The PRIMERO birth cohort: Design and baseline characteristics

Background: Although early-life respiratory illnesses (RIs) are linked to childhood asthma, it is unclear whether children are predisposed to both conditions or if RIs induce alterations that lead to asthma. Puerto Rican children, who bear a disproportionate burden of early-life RIs and asthma, are...

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Main Authors: Jonathan I. Witonsky, MD, MAS, Jennifer R. Elhawary, MS, Celeste Eng, BS, Sam S. Oh, PhD, MPH, Sandra Salazar, Maria G. Contreras, BS, Vivian Medina, RN, BSN, SC, Elizabeth A. Secor, MA, Priscilla Zhang, BS, Jamie L. Everman, PhD, Ana Fairbanks-Mahnke, BS, Elmar Pruesse, PhD, Satria P. Sajuthi, PhD, Chih-Hao Chang, PhD, MPH, Tsunami Rosado Guerrero, BS, Keyshla Canales Fuentes, BS, Natalie Lopez, MD, Chris Angely Montañez-López, MS, Emily Vazquez Morales, MD, Nicole Vazquez Morales, MD, Richeliz Alfonso Otero, MD, Raymarie Colon Rivera, BS, Leysha Rodriguez, BA, Gabriela Vazquez, BS, Donglei Hu, PhD, Scott Huntsman, MS, Nathan D. Jackson, PhD, Yingchun Li, MD, PhD, Andrew Morin, MA, Natalie A. Nieves, BS, Cydney Rios, BS, Gonzalo Serrano, BS, Blake J.M. Williams, MS, Elad Ziv, MD, Camille M. Moore, PhD, Dean Sheppard, MD, Esteban González Burchard, MD, MPH, Max A. Seibold, PhD, Jose R. Rodríguez-Santana, MD
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Journal of Allergy and Clinical Immunology: Global
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772829325000712
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author Jonathan I. Witonsky, MD, MAS
Jennifer R. Elhawary, MS
Celeste Eng, BS
Sam S. Oh, PhD, MPH
Sandra Salazar
Maria G. Contreras, BS
Vivian Medina, RN, BSN, SC
Elizabeth A. Secor, MA
Priscilla Zhang, BS
Jamie L. Everman, PhD
Ana Fairbanks-Mahnke, BS
Elmar Pruesse, PhD
Satria P. Sajuthi, PhD
Chih-Hao Chang, PhD, MPH
Tsunami Rosado Guerrero, BS
Keyshla Canales Fuentes, BS
Natalie Lopez, MD
Chris Angely Montañez-López, MS
Emily Vazquez Morales, MD
Nicole Vazquez Morales, MD
Richeliz Alfonso Otero, MD
Raymarie Colon Rivera, BS
Leysha Rodriguez, BA
Gabriela Vazquez, BS
Donglei Hu, PhD
Scott Huntsman, MS
Nathan D. Jackson, PhD
Yingchun Li, MD, PhD
Andrew Morin, MA
Natalie A. Nieves, BS
Cydney Rios, BS
Gonzalo Serrano, BS
Blake J.M. Williams, MS
Elad Ziv, MD
Camille M. Moore, PhD
Dean Sheppard, MD
Esteban González Burchard, MD, MPH
Max A. Seibold, PhD
Jose R. Rodríguez-Santana, MD
author_facet Jonathan I. Witonsky, MD, MAS
Jennifer R. Elhawary, MS
Celeste Eng, BS
Sam S. Oh, PhD, MPH
Sandra Salazar
Maria G. Contreras, BS
Vivian Medina, RN, BSN, SC
Elizabeth A. Secor, MA
Priscilla Zhang, BS
Jamie L. Everman, PhD
Ana Fairbanks-Mahnke, BS
Elmar Pruesse, PhD
Satria P. Sajuthi, PhD
Chih-Hao Chang, PhD, MPH
Tsunami Rosado Guerrero, BS
Keyshla Canales Fuentes, BS
Natalie Lopez, MD
Chris Angely Montañez-López, MS
Emily Vazquez Morales, MD
Nicole Vazquez Morales, MD
Richeliz Alfonso Otero, MD
Raymarie Colon Rivera, BS
Leysha Rodriguez, BA
Gabriela Vazquez, BS
Donglei Hu, PhD
Scott Huntsman, MS
Nathan D. Jackson, PhD
Yingchun Li, MD, PhD
Andrew Morin, MA
Natalie A. Nieves, BS
Cydney Rios, BS
Gonzalo Serrano, BS
Blake J.M. Williams, MS
Elad Ziv, MD
Camille M. Moore, PhD
Dean Sheppard, MD
Esteban González Burchard, MD, MPH
Max A. Seibold, PhD
Jose R. Rodríguez-Santana, MD
author_sort Jonathan I. Witonsky, MD, MAS
collection DOAJ
description Background: Although early-life respiratory illnesses (RIs) are linked to childhood asthma, it is unclear whether children are predisposed to both conditions or if RIs induce alterations that lead to asthma. Puerto Rican children, who bear a disproportionate burden of early-life RIs and asthma, are an important population for studying this relationship. Objective: We sought to describe the design and baseline characteristics of the Puerto Rican Infant Metagenomic and Epidemiologic Study of Respiratory Outcomes (PRIMERO) birth cohort. Methods: PRIMERO is designed to examine the role of respiratory viruses on the development of RIs and asthma. Pregnant women were recruited at Hospital Interamericano de Medicina Avanzada–San Pablo in Caguas, Puerto Rico. Questionnaires at birth and annual follow-ups gather clinical, social, and environmental data. Collected samples include postterm maternal blood; infant cord blood; the child’s blood at year 2; and the child’s nasal airway epithelium at birth, during RIs over the first 2 years, and annually until age 5. Results: We enrolled 2,100 mother–child dyads into the PRIMERO study between February 2020 and June 2023, representing 59% of births at Hospital Interamericano de Medicina Avanzada. As of April 29, 2024, 2,069 participants remain active, with high rates of biospecimen collection and annual visit participation. Illness surveillance detected 6,076 RIs, with 38.4% involving the lower respiratory tract. Conclusion: The PRIMERO birth cohort study, with its comprehensive data on viral exposures, respiratory outcomes, and airway molecular phenotypes in a high-risk population of Puerto Rican children, is uniquely positioned to address long-standing questions about the early-life determinants and mechanisms underlying virus-related asthma development.
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spelling doaj-art-c5b04f4d5ad9490d83072eb8f060dc342025-08-20T03:57:31ZengElsevierJournal of Allergy and Clinical Immunology: Global2772-82932025-08-014310047010.1016/j.jacig.2025.100470The PRIMERO birth cohort: Design and baseline characteristicsJonathan I. Witonsky, MD, MAS0Jennifer R. Elhawary, MS1Celeste Eng, BS2Sam S. Oh, PhD, MPH3Sandra Salazar4Maria G. Contreras, BS5Vivian Medina, RN, BSN, SC6Elizabeth A. Secor, MA7Priscilla Zhang, BS8Jamie L. Everman, PhD9Ana Fairbanks-Mahnke, BS10Elmar Pruesse, PhD11Satria P. Sajuthi, PhD12Chih-Hao Chang, PhD, MPH13Tsunami Rosado Guerrero, BS14Keyshla Canales Fuentes, BS15Natalie Lopez, MD16Chris Angely Montañez-López, MS17Emily Vazquez Morales, MD18Nicole Vazquez Morales, MD19Richeliz Alfonso Otero, MD20Raymarie Colon Rivera, BS21Leysha Rodriguez, BA22Gabriela Vazquez, BS23Donglei Hu, PhD24Scott Huntsman, MS25Nathan D. Jackson, PhD26Yingchun Li, MD, PhD27Andrew Morin, MA28Natalie A. Nieves, BS29Cydney Rios, BS30Gonzalo Serrano, BS31Blake J.M. Williams, MS32Elad Ziv, MD33Camille M. Moore, PhD34Dean Sheppard, MD35Esteban González Burchard, MD, MPH36Max A. Seibold, PhD37Jose R. Rodríguez-Santana, MD38Department of Pediatrics, University of California, San Francisco, Calif; Corresponding author: Jonathan Witonsky, MD, MAS, Department of Pediatrics, University of California, San Francisco, 550 16th St, 4th Fl, San Francisco, CA 94143.Department of Medicine, University of California, San Francisco, CalifDepartment of Medicine, University of California, San Francisco, CalifDepartment of Medicine, University of California, San Francisco, CalifDepartment of Medicine, University of California, San Francisco, CalifDepartment of Medicine, University of California, San Francisco, CalifCentro de Neumología Pediátrica, San Juan, Puerto RicoCenter for Genes, Environment & Health, National Jewish Health, Denver, ColoDepartment of Medicine, University of California, San Francisco, CalifCenter for Genes, Environment & Health, National Jewish Health, Denver, ColoCenter for Genes, Environment & Health, National Jewish Health, Denver, ColoCenter for Genes, Environment & Health, National Jewish Health, Denver, ColoCenter for Genes, Environment & Health, National Jewish Health, Denver, ColoDepartment of Medicine, University of California, San Francisco, CalifCentro de Neumología Pediátrica, San Juan, Puerto RicoCentro de Neumología Pediátrica, San Juan, Puerto RicoCentro de Neumología Pediátrica, San Juan, Puerto RicoCentro de Neumología Pediátrica, San Juan, Puerto RicoCentro de Neumología Pediátrica, San Juan, Puerto RicoCentro de Neumología Pediátrica, San Juan, Puerto RicoCentro de Neumología Pediátrica, San Juan, Puerto RicoCentro de Neumología Pediátrica, San Juan, Puerto RicoCentro de Neumología Pediátrica, San Juan, Puerto RicoCentro de Neumología Pediátrica, San Juan, Puerto RicoDepartment of Medicine, University of California, San Francisco, CalifDepartment of Medicine, University of California, San Francisco, CalifCenter for Genes, Environment & Health, National Jewish Health, Denver, ColoCenter for Genes, Environment & Health, National Jewish Health, Denver, ColoCenter for Genes, Environment & Health, National Jewish Health, Denver, ColoCentro de Neumología Pediátrica, San Juan, Puerto RicoCenter for Genes, Environment & Health, National Jewish Health, Denver, ColoCentro de Neumología Pediátrica, San Juan, Puerto RicoCenter for Genes, Environment & Health, National Jewish Health, Denver, ColoDepartment of Medicine, University of California, San Francisco, CalifCenter for Genes, Environment & Health, National Jewish Health, Denver, ColoDepartment of Medicine, University of California, San Francisco, CalifDepartment of Medicine, University of California, San Francisco, CalifCenter for Genes, Environment & Health, National Jewish Health, Denver, Colo; Department of Pediatrics and Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado, Aurora, ColoCentro de Neumología Pediátrica, San Juan, Puerto RicoBackground: Although early-life respiratory illnesses (RIs) are linked to childhood asthma, it is unclear whether children are predisposed to both conditions or if RIs induce alterations that lead to asthma. Puerto Rican children, who bear a disproportionate burden of early-life RIs and asthma, are an important population for studying this relationship. Objective: We sought to describe the design and baseline characteristics of the Puerto Rican Infant Metagenomic and Epidemiologic Study of Respiratory Outcomes (PRIMERO) birth cohort. Methods: PRIMERO is designed to examine the role of respiratory viruses on the development of RIs and asthma. Pregnant women were recruited at Hospital Interamericano de Medicina Avanzada–San Pablo in Caguas, Puerto Rico. Questionnaires at birth and annual follow-ups gather clinical, social, and environmental data. Collected samples include postterm maternal blood; infant cord blood; the child’s blood at year 2; and the child’s nasal airway epithelium at birth, during RIs over the first 2 years, and annually until age 5. Results: We enrolled 2,100 mother–child dyads into the PRIMERO study between February 2020 and June 2023, representing 59% of births at Hospital Interamericano de Medicina Avanzada. As of April 29, 2024, 2,069 participants remain active, with high rates of biospecimen collection and annual visit participation. Illness surveillance detected 6,076 RIs, with 38.4% involving the lower respiratory tract. Conclusion: The PRIMERO birth cohort study, with its comprehensive data on viral exposures, respiratory outcomes, and airway molecular phenotypes in a high-risk population of Puerto Rican children, is uniquely positioned to address long-standing questions about the early-life determinants and mechanisms underlying virus-related asthma development.http://www.sciencedirect.com/science/article/pii/S2772829325000712Childhood asthmarespiratory illnessbirth cohortgene–environment interactionstranscriptomicsviral pathogen detection
spellingShingle Jonathan I. Witonsky, MD, MAS
Jennifer R. Elhawary, MS
Celeste Eng, BS
Sam S. Oh, PhD, MPH
Sandra Salazar
Maria G. Contreras, BS
Vivian Medina, RN, BSN, SC
Elizabeth A. Secor, MA
Priscilla Zhang, BS
Jamie L. Everman, PhD
Ana Fairbanks-Mahnke, BS
Elmar Pruesse, PhD
Satria P. Sajuthi, PhD
Chih-Hao Chang, PhD, MPH
Tsunami Rosado Guerrero, BS
Keyshla Canales Fuentes, BS
Natalie Lopez, MD
Chris Angely Montañez-López, MS
Emily Vazquez Morales, MD
Nicole Vazquez Morales, MD
Richeliz Alfonso Otero, MD
Raymarie Colon Rivera, BS
Leysha Rodriguez, BA
Gabriela Vazquez, BS
Donglei Hu, PhD
Scott Huntsman, MS
Nathan D. Jackson, PhD
Yingchun Li, MD, PhD
Andrew Morin, MA
Natalie A. Nieves, BS
Cydney Rios, BS
Gonzalo Serrano, BS
Blake J.M. Williams, MS
Elad Ziv, MD
Camille M. Moore, PhD
Dean Sheppard, MD
Esteban González Burchard, MD, MPH
Max A. Seibold, PhD
Jose R. Rodríguez-Santana, MD
The PRIMERO birth cohort: Design and baseline characteristics
Journal of Allergy and Clinical Immunology: Global
Childhood asthma
respiratory illness
birth cohort
gene–environment interactions
transcriptomics
viral pathogen detection
title The PRIMERO birth cohort: Design and baseline characteristics
title_full The PRIMERO birth cohort: Design and baseline characteristics
title_fullStr The PRIMERO birth cohort: Design and baseline characteristics
title_full_unstemmed The PRIMERO birth cohort: Design and baseline characteristics
title_short The PRIMERO birth cohort: Design and baseline characteristics
title_sort primero birth cohort design and baseline characteristics
topic Childhood asthma
respiratory illness
birth cohort
gene–environment interactions
transcriptomics
viral pathogen detection
url http://www.sciencedirect.com/science/article/pii/S2772829325000712
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