# The school microbiome and asthma morbidity in inner-city children

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2020 · $770,182

## Abstract

PROJECT SUMMARY/ABSTRACT
There is a fundamental gap in understanding how to define and create a “healthy” indoor microbial
environment for the 300 million children and adults with asthma. There is a growing recognition that the indoor
microbiome may impact asthma development and morbidity, yet the few available environmental microbiome
studies in asthma suggest that microbial exposures such as microbial diversity are simultaneously beneficial
for asthma prevention and harmful for asthma symptoms in children already diagnosed with asthma. The long-
term goal is to create healthy indoor environments for children with asthma. The overall objective of this
application is to investigate the contribution of the classroom microbiome to asthma morbidity and determine
whether we can modify the indoor microbiome to reduce asthma symptoms by leveraging the infrastructure of
the School Inner-City Asthma Intervention (SICAS-2) study, a randomized controlled trial conducted by our
group of a comprehensive school-based integrated pest management (IPM) intervention combined with a
placebo-controlled classroom high efficiency particulate air (HEPA) cleaner intervention to assess the impact of
these environmental interventions on asthma morbidity. Our strong preliminary data supports the central
hypothesis that the classroom microbiome is modifiable and affects asthma morbidity independent of allergen
exposure through colonization. We will test the central hypothesis by pursuing three specific aims: 1) To
determine the extent to which the classroom microbiome is modifiable by a randomized IPM and HEPA cleaner
intervention, findings that may be relevant for other infectious and inflammatory diseases; 2) Identify specific
classroom microbial features independently associated with asthma symptoms, including identifying joint and
interaction effects with allergen exposure, findings that may lead to identification of specific microbial strains
important for future environmental remediation efforts; 3) Estimate the effect of upper airway colonization by
classroom-associated microbes on asthma symptoms and the host immune profile, an important aim that may
lead to a paradigm shift for how we approach exposure mitigation for asthma symptoms, since changes to the
human microbiome may persist after exposure cessation. The approach is innovative, because the study is in
the school setting with a randomized environmental intervention, a robust design for human studies that allows
for causal interpretations. The hypothesis tested departs from the status quo, which is largely focused on
allergens and microbial toxins in the home setting. The proposed research is significant, because asthma
affects 8.4% of children in the United States and is the leading cause of school absenteeism. Ultimately, such
knowledge has the potential to lead to better future prevention and treatment strategies for chronic lung
disease due to environmental microbial exposures.

## Key facts

- **NIH application ID:** 9841892
- **Project number:** 5R01AI144119-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Peggy Sue Lai
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $770,182
- **Award type:** 5
- **Project period:** 2019-01-01 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9841892

## Citation

> US National Institutes of Health, RePORTER application 9841892, The school microbiome and asthma morbidity in inner-city children (5R01AI144119-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9841892. Licensed CC0.

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