15 Years of the COAST Study

Young participants from the COAST study, which completed its 15th year in 2013.

Young participants from the COAST study, which completed its 15th year in 2013.

The Childhood Origins of Asthma (COAST) study, led by Robert Lemanske, MD, completed its 15th year in 2013.

Launched in 1998, COAST is a longitudinal study that follows a cohort of 270 children born at high risk for childhood asthma and allergies. It evaluates how genetic and environmental factors, especially viral respiratory tract infections, contribute to the expression, progression and remission of those disorders.

Funding comes from the National Institutes of Health’s National Heart, Lung and Blood Institute. Study group members are from the Department of Pediatrics’ Division of Allergy, Immunology and Rheumatology, the UW SMPH Department of Biostatistics and Medical Informatics and the University of Chicago Department of Human Genetics.

Substantial Contributions to Scientific Literature

Since 1998, the research team has used data generated from this study to publish 56 original papers in peer-reviewed journals.

For example, they found that rhinovirus wheezing illnesses in the first three years of life are the type of viral infections most significantly associated with the development of childhood asthma at age six (PMID: 18565953).

They also found that allergic sensitization in early life precedes virus-induced wheezing illnesses (not the other way around) and that this substantially increases childrens’ risk of developing asthma (PMID: 21960534 and PMID: 18565953).

Last year, in an article published in the New England Journal of Medicine, the team was the first to demonstrate that a previous association between a variation in the 17q21 gene and asthma risk is in fact limited only to children who had rhinovirus wheezing illnesses in early life (PMID: 23534543).

Spawning New Research

Due to its longevity and high retention rate (over 75 percent), COAST has spawned new studies at UW and beyond that aim to identify the immunologic and biologic mechanisms of childhood asthma—work that may lead to better strategies for disease prevention and treatment.

Most recently, COAST received a five-year, $11.8 million renewal to further analyze the mechanisms underlying gender-specific changes in asthma prevalence during adolescence, and the contribution of the microbiome and allergic and nonallergic immunologic and genetic pathways in asthma development.

The COAST team includes principal investigator Robert Lemanske, MD, and co-investigators James Gern, MD; Daniel Jackson, MD; Judy Smith, MD; Christine Seroogy, MD; Ronald Gangnon, PhD; Yury Bochkov, MD; and Carole Ober, PhD.

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