Robert O. Wright, MD, MPH, and Rosalind J. Wright, MD, MPH
Researchers at the Icahn School of Medicine at Mount Sinai have been awarded a $43 million grant from the National Institutes of Health (NIH) to continue their work in a sweeping five-year research program called Environmental influences on Child Health Outcomes (ECHO). The national ECHO study aims to evaluate how a range of environmental factors, also known as the exposome, affect health during childhood, adolescence, and the transition into adulthood. At Mount Sinai, this work builds on the expertise and resources of the Institute for Exposomic Research, which is co-directed by two international leaders in the field, Rosalind J. Wright, MD, MPH, Horace W. Goldsmith Professor of Pediatrics, and Dean for Translational Biomedical Sciences at the Icahn School of Medicine; and Robert O. Wright, MD, MPH, Professor and Ethel H. Wise Chair of the Department of Environmental Medicine and Public Health.
“Exposomic research is changing the way medicine is practiced by finally addressing the largely unstudied role that our environment plays in our health—and doing so on the grandest possible scale,” says Dr. Robert Wright. In the ECHO program, institutions across the nation will study up to 50,000 families, investigating the influence of environmental exposures on four key areas: perinatal outcomes such as preterm birth; child growth and obesity; respiratory disorders; and neurobehavioral and cognitive difficulties that may affect social and academic functioning in the longer term. The Wrights are principal investigators of a regional ECHO consortium, including sites in New York City, Boston, and Virginia, that will study 5,000 women and children, measuring the exposome across their diverse ethnic backgrounds.
“Synergistic programs”
Mount Sinai has also received two related NIH grants, for a total of $19.4 million, that fund its participation in the Children’s Health Exposure Analysis Resource (CHEAR) program, which is designed to support ECHO. One CHEAR grant funds a Laboratory Hub, led by Dr. Robert Wright, which analyzes environmental chemicals, metabolites, hormones, and other factors. The other supports the Data Repository, Analysis, and Science Center, led by Susan Teitelbaum, PhD, Professor, Environmental Medicine and Public Health, which conducts big data analysis. Across the nation, there are six CHEAR laboratory hubs, and one data center, at Mount Sinai. “ECHO and CHEAR are naturally synergistic programs,” says Dr. Robert Wright. “CHEAR will run exposomic assays on samples collected by ECHO that can identify thousands of chemicals to which children are exposed, and can systematically study which are toxic, which are harmless, and which are beneficial.”
In 2016, Mount Sinai won a large NIH grant during the development phase of ECHO, and since then Dr. Robert Wright and Dr. Rosalind Wright have been part of a select national committee that has shaped the program. Now they are helping set protocols for the researchers who will follow up with mothers and children at multiple stages of life—collecting samples of blood, urine, hair, saliva, and placental tissue, and gathering data on birth weight, preterm birth, growth, cognitive development, and lung development.
Informing better health
One overarching goal of the ECHO study is “solution-oriented research,” Dr. Rosalind Wright says. “We are not just looking for risk factors, we are also measuring factors that might be protective and build resilience. For example, there is evidence that higher intake of antioxidants such as vitamin C and anti-inflammatory fatty acids, like omega-3 fish oils, can buffer the effects of stress and other toxins. We are now looking at the effect of diet on exposure to air pollution and chemical toxicities,” she says. “People in the ECHO program are really excited—we are all in this because we want our research to inform better health.”