The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, has renewed the contract to continue studying asthma in children living in lower-income, inner city environments. This five-year, US$ 56 million award will support the Inner-City Asthma Consortium (ICAC), a nationwide clinical trials network to evaluate promising new therapies to reduce asthma severity and prevent disease, and to perform basic research to understand how these therapies work.

"As many as 20 million Americans have asthma, but it disproportionately afflicts children, especially minority children who live in inner city areas," said Anthony S Fauci, director of NIAID, which supports ICAC. "ICAC research has generated new insights that have improved how we prevent and treat asthma, especially in this vulnerable target population. We expect this new contract will help us to further improve the lives of children with asthma."

The primary goal of ICAC is to reduce the burden of asthma in children and adolescents living in the inner city. The new network of 10 basic and clinical ICAC research sites will be led by William Busse, of the University of Wisconsin-Madison.

Investigators at participating sites will develop and conduct clinical trials that evaluate the safety and efficacy of promising immune-based therapies designed to reduce asthma severity and prevent disease. In addition, the researchers will examine what makes inner-city asthma different from that in other environments. Another goal is to determine what causes exacerbations (a worsening of asthma symptoms) and develop appropriate treatments.

The ICAC researchers will also continue the Urban Environment and Childhood Asthma Study, which enrolled 500 inner city children at birth, starting in 2005, and is following them until age seven to see if they develop asthma. The investigators expect that the information collected in this study will identify specific infectious, genetic or immunologic factors that place inner city children at risk for asthma.

NIAID's support of inner city asthma research began in 1991 with the National Cooperative Inner-City Asthma Study, which was followed by the Inner-City Asthma Study. Investigators from these consortia demonstrated that reducing the exposure of children to allergens commonly found in urban environments --including those originating from cockroaches, rodents and second-hand smoke --reduced their risk of developing asthma. Building on the accomplishments of these two programmes, NIAID first established ICAC in 2002.

"Earlier ICAC studies demonstrated that asthma, even in inner city populations, can be well-controlled using current asthma treatment guidelines," said Daniel Rotrosen, director of the NIAID's Division of Allergy, Immunology and Transplantation. "Nonetheless, the need remains to better understand the underlying causes of inner city asthma and develop improved treatment options. ICAC, with its expert investigators and established clinical sites, is uniquely positioned to meet these objectives."

Investigators at eight clinical and two basic research sites nationwide will participate in the new ICAC.