SOY isoflavones for inner city infants at risk for asthma (SIRA)

Active Cooperative Agreement Awarded Last action

Award ID
U01AI160018
Recipient
Awarding agency
Obligated
$6,848,487

Award facts

Assistance listing
93.855 Allergy and Infectious Diseases Research
Completion date 80% complete
Funding
  • $6,386,965.00 Federal
  • $461,522.00 Non-federal
Place of performance
Chicago, IL 60611, USA

Award details come from USAspending.gov.

Description

Abstract
A frequent gain of function promoter polymorphism for the PAI-1 gene (~60% of the population are homozygous or heterozygous) is associated with elevated circulating PAI-1 levels. Children homo or heterozygous for this allele who had a medically attended respiratory viral illness before age 2, had a 12 (any virus) to 18-fold (RSV) increased risk of asthma. The mechanisms for this association are not established. PAI- 1 is associated with airway thymic stromal lymphopoietin (TSLP) production, which promotes TH2 type airway responses. Furthermore, the PAI-1 overproducing genotype is associated with increased serum levels of IGE. IGE elevation increases fceri levels on pdcs which attenuates type I interferon antiviral responses. Of note, SOY isoflavones reduce TGF-1-induced PAI-1 gene expression and protein production from airway epithelial cells, and have been shown to decrease the risk of asthma exacerbations by 70% in individuals with the genotype. IT is not known whether supplementation with SOY isoflavones will decrease the risk of developing TH2 airway inflammation or the likelihood of allergic sensitization if IT is given to children at risk of asthma in the first year of life. SOY isoflavones for inner city infants at risk for asthma (SIRA) is a single center, prospective randomized, quadruple masked trial of high-risk infants with the PAI-1 genotype to compare supplementation with SOY genistein at doses similar to SOY formula ingestion or placebo during peak viral season of the first year of life. Children aged 2-6 months at enrollment will be randomized to SOY isoflavone or placebo in august, receiving active treatment from august to march 1ST, followed by observation over the next year for each yearly cohort. The objective of this proposal is to determine 1) whether SOY isoflavones can modulate development of TH2 airway endotypes, decrease eosinophilic airway inflammation, and reduce sensitization in high risk infants with the PAI-1 risk genotype, and 2) decrease IGE production via effects on PAI-1, and thereby improve rhinovirus-induced IFN-a response. As such, the primary outcome of the trial will be the development of T2 airway endotypes by interrupting the PAI-1/TSLP axis. Secondary outcomes will include nasal PAI-1, nasal ECP, nasal TH2 cytokine levels, serum periostin, total and specific IGE, and respiratory morbidity. The secondary aim will determine if antiviral IFN-a responses by pbmc stimulated by HRV and IGE crosslinking are augmented by SOY genistein in a similar fashion as has been described for omalizumab. Secondary outcomes for this aim will evaluate if SOY genistein will augment IFN-a responses by PDC in similar experiments. The current project uses a safe and inexpensive intervention, SOY genistein, directed to a common genotype as a precision medicine approach to provide a better understanding of key pathways relevant to development of allergic airway inflammation in early life. If confirmatory, these results would lead into intervention trials focused on clinical outcomes. This line of inquiry has the potential to benefit a large number of children at risk of developing asthma.

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Subawards

Subrecipient Amount Awarded
University Of South Florida The objective of this study is to determine whether soy isoflavones can decrease eosinophilic airway inflammation, decrease sensitization, and improve… $472,829
Northwestern University Kwang Youn Kim, PhD, will provide the following support for the research project: overseeing the database development to collect and ensure quality data,… $196,917
Northwestern University Soy Isoflavones for Inner City Infants at Risk for Asthma (SIRA) $29,634
Northwestern University $45,658
University Of South Florida Research Foundation Inc. $96,534

Quick answers

Who received award U01AI160018?

U01AI160018 was awarded to ANN & Robert H Lurie Childrens Hospital Of Chicago by National Institute of Allergy and Infectious Diseases (National Institutes of Health) on April 14, 2021.

How much is award U01AI160018 worth?

$6,848,487 has been obligated on U01AI160018: $6,386,965 in federal funding and $461,522 in non-federal funding.

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