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The Cohort for Childhood Origin of Asthma and allergic diseases (COCOA) study: design, rationale and methods

 Hyeon-Jong Yang  ;  So-Yeon Lee  ;  Dong In Suh  ;  Youn Ho Shin  ;  Byoung-Ju Kim  ;  Ju-Hee Seo  ;  Hyoung Yoon Chang  ;  Kyung Won Kim  ;  Kangmo Ahn  ;  Yee-Jin Shin  ;  Kyung-Sook Lee  ;  Cheol Min Lee  ;  Se-Young Oh  ;  Ho Kim  ;  Jong-Han Leem  ;  Hwan-Cheol Kim  ;  Eun-Jin Kim  ;  Joo-Shil Lee  ;  Soo-Jong Hong 
 BMC PULMONARY MEDICINE, Vol.14(109) : 1-12, 2014 
Journal Title
Issue Date
Air Pollutants ; Asthma/epidemiology ; Asthma/etiology ; Child ; Child, Preschool ; DNA/analysis ; Dermatitis, Atopic/epidemiology ; Disease Susceptibility/epidemiology ; Environmental Exposure* ; Epigenesis, Genetic ; Female ; Fetal Blood/chemistry ; Food Hypersensitivity/epidemiology ; Humans ; Hypersensitivity, Immediate/epidemiology* ; Hypersensitivity, Immediate/etiology* ; Infant ; Infant, Newborn ; Longitudinal Studies ; Male ; Maternal Exposure* ; Microbiota ; Nutrition Assessment ; Paternal Exposure ; Pregnancy ; Prenatal Exposure Delayed Effects/epidemiology ; Prospective Studies ; Republic of Korea ; Research Design* ; Respiratory Sounds ; Rhinitis, Allergic/epidemiology ; Skin/microbiology ; Stress, Psychological/epidemiology ; Urban Population
Cohort study ; Gene-environment interaction ; Allergy ; Microbiota ; Nutritional Status ; Psychologic stress
BACKGROUND: This paper describes the background, aim, and design of a prospective birth-cohort study in Korea called the COhort for Childhood Origin of Asthma and allergic diseases (COCOA). COCOA objectives are to investigate the individual and interactive effects of genetics, perinatal environment, maternal lifestyle, and psychosocial stress of mother and child on pediatric susceptibility to allergic diseases. METHODS/DESIGN: The participants in COCOA represents a Korean inner-city population. Recruitment started on 19 November, 2007 and will continue until 31 December, 2015. Recruitment is performed at five medical centers and eight public-health centers for antenatal care located in Seoul. Participating mother-baby pairs are followed from before birth to adolescents. COCOA investigates whether the following five environmental variables contribute causally to the development and natural course of allergic diseases: (1) perinatal indoor factors (i.e. house-dust mite, bacterial endotoxin, tobacco smoking, and particulate matters 2.5 and 10), (2) perinatal outdoor pollutants, (3) maternal prenatal psychosocial stress and the child's neurodevelopment, (4) perinatal nutrition, and (5) perinatal microbiome. Cord blood and blood samples from the child are used to assess whether the child's genes and epigenetic changes influence allergic-disease susceptibility. Thus, COCOA aims to investigate the contributions of genetics, epigenetics, and various environmental factors in early life to allergic-disease susceptibility in later life. How these variables interact to shape allergic-disease susceptibility is also a key aim.The COCOA data collection schedule includes 11 routine standardized follow-up assessments of all children at 6 months and every year until 10 years of age, regardless of allergic-disease development. The mothers will complete multiple questionnaires to assess the baseline characteristics, the child's exposure to environmental factors, maternal pre- and post-natal psychological stress, and the child's neurodevelopment, nutritional status, and development of allergic and respiratory illnesses. The child's microbiome, genes, epigenetics, plasma cytokine levels, and neuropsychological status, the microbiome of the residence, and the levels of indoor and outdoor pollutants are measured by standard procedures. DISCUSSION: The COCOA study will improve our understanding of how individual genetic or environmental risk factors influence susceptibility to allergic disease and how these variables interact to shape the phenotype of allergic diseases.
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1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Won(김경원) ORCID logo https://orcid.org/0000-0003-4529-6135
Shin, Yee Jin(신의진) ORCID logo https://orcid.org/0000-0001-8573-4342
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