Insights from the COCOA birth cohort: The origins of childhood allergic diseases and future perspectives

  • Lee Eun
    Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School
  • Lee So-Yeon
    Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine
  • Kim Hyo-Bin
    Department of Pediatrics, Inje University Sanggye Paik Hospital
  • Yang Song-I
    Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine
  • Yoon Jisun
    Department of Pediatrics, Chung-Ang University College of Medicine, Chung-Ang University Gwangmyeong Hospital
  • Suh Dong In
    Department of Pediatrics, Seoul National University College of Medicine
  • Oh Hea Young
    Department of Medicine, University of Ulsan College of Medicine
  • Ahn Kangmo
    Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine
  • Kim Kyung Won
    Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine
  • Shin Youn Ho
    Department of Pediatrics, The Catholic University of Korea, Yeouido St. Mary's Hospital
  • Hong Soo-Jong
    Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine

抄録

<p>The ongoing COhort for Childhood Origin of Asthma and allergic diseases (COCOA) study is a prospective birth cohort investigating the origin and natural courses of childhood allergic diseases, including atopic dermatitis, food allergy, allergic rhinitis and asthma, with long-term prognosis. Initiated under the premise that allergic diseases result from a complex interplay of immune development alterations, environmental exposures, and host susceptibility, the COCOA study explores these dynamic interactions during prenatal and postnatal periods, framed within the hygiene and microbial hypotheses alongside the developmental origins of health and disease (DOHaD) hypothesis. The scope of the COCOA study extends to genetic predispositions, indoor and outdoor environmental variables affecting mothers and their offsprings such as outdoor and indoor air pollution, psychological factors, diets, and the microbiomes of skin, gut, and airway. We have embarked on in-depth investigations of diverse risk factors and the pathophysiological underpinnings of allergic diseases. By employing multi-omics approaches—proteomics, transcriptomics, and metabolomics—we gain deeper insights into the distinct pathophysiological processes across various endotypes of childhood allergic diseases, incorporating the exposome using extensive resources within the COCOA study. Integration with large-scale datasets, such as national health insurance records, enhances robustness and mitigates potential limitations inherent to birth cohort studies. As part of global networks focused on childhood allergic diseases, the COCOA study fosters collaborative research across multiple cohorts. The findings from the COCOA study are instrumental in informing precision medicine strategies for childhood allergic diseases, underpinning the establishment of disease trajectories.</p>

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