What is PRIMERO?

The Puerto Rican Infant Metagenomic and Epidemiological Study of Respiratory Outcomes (PRIMERO), is the first birth cohort in Puerto Rico that was designed to illuminate the early origins of asthma and other respiratory conditions. To carry out this study, we recruited more than 2,000 mothers and their newborn babies in Puerto Rico and are following the babies during the first five years of their lives to understand respiratory diseases in babies and to determine how early-life viral infections impact the developmental trajectory of infants' airways.

WHY IS THIS STUDY being done?

Decades of studies have shown an association between severe viral respiratory illnesses in the first years of life and the development of wheezing and asthma in childhood, particularly respiratory illnesses in the first years of life caused by respiratory syncytial virus (RSV). and human rhinovirus (HRV), which causes colds. However, most people affected by respiratory viruses are resistant to severe illness, recurrent wheezing, and asthma. We believe there is a complex relationship between genetics, viral species, and environmental exposures in determining asthma risk.

Why Puerto Rico?

Puerto Ricans are among the populations most severely affected by asthma in the world. They have the highest childhood asthma prevalence and mortality (death) rates, and the lowest response to common asthma medications, such as albuterol. Additionally, Puerto Ricans are disproportionately affected by early respiratory illnesses such as pneumonia, bronchitis, and RSV (Wohlford et al. 2020). Also, unlike in the continental US, where RSV is seasonal, RSV is present year-round in Puerto Rico. Conducting the study in Puerto Rico provides a unique opportunity to unravel the contributions of genetics, infections, and other exposures to the development of asthma.