Pilot Project Recipients Year 4

Impact of exogenous and endogenous exposures on child developmental outcomes in classic galactosemia

Judy Fridovich-Keil, School of Medicine, Department of Human Genetics

Classic galactosemia (CG) is characterized as a genetic disorder in which affected individuals are unable to fully metabolize galactose. In many countries, infant screening for CG allows for early dietary intervention to prevent the significant and rapid decline that would occur otherwise. Yet even with these dietary interventions, children with CG often experience long-term complications from developmental delays. Recent research suggests that CG may result in an increased susceptibility to dietary oxidants and trace environmental toxicants. This study will explore metabolomic profiles of a group of phenotyped CG patients and set of controls to identify what metabolites and/or patterns of m/z features distinguish those with and without significant developmental complications from CG as well as from the control group overall. In the long-term, the research aims to discover and understand both the environmental and endogenous exposures and the mechanisms by which they are contributing to prevalent disabilities among CG patients.

Dr. Judy Fridovich-Keil is a professor in the Department of Human Genetics at the School of Medicine at Emory. Her research focuses on the roles of galactose and galactose metabolism in normal development, homeostasis and disease.

Modeling maternal alcohol exposure using cardiomyocytes derived from human pluripotent stem cells

Chunhui Xu, School of Medicine, Department of Pediatrics

Congenital heart disease is the leading non-infectious cause of infant mortality. Environmental toxicants are suspected to contribute to the development of CHD, particularly maternal exposures. Utilizing cardiomyocytes derived from human pluripotent stem cells, the research team aims to establish a novel and physiologically relevant model of maternal alcohol exposure. Various pathological characteristics and cardiogenesis events will be examined including if exposure induces oxidative stress, nitrative damage and cell death via NOX activation, induces impaired mitochondrial function, and alters contractile and intracellular calcium handling. Once the model is established, the research team will be able to examine the effect of other environmental toxicants. They will also examine potential therapeutic approaches in the various exposure models with the long-term goal of developing treatment strategies.

Dr. Chunhui Xu is an associate professor in the Department of Pediatrics in the School of Medicine at Emory. Her research focuses on the use of human cardiomyocytes derived from human pluripotent stem cells for such applications as cardiac cell therapy, disease modeling, drug discovery, and the study of developmental biology.

Assessment of health risks associated with urban flooding in Atlanta, GA

Amy Kirby, School of Public Health, Department of Global Health

Peoplestown Revitalization Corporation, Community Collaborator

Urban flooding presents potential health risks for those in affected neighborhoods. The Peoplestown neighborhood in central Atlanta faces significant flooding challenges due to the presence of three major sewer overflow systems, low-capacity water infrastructure, runoff from three major interstates and relatively frequent high rainfall events. In collaboration with a local community organization, Peoplestown Revitalization Corporation, this pilot project aims to address the concerns community residents have expressed about the health risks associated with frequent, localized flooding. After collecting samples of drinking water and floodwater during rain events, the samples will be analyzed for microbial and chemical contaminants. In order to assess personal health risks for community members, the team will also assess knowledge and behaviors associated with urban flooding events. Through these surveys, education materials and other resources can be distributed to the community. As a true community-based participatory research project, community needs, input and capacity building are primary focal points for this pilot.

Dr. Amy Kirby is an assistant professor in the Department of Global Health at the School of Public Health at Emory. Her research focuses on using molecular microbiology tools to address questions regarding water- and foodborne diseases.

Peoplestown Revitalization Corporation works to improve the quality of life for residents of the Peoplestown community in Atlanta through promoting activities such as economic development, residential development, and other activities that work to better the community and its residents.

Heat-related illness, adaptation, the microbiome, and inflammation

Vicki Hertzberg, School of Nursing & School of Public Health

Heat-related illness (HRI) impacts people across a continuum of symptoms including heat stress and adaptation, heat exhaustion and heat stroke. As climate models project increasing frequency and severity of heat waves, HRI may be seen increasingly in the population. Farmworkers are a particularly vulnerable group, facing heat-related mortality at a rate of nearly 20 times the US civilian population. The pathophysiological processes underlying heat adaptation and heat-related illness are not understood. Evidence suggests that the gut microbiome and inflammation may play a role in HRI. The research team aims to investigate the association of HRI symptoms with the exposome, gut microbiome and inflammatory profiles in a small cohort of farmworkers. To examine these questions, emerging technologies such as multiplexed immunoassays and high throughput sequencing will be used. The research from this pilot could lead to mechanism-based insight into causes of HRI and identification of new interventions for its prevention and treatment.

Dr. Vicki Hertzberg is a professor in the School of Nursing and Department of Biostatistics and Bioinformatics in the School of Public Health at Emory. Her current research focuses on the application of network science to public health questions.

The spatial exposome, geo-microbiome, and the health of African American infants

Michael Kramer, School of Public Health, Department of Epidemiology

Racial and socioeconomic disparities are recognized as factors in various children’s health outcomes such as low birth weight, neurocognitive development, and academic readiness. Evidence points to the impact of early-life exposures (social, physical and toxicant) on these disparities. As people move throughout their days, they experience different exposures depending on their location. Many research studies will use one location such as place of work or home as a proxy for potential exposures but this oversimplifies the dynamic nature of exposures across time and space. In this study, researchers aim to assess whether the lifecourse residential histories and routine activity space of socioeconomically diverse pregnant African American women in Atlanta are linked with environmental exposures and impacts on child health and development. After characterizing their spatial exposome, urine and serum will be analyzed for spatially linked variation in environmental toxicant levels. These analyses will also be completed for gut and vaginal microbiome samples to look for variations in microbial diversity that could be linked to geographic, social and environmental factors. This novel approach will serve to move research towards eliminating health disparities through no longer simply describing disparities that exist but understanding why they persist.

Dr. Michael Kramer is an assistant professor in the Department of Epidemiology at the School of Public Health at Emory. His research focuses on social determinants of health, maternal and child health and spatial analysis and their intersection.

*Pilot is co-funded with the C-CHEM2 Children’s Environmental Health Center

Drinking water quality and gut microbiome composition in infants

Karen Levy, School of Public Health, Department of Environmental Health

Recent research indicates that the gut microbiome may be a key determinant of overall health and resilience. Through understanding what environmental determinants underlie the development and maintenance of the gut microbiome, there is the potential to identify interventions to improve gut health for entire populations. Utilizing a recently recruited cohort of infants exposed to different drinking water sources in rural and urban communities of Peru, the research team will characterize the gut microbial communities and determine if variations in the infant microbiome associate with specific environmental exposures. The research team will assess both chemical and microbial water quality to determine the complexity of exposures occurring. As diarrheal events for infants can have significant implications for their health, the team will also assess how exposure to enteropathogens in drinking water may be associated with diarrheal events across a two week time period. Through exploring these various exposures, outcomes, and overall variations in gut microbiome composition, this study will inform what associations may exist and how future research should be focused to more effectively target interventions for vulnerable populations.

Dr. Karen Levy is an assistant professor in the Department of Environmental Health in the School of Public Health at Emory. Her research is focused on the ecology and epidemiology of waterborne and enteric diseases.

*Pilot is co-funded with the C-CHEM2 Children’s Environmental Health Center

Validation and use of quantitative biomarkers to assess the health impact of improved cookstoves

Tom Clasen, School of Public Health, Department of Environmental Health

Household air pollution from indoor cooking fires can have a significant impact on respiratory health, particularly of young children. Acute lower respiratory infection is the leading contributor to childhood mortality in sub-Saharan Africa and it is well understood that household air pollution increases risk of ALRI. Improved cookstoves are one proposed solution to impact health outcomes. In this pilot study, the research team will validate the use of dried blood spots for the analysis of biomarkers related to household air pollution. The team will utilize stored samples from a completed randomized control trial in Rwanda to assess the health impact of an improved cookstove intervention. Since assessing environmental health interventions through questionnaires cannot be blinded, these questionnaires are at particular risk of disease outcome misclassification and recall bias. Biomarkers would offer one solution to objectively assess physiological effects of these types of interventions. Once the biomarkers are validated, a broader assessment will be completed to assess the impact of the intervention on biomarkers that may be linked to air pollution exposures and health outcomes such as pneumonia and CVD. Through validating and using biomarkers from dried blood spots, this could be incorporated into future studies. This has the potential to significantly enhance researchers’ ability to evaluate similar interventions.

Dr. Tom Clasen is a professor in the Department of Environmental Health in the School of Public Health at Emory. His research interests include health impact evaluations of water, sanitation and household air pollution interventions in low-income countries.