Article Text
Abstract
Introduction Chronic gastrointestinal and respiratory conditions of childhood can have long-lasting physical, psychosocial and economic effects on children and their families. Alterations in diet and intestinal and respiratory microbiomes may have important implications for physical and psychosocial health. Diet influences the intestinal microbiome and should be considered when exploring disease-specific alterations. The concepts of gut-brain and gut-lung axes provide novel perspectives for examining chronic childhood disease(s). We established the ‘Evaluating the Alimentary and Respiratory Tracts in Health and disease’ (EARTH) research programme to provide a structured, holistic evaluation of children with chronic gastrointestinal and/or respiratory conditions.
Methods and analysis The EARTH programme provides a framework for a series of prospective, longitudinal, controlled, observational studies (comprised of individual substudies), conducted at an Australian tertiary paediatric hospital (the methodology is applicable to other settings). Children with a chronic gastrointestinal and/or respiratory condition will be compared with age and gender matched healthy controls (HC) across a 12-month period. The following will be collected at baseline, 6 and 12 months: (i) stool, (ii) oropharyngeal swab/sputum, (iii) semi-quantitative food frequency questionnaire, (iv) details of disease symptomatology, (v) health-related quality of life and (vi) psychosocial factors. Data on the intestinal and respiratory microbiomes and diet will be compared between children with a condition and HC. Correlations between dietary intake (energy, macro-nutrients and micro-nutrients), intestinal and respiratory microbiomes within each group will be explored. Data on disease symptomatology, quality of life and psychosocial factors will be compared between condition and HC cohorts.
Results will be hypothesis-generating and direct future focussed studies. There is future potential for direct translation into clinical care, as diet is a highly modifiable factor.
Ethics and dissemination Ethics approval: Sydney Children’s Hospitals Network Human Research Ethics Committee (HREC/18/SCHN/26). Results will be presented at international conferences and published in peer-reviewed journals.
Trial registration number NCT04071314
- paediatrics
- gastroenterology
- respiratory medicine (see Thoracic Medicine)
- nutrition & dietetics
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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Footnotes
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Contributors MJC, TK and CYO jointly conceived and designed the research programme. MJC wrote the study protocol. IRM, MD, SC, SA, SS-B, SAW, NK, TT and AJ refined the research programme design. All authors will take part in study conduct, recruitment, data management and/or analysis. MJC, IRM and CYO prepared this manuscript and all authors read and approved the final version.
Funding This is an investigator-initiated research programme. Funding to support medical research students is available through the Independent Learning Project scheme (involves a research term for medical students) at the University of New South Wales Sydney. Additional funding will be sought through seed grants. Dr Coffey is the recipient of the Sydney Children’s Hospital Foundation PhD Scholarship and the Australian Government Department of Education and Training Australian Postgraduate Award. Assistant Professor Kasparian is the recipient of a National Heart Foundation of Australia Future Leader Fellowship (101229), and a 2018–2019 Harkness Fellowship in Healthcare Policy and Practice from the Commonwealth Fund.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.
Patient consent for publication Informed written consent.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement De-identified participant data that underlies the results of publications from the EARTH program will be shared with investigators whose proposed use of the data has been approved by an independent review committee.