The National Institutes of Health today announced $157 million in awards to several leading institutions, including the University of North Carolina, to launch a seven-year initiative called Environmental influences on Child Health Outcomes (ECHO), which will investigate how exposure to environmental factors in early development – from conception through early childhood – can influence the health of children and adolescents.
UNC, which was awarded $5 million over two years by the NIH, will join several other universities to focus on enrolling more than 50,000 children from diverse racial, geographic, and socioeconomic backgrounds to become part of the ECHO consortium. These studies will analyze existing data, as well as follow children over time to address the early environmental origins of at least one of ECHO’s health outcome areas, including upper and lower airway health and development, obesity, and brain and nervous system development.
Michael O’Shea, MD, division chief of neonatal-perinatal medicine in the department of pediatrics at the University of North Carolina, is the principal investigator for the third phase of the ELGAN Study, which began in 2002. This study enrolled 1506 babies born before 28 weeks of gestation and has followed these children and their families through age 10. UNC’s leadership of the third phase of the ELGAN Study builds on UNC’s reputation as a leader in the study of health outcomes in premature babies.
“The NIH ECHO grant will allow us to see these families again now that the children are reaching the age of 15,” O’Shea said. “The ECHO research consortium will also allow us to study relationships between placental epigenetics and childhood obesity, brain development, and asthma. This kind of research makes it possible to design treatments that could be applied prenatally or in the early postnatal period to have long-term benefits to individuals born extremely prematurely.”
“This kind of research makes it possible to design treatments that could be applied prenatally or in the early postnatal period to have long-term benefits to individuals born extremely prematurely.”
Rebecca Fry, PhD, associate professor in the UNC Gillings School of Global Public Health, is the co-principal investigator on the UNC ECHO grant. Another key researcher is Sonia Davis, DrPH, director of the Collaborative Studies Coordinating Center in the department of biostatistics at Gillings.
“Their expertise and contributions will be invaluable during this study,” O’Shea said.
The awards announced today will build the infrastructure and capacity for the ECHO program to support multiple, synergistic longitudinal studies that extend and expand existing cohort studies of mothers and their children. A critical component of ECHO will be to use the NIH-funded Institutional Development Awards (IDeA) program to build state-of-the art pediatric clinical research networks in rural and medically underserved areas, so that children from these communities can participate in clinical trials.
“I’m very excited to work with many of our nation’s best scientists to tackle vital unanswered questions about child health and development,” said ECHO Program Director Matthew W. Gillman, MD. “I believe we have the right formula of cohorts, clinical trials, and supporting resources, including a range of new tools and measures, to help figure out which factors may allow children to achieve the best health outcomes over their lifetimes.”
“Every baby should have the best opportunity to remain healthy and thrive throughout childhood.”
Experiences during sensitive developmental windows, including around the time of conception, later in pregnancy, and during infancy and early childhood, can have long-lasting effects on the health of children. These experiences encompass a broad range of exposures, from air pollution and chemicals in our neighborhoods, to societal factors such as stress, to individual behaviors like sleep and diet. These exposures may affect any number of biological processes, for example the expression of genes or development of the immune system.
“Every baby should have the best opportunity to remain healthy and thrive throughout childhood,” said NIH Director Francis S. Collins, MD, PhD. “ECHO will help us better understand the factors that contribute to optimal health in children.”