Exposure to Fine Particulate Air Pollution Causes Vascular Insulin Resistance by Inducing Pulmonary Oxidative Stress

Long-Term Exposure to Fine Particulate Matter and the Risk of Chronic Liver Diseases: A Meta-Analysis of Observational Studies

Although fine particulate matter (PM2.5) is a known carcinogen, evidence of the association between PM2.5 and chronic liver disease is controversial. In the present meta-analysis study, we reviewed epidemiological studies to strengthen evidence for the association between PM2.5 and chronic liver disease. We searched three online databases from 1990 up to 2022. The random-effect model was applied for detection of overall risk estimates. Sixteen eligible studies, including one cross-sectional study, one retrospective cohort study, and 14 prospective cohort studies, fulfilled inclusion criteria with more than 330 thousand participants from 13 countries. Overall risk estimates of chronic liver disease for 10 μg/m3 increase in PM2.5 was 1.27 (95% confidence interval (CI): 1.19−1.35, p < 0.001). We further analyzed the relationship between PM2.5 exposure and different chronic liver diseases. The results showed that increments in PM2.5 exposure significantly increased the risk of liver cancer, liver cirrhosis, and fatty liver disease (hazard ratio (HR) = 1.23, 95% CI: 1.14−1.33; HR = 1.17, 95% CI: 1.06−1.29; HR = 1.51, 95% CI: 1.09−2.08, respectively). Our meta-analysis indicated long-term exposure to PM2.5 was associated with increased risk of chronic liver disease. Moreover, future researches should be focused on investigating subtypes of chronic liver diseases and specific components of PM2.5.

Identification of the susceptible subpopulations for wide pulse pressure under long-term exposure to ambient particulate matters

Wide pulse pressure (WPP) is a preclinical indicator for arterial stiffness and cardiovascular diseases. Long-term exposure to ambient particulate matters (PMs) would increase the risk of WPP. Although reducing pollutants emissions and avoiding outdoor activity during a polluted period are effective ways to blunt the adverse effects. Identifying and protecting the susceptible subpopulation is another crucial way to reduce the disease burdens. Therefore, we aimed to identify the susceptible subpopulations of WPP under long-term exposure to PMs. The WPP was defined as pulse pressure over 60 mmHg. Three-year averages of PMs were estimated using random forest approaches. Associations between WPP and PMs exposure were estimated using generalized propensity score weighted logistic regressions. Demographic, socioeconomic characteristics, health-related behaviors, and hematological biomarkers were collected to detect the modification effects on the WPP-PMs associations. Susceptible subpopulations were defined as those with significantly higher risks of WPP under PMs exposures. The PMs-WPP associations were significant with ORs (95%CI) of 1.126 (1.094, 1.159) for PM₁, 1.174 (1.140, 1.210) for PM_2.5, and 1.111 (1.088, 1.135) for PM₁₀. There were 17 subpopulations more sensitive to WPP under long-term exposure to PMs. The susceptibility was higher in subpopulations with high BMI (Q3-Q4 quartiles), high-intensive physical activity (Q3 or Q4 quartile), insufficient or excessive fruit intake (Q1 or Q5 quartile), insufficient or too long sleep length (<7 or >8 h). Subpopulations with elevated inflammation markers (WBC, LYM, BAS, EOS: Q3-Q4 quartiles) and glucose metabolism indicators (HbA1c, GLU: Q3-Q4 quartiles) were more susceptible. Besides, elder, urban living, low socioeconomic level, and excessive red meat and sodium salt intake were also related to higher susceptibility. Our findings on the susceptibility characteristics would help to develop more targeted disease prevention and therapy strategies. Health resources can be allocated more effectively by putting more consideration to subpopulations with higher susceptibility.

Could greenness modify the effects of physical activity and air pollutants on overweight and obesity among children and adolescents?

Greenness could theoretically increase the impact of physical activity (PA) and reduce the adverse effects of air pollution on overweight/obesity. However, no evidence systematically compares these two pathways, especially in longitudinal studies of children and adolescent's cohort. Greenness, PA, and air pollution were assessed by Normalized Difference Vegetation Index (NDVI), International Physical Activity Short Form, and 7 pollutants (PM₁, PM_2.5, PM₁₀, SO₂, NO₂, CO, and O₃). Each exposure was divided into low-/high-level groups based on the 50% quantile. Proportional hazards and logistic regression model were used to assess the associations of greenness, PA, pollutants with overweight/obesity. The incidence of overweight/obesity was 1.98% in the national survey, and the cumulative incidence and incidence density were 12.76% and 3.43 per 100 person-year in the dynamic cohort, separately. An increase of 0.1 units in NDVI was associated with a 12% lower risk of overweight/obesity, but no significant link between PA and incidence was observed. The HRs of the high-level of PM₁, PM_2.5, PM₁₀, SO₂, NO₂, CO, and O₃ on the risk of overweight/obesity were 2.21, 2.63, 1.88, 2.38, 1.33, 2.43, and 1.33 in the low-level of greenness, which was higher than those in the high-level of greenness. The AFs of PM₁, PM_2.5, PM₁₀, SO₂, NO₂, CO, and O₃ were 25.58%, 44.37%, 22.96%, 29.15%, 11.55%, 29.50%, and 10.92% in the low-level of greenness, which simultaneously was higher than those in the high-level of greenness. Moreover, the risk of overweight/obesity associated with high-level of greenness in the high-level of PM₁₀, SO₂, CO were 0.83, 0.81, and 0.83 respectively. Our findings confirmed that greenness has a moderating effect on the effects of air pollutants on childhood overweight/obesity especially in heavy-industry areas where PM₁₀, SO₂, and CO are the major pollutants, although it did not influence the association between PA and overweight/obesity risks.

Ceramide metabolism mediates the impaired glucose homeostasis following short-term black carbon exposure: A targeted lipidomic analysis

BACKGROUND

Ambient particulate matter (PM), especially its carbonaceous composition black carbon (BC) increases cardiometabolic risks, yet the underlying mechanisms are incompletely understood. Ceramides (Cer; a class of sphingolipids) are biological intermediates in glucose metabolism.

OBJECTIVES

To explore whether Cer metabolism mediates impaired glucose homeostasis following short-term PM exposure.

METHODS

In a panel study in Beijing, China, 112 participants were followed-up between 2016 and 2017. Targeted lipidomic analyses quantified 26 sphingolipids in 387 plasma samples. Ambient BC and PM with aerodynamic diameter ≤ 2.5 μm (PM_2.5) were continuously monitored in a station. We examined the associations of sphingolipid levels with average BC and PM_2.5 concentrations 1-14 days before clinical visits using linear mixed-effects models, and explored the mediation effects of sphingolipids on PM-associated fasting blood glucose (FBG) difference using mediation analyses.

RESULTS

Increased levels of FBG and multiple sphingolipids in Cer metabolic pathways were associated with BC exposure in 1-14-day time window, but not with PM_2.5 exposure. For each 10 μg/m³ increase in the average BC concentration 1-14 days before the clinical visits, species in the Cer C24:1 pathway (Cer, dihydroceramide, hexosylceramide, lactosylceramide, and sphingomyelin C24:1) increased in levels ranging from 11.8% (95% confidence interval [CI]: -6.2-33.2) to 48.7% (95% CI: 8.8-103.4), as did the Cer C16:0, C18:0, and C20:0 metabolic pathway species, ranging from 3.2% (95% CI: -5.6-12.9) to 32.4% (95% CI: 7.0-63.8), respectively. The Cer C24:1 metabolic pathway species mediated 6.5-25.5% of the FBG increase associated with BC exposure in 9-day time window. The Cer C16:0, C18:0, and C20:0 metabolic pathway species mediated 5.4-26.2% of the BC-associated FBG difference.

CONCLUSIONS

In conclusion, Cer metabolism may mediate impaired glucose homeostasis following short-term BC exposure. The current findings are preliminary, which need to be corroborated by further studies.

Traffic-related air pollution, biomarkers of metabolic dysfunction, oxidative stress, and CC16 in children

BACKGROUND

Previous research has revealed links between air pollution exposure and metabolic syndrome in adults; however, these associations are less explored in children.

OBJECTIVE

This study aims to investigate the association between traffic-related air pollutants (TRAP) and biomarkers of metabolic dysregulation, oxidative stress, and lung epithelial damage in children.

METHODS

We conducted cross-sectional analyses in a sample of predominantly Latinx, low-income children (n = 218) to examine associations between air pollutants (nitrogen dioxide (NO₂), nitrogen oxides (NO_x), elemental carbon, polycyclic aromatic hydrocarbons, carbon monoxide (CO), fine particulates (PM_2.5)) and biomarkers of metabolic function (high-density lipoprotein (HDL), hemoglobin A1c (HbA1c), oxidative stress (8-isoprostane), and lung epithelial damage (club cell protein 16 (CC16)).

RESULTS

HDL cholesterol showed an inverse association with NO₂ and NO_x, with the strongest relationship between HDL and 3-month exposure to NO₂ (-15.4 mg/dL per IQR increase in 3-month NO₂, 95% CI = -27.4, -3.4). 8-isoprostane showed a consistent pattern of increasing values with 1-day and 1-week exposure across all pollutants. Non-significant increases in % HbA1c were found during 1-month time frames and decreasing CC16 in 3-month exposure time frames.

CONCLUSION

Our results suggest that TRAP is significantly associated with decreased HDL cholesterol in longer-term time frames and elevated 8-isoprostane in shorter-term time frames. TRAP could have the potential to influence lifelong metabolic patterns, through metabolic effects in childhood.

Global association between atmospheric particulate matter and obesity: A systematic review and meta-analysis

BACKGROUND

Among various air pollutants, particulate matter (PM) is the most harmful and representative pollutant. Although several studies have shown a link between particulate pollution and obesity, the conclusions are still inconsistent.

METHODS

We conducted a systematic review and meta-analysis to pool the effect of PM exposure on obesity. Five databases (including PubMed, Web of Science, Scopus, Embase, and Cochrane) were searched for relevant studies up to Jan 2022. Adjusted risk ratio (RR) with corresponding 95% confidence interval (CI) were retrieved from individual studies and pooled with random effect models by STATA software. Besides, we tested the stability of results by Egger's test, Begg's test, funnel plot, and using the trim-and-fill method to modify the possible asymmetric funnel graph. The NTP-OHAT guidelines were followed to assess the risk of bias. Then the GRADE was used to evaluate the certainty of evidence.

RESULTS

26 studies were included in this meta-analysis. 19 studies have shown that PM_2.5 can increase the risk of obesity per 10 μg/m³ increment (RR: 1.159, 95% CI: 1.111-1.209), while 15 studies have indicated that PM₁₀ increase the risk of obesity per 10 μg/m³ increment (RR: 1.092, 95% CI: 1.070-1.116). Besides, 5 other articles with maternal exposure showed that PM_2.5 increases the risk of obesity in children (RR: 1.06, 95% CI: 1.02-1.11). And we explored the source of heterogeneity by subgroup analysis, which suggested associations between PM and obesity tended to vary by region, age group, participants number, etc. The analysis results showed publication bias and other biases are well controlled, but most certainties of the evidence were low, and more research is required to reduce these uncertainties.

CONCLUSION

Exposure to PM_2.5 and PM₁₀ with per 10 μg/m³ increment could increase the risk of obesity in the global population.

Abnormal fasting blood glucose enhances the risk of long-term exposure to air pollution on dyslipidemia: A cross-sectional study

Both long-term exposure to air pollution and abnormal fasting blood glucose (FBG) are linked to dyslipidemia prevalence. However, the joint role of air pollution and FBG on dyslipidemia remains unknown clearly. In this study, we aimed to test whether abnormal FBG could enhance the risks of long-term exposure to air pollutants on dyslipidemia in general Chinese adult population. The present study recruited 8917 participants from 4 cities in Hebei province, China. Participants' individual exposure to air pollutants was evaluated by the Empirical Bayesian Kriging statistical model in ArcGIS10.2 geographic information system. Dyslipidemia was defined according to Guidelines for the Prevention and Treatment of Dyslipidemia in Chinese Adults. Subjects were grouped into normal, prediabetes, diabetes according to FBG level. Generalized linear models were applied to analyze the interaction of air pollutants and FBG on dyslipidemia prevalence. The prevalence of dyslipidemia was 43.83% in our investigation. After adjusting all covariates, we found the risk of four air pollutants (PM_2.5, PM₁₀, NO₂, SO₂) on dyslipidemia prevalence was stronger as higher FBG level, and the adjusted odd ratio of interaction (OR_inter (95% CI)) between PM_2.5, PM₁₀, NO₂, SO₂ and FBG levels on dyslipidemia was 1.171 (1.162, 1.189), 1.119 (1.111, 1.127), 1.124 (1.115, 1.130), 1.107 (1.098, 1.115), respectively. Stratified analyses indicated the modifying effects of FBG on the association of air pollution with dyslipidemia were stronger among male, less than 65 years old, overweight/obesity (all P_inter<0.1). Our study concluded that high FBG levels strengthened the risk of long-term exposure to air pollution on dyslipidemia, especially more noticeable in male, less than 65 years old, overweight.

Modification Effect of PARP4 and ERCC1 Gene Polymorphisms on the Relationship between Particulate Matter Exposure and Fasting Glucose Level

Particulate matter (PM) has been linked to adverse health outcomes, including insulin resistance (IR). To evaluate the relationships between exposures to PM₁₀, PM_2.5–10, and PM_2.5; the serum level of fasting glucose, a key IR indicator; and effects of polymorphisms of two repair genes (PARP4 and ERCC1) on these relations, PMs exposure data and blood samples for glucose measurement and genotyping were collected from 527 Korean elders. Daily average levels of PMs during 8 days, from 7 days before examination to the health examination day (from lag day 7 to lag day 0), were used for association analyses, and mean concentrations of PM₁₀, PM_2.5–10, and PM_2.5 during the study period were 43.4 µg/m³, 19.9 µg/m³, and 23.6 µg/m³, respectively. All three PMs on lag day 4 (mean, 44.5 µg/m³ for PM₁₀, 19.9 µg/m³ for PM_2.5–10, and 24.3 µg/m³ for PM_2.5) were most strongly associated with an increase in glucose level (percent change by inter-quartile range-change of PM: (β) = 1.4 and p = 0.0023 for PM₁₀; β = 3.0 and p = 0.0010 for PM_2.5–10; and β = 2.0 and p = 0.0134 for PM_2.5). In particular, elders with PARP4 G-C-G or ERCC1 T-C haplotype were susceptible to PMs exposure in relation to glucose levels (PARP4 G-C-G: β = 2.6 and p = 0.0006 for PM₁₀, β = 3.5 and p = 0.0009 for PM_2.5–10, and β = 1.6 and p = 0.0020 for PM_2.5; ERCC1 T-C: β = 2.2 and p = 0.0016 for PM₁₀, β = 3.5 and p = 0.0003 for PM_2.5–10, and β = 1.2 and p = 0.0158 for PM_2.5). Our results indicated that genetic polymorphisms of PARP4 and ERCC1 could modify the relationship between PMs exposure and fasting glucose level in the elderly.

Transcriptional pathways of elevated fasting blood glucose associated with short-term exposure to ultrafine particles: A panel study in Beijing, China

There is growing concern about the strong health effects of ultrafine particles (UFPs). However, less is known about the biological mechanisms. The objective of this study is to examine the association between short-term exposure to UFPs and fasting blood glucose (FBG) levels, and explore the potential physiological mechanisms at transcriptional levels. In a panel study of 135 participants, we measured FBG and the whole blood transcriptome repeatedly. The concentrations of ambient air pollutants were monitored continuously at a station. Linear mixed-effects models coupled with a mediating effect model were used to discriminate transcripts associated with air pollutant exposure and ln-transformed FBG levels. We found that FBG was significantly associated with interquartile range increase in the average UFPs concentrations 1-13 d prior to the clinical visits (ranging from 5.1% [95% CI 2.0-8.1%] in the 1-d time-window to 12.1% [95% CI 6.5-17.8%] in the 13-d time-window). Top 1000 transcripts associated with FBG increase following UFPs exposure were enriched into some biological pathways, such as pro-opiomelanocortin processing, negative regulation of hypoxia-inducible factor 1 A function, ubiquinone metabolism, and antigen presentation by major histocompatibility complex class I, classical pathway. These results suggest that elevated FBG associated with UFPs exposure may be related to regulation of metabolism, immune response, DNA damage, and apoptosis and survival.

Combined effects of air pollution in adulthood and famine exposure in early life on type 2 diabetes

Famine exposure or air pollution is linked to type 2 diabetes mellitus (T2DM). However, their combined effects on T2DM remain largely unknown. A total of 11,640 individuals were obtained from the Henan Rural Cohort Study. According to their birthdate, participants were divided into three famine exposure subgroups: fetal exposed, childhood exposed, and unexposed groups. The air pollutants (particles with aerodynamics diameters ≤ 1.0 µm (PM₁), ≤ 2.5 µm, and ≤ 10 µm, and nitrogen dioxide) concentrations of each individual were estimated by a spatiotemporal model. Participants were divided into low or high air pollution exposure groups taking the 1st quartile value of air pollutants as the cut-off point. Logistic regression model was used to analyze independent and joint associations between air pollution exposure, famine exposure, and T2DM. Positive associations of air pollution and famine exposure with T2DM were found. Participants who experienced fetal or childhood famine and also were exposed to high concentrations of any kind of the air pollutants had a much higher risk for T2DM than those with no famine and low air pollutants exposure (taking PM_1.0 for example, the odds ratio [OR]: 1.76, 95% confidence interval [CI]: 1.25, 2.47 for fetal famine, and OR: 1.64, 95%CI: 1.13, 2.40 for childhood famine). After stratified analysis, similar results were observed in women. The results indicated that both famine exposure in early life and air pollution exposure in adulthood are related to increased risk for prevalent T2DM, and they have combined effects on T2DM.

Obesity II: Establishing causal links between chemical exposures and obesity

Obesity is a multifactorial disease with both genetic and environmental components. The prevailing view is that obesity results from an imbalance between energy intake and expenditure caused by overeating and insufficient exercise. We describe another environmental element that can alter the balance between energy intake and energy expenditure: obesogens. Obesogens are a subset of environmental chemicals that act as endocrine disruptors affecting metabolic endpoints. The obesogen hypothesis posits that exposure to endocrine disruptors and other chemicals can alter the development and function of the adipose tissue, liver, pancreas, gastrointestinal tract, and brain, thus changing the set point for control of metabolism. Obesogens can determine how much food is needed to maintain homeostasis and thereby increase the susceptibility to obesity. The most sensitive time for obesogen action is in utero and early childhood, in part via epigenetic programming that can be transmitted to future generations. This review explores the evidence supporting the obesogen hypothesis and highlights knowledge gaps that have prevented widespread acceptance as a contributor to the obesity pandemic. Critically, the obesogen hypothesis changes the narrative from curing obesity to preventing obesity.

Ambient air pollution during pregnancy and cardiometabolic biomarkers in cord blood

Prenatal air pollution exposure has been associated with adverse childhood cardiometabolic outcomes. It is unknown whether evidence of metabolic disruption associated with air pollution is identifiable at birth. We examined exposure to prenatal ambient air pollution and cord blood cardiometabolic biomarkers among 812 mother-infant pairs in the Healthy Start study.

Polystyrene bead ingestion promotes adiposity and cardiometabolic disease in mice

Vast amounts of plastic materials are produced in the modern world and despite recycling efforts, large amounts are disposed in water systems and landfills. Under these storage conditions, physical weathering and photochemical processes break down these materials into smaller particles of the micro- and nano-scale. In addition, ecosystems can be contaminated with plastic particles which are manufactured in these size ranges for commercial purposes. Independent of source, microplastics are abundant in the environment and have found their way into water supplies and the food cycle where human exposure is inevitable. Nevertheless, the health consequences of microplastic ingestion, inhalation, or absorption are largely unknown. In this study we sought to determine if ingestion of microplastics promoted pre-clinical cardiovascular disease (CVD). To do this, we supplied mice with normal drinking water or that supplemented with polystyrene beads of two different sizes (0.5 µm and 5 µm) and two different doses (0.1 μg/ml and 1 μg/ml) each for 12 weeks and measured several indices of metabolism and glucose homeostasis. As early as 3 weeks of consumption, we observed an accelerated weight gain with a corresponding increase in body fat for some exposure groups versus the control mice. Some exposure groups demonstrated increased levels of fasting plasma glucose. Those mice consuming the smaller sized beads (0.5 µm) at the higher dose (1 μg/ml), had increased levels of fasting plasma insulin and higher homeostatic model assessment of insulin resistance (HOMA-IR) scores as well. This was accompanied by changes in the gut microbiome consistent with an obese phenotype. Using samples of perivascular adipose tissue collected from the same group, we observed changes in gene expression consistent with increased adipogenesis. These results suggest that ingestion of polystyrene beads promotes a cardiometabolic disease phenotype and thus may be an unrecognized risk factor for CVD.

Association between residential greenness and overweight/obesity among rural adults in northwestern China

BACKGROUND

Living in greener areas may reduce adiposity, but epidemiological evidence on this topic is still inconsistence and limited, especially in rural areas.

METHODS

We performed a cross-sectional study among 4651 Uyghur adults in rural areas in Xinjiang province, northwestern China, from May to September 2016. We measured residential greenness levels using satellite-derived Normalized Difference Vegetation Index (NDVI) and Soil Adjusted Vegetation Index (SAVI) in 100 m, 300 m, 500 m, and 1000 m buffers around each home address. Body height, weight, and waist circumference were assessed according to recommended guidelines. Data on baseline characteristics and confounders were collected using a questionnaire. We used generalized linear mixed models to estimate the associations of residential greenness with overweight/obesity prevalence and obesity-related anthropometric indices.

RESULTS

Higher residential greenness levels were associated with lower waist circumference and body mass index levels, as well as with a lower odds ratio of peripheral overweight/obesity prevalence. No significant association was found for greenness and central obesity prevalence. The associations persisted in magnitude and direction across several sensitivity analyses we performed. Stratified analysis suggested that the associations were generally stronger in older adults than those in younger adults. Additionally, neither air pollutants nor physical activity significantly mediated the associations between greenness and obesity.

CONCLUSIONS

Our results suggest that higher residential greenness were associated with lower odds of overweight/obesity and lower obesity-related anthropometric indices among rural Uyghur adults in China, especially for older adults.

Melatonin alleviates PM2.5-triggered macrophage M1 polarization and atherosclerosis via regulating NOX2-mediated oxidative stress homeostasis

It is reported that oxidative stress homeostasis was involved in PM_2.5-induced foam cell formation and progression of atherosclerosis, but the exact molecular mechanism is still unclear. Melatonin is an effective antioxidant that could reverse the cardiopulmonary injury. The main purpose of this study is to investigate the latent mechanism of PM_2.5-triggered atherosclerosis development and the protective role of melatonin administration. Vascular Doppler ultrasound showed that PM_2.5 exposure reduced aortic elasticity in ApoE^-/- mice. Meanwhile, blood biochemical and pathological analysis demonstrated that PM_2.5 exposure caused dyslipidemia, elicited oxidative damage of aorta and was accompanied by an increase in atherosclerotic plaque area; while the melatonin administration could effectively alleviate PM_2.5-induced macrophage M1 polarization and atherosclerosis in mice. Further investigation verified that NADPH oxidase 2 (NOX2) and mitochondria are two prominent sources of PM_2.5-induced ROS production in vascular macrophages. Whereas, the combined use of two ROS-specific inhibitors and adopted with melatonin markedly rescued PM_2.5-triggered macrophage M1 polarization and foam cell formation by inhibiting NOX2-mediated crosstalk of Keap1/Nrf2/NF-κB and TLR4/TRAF6/NF-κB signaling pathways. Our results demonstrated that NOX2-mediated oxidative stress homeostasis is critical for PM_2.5-induced atherosclerosis and melatonin might be a potential treatment for air pollution-related cardiovascular diseases.

Chronic exposure to polluted urban air aggravates myocardial infarction by impaired cardiac mitochondrial function and dynamics

Air pollution exposure positively correlates with increased cardiovascular morbidity and mortality rates, mainly due to myocardial infarction (MI). Herein, we aimed to study the metabolic mechanisms underlying this association, focusing on the evaluation of cardiac mitochondrial function and dynamics, together with its impact over MI progression. An initial time course study was performed in BALB/c mice breathing filtered air (FA) or urban air (UA) in whole-body exposure chambers located in Buenos Aires City downtown for up to 16 weeks (n = 8 per group and time point). After 12 weeks, lung inflammatory cell recruitment was evident in UA-exposed mice. Interestingly, impaired redox metabolism, characterized by decreased lung SOD activity and increased GSSG levels and NOX activity, precede local inflammation in this group. At this selected time point, additional mice were exposed to FA or UA (n = 12 per group) and alveolar macrophage PM uptake and nitric oxide (NO) production was observed in UA-exposed mice, together with increased pro-inflammatory cytokine levels (TNF-α and IL-6) in BAL and plasma. Consequently, impaired heart tissue oxygen metabolism and altered mitochondrial ultrastructure and function were observed in UA-exposed mice after 12 weeks, characterized by decreased active state respiration and ATP production rates, and enhanced mitochondrial H₂O₂ production. Moreover, disturbed cardiac mitochondrial dynamics was detected in this group. This scenario led to a significant increase in the area of infarcted tissue following myocardial ischemia reperfusion injury in vivo, from 43 ± 3% of the area at risk in mice breathing FA to 66 ± 4% in UA-exposed mice (n = 6 per group, p < 0.01), together with a sustained increase in LVEDP during myocardial reperfusion. Taken together, our data unravel cardiac mitochondrial mechanisms that contribute to the understanding of the adverse health effects of urban air pollution exposure, and ultimately highlight the importance of considering environmental factors in the development of cardiovascular diseases.

Intermittent exposure to airborne particulate matter induces subcellular dysfunction and aortic cell damage in BALB/c mice through multi-endpoint assessment at environmentally relevant concentrations

Airborne particulate matter (PM) has been linked to cardiovascular diseases, but the underlying mechanisms remain unclear, especially at realistic exposure levels. In this study, both male and female BALB/c mice were employed to assess vascular homeostasis following a standard urban particulate matter, PM SRM1648a, via oropharyngeal aspiration at three environmentally relevant concentrations. The tested indicators included histopathological observation and lipid deposition, as well as redox biology and inflammatory responses. Furthermore, endothelial monolayer, vascular cell apoptosis and subcellular function were assessed to decipher whether episodic PM SRM1648a exposure leads to vascular damage after multiple periods of treatment, including subacute (4 weeks) and subchronic (8 weeks) durations. As a result, PM aspiration caused thickening of airways, leukocytes infiltration and adhesion to alveoli, with the spot of particles engulfed by pulmonary macrophages. Meanwhile, it induced local and systemic oxidative stress and inflammation, but limited pathological changes were captured throughout aortic tissues after either subacute or subchronic treatment. Furthermore, even in the absence of aortic impairment, vascular cell equilibrium has been disturbed by the characteristics of endothelial monolayer disintegration and cell apoptosis. Mechanistically, PM SRM1648a activated molecular markers of ER stress (BIP) and mitochondrial dynamics (DRP1) at both transcriptional and translational levels, which were strongly correlated to ox-inflammation and could serve as early checkpoints of hazardous events. In summary, our data basically indicate that episodic exposure of BALB/c mice to PM SRM1648a exerts limited effects on vascular histopathological alterations, but induces vascular cell apoptosis and subcellular dysfunction, to which local and systemic redox biology and inflammation are probably correlated.

Association of abnormal-glucose tolerance during pregnancy with exposure to PM2.5 components and sources

Maternal exposure to PM_2.5 has been associated with abnormal glucose tolerance during pregnancy, but little is known about which constituents and sources are most relevant to glycemic effects. We conducted a retrospective cohort study of 1148 pregnant women to investigate associations of PM_2.5 chemical components with gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT) and to identify the most harmful sources in Heshan, China from January 2015 to July 2016. We measured PM_2.5 using filter-based method and analyzed them for 28 constituents, including carbonaceous species, water-soluble ions and metal elements. Contributions of PM_2.5 sources were assessed by positive matrix factorization (PMF). Logistic regression model was used to estimate composition-specific and source-specific effects on GDM/IGT. Random forest algorithm was applied to evaluate the relative importance of components to GDM and IGT. PM_2.5 total mass and several chemical constituents were associated with GDM and IGT across the early to mid-gestation periods, as were the PM_2.5 sources fossil fuel/oil combustion, road dust, metal smelting, construction dust, electronic waster, vehicular emissions and industrial emissions. The trimester-specific associations differed among pollutants and sources. The third and highest quartile of elemental carbon, ammonium (NH₄⁺), iron (Fe) and manganese (Mn) across gestation were consistently associated with higher odds of GDM/IGT. Maternal exposures to zinc (Zn), titanium (Ti) and vehicular emissions during the first trimester, and vanadium (V), nickel (Ni), road dust and fossil fuel/oil combustion during the second trimester were more important for GDM/IGT. This study provides important new evidence that maternal exposure to PM_2.5 components and sources is significantly related to elevated risk for abnormal glucose tolerance during pregnancy.

Impact of polluting fuels for cooking on diabetes mellitus and glucose metabolism in south urban China

We hypothesized that exposure to polluting fuels for cooking was associated with abnormality of glucose metabolism and diabetes mellitus (DM) in south urban China. 3414 residents were surveyed in 14 urban areas of Guangdong Province in 2018. We recorded polluting fuels for cooking exposure, different DM status (DM, prediabetes), fasting blood glucose (FBG), oral glucose tolerance test (OGTT), glycated hemoglobin (HbA_1c ), and other covariates by using a structured questionnaire. We conducted logistic regression model and multivariate linear regression model based on propensity-score method (inverse probability of weighting) to examine the effect of polluting fuels for cooking exposure on DM and glucose metabolism. Exposure to polluting fuels for cooking was associated with DM (odds ratio: 2.57, 95% confidence interval: 1.71 to 3.86) and prediabetes (odds ratio: 1.98, 95% confidence interval: 1.52 to 2.58) in both the adjusted and unadjusted models (all p < 0.05). Exposure to polluting fuels for cooking was significantly associated with an increase of FBG (β: 0.30 mmol/L, 95% confidence interval: 0.22 to 0.38 mmol/L). Sensitivity analysis showed that the results were not substantially changed. There was an increased risk of DM, prediabetes and high levels of FBG, OGTT, and HbA_1c among participants aged ≥ 40 years with exposure to polluting fuels for cooking. We demonstrated that exposure to polluting fuels for cooking was associated with higher levels of FBG, which contributed to the increased risk of DM and prediabetes in middle-aged elderly Chinese population living in urban areas.

Investigating the association between long-term exposure to air pollution and greenness with mortality from neurological, cardio-metabolic and chronic obstructive pulmonary diseases in Greece

Long-term exposure to air pollution has been associated with increased natural-cause mortality, but the evidence on diagnoses-specific mortality outcomes is limited. Few studies have examined the potential synergistic effects of exposure to pollutants and greenness. We investigated the association between exposure to air pollution and greenness with nervous system related mortality, cardiometabolic and chronic obstructive pulmonary diseases (COPD) mortality in Greece, using an ecological study design. We collected socioeconomic and mortality data for 1035 municipal units from the 2011 Census. Annual PM_2.5, NO₂, BC and O₃ concentrations for 2010 were predicted at 100 × 100 m grids by hybrid land use regression models. The normalized difference vegetation index (NDVI) was used for greenness. We applied single and two-exposure Poisson regression models on standardized mortality rates accounting for spatial autocorrelation. We assessed interactions between pollutants and greenness. An interquartile range increase in PM_2.5, NO₂ and BC was associated with increased risk in mortality from diseases of the nervous system (relative risk (RR): 1.14, 95% confidence interval (CI): 1.01, 1.28); 1.03 (95% CI: 0.99, 1.07); 1.05 (95% CI: 1.00, 1.10) respectively) and from cerebrovascular disease (RR: 1.14, 95% CI: 1.10, 1.18); 1.02 (95% CI: 1.01, 1.04); 1.02 (95% CI: 1.00, 1.04) respectively). PM_2.5 was associated with ischemic heart disease mortality (RR: 1.05, 95% CI: 1.01, 1.10). We estimated inverse associations for all outcomes with O₃ and for mortality from diseases of the nervous system or COPD with greenness. Estimates were mostly robust to co-exposure adjustment. Interactions were identified between NDVI and O₃ or PM_2.5 on mortality from the diseases of the nervous system, with higher effect estimates in greener areas. Our findings support the adverse effects of air pollution and the beneficial role of greenness on cardiovascular and nervous system related mortality. Further research is needed on diabetes mellitus.

Systematic review of preclinical studies on the neutrophil-mediated immune response to air pollutants, 1980-2020

Preclinical evidence about the neutrophil-mediated response in exposure to air pollutants is scattered and heterogeneous. This has prevented the consolidation of this research field around relevant models that could advance towards clinical research. The purpose of this study was to systematic review the studies of the neutrophils response to air pollutants, following the recommendations of the Cochrane Collaboration and the PRISMA guide, through 54 search strategies in nine databases. We include 234 studies (in vitro, and in vivo), being more frequent using primary neutrophils, Balb/C and C57BL6/J mice, and Sprague-Dawley and Wistar rats. The most frequent readouts were cell counts, cytokines and histopathology. The temporal analysis showed that in the last decade, the use of mice with histopathological and cytokine measurement have predominated. This systematic review has shown that study of the neutrophils response to air pollutants started 40 years ago, and composed of 100 different preclinical models, 10 pollutants, and 11 immunological outcomes. Mechanisms of neutrophils-mediated immunopathology include cellular activation, ROS production, and proinflammatory effects, leading to cell-death, oxidative stress, and inflammatory infiltrates in lungs. This research will allow consolidating the research efforts in this field, optimizing the study of causal processes, and facilitating the advance to clinical studies.

The Roles of Liver Inflammation and the Insulin Signaling Pathway in PM2.5 Instillation-Induced Insulin Resistance in Wistar Rats

To elucidate the mechanism of how the liver participates in PM2.5-caused insulin resistance. A novel Wistar rat model was developed in this study by instilling a suspension of lyophilized PM2.5 sample (2.5 mg/kg, 5 mg/kg, or 10 mg/kg) collected from the atmosphere. Systemic insulin resistance indicators, including serum fasting blood glucose (FBG), fasting insulin (FINS), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and hemoglobin A1 (HbA1), were upregulated by the PM2.5 instillation. The area under the curve (AUC_glu) calculated by intraperitoneal glucose tolerance testing (IPGTT) was also significantly greater in the PM2.5 instillation groups. Additionally, PM2.5 instillation was found to cause liver damage and inflammation. The serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were significantly elevated by PM2.5 instillation. PM2.5 also triggered IL-6 and TNF-α transcription but inhibited mRNA synthesis and suppressed signaling activation of the insulin-phosphoinositide 3-kinase- (PI3K-) Akt-glucose transporter 2 (GLUT2) pathway in the rat liver by reducing the ratio of phosphorylated Akt to phosphorylated insulin receptor substrate 1 (IRS-1). Thus, PM2.5-induced inflammation activation and insulin signaling inhibition in the rat liver contribute to the development of systemic insulin resistance.

HSP70 as a biomarker of the thin threshold between benefit and injury due to physical exercise when exposed to air pollution

Physical exercise has acute and chronic effects on inflammatory balance, metabolic regulation, and redox status. Exercise-induced adaptations are mediated by enhanced 70-kDa heat shock protein (HSP70) levels and an improved heat shock response (HSR). Therefore, exercise could be useful against disease conditions [obesity, diabetes mellitus (DM), and exposure to atmospheric pollutants] marked by an impaired HSR. However, exercise performed by obese or diabetic subjects under pollution conditions might also be dangerous at certain intensities. Intensity correlates with an increase in HSP70 levels during physical exercise until a critical point at which the effort becomes harmful and impairs the HSR. Establishing a unique biomarker able to indicate the exercise intensity on metabolism and cellular fatigue is essential to ensure adequate and safe exercise recommendations for individuals with obesity or DM who require exercise to improve their metabolic status and live in polluted regions. In this review, we examined the available evidence supporting our hypothesis that HSP70 could serve as a biomarker for determining the optimal exercise intensity for subjects with obesity or diabetes when exposed to air pollution and establishing the fine threshold between anti-inflammatory and pro-inflammatory exercise effects.

Type 2 diabetes attributable to PM2.5: A global burden study from 1990 to 2019

BACKGROUND

Long-term exposure to fine particulate matter (PM_2.5) is associated with an increased risk of type 2 diabetes (T2D). However, limited data on trends in the global burden of T2D attributed to PM_2.5, particularly in different regions by social-economic levels. We evaluated the spatio-temporal changes in the disease burden of T2D attributed to PM_2.5 from 1990 to 2019 in 204 countries and regions with different socio-demographic indexes (SDI).

METHODS

This is a retrospective analysis with data from the Global Burden of Disease Study 2019 (GBD2019) database. The burden of T2D attributed to PM_2.5, age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life year rate (ASDR) were estimated according to sex, age, nationality and SDI. The annual percentage change (APCs) and the average annual percentage change (AAPCs) were calculated by using the Joinpoint model to evaluate the changing trend of ASMR and ASDR attributed to PM_2.5 from 1990 to 2019. The Gaussian process regression model was used to estimate the relationship of SDI with ASMR and ASDR.

RESULTS

Overall, the global burden of T2D attributable to PM_2.5 increased significantly since 1990, particularly in the elderly, men, Africa, Asia and low-middle SDI regions. The ASMR and ASDR of T2D attributable to PM_2.5 in 2019 were 2.47 (95% CI: 1.71, 3.24) per 100,000 population and 108.98 (95% CI: 74.06, 147.23) per 100,000 population, respectively. From 1990 to 2019, the global ASMR and ASDR of T2D attributed to T2D increased by 57.32% and 86.75%, respectively. The global AAPCs of ASMR and ASDR were 1.57 (95% CI: 1.46, 1.68) and 2.17 (95% CI: 2.02, 2.32), respectively. Declining trends were observed in North America, South America, Europe, Australia, and other regions with high SDI.

CONCLUSIONS

Over this 30-years study, the global T2D burden attributable to PM_2.5 has increased particularly in regions with low-middle SDI. PM_2.5 remains a great concern on the global burden of diabetes.

NLRP3 inflammasome is involved in ambient PM2.5-related metabolic disorders in diabetic model mice but not in wild-type mice

AIMS

To explore the role of nucleotide-binding domain and leucine-rich repeat protein 3 (NLRP3) inflammasome in ambient fine particulate matter (PM_2.5)-related metabolic disorders.

METHODS

In this study, the C57BL/6 and db/db mice were exposed to concentrated PM_2.5 or filtered air (FA) using Shanghai Meteorological and Environmental Animal Exposure System (Shanghai-METAS) for 12 weeks. Indices of lipid metabolism, glucose metabolism, insulin sensitivity, and protein expression of NLRP3 inflammasome in visceral adipose tissue (VAT) were measured, respectively.

RESULTS

The results showed that PM_2.5 exposure increased circulatory insulin, triglycerides (TG), and total cholesterol (TC), and decreased high-density lipoprotein (HDL) in both C57BL/6 and db/db mice. The levels of NLRP3-related circulatory inflammatory cytokines including both interleukin (IL)-18 and IL-1β in serum were increased in the PM_2.5-exposed mice and accompanied by the elevation in fasting blood glucose and insulin. The results also showed that exposure to PM_2.5 promoted the activation of NLRP3, pro-caspase-1, caspase-1, and apoptosis-associated speck-like protein containing CARD (ASC), simultaneously accompanied by the increase of IL-18 and IL-1β expression in VAT, but the statistically significant difference only found in the db/db mice, not in C57BL/6 mice.

CONCLUSION

The activation of NLRP3 inflammasome might be not the main mechanism of PM_2.5-related metabolic disorders in wide type mice but it partly mediated the exacerbation of metabolic disorders in diabetic model mice.

Cardiovascular Effects of Particulate Air Pollution

Inhalation of fine particulate matter (PM_2.5), produced by the combustion of fossil fuels, is an important risk factor for cardiovascular disease. Exposure to PM_2.5 has been linked to increases in blood pressure, thrombosis, and insulin resistance. It also induces vascular injury and accelerates atherogenesis. Results from animal models corroborate epidemiological evidence and suggest that the cardiovascular effects of PM_2.5 may be attributable, in part, to oxidative stress, inflammation, and the activation of the autonomic nervous system. Although the underlying mechanisms remain unclear, there is robust evidence that long-term exposure to PM_2.5 is associated with premature mortality due to heart failure, stoke, and ischemic heart disease. Expected final online publication date for the Annual Review of Medicine, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Endocrine disrupting chemicals: Friend or foe to brown and beige adipose tissue?

The effects of Endocrine Disrupting Chemicals (EDCs) on the current obesity epidemic is a growing field of interest. Numerous EDCs have shown the potential to alter energy metabolism, which may increase the risk of obesity, in part, through direct actions on adipose tissue. While white adipose tissue has historically been the primary focus of this work, evidence of the EDC-induced disruption of brown and beige adipose tissues continues to build. Both brown and beige fat are thermogenic adipose depots rich in mitochondria that dispense heat when activated. Due to these properties, brown and beige fat are implicated in metabolic diseases such as obesity, diabetes, and cachexia. This review delves into the current literature of different EDCs, including bisphenols, dioxins, air pollutants, phthalates, and phytochemicals. The possible implications that these EDCs have on thermogenic adipose tissues are covered. This review also introduces the possibility of using brown and beige fat as a therapeutic target organ by taking advantage of some of the properties of EDCs. Collectively, we provide a comprehensive discussion of the evidence of EDC disruption in white, brown, and beige fat and highlight gaps worthy of further exploration.

Associations of Reduced Ambient PM2.5 Level With Lower Plasma Glucose Concentration and Decreased Risk of Type 2 Diabetes in Adults: A Longitudinal Cohort Study

It remains unknown whether reduced air pollution levels can prevent type 2 diabetes mellitus. In this study, we investigated the associations between dynamic changes in long-term exposure to ambient fine particulate matter, defined as particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5), and changes in fasting plasma glucose (FPG) levels and incidence of type 2 diabetes. A total of 151,398 adults (ages ≥18 years) were recruited in Taiwan between 2001 and 2014. All participants were followed up for a mean duration of 5.0 years. Change in PM2.5 (ΔPM2.5) was defined as the value at a follow-up visit minus the corresponding value at the immediately preceding visit. The PM2.5 concentration in Taiwan increased during 2002-2004 and began to decrease in 2005. Compared with participants with little or no change in PM2.5 exposure, those with the largest decrease in PM2.5 had a decreased FPG level (β = -0.39, 95% confidence interval: -0.47, -0.32) and lower risk of type 2 diabetes (hazard ratio = 0.86, 95% confidence interval: 0.80, 0.93). The sensitivity analysis and analyses stratified by sex, age, body mass index, smoking, alcohol drinking, and hypertension generally yielded similar results. Improved PM2.5 air quality is associated with a better FPG level and a decreased risk of type 2 diabetes development.

Emerging role of air pollution in chronic kidney disease

Chronic kidney disease (CKD), a global disease burden related to high rates of incidence and mortality, manifests as progressive and irretrievable nephron loss and decreased kidney regeneration capacity. Emerging studies have suggested that exposure to air pollution is closely relevant to increased risk of CKD, CKD progression and end-stage kidney disease (ESKD). Inhaled airborne particles may cause vascular injury, intraglomerular hypertension, or glomerulosclerosis through non-hemodynamic and hemodynamic factors with multiple complex interactions. The mechanisms linking air pollutants exposure to CKD include elevated blood pressure, worsening oxidative stress and inflammatory response, DNA damage and abnormal metabolic changes to aggravate kidney damage. In the present review, we will discuss the epidemiologic observations linking air pollutants exposure to the incidence and progression of CKD. Then, we elaborate the potential roles of several air pollutants including particulate matter and gaseous co-pollutants, environmental tobacco smoke, and gaseous heavy metals in its pathogenesis. Finally, this review outlines the latent effect of air pollution in ESKD patients undergoing dialysis or renal transplant, kidney cancer and other kidney diseases. The information obtained may be beneficial for further elucidating the pathogenesis of CKD and making proper preventive strategies for this disease.

The cardiovascular effects of air pollution: Prevention and reversal by pharmacological agents

Air pollution is associated with staggering levels of cardiovascular morbidity and mortality. Airborne particulate matter (PM), in particular, has been associated with a wide range of detrimental cardiovascular effects, including impaired vascular function, raised blood pressure, alterations in cardiac rhythm, blood clotting disorders, coronary artery disease, and stroke. Considerable headway has been made in elucidating the biological processes underlying these associations, revealing a labyrinth of multiple interacting mechanistic pathways. Several studies have used pharmacological agents to prevent or reverse the cardiovascular effects of PM; an approach that not only has the advantages of elucidating mechanisms, but also potentially revealing therapeutic agents that could benefit individuals that are especially susceptible to the effects of air pollution. This review gathers investigations with pharmacological agents, offering insight into the biology of how PM, and other air pollutants, may cause cardiovascular morbidity.

Exposure to biomass fuel is associated with high blood pressure and fasting blood glucose impairment in females in southern rural China

OBJECTIVES

We sought to investigate the association between household exposure to biomass fuel and metabolic syndrome (MetS) and its components including blood pressure, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG) and waist circumference among females in southern rural China.

METHODS

We surveyed 1664 residents in the Chronic Disease and Risk Factors Surveillance, conducted in 14 districts of Guangdong province. We recorded the use of biomass fuel, MetS and its components, and other covariates by using a structured questionnaire. Logistic regression model and multivariate linear regression model were adopted for analysis.

RESULTS

Exposure to biomass fuel was significantly associated with an increase of systolic blood pressure (SBP) (β: 2.15, 95% confidence interval: 0.13 to 4.17) and FBG (β: 0.19, 95% confidence interval: 0.01 to 0.37) in the adjusted and unadjusted models (all P < 0.05). Among participants with exposure to biomass fuel, being overweight or obese was associated with an increased risk of having hypertension (odds ratio: 3.19, 95% confidence interval: 2.13 to 4.76) and higher FBG levels (odds ratio: 2.10, 95% confidence interval: 1.46 to 3.02). Exposure to biomass fuel was significantly associated with a decrease of the prevalence of central obesity (P < 0.05). However, exposure to biomass fuel was not associated with MetS, diastolic blood pressure and TG (all P > 0.05).

CONCLUSIONS

Exposure to biomass fuel is associated with an increase in blood pressure and FBG levels, but not MetS per se. Efforts should be made to protect females in southern rural China from the adverse effects associated with biomass fuel pollution.

Fine particulate matter air pollution and aortic perivascular adipose tissue: Oxidative stress, leptin, and vascular dysfunction

Exposure to fine particulate matter (PM2.5 ) air pollution increases blood pressure, induces vascular inflammation and dysfunction, and augments atherosclerosis in humans and rodents; however, the understanding of early changes that foster chronic vascular disease is incomplete. Because perivascular adipose tissue (PVAT) inflammation is implicated in chronic vascular diseases, we investigated changes in aortic PVAT following short-term air pollution exposure. Mice were exposed to HEPA-filtered or concentrated ambient PM2.5 (CAP) for 9 consecutive days, and the abundance of inflammatory, adipogenic, and adipokine gene mRNAs was measured by gene array and qRT-PCR in thoracic aortic PVAT. Responses of the isolated aorta with and without PVAT to contractile (phenylephrine, PE) and relaxant agonists (acetylcholine, ACh; sodium nitroprusside, SNP) were measured. Exposure to CAP significantly increased the urinary excretion of acrolein metabolite (3HPMA) as well as the abundance of protein-acrolein adducts (a marker of oxidative stress) in PVAT and aorta, upregulated PVAT leptin mRNA expression without changing mRNA levels of several proinflammatory genes, and induced PVAT insulin resistance. In control mice, PVAT significantly depressed PE-induced contractions-an effect that was dampened by CAP exposure. Pulmonary overexpression of extracellular dismutase (ecSOD-Tg) prevented CAP-induced effects on urinary 3HPMA levels, PVAT Lep mRNA, and alterations in PVAT and aortic function, reflecting a necessary role of pulmonary oxidative stress in all of these deleterious CAP-induced changes. More research is needed to address how exactly short-term exposure to PM2.5 perturbs PVAT and aortic function, and how these specific genes and functional changes in PVAT could lead over time to chronic inflammation, endothelial dysfunction, and atherosclerosis.

Oxidative Stress Biomarkers in the Relationship between Type 2 Diabetes and Air Pollution

The incidence and prevalence of type 2 diabetes have increased in the last decades and are expected to further grow in the coming years. Chronic hyperglycemia triggers free radical generation and causes increased oxidative stress, affecting a number of molecular mechanisms and cellular pathways, including the generation of advanced glycation end products, proinflammatory and procoagulant effects, induction of apoptosis, vascular smooth-muscle cell proliferation, endothelial and mitochondrial dysfunction, reduction of nitric oxide release, and activation of protein kinase C. Among type 2 diabetes determinants, many data have documented the adverse effects of environmental factors (e.g., air pollutants) through multiple exposure-induced mechanisms (e.g., systemic inflammation and oxidative stress, hypercoagulability, and endothelial and immune responses). Therefore, here we discuss the role of air pollution in oxidative stress-related damage to glycemic metabolism homeostasis, with a particular focus on its impact on health. In this context, the improvement of new advanced tools (e.g., omic techniques and the study of epigenetic changes) may provide a substantial contribution, helping in the evaluation of the individual in his biological totality, and offer a comprehensive assessment of the molecular, clinical, environmental, and epidemiological aspects.

Characterization of blood protein adsorption on PM2.5 and its implications on cellular uptake and cytotoxicity of PM2.5

In biological fluids, micro- or nano-size particles are prone to adsorb proteins and form a layer. The ambient air fine particulate matter (PM_2.5) is inhaled via the lung, penetrates biological barriers and eventually reaches systemic blood circulation. However, there are very few data available regarding the adsorption of proteins on PM_2.5. Here, we compared protein corona formed in plasma after bronchoalveolar lavage fluid (BALF) exposure with those formed in plasma alone. Using purified coronal proteins, we explored their adsorption behaviors on PM_2.5 and their influence on biological reactivity of PM_2.5. Liquid-chromatography tandem mass-spectrometry (LC-MS/MS) analysis revealed that exposure to BALF significantly changed the blood protein profile on PM_2.5. Regardless of the presence of BALF, the protein corona on PM_2.5 contained an abundance of serum albumin, hemoglobin (Hb) and fibrinogen (Fg) proteins. Using Fg as a corona surrogate, we found that van der Waals interactions, hydrophobic interactions, π-π stacking and electrostatic attractions contributed to the Fg adsorption and led to the conformational changes of Fg. In addition, Fg decoration decreased cellular internalization of PM_2.5 and corresponding subsequent oxidative stress responses in a murine RAW264.7 macrophage. These results support the view that the formation of PM_2.5 corona should be considered for toxicity assessment of PM_2.5.

Exposure to Fine Particulate Matter Air Pollution Alters mRNA and miRNA Expression in Bone Marrow-Derived Endothelial Progenitor Cells from Mice

Exposure to fine particulate matter (PM2.5) air pollution is associated with quantitative deficits of circulating endothelial progenitor cells (EPCs) in humans. Related exposures of mice to concentrated ambient PM2.5 (CAP) likewise reduces levels of circulating EPCs and induces defects in their proliferation and angiogenic potential as well. These changes in EPC number or function are predictive of larger cardiovascular dysfunction. To identify global, PM2.5-dependent mRNA and miRNA expression changes that may contribute to these defects, we performed a transcriptomic analysis of cells isolated from exposed mice. Compared with control samples, we identified 122 upregulated genes and 44 downregulated genes in EPCs derived from CAP-exposed animals. Functions most impacted by these gene expression changes included regulation of cell movement, cell and tissue development, and cellular assembly and organization. With respect to miRNA changes, we found that 55 were upregulated while 53 were downregulated in EPCs from CAP-exposed mice. The top functions impacted by these miRNA changes included cell movement, cell death and survival, cellular development, and cell growth and proliferation. A subset of these mRNA and miRNA changes were confirmed by qRT-PCR, including some reciprocal relationships. These results suggest that PM2.5-induced changes in gene expression may contribute to EPC dysfunction and that such changes may contribute to the adverse cardiovascular outcomes of air pollution exposure.

Association of PM2.5 with Insulin Resistance Signaling Pathways on a Microfluidic Liver-Kidney Microphysiological System (LK-MPS) Device

Insulin resistance (IR) is a typical sign of metabolic dysregulation caused by fine particulate matter (PM_2.5), but the underlying signaling has not been clearly determined. Herein, a microfluidic liver-kidney microphysiological system (LK-MPS) is presented to assess the signaling pathways of IR generated by PM_2.5 at 200 μg/mL for 24 h. The LK-MPS device consisted of a biomimetic liver-kidney architecture and reconstructed two circulation paths: the liver metabolism-kidney excretion (LM-KE) and kidney excretion-liver metabolism (KE-LM), by which PM_2.5 is feasibly distributed in the two organs. Transmission electron microscopy (TEM) analysis revealed that PM_2.5 can embed in the cytoplasm and nuclei, undergo transport by vesicles, and lead to the destruction of mitochondria. Further comprehensive immunofluorescence, enzyme-linked immunosorbent assays (ELISAs) and untargeted metabolomic analyses confirmed that PM_2.5 disturbed the classic IRS-1/AKT signaling pathway (INSR, IRS-1, PI3K, AKT, GLUT2, GLUT4, and FOXO1 downregulated) and IR-related metabolic pathways: UDP-hexosamine (UDP-GlcNAc), gluconeogenesis (β-d-glucose 6-phosphate), and lipid biosynthesis (ceramide (Cer) and triacylglycerol (TG)) pathways, leading to the disorder of glucose levels. Collectively, these disorders aggravate hepatic and renal IR. Pearson's correlation coefficient test showed that elemental carbon (EC), polycyclic aromatic hydrocarbons (PAHs), and metals (Ca, Co, and V) were negatively correlated to the dysregulated proteins (INSR, IRS-1, AKT, FOXO1, GLUT2, and GLUT4). These findings may partially explain IR-related signaling pathways triggered by PM_2.5.

Exposure to fine particulate matter promotes platelet activation and thrombosis via obesity-related inflammation

Short-term exposure to fine particulate matter (PM_2.5) increases thrombotic risk particularly in obese individuals, but the underlying mechanisms remain unclear. This study aims to compare the effects of PM_2.5 on inflammation and platelet activation in obese versus normal-weight adults, and investigate potential causal pathways. We conducted a panel study measuring blood markers in 44 obese and 53 normal-weight adults on 3 separate occasions in 2017-2018. Associations between PM_2.5/black carbon (BC) and biomarkers were estimated using mixed-effect models. An interaction analysis compared PM_2.5/BC-related effects between subgroups. Biomarker combinations and mediation analysis were performed to elucidate the biological pathways. There was a significant "low-high-low" trend of PM_2.5 levels across the 3 study periods. Increases in pro-inflammatory cytokines and changes of platelet activation and aggregation markers were associated with PM_2.5/BC in obese subgroup only. Among obese subjects, the combination of pro-inflammatory cytokines and that of platelet markers increased 26.8% (95% CI: 16.0%, 37.9%) and 14.7% (95% CI: 1.9%, 27.0%) per IQR increase in PM_2.5 over 5-day and 7-day averages. Inflammation mediated 24.5% of the pathways through which PM_2.5 promoted platelet activation. This study suggested obese people are susceptible to pro-thrombotic impacts of PM_2.5 exposures. PM_2.5 may aggravate thrombosis through obesity-related inflammation.

Associations of residing greenness and long-term exposure to air pollution with glucose homeostasis markers

BACKGROUND

Although long-term exposure to higher air pollutants and lower residing greenness related to disorders of glucose homeostasis have been reported, their interaction effects on glucose homeostasis in developing countries remained unclear.

METHODS

A total of 35, 482 participants were obtained from the Henan Rural Cohort (n = 39, 259). Exposure to air pollutants (PM₁, PM_2.5, PM₁₀ and NO₂) were predicted by using a spatiotemporal model-based on satellites data. Residing greenness was reflected by Enhanced Vegetation Index (EVI) and Normalized Difference Vegetation Index (NDVI) which were derived from satellites data. Independent associations of single or mixture of air pollutant or residing greenness with glucose homeostasis markers were analyzed by quantile regression models and quantile g (qg)-computation method, respectively. Furthermore, interaction effects of residing greenness and air pollution on glucose homeostasis markers were analyzed by generalized additive models.

RESULTS

Positive associations of single or mixture of air pollutants (PM₁, PM_2.5, PM₁₀ or NO₂) with fasting plasma glucose (FPG) were observed, while negative associations of single or mixture of air pollutants with insulin or HOMA-β were observed. Residing greenness was negatively associated with FPG but positively related to insulin or HOMA-β. Quantile regression revealed the heterogeneity were observed in the associations the residing greenness or air pollutants with glucose homeostasis markers (insulin or HOMA-β) across deciles of the glucose homeostasis markers distributions. Furthermore, joint associations of single air pollutant and residing greenness on glucose homeostasis markers were found.

CONCLUSIONS

The results indicated that exposure to air pollution had negative effect on glucose homeostasis markers and these effects may be modified by living in higher green space. These findings suggest that increased residing greenness and air pollution control may have joint effect on decreased the risk of diabetes.

CLINICAL TRIAL REGISTRATION

The Henan Rural Cohort study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699, http://www.chictr.org.cn/showproj.aspx?proj=11375).

PM2.5 and Diabetes in the Japanese Population

Growing evidence suggests that PM_2.5 is associated with diabetes mellitus (DM). Although DM is a major public health concern, there has not yet been a study of this association in Japan. We used health examination data from 66,885 individuals in Tokyo, Japan 2005–2019. Cox proportional hazards models were used to evaluate an association between annual exposure to PM_2.5 and glycated hemoglobin A_1c (HbA_1c), or fasting plasma glucose (FPG). An increase of 1 μg/m³ in the annual average of PM_2.5 concentration was associated (HR = 1.029; 95% CI = 1.004–1.055) with an increase in diabetes (incident + prevalent). For incident DM, a greater PM_2.5 level was associated with more DM (HR = 1.029; 95% CI, 1.003–1.055). Compared to HbA_1c, FPG showed a stronger association with the annual exposure to PM_2.5 (HR = 1.065; 95% CI, 1.040–1.091). We found that greater exposure to PM_2.5 in the long-term was associated with an increased risk of diabetes, and that the magnitude of association became stronger as the exposure duration increased. Omorogieva Ojo

Source contributions to multiple toxic potentials of atmospheric organic aerosols

Fine particulate matter (PM_2.5) in the atmosphere is of high priority for air quality management efforts to address adverse health effects in human. We believe that emission control policies, which are traditionally guided by source contributions to PM mass, should also consider source contributions to PM health effects or toxicity. In this study, we estimated source contributions to the toxic potentials of organic aerosols (OA) as measured by a series of chemical and in-vitro biological assays and chemical mass balance model. We selected secondary organic aerosols (SOA), vehicles, biomass open burning, and cooking as possible important OA sources. Fine particulate matter samples from these sources and parallel atmospheric samples from diverse locations and seasons in East Asia were collected for the study. The source and atmospheric samples were analyzed for chemical compositions and toxic potentials, i.e. oxidative potential, inflammatory potential, aryl hydrocarbon receptor (AhR) agonist activity, and DNA-damage, were measured. The toxic potentials per organic carbon (OC) differed greatly among source and ambient particulate samples. The source contributions to oxidative and inflammatory potentials were dominated by naphthalene-derived SOA (NapSOA), followed by open burning and vehicle exhaust. The AhR activity was dominated by open burning, followed by vehicle exhaust and NapSOA. The DNA damage was dominated by vehicle exhaust, followed by open burning. Cooking and biogenic SOA had smaller contributions to all the toxic potentials. Regarding atmospheric OA, urban and roadside samples showed stronger toxic potentials per OC. The toxic potentials of remote samples in summer were consistently very weak, suggesting that atmospheric aging over a long time decreased the toxicity. The toxic potentials of the samples from the forest and the experimentally generated biogenic SOA were low, suggesting that toxicity of biogenic primary and secondary particles is relatively low.

Synergistic effects of carbon nanoparticle-Cr-Pb in PM2.5 cause cell cycle arrest via upregulating a novel lncRNA NONHSAT074301.2 in human bronchial epithelial cells

Inhalation of carcinogenic PM_2.5 particles is a severe threat to all the people in both developing and developed nations. However, which components of PM_2.5 and how they perturb human cells to cause various diseases are still not understood. Here, employing a reductionism approach, we revealed that one of the crucial toxic and pathogenic mechanisms of PM_2.5 was the blocking of human bronchial cell cycle through upregulation of a novel long non-coding RNA NONHSAT074301.2 by carbon particles with payloads of Cr(VI) and Pb²⁺. We also discovered that NONHSAT074301.2 is a key regulatory molecule controlling cell cycle arrest at G2/M phase. This work highlights cellular function and molecular signaling events investigations using a 16-membered combinational model PM_2.5 library which contain carbon particles carrying four toxic pollutants in all possible combinations at environmental relevant concentrations. This work demonstrates a very powerful methodology to elucidate mechanisms at molecular level and help unlock the "black box" of PM_2.5-induced toxicities.

More to Explore: Further Definition of Risk Factors for COPD - Differential Gender Difference, Modest Elevation in PM2.5, and e-Cigarette Use

Chronic obstructive pulmonary disease (COPD) is a severe respiratory disease with high morbidity and mortality, representing the third leading cause of death worldwide. Traditional risk factors for COPD include aging, genetic predisposition, cigarette smoking, exposure to environmental pollutes, occupational exposure, and individual or parental respiratory disease history. In addition, latest studies have revealed novel and emerging risk factors. In this review, differential gender difference as a factor for COPD development at different territories is discussed for the first time. First, women seem to have more COPD, while more women die of COPD or have more severe COPD, in Western societies. This seems different from the impression that COPD dominants in men, which is true in Eastern societies. It might be related to higher rate of cigarette smoking in women in developed countries (i.e., 12.0% of women in United States smoke vs. 2.2% in China). Nonetheless, women in Eastern societies are exposed to more biomass usage. Second, modest elevation in PM2.5 levels at >∼21.4-32.7 μg/m3, previously considered "cleaner air," is associated with incidence of COPD, indicating that more stringent goals should be set for the reduction of PM2.5 levels to prevent COPD development. Last but not least, e-cigarette use, which has become an epidemic especially among adolescents as officially declared by the United States government, has severe adverse effects that may cause development of COPD early in life. Built upon an overview of the established risk factors for COPD primarily focusing on cigarette smoking and environmental pollutions, the present review further discusses novel concepts, mechanisms, and solutions evolved around the emerging risk factors for COPD discussed above, understanding of which would likely enable better intervention of this devastating disease.

Ambient air pollution and the development of overweight and obesity in children: a large longitudinal study

BACKGROUND

Ambient air pollution may play a role in childhood obesity development, but evidence is scarce, and the modifying role of socioeconomic status (SES) is unclear. We aimed to examine the association between exposure to air pollution during early childhood and subsequent risk of developing overweight and obesity, and to evaluate whether SES is a modifier of this association.

METHODS

This longitudinal study included 416,955 children identified as normal weight between 2-5 years old and registered in an electronic primary healthcare record between 2006 and 2016 in Catalonia (Spain). Children were followed-up until they developed overweight or obesity, reached 15 years of age, died, transferred out, or end of study period (31/12/2018). Overweight and obesity were defined following the WHO reference obtained from height and weight measures. We estimated annual residential census levels of nitrogen dioxide (NO₂) and particulate matter <10 μm (PM₁₀), <2.5 μm (PM_2.5), and 2.5-10 μm (PM_coarse) at study entry. We estimated the risk of developing overweight and obesity per interquartile range increase in air pollution exposure with Cox proportional hazard models.

RESULTS

A total of 142,590 (34.2%) children developed overweight or obesity. Increased exposure to NO₂, PM₁₀, and PM_coarse was associated with a 2-3% increased risk of developing overweight and obesity (hazard ratio [HR] per 21.8 μg/m³ NO₂ = 1.03 [95% CI: 1.02-1.04]; HR per 6.4 μg/m³ PM₁₀ = 1.02 [95% CI: 1.02-1.03]; HR per 4.6 µg/m³ PM_coarse = 1.02, [95% CI: 1.01-1.02]). For all air pollutants, associations were stronger among children living in most compared to least deprived areas.

CONCLUSIONS

This study suggests that early life exposure to air pollution may be associated with a small increase in the risk of developing overweight and obesity in childhood, and that this association may be exacerbated in the most deprived areas. Even these small associations are of potential global health importance because air pollution exposure is widespread and the long-term health consequences of childhood obesity are clear.

Fine particulate matter (PM2.5) inhalation-induced alterations in the plasma lipidome as promoters of vascular inflammation and insulin resistance

Fine particulate matter (PM2.5) air pollution exposure increases the risk of developing cardiovascular disease (CVD). Although the precise mechanisms by which air pollution exposure increases CVD risk remain uncertain, research indicates that PM2.5-induced endothelial dysfunction contributes to CVD risk. Previous studies demonstrate that concentrated ambient PM2.5 (CAP) exposure induces vascular inflammation and impairs insulin and vascular endothelial growth factor (VEGF) signaling dependent on pulmonary oxidative stress. To assess whether CAP exposure induces these vascular effects via plasmatic factors, we incubated aortas from naïve mice with plasma isolated from mice exposed to HEPA-filtered air or CAP (9 days) and examined vascular inflammation and insulin and VEGF signaling. We found that treatment of naïve aortas with plasma from CAP-exposed mice activates NF-κBα and induces insulin and VEGF resistance, indicating transmission by plasmatic factor(s). To identify putative factors, we exposed lung-specific ecSOD-transgenic (ecSOD-Tg) mice and wild-type (WT) littermates to CAP at concentrations of either ∼60 µg/m3 (CAP60) or ∼100 µg/m3 (CAP100) and measured the abundance of plasma metabolites by mass spectrometry. In WT mice, both CAP concentrations increased levels of fatty acids such as palmitate, myristate, and palmitoleate and decreased numerous phospholipid species; however, these CAP-induced changes in the plasma lipidome were prevented in ecSOD-Tg mice. Consistent with the literature, we found that fatty acids such as palmitate are sufficient to promote endothelial inflammation. Collectively, our findings suggest that PM2.5 exposure, by inducing pulmonary oxidative stress, promotes unique lipidomic changes characterized by high levels of circulating fatty acids, which are sufficient to trigger vascular pathology.NEW & NOTEWORTHY We found that circulating plasma constituents are responsible for air pollution-induced vascular pathologies. Inhalation of fine particulate matter (≤PM2.5) promotes a unique form of dyslipidemia that manifests in a manner dependent upon pulmonary oxidative stress. The air pollution-engendered dyslipidemic phenotype is characterized by elevated free fatty acid species and diminished phospholipid species, which could contribute to vascular inflammation and loss of insulin sensitivity.

Effect of Air Pollution on Obesity in Children: A Systematic Review and Meta-Analysis

Air pollution exposure has been identified as being associated with childhood obesity. Nevertheless, strong evidence of such an association is still lacking. To analyze whether air pollution exposure affects childhood obesity, we conducted a systematic review and meta-analysis utilizing the PRISMA guidelines. Of 7343 studies identified, eight studies that investigated the effects of air pollutant characteristics, including PM_2.5, PM₁₀, PM_coarse, PM_absorbance, NO_x, and NO₂, on childhood obesity were included. The polled effects showed that air pollution is correlated with a substantially increased risk of childhood obesity. PM_2.5 was found to be associated with a significantly increased risk (6%) of childhood obesity (OR 1.06, 95% CI 1.02–1.10, p = 0.003). In addition, PM₁₀, PM_{2.5absorbance}, and NO₂ appeared to significantly increase the risk of obesity in children (OR 1.07, 95% CI 1.04–1.10, p < 0.00; OR 1.23, 95% CI 1.06–1.43, p = 0.07; and OR 1.10, 95% CI 1.04–1.16, p < 0.001, respectively). PM_coarse and NO_x also showed trends towards being associated with an increased risk of childhood obesity (OR 1.07, 95% CI 0.95–1.20, p = 0.291, and OR 1.00, 95% CI 0.99–1.02, p = 0.571, respectively). Strong evidence was found to support the theory that air pollution exposure is one of the factors that increases the risk of childhood obesity.

Endothelial progenitor cells as critical mediators of environmental air pollution-induced cardiovascular toxicity

Environmental air pollution exposure is a leading cause of death worldwide, and with increasing industrialization and urbanization, its disease burden is expected to rise even further. The majority of air pollution exposure-associated deaths are linked to cardiovascular disease (CVD). Although ample research demonstrates a strong correlation between air pollution exposure and CVD risk, the mechanisms by which inhalation of polluted air affects cardiovascular health are not completely understood. Inhalation of environmental air pollution has been associated with endothelial dysfunction, which suggests that air pollution exposure impacts CVD health by inducing endothelial injury. Interestingly, recent studies demonstrate that air pollution exposure affects the number and function of endothelial progenitor cells (EPCs), subpopulations of bone marrow-derived proangiogenic cells that have been shown to play an essential role in maintaining cardiovascular health. In line with their beneficial function, chronically low levels of circulating EPCs and EPC dysfunction (e.g., in diabetic patients) have been associated with vascular dysfunction, poor cardiovascular health, and increases in the severity of cardiovascular outcomes. In contrast, treatments that improve EPC number and function (e.g., exercise) have been found to attenuate cardiovascular dysfunction. Considering the critical, nonredundant role of EPCs in maintaining vascular health, air pollution exposure-induced impairments in EPC number and function could lead to endothelial dysfunction, consequently increasing the risk for CVD. This review article covers novel aspects and new mechanistic insights of the adverse effects of air pollution exposure on cardiovascular health associated with changes in EPC number and function.

Association of ambient particle pollution with gestational diabetes mellitus and fasting blood glucose levels in pregnant women from two Chinese birth cohorts

BACKGROUND

Fasting blood glucose may capture the adverse effects of air pollution on pregnant women better than the incidence of gestational diabetes mellitus (GDM), but evidence on the association between air pollution and maternal glucose concentrations is limited.

OBJECTIVE

To investigate the associations between air pollutants, GDM and fasting blood glucose during pregnancy.

METHODS

We recruited 2326 pregnant women from two birth cohorts located in Guangzhou and Heshan, the Pearl River Delta region (PRD), China. PM₁₀, PM_2.5 and black carbon (BC) exposure concentrations in the first and second trimesters of pregnancy were collected at fixed-site monitoring stations for each cohort. Multiple logistic regressions were employed to estimate the associations between particle pollution and GDM. Mixed-effects models were used to evaluate the associations of air pollutants with blood glucose levels. Restricted cubic spline functions were fitted to visualize the concentration-response relationships. Distributed lag non-linear models were used to estimate week-specific lag effects of particle pollution exposure on GDM and blood glucose. Unconstrained distributed lag models with lags of 0-3 weeks were used to examine potential cumulative effects.

RESULTS

We observed positive and significant associations of PM₁₀, PM_2.5 and BC exposure with fasting glucose, particularly in the second trimester. PM₁₀, PM_2.5 and BC were strongly correlated and displayed similar cumulative (lag 0-3 weeks) associations with fasting blood glucose. Exposure to particle pollution was not associated with 1-h or 2-h blood glucose. Models estimating the association between air pollutants and GDM were consistent with statistical insignificance.

CONCLUSIONS

Based on the results of the present study, exposure to air pollution during pregnancy exerts cumulative, adverse effects on fasting glucose levels. This study provides preliminary support for the use of blood glucose levels to explore the potential health impact of air pollution on pregnant women.

The influence of PM2.5 exposure on non-alcoholic fatty liver disease

Emerging studies have pointed to a significant relationship between exposure to ambient fine particulate matter (aerodynamic diameter < 2.5 μm, PM2.5) and the incidence of non-alcoholic fatty liver disease (NAFLD). By referring to previous studies on the pathogenesis of NAFLD and PM2.5 exposure-induced metabolic damage, we summarized the possible mediating pathways through which PM2.5 exposure can cause the phenotype and progression of NAFLD. Crucially, PM2.5 exposure is considered to have an impact on the classic hypothesis "multiple hits" of NAFLD. In addition, we also concluded that exposure to PM2.5 can promote the development of NAFLD by destroying the intestinal epithelium and microbiotic homeostasis, triggering endoplasmic reticulum stress, inducing abnormal expression of specific microRNA or inflammatory factors.