COASTing News…………….Holiday 2004
COAST has just begun its sixth year!!
We have completed our first six-year visit and about 2/3 of our 5 year visits. It is really
amazing for us to realize that we have come this far….it is a privilege to see your children
grow up. Just the other day, one of our mothers was telling us about a “big” transition for
her daughter, she used to say “hop-spital”. Now, she can say “hospital”… and it is just as
hard – and wonderful – for us to see them grow up!!
COAST – THE BIG PICTURE
Sometimes, I suspect that it is a bit difficult to realize the BIG PICTURE that is COAST.
We like to take this time of year to do a little “THANKS-GIVING” by telling you just how
much the world is appreciative of all that you have given to the COAST project.
Here are some of this year’s accomplishments:
COAST on the speaker’s circuit: Dr. Rob Lemanske has been asked to speak about this
project in these locations during the past 12 months: San Francisco (two occasions),
Phoenix, WashingtonD.C. (seven occasions), North Carolina, Boston (three occasions)
San Diego, (two occasions) Dallas, Memphis, Florida (three occasions), New Jersey,
Virginia Beach, Milwaukee (two occasions), Kansas City, Indiana, Philadelphia, Cincinnati,
Hawaii, Tokyo, Scotland, Nova Scotia, Thailand, and India.
“ Imitation is the Greatest Form of Flattery”: URECA (Urban Environment and
Childhood Asthma) is a research study that is scheduled to begin January 2005 with Dr.
Jim Gern (co-investigator for COAST) as the Principal Investigator for this project. It is
modeled after COAST and will enroll 125 children in each of four inner-city sites: Boston,
New York, Baltimore and St. Louis (a total of 500 children and their families). It was
developed because the data from COAST is so significant and complete and because it
needs to be understood whether inner-city children have special risk factors for the
development of asthma. Kathy Roberg has worked with the URECA staff in both the
development of policies, in on-site training and continually uses the experiences from the
COAST families to develop this research study. The Madison site will also serve as the
virology and immunology center for this project.
Additional projects because of COAST:
Nutrition Study
At the 5 year visit we have told families about a study being conducted by Dr. HuiChuan
Lai which is investigating the relationship between asthma and obesity. This study is only
open to the children who are already enrolled in the COAST project.
Energy Expenditure Study
Dr. Lai is also conducting an additional piece with 30 COAST children who enroll in the
nutrition study. This subset is investigating the actual energy expenditure of children and
correlating this information with food and activity diaries. This novel information will be
very important to better understand how body mass (weight) and activities influence the
development of asthma.
T Regulatory and Environmental
More recently, we have started asking families to participate in an additional project that
compares the environment with the development of the immune system. This involves, a
one time home visit to vacuum “samples” from three different locations in your home. We
will also be looking at previously drawn blood samples to study the T-Regulatory blood
cell, which has been found to be related to asthma. Dr. Gern is also the Principal
Investigator for this study and has received funding from the NIH.
COAST FINDINGS
The magnitude of new information derived from the COAST project thus far is truly
remarkable. The following are just a few of the many exciting findings we have published.
 We have learned how to obtain, process and safely store blood samples long-term,
methods that will be very useful to the URECA project for developing similar
techniques that will be used in 4 different cities.
 We have learned that immune responses of newborns are different than their
parents, and that allergy to egg protein during infancy is a risk factor for wheezing in
the third year of life.
 We have learned that RSV infections during infancy do indeed cause wheezing. A
new and exciting finding, however, was that the common cold virus, rhinovirus (of
which there are more than 100 types) also causes wheezing during infancy, and
that children who wheeze with this virus are ten times more likely to be wheezing at
age 3 with respiratory tract infections.
 We have learned that having a dog (but not a cat) in the first year of life is protective
against allergic sensitization and the development of eczema during infancy. This
protective effect is most often seen in children with a particular gene that regulates
immune responses to bacteria commonly found in pet fur. However, by age 3, this
protective effect tends to diminish
 We have demonstrated that daycare and older siblings increase the frequency of
respiratory infections in children; as your child continues to grow, we will later
determine if this increase can actually protect against the development of allergies
and/or asthma (the so-called “hygiene hypothesis”)
 We have shown that nasal mucus samples obtained during childhood respiratory
illnesses contain inflammatory mediators that differ based on the severity of the
illness and the type of virus causing the illness.
 We have learned that, at birth, low levels of certain inflammatory mediators made
from cord blood white blood cells are associated with the development of more
respiratory tract infections during infancy
 Finally, we have demonstrated that certain genes influence immune responses in
your children; we will later be able to evaluate if these same genes are associated
with the development of wheezing illnesses, allergic diseases, and/or asthma.
Thus, as we prepare to begin a New Year, thank you for all that
you have allowed us to give to the scientific world and all that you
have done to improve the health of children everywhere.