECHO consortium," Keenan added. "This is an unprecedented opportunity to significantly advance understanding of the developmental origins of deficits in offspring health. The data generated will inform the design and deployment of public health initiatives to reduce cognitive deficits."