W180 - Immune Development in Early Life (IDEAL): A Systems Immunology Approach to Identify Endotypes Predictive of Vaccine Responsiveness, Respiratory Infections, and Asthma

Abstract Text:

Background: The IDEaL-Rome prospective pediatric cohort, based at Bambino Gesù Children’s Hospital (OPBG, Rome, Italy), is part of a longitudinal observational study supported by NIH/NIAID. The study aims to identify molecular endotypes associated with increased susceptibility to respiratory infection, asthma (AS) and vaccine responsiveness (VR) in childhood using a systems immunology approach.

Methods: The study includes six scheduled visits (V1 at 2 months, V2 at 5 months, V3 at 9 months, V4 at 1 year, V5 at 3 years, and V6 at 5 years of age). Clinical data are integrated with multi-omic datasets, including cytokine/chemokine profiles, proteomic, metabolomic, microbiome, and epigenetics, to define developmental trajectories associated with VR, AS, and infection proneness (IP). VR is assessed by specific antibody titers, AS diagnosis is based on the Asthma Predictive Index, and IP is defined as ≥3 respiratory infections and/or severe infections during the first year of life.

Results: From April 2023 to November 2024, 273 participants (129 males, 144 females) were enrolled. To date, 210 participants have completed V4. Among these, 37.1% experienced ≥3 infections in the first year. Reported infections included common cold (168 cases), SARS-CoV-2 (51 cases: 37 confirmed, 14 suspected), bronchiolitis (39 cases), bronchitis (45 cases), pneumonia (2 cases), pharyngitis/tonsillitis (53 cases), otitis media (37 cases), and septic osteoarthritis (1 case).

Conclusions: The IDEaL-Rome prospective cohort will provide a robust repository of biospecimens as well as clinical, immunologic, and systems biology data enabling multi-omic analyses to define molecular endotypes predictive of vaccine responsiveness, infection susceptibility, and asthma.