# Mechanistic Study of Inspiratory Training in Childhood Asthma

> **NIH NIH R01** · DUKE UNIVERSITY · 2024 · $362,490

## Abstract

PROJECT SUMMARY/ABSTRACT
In children, asthma is a leading cause of respiratory symptoms and missed school. By mechanisms that
are unclear, obesity in children with asthma is a strong risk factor for asthma that is more symptomatic
and difficult to manage. Among asthmatic children, obesity is associated with a reduced response to
conventional anti-inflammatory asthma drugs. Therefore, a better understanding of the underlying
mechanisms of obesity-related asthma in children is needed. Discovering the mechanisms of `obese
asthma' in order to foster more appropriate phenotype-specific therapies is a pressing public health
need. Obesity, regardless of underlying asthma, is known to impair respiratory system compliance and
inspiratory muscle efficiency leading to increases in the effort of respiration. Our lab found in asthmatic
children that obesity is associated with more frequent asthma symptoms and a higher likelihood of
having dyspnea. Inspiratory training and other forms of rehabilitation are common in adults but is
understudied in pediatrics. Inspiratory `rehabilitation' training (IT) recently has been shown in both
children and adults to reduce dyspnea and asthma symptoms. Our research team found IT over 6 weeks
was well-tolerated, and led to improved inspiratory function and consistently improved trends in clinical
measures, among children with asthma. The central objective of our proposed MICA (Mechanistic Study
of Inspiratory Training in Childhood Asthma) study is to measure the effects of 8-weeks of IT on
inspiratory function (strength and endurance) and small airway dysfunction measured by oscillometry in
6-17 year olds with asthma - with and without obesity. Our central hypothesis is that obesity promotes
inspiratory muscle fatigue and small airway dysfunction, and that IT will mitigate these mechanisms.
In a masked parallel arm trial, 75 youths with asthma (half with obesity) will be randomized to either IT
(low or high dose) or SHAM control for 8-weeks. Inspiratory strength and endurance, small airway
dysfunction (SAD), and exercise capacity will be assessed at baseline and after IT. Aim 1 will describe
the contributions of inspiratory fatigue and SAD to obesity-related asthma. Aim 2 will determine the
effects of IT on inspiratory muscle fatigue. Aim 3 will determine the effects of IT on small airway
dysfunction. The MICA study will provide mechanistic knowledge about pediatric `obese asthma' by
comparing treatment responses by obesity status. Measuring the changes in inspiratory muscle function
and small airways dysfunction following a short regimen IT in children with symptomatic obesity-related
asthma will provide much needed understanding about mechanisms underlying how obesity worsens
asthma in children; and will uncover mechanisms and optimal dosing intensity involved in a safe non-
drug intervention that will pave the way for larger phase III trials.

## Key facts

- **NIH application ID:** 10871907
- **Project number:** 5R01HL168107-02
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Jason E. Lang
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $362,490
- **Award type:** 5
- **Project period:** 2023-07-01 → 2028-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10871907

## Citation

> US National Institutes of Health, RePORTER application 10871907, Mechanistic Study of Inspiratory Training in Childhood Asthma (5R01HL168107-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10871907. Licensed CC0.

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