The emerging risk of exposure to air pollution on cognitive decline and Alzheimer's disease - Evidence from epidemiological and animal studies

The proteostatic effects of traffic-derived air pollution on Alzheimer's disease risk

Alzheimer's disease (AD) is an age-related neurodegenerative disease and the leading cause of dementia in the elderly. Recent decades have been marked by considerable advances in our understanding of genetic and environmental risk factors and also of the AD mechanism(s) of action. Nonetheless, there is still no cure and the myriad ways AD affects the brain is overwhelmingly complex. Such complexity is manifest in part by the fact that genetic background interacts with the environment, including traffic-derived particulate air pollution, to greatly exacerbate AD risk. Determining the mechanisms by which particulate air pollution acts as an AD risk factor has the potential to reveal yet unknown aspects of AD pathology. This review carefully peels back the layers of complexity to discern whether a unifying disease model, one with proteostasis imbalance at its core, holds up to scrutiny in light of the recent literature. While the data are compelling, it is now time for carefully designed studies to definitively determine whether particulate air pollution acts with ageing, genetic background and other sources of proteotoxic stress to disrupt the delicate proteostasis balance.

Reduced cortical thickness in World Trade Center responders with cognitive impairment

INTRODUCTION

This study examined cortical thickness (CTX) in World Trade Center (WTC) responders with cognitive impairment (CI).

METHODS

WTC responders (N = 99) with/without CI, recruited from an epidemiologic study, completed a T1-MPRAGE protocol. CTX was automatically computed in 34 regions of interest. Region-based and surface-based morphometry examined CTX in CI versus unimpaired responders. CTX was automatically computed in 34 regions of interest. Region-based measures were also compared to published norms.

RESULTS

Participants were 55.8 (SD = 0.52) years old; 48 had CI. Compared to unimpaired responders, global mean CTX was reduced in CI and across 21/34 cortical subregions. Surface-based analyses revealed reduced CTX across frontal, temporal, and parietal lobes when adjusting for multiple comparisons. Both CI and unimpaired WTC groups had reduced CTX in the entorhinal and temporal cortices compared to published normative data.

DISCUSSION

Results from the first structural magnetic resonance imaging study in WTC responders identified reduced CTX consistent with a neurodegenerative disease of unknown etiology.

Risk assessment of temperature and air pollutants on hospitalizations for mental and behavioral disorders in Curitiba, Brazil

BACKGROUND

Extreme ambient temperatures and air quality have been directly associated with various human diseases from several studies around the world. However, few analyses involving the association of these environmental circumstances with mental and behavioral disorders (MBD) have been carried out, especially in developing countries such as Brazil.

METHODS

A time series study was carried out to explore the associations between daily air pollutants (SO2, NO2, O3, and PM10) concentrations and meteorological variables (temperature and relative humidity) on hospital admissions for mental and behavioral disorders for Curitiba, Brazil. Daily hospital admissions from 2010 to 2016 were analyzed by a semi-parametric generalized additive model (GAM) combined with a distributed lag non-linear model (DLNM).

RESULTS

Significant associations between environmental conditions (10 μg/m3 increase in air pollutants and temperature °C) and hospitalizations by MBD were found. Air temperature was the environmental variable with the highest relative risk (RR) at 0-day lag for all ages and sexes analyzed, with RR values of 1.0182 (95% CI: 1.0009-1.0357) for men, and 1.0407 (95% CI: 1.0230-1.0587) for women. Ozone exposure was a risk for all women groups, being higher for the young group, with a RR of 1.0319 (95% CI: 1.0165-1.0483). Elderly from both sexes were more susceptible to temperature variability, with a RR of 1.0651 (95% CI: 1.0213-1.1117) for women, and 1.0215 (95% CI: 1.0195-1.0716) for men.

CONCLUSIONS

This study suggests that temperatures above and below the thermal comfort threshold, in addition to high concentrations of air pollutants, present significant risks on hospitalizations by MBD; besides, there are physiological and age differences resulting from the effect of this exposure.

Air Pollution and Emergency Department Visits for Mental Disorders among Youth

Although exposure to ambient air pollution has been linked to mental health problems, little is known about its potential effects on youth. This study investigates the association between short-term exposure to air pollutants and emergency department (ED) visits for mental health disorders. The National Ambulatory Care Reporting System database was used to retrieve ED visits for young individuals aged 8–24 years in Toronto, Canada. Daily average concentrations of nitrogen dioxide (NO₂), fine particulate matter (PM_2.5), and daily maximum 8 h ozone (O₃) were calculated using measurement data from seven fixed stations. A case-crossover (CC) design was implemented to estimate the associations between ED visits and air pollution concentrations. Mental health ED visits were identified using International Classification of Diseases 10th Revision (ICD-10) codes, with seven categories considered. Models incorporating air pollutants and ambient temperature (with lags of 0–5 days) using a time-stratified CC technique were applied. Multivariable regression was performed by sex, three age groups, and seven types of mental health disorders to calculate relative risk (RR). The RRs were reported for one interquartile range (IQR) change in the air pollutant concentrations. Between April 2004 and December 2015 (4292 days), there were 83,985 ED visits for mental-health related problems in the target population. Several exposures to air pollutants were shown to have associations with ED visits for mental health including same day exposure to fine particulate matter (IQR = 6.03 μg/m³, RR = 1.01 (95% confidence interval: 1.00–1.02), RR = 1.02 (1.00–1.03)) for all and female-only patients, respectively. One-day lagged exposure was also associated with ED visits for PM_2.5 (RR = 1.02 (1.01–1.03)), for nitrogen dioxide (IQR = 9.1 ppb, RR = 1.02 (1.00–1.04)), and ozone (IQR = 16.0 ppb, RR = 1.06 (1.01–1.10)) for males. In this study, urban air pollution concentration—mainly fine particulate matter and nitrogen dioxide—is associated with an increased risk for ED visits for adolescents and young adults with diagnosed mental health disorders.

Chemical Analysis of Surface-Level Ozone Exceedances during the 2015 Pan American Games

Surface-level ozone (O3) continues to be a significant health risk in the Greater Toronto Hamilton Area (GTHA) of Canada even though precursor emissions in the area have decreased significantly over the past two decades. In July 2015, Environment and Climate Change Canada (ECCC) led an intensive field study coincident with Toronto hosting the 2015 Pan American Games. During the field study, the daily 1-h maximum O3 standard (80 ppbv) was exceeded twice at a measurement site in North Toronto, once on July 12 and again on July 28. In this study, ECCC’s 2.5-km configuration of the Global Environmental Multi-scale (GEM) meteorological model was combined with the Modelling Air-quality and CHemistry (MACH) on-line atmospheric chemistry model and the Town Energy Balance (TEB) urban surface parameterization to create a new urban air quality modelling system. In general, the model results showed that the nested 2.5-km grid-spaced urban air quality model performed better in statistical scores compared to the piloting 10-km grid-spaced GEM-MACH model without TEB. Model analyses were performed with GEM-MACH-TEB for the two exceedance periods. The local meteorology for both cases consisted of light winds with the highest O3 predictions situated along lake-breeze fronts. For the July 28 case, O3 production sensitivity analysis along the trajectory of the lake-breeze circulation showed that the region of most efficient O3 production occurred in the updraft region of the lake-breeze front, as the precursors to O3 formation underwent vertical mixing. In this updraft region, the ozone production switches from volatile organic compound (VOC)-sensitive to NOx-sensitive, and the local net O3 production rate reaches a maximum. This transition in the chemical regime is a previously unidentified factor for why O3 surface-level mixing ratios maximize along the lake-breeze front. For the July 12 case, differences between the model and observed Lake Ontario water temperature and the strength of lake-breeze opposing wind flow play a role in differences in the timing of the lake-breeze, which impacts the predicted location of the O3 maximum north of Toronto.

Effects of air pollution on the nervous system and its possible role in neurodevelopmental and neurodegenerative disorders

Recent extensive evidence indicates that air pollution, in addition to causing respiratory and cardiovascular diseases, may also negatively affect the brain and contribute to central nervous system diseases. Air pollution is comprised of ambient particulate matter (PM) of different sizes, gases, organic compounds, and metals. An important contributor to PM is represented by traffic-related air pollution, mostly ascribed to diesel exhaust (DE). Epidemiological and animal studies have shown that exposure to air pollution may be associated with multiple adverse effects on the central nervous system. In addition to a variety of behavioral abnormalities, the most prominent effects caused by air pollution are oxidative stress and neuro-inflammation, which are seen in both humans and animals, and are supported by in vitro studies. Among factors which can affect neurotoxic outcomes, age is considered most relevant. Human and animal studies suggest that air pollution may cause developmental neurotoxicity, and may contribute to the etiology of neurodevelopmental disorders, including autism spectrum disorder. In addition, air pollution exposure has been associated with increased expression of markers of neurodegenerative disease pathologies, such as alpha-synuclein or beta-amyloid, and may thus contribute to the etiopathogenesis of neurodegenerative diseases, particularly Alzheimer's disease and Parkinson's disease.

Concentrated ambient fine particulate matter (PM2.5) exposure induce brain damage in pre and postnatal exposed mice

Air pollution is a public health concern that has been associated with adverse effects on the development and functions of the central nervous system (CNS). However, studies on the effects of exposure to pollutants on the CNS across the entire developmental period still remain scarce. In this study, we investigated the impacts of prenatal and/or postnatal exposure to fine particulate matter (PM_2.5) from São Paulo city, on the brain structure and behavior of juvenile male mice. BALB/c mice were exposed to PM_2.5 concentrated ambient particles (CAP) at a daily concentration of 600 μg/m³ during the gestational [gestational day (GD) 1.5-18.5] and the postnatal periods [postnatal day (PND) 22-90] to filtered air (FA) in both periods (FA/FA), to CAP only in the postnatal period (FA/CAP), to CAP only in the gestational period (CAP/FA), and to CAP in both periods (CAP/CAP). Behavioral tests were performed when animals were at PND 30 and PND 90. Glial activation, brain volume, cortical neuron number, serotonergic and GABAergic receptors, as well as oxidative stress, were measured. Mice at PND 90 presented greater behavioral changes in the form of greater locomotor activity in the FA-CAP and CAP-CAP groups. In general, these same groups explored objects longer and the CAP-FA group presented anxiolytic behavior. There was no difference in total brain volume among groups, but a lower corpus callosum (CC) volume was observed in the CAP-FA group. Also, the CAP-CAP group presented an increase in microglia in the cortex and an increased in astrocytes in the cortex, CC, and C1A and dentate gyrus of hippocampus regions. Gene expression analysis showed a decrease in BDNF in the hippocampus of CAP-CAP group. Treatment of immortalized glial cells with non-cytotoxic doses of ambient PM_2.5 increased micronuclei frequencies, indicating genomic instability. These findings highlight the potential for negative neurodevelopmental outcomes induced by exposure to moderate levels of PM_2.5 in Sao Paulo city.

Role of Vegetation as a Mitigating Factor in the Urban Context

It is known that the urban environment amplifies the effects of climate change, sometimes with disastrous consequences that put people at risk. These aspects can be affected by urban vegetation and planting design but, while there are thousands of papers related to the effects of climate change, a relatively limited number of them are directly aimed at investigating the role of vegetation as a mitigating factor in the urban context. This paper focuses on reviewing the research on the role of urban vegetation in alleviating the adverse conditions of the urban environment in order to provide some practical guidelines to be applied by city planners. Through an analysis of the documents found in Scopus, Web of Science, and Google Scholar using urban vegetation and climate change-related keywords we selected five major issues related to the urban environment: (1) particulate matter, (2) gaseous pollution, (3) noise pollution, (4) water runoff, (5) urban heat island effect. The analysis of existing knowledge reported here indicates that the roles of urban vegetation on the adverse effect of climate change could not be simply deemed positive or negative, because the role of urban green is also strongly linked to the structure, composition, and distribution of vegetation, as well as to the criteria used for management. Therefore, it could help to better understand the roles of urban green as a complex system and provide the foundation for future studies.

Comprehensive review of the current literature on impact of ambient air pollution and sleep quality

Air pollution is associated with increasing morbidity, mortality and decreasing health and life span. Accumulating epidemiological and experimental evidence has shown that exposure to ambient air pollutants such as particulate matters (PM) and gaseous components [eg, nitrogen dioxide (NO₂), ozone (O₃)] has detrimental effects on sleep quality. We conducted this comprehensive review to explore the association between ambient air pollution and sleep quality. A systematic search was conducted with the databases of PubMed and Web of Science from inception to November 2019. Overall, 15 studies with 133,695 subjects that evaluated the association between ambient air pollution and sleep quality were conducted in 10 different countries (ie, USA, Brazil, Canada, Chile, China, Egypt, Germany, Iran, Mexico, and Turkey). Most included studies in the current review have shown that one or more air pollutants have negative influences on sleep quality. Air pollutants might be one of the triggers for poor sleep quality via disparate mechanisms including but not limited to the central ventilator control centers, central nervous system, allergic and non-allergic mechanisms. The possible association between air pollution and select chronic diseases (eg, mental illnesses, cardiovascular diseases) and behaviors (eg, impulsivity) may also play important roles in explaining the association between ambient air pollution and sleep quality. The associations and underlying mechanisms between ambient air pollutants and sleep quality need to be clarified with long-term, multi-centered cohort studies.

Disentangling the Amyloid Pathways: A Mechanistic Approach to Etiology

Amyloids are fibrillar protein aggregates associated with diseases such as Alzheimer's disease (AD), Parkinson's disease (PD), type II diabetes and Creutzfeldt-Jakob disease. The process of amyloid polymerization involves three pathological protein transformations; from natively folded conformation to the cross-β conformation, from biophysically soluble to insoluble, and from biologically functional to non-functional. While amyloids share a similar cross-β conformation, the biophysical transformation can either take place spontaneously via a homogeneous nucleation mechanism (HON) or catalytically on an exogenous surface via a heterogeneous nucleation mechanism (HEN). Here, we postulate that the different nucleation pathways can serve as a mechanistic basis for an etiological classification of amyloidopathies, where hereditary forms generally follow the HON pathway, while sporadic forms follow seed-induced (prions) or surface-induced (including microbially induced) HEN pathways. Critically, the conformational and biophysical amyloid transformation results in loss-of-function (LOF) of the original natively folded and soluble protein. This LOF can, at least initially, be the mechanism of amyloid toxicity even before amyloid accumulation reaches toxic levels. By highlighting the important role of non-protein species in amyloid formation and LOF mechanisms of toxicity, we propose a generalized mechanistic framework that could help better understand the diverse etiology of amyloid diseases and offer new opportunities for therapeutic interventions, including replacement therapies.

Chemical content and source apportionment of 36 heavy metal analysis and health risk assessment in aerosol of Beijing

The concentration levels of 36 airborne heavy metals and atmospheric radioactivity in total suspended particulate (TSP) samples were measured to investigate the chemical characteristics, potential sources of aerosols, and health risk in Beijing, China, from September 2016 to September 2017. The TSP concentrations varied from 6.93 to 469.18 μg/m³, with a median of 133.97 μg/m³. The order for the mean concentrations of heavy metals, known as hazardous air pollutants (HAPs), was as follows: Mn > Pb > As > Cr > Ni > Se > Cd > Co > Sb > Hg > Be; Non-Designated HAPs Metals: Ca > Fe > Mg > Al > K > Na > Zn > P > Ba > Ti > Cu > Sr > B > Sn > I > V > Rb > Ce > Mo > Cs > Th > Ag > U > Pt. The median concentration of As was higher than China air quality standard (6 ng/m³). The gross α and β concentration levels in aerosols were (1.84 ± 1.59) mBg/m³ and (1.15 ± 0.85) mBg/m³, respectively. The enrichment factor values of Cu, Ba, B, Ce, Tl, Cs, Pb, As, Cd, Sb, Hg, Fe, Zn, Sn, I, Mo, and Ag were higher than 10, which indicated enriched results from anthropogenic sources. Pb, As, and Cd are considered to originate from multiple sources; fireworks released Ba during China spring festival; Fe, Ce, and Cs may come from stable emissions such as industrial gases. The health risks from anthropogenic metals via inhalation, ingestion, and dermal pathway were estimated on the basis of health quotient as well as the results indicated that children faced the higher risk than adults during the research period. For adults, the health risk posed by heavy metals in atmospheric particles was below the acceptable level.

The Relationship Between Ambient Atmospheric Fine Particulate Matter (PM2.5) and Glaucoma in a Large Community Cohort

Purpose

Glaucoma is more common in urban populations than in others. Ninety percent of the world's population are exposed to air pollution above World Health Organization (WHO) recommended limits. Few studies have examined the association between air pollution and glaucoma.

Methods

Questionnaire data, ophthalmic measures, and ambient residential area air quality data for 111,370 UK Biobank participants were analyzed. Particulate matter with an aerodynamic diameter < 2.5 μm (PM2.5) was selected as the air quality exposure of interest. Eye measures included self-reported glaucoma, intraocular pressure (IOP), and average thickness of macular ganglion cell-inner plexiform layer (GCIPL) across nine Early Treatment Diabetic Retinopathy Study (ETDRS) retinal subfields as obtained from spectral-domain optical coherence tomography. We examined the associations of PM2.5 concentration with self-reported glaucoma, IOP, and GCIPL.

Results

Participants resident in areas with higher PM2.5 concentration were more likely to report a diagnosis of glaucoma (odds ratio = 1.06, 95% confidence interval [CI] = 1.01-1.12, per interquartile range [IQR] increase P = 0.02). Higher PM2.5 concentration was also associated with thinner GCIPL (β = -0.56 μm, 95% CI = -0.63 to -0.49, per IQR increase, P = 1.2 × 10-53). A dose-response relationship was observed between higher levels of PM2.5 and thinner GCIPL (P < 0.001). There was no clinically relevant relationship between PM2.5 concentration and IOP.

Conclusions

Greater exposure to PM2.5 is associated with both self-reported glaucoma and adverse structural characteristics of the disease. The absence of an association between PM2.5 and IOP suggests the relationship may occur through a non-pressure-dependent mechanism, possibly neurotoxic and/or vascular effects.

Pollution, Particles, and Dementia: A Hypothetical Causative Pathway

Epidemiological studies of air pollution have shown associations between exposure to particles and dementia. The mechanism of this is unclear. As these seem unlikely in terms of the very small dose likely to reach the brain in usual Western urban circumstances, we extend our 1995 hypothetical explanation of the association of air pollution with cardiac deaths as a plausible alternative explanation of its associations with dementia. Since our original proposal, it has become apparent that inflammation may be carried by blood from organ to organ by biologic microparticles derived from cell membranes. These transmit inflammatory messages to endothelial cells throughout the body as part of a general defensive response to assumed bacterial infection; particulate air pollution has recently been shown to be associated with their release into the blood. We propose that episodic release of biologic microparticles from pollution-induced lung inflammation causes secondary inflammation in the blood-brain barrier and cerebral microbleeds, culminating over time in cognitive impairment. Ultimately, by incomplete repair and accumulation of amyloid, this increases the risk of Alzheimer’s disease. Importantly, this mechanism may also explain the relationships of other inflammatory conditions and environmental factors with cognitive decline, and point to new opportunities to understand and prevent dementia.

Impact of Ambient Temperature and Relative Humidity on the Incidence of Hand-Foot-Mouth Disease in Wuhan, China

Background: Few studies have previously explored the relationship between hand, foot, and mouth disease (HFMD) and meteorological factors with the effect modification of air pollution, and these studies had inconsistent findings. We therefore applied a time-series analysis assessing the effects of temperature and humidity on the incidence of HFMD in Wuhan, China to deepen our understanding of the relationship between meteorological factors and the risk of HFMD. Methods: Daily HFMD cases were retrieved from Hubei Provincial Center for Disease Control and Prevention from 1 February 2013 to 31 January 2017. Daily meteorological data including 24 h average temperature, relative humidity, wind velocity, and atmospheric pressure were obtained from Hubei Meteorological Bureau. Data on Air pollution was collected from 10 national air-monitoring stations in Wuhan city. We adopted a distributed lag non-linear model (DLNM) combined with Poisson regression and time-series analysis to estimate the effects of temperature and relative humidity on the incidence HFMD. Results: We found that the association between temperature and HFMD incidence was non-linear, exhibiting an approximate "M" shape with two peaks occurring at 2.3 °C (RR = 1.760, 95% CI: 1.218-2.542) and 27.9 °C (RR = 1.945, 95% CI: 1.570-2.408), respectively. We observed an inverted "V" shape between relative humidity and HFMD. The risk of HFMD reached a maximum value at a relative humidity of 89.2% (RR = 1.553, 95% CI: 1.322-1.824). The largest delayed cumulative effects occurred at lag 6 for temperature and lag 13 for relative humidity. Conclusions: The non-linear relationship between meteorological factors and the incidence of HFMD on different lag days could be used in the early targeted warning system of infectious diseases, reducing the possible outbreaks and burdens of HFMD among sensitive populations.

Short review: Air pollution, noise and lack of greenness as risk factors for Alzheimer's disease- epidemiologic and experimental evidence

The number of patients with Alzheimer's disease (AD) is likely to triple in a few decades as the world's population ages. Given the high personal and societal burden of this disease, it is imperative to identify its risk factors. The etiology of AD is still not fully understood, but environmental factors have emerged as plausible important risk factors on the population-level. In this short review, the author summarizes literature on air pollution, noise and (lack of) greenness as risk factors for AD. In conclusion, a link between air pollution and AD is supported by experimental studies as well as epidemiological studies, although a multi-exposure approach is lacking in most epidemiological studies. Although evidence is much more limited regarding noise and (lack of) greenness as risk factors for AD, future epidemiological studies should have a multi-exposure approach in order to separate potential effects of air pollution, noise and lack of greenness. Given the heavy toll of AD on individuals and society, as well as the ubiquitous nature of environmental factors, a link between environmental stressors and AD deserves special attention.

Mitochondrial Bioenergetics in Brain Following Ozone Exposure in Rats Maintained on Coconut, Fish and Olive Oil-Rich Diets

Dietary supplementation with omega-3 and omega-6 fatty acids offer cardioprotection against air pollution, but these protections have not been established in the brain. We tested whether diets rich in omega-3 or -6 fatty acids offered neuroprotective benefits, by measuring mitochondrial complex enzyme I, II and IV activities and oxidative stress measures in the frontal cortex, cerebellum, hypothalamus, and hippocampus of male rats that were fed either a normal diet, or a diet enriched with fish oil olive oil, or coconut oil followed by exposure to either filtered air or ozone (0.8 ppm) for 4 h/day for 2 days. Results show that mitochondrial complex I enzyme activity was significantly decreased in the cerebellum, hypothalamus and hippocampus by diets. Complex II enzyme activity was significantly lower in frontal cortex and cerebellum of rats maintained on all test diets. Complex IV enzyme activity was significantly lower in the frontal cortex, hypothalamus and hippocampus of animals maintained on fish oil. Ozone exposure decreased complex I and II activity in the cerebellum of rats maintained on the normal diet, an effect blocked by diet treatments. While diet and ozone have no apparent influence on endogenous reactive oxygen species production, they do affect antioxidant levels in the brain. Fish oil was the only diet that ozone exposure did not alter. Microglial morphology and GFAP immunoreactivity were assessed across diet groups; results indicated that fish oil consistently decreased reactive microglia in the hypothalamus and hippocampus. These results indicate that acute ozone exposure alters mitochondrial bioenergetics in brain and co-treatment with omega-6 and omega-3 fatty acids alleviate some adverse effects within the brain.

Exposure to Ambient Air Pollution and Cognitive Impairment in Community-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study

The aim of this study was to investigate the associations between ambient air pollutants and cognitive impairment in Korean older adults. The cognitive function of 2,896 participants aged 70 to 84 years was measured using the Korean version of the mini-mental state examination, the digit span test, the word list learning test, and the frontal assessment battery. After matching the average concentrations of particulate matter (PM) <10 μm in size (PM₁₀) and <2.5 μm (PM_2.5), NO₂, CO, SO₂, and O₃ between 2013 and 2017, the association between air pollutants and cognitive scales was analyzed using a linear mixed regression and a multiple logistic regression analysis (after adjusting for age, sex, health related behaviors, socioeconomic status, comorbidity, and meteorological data). Exposure to PM_2.5, PM₁₀, NO₂, SO₂, and CO was associated with cognitive impairment above and beyond age or education level effects. Specifically, PM_2.5 was negatively associated with most components of the cognitive scales (interquartile range for PM_2.5: 2.0 μg/m³, odds ratio for poor global cognition: 2.28, 95% confidence interval: 1.60-3.26). These associations may be affected by sex, residence area, or alcohol intake. Conclusively, air pollutants, especially PM_2.5, were associated with cognitive impairment, including global cognition, attention, memory, and executive function in Korean older adults aged ≥70 years.

Respiratory gases, air pollution and epilepsy

A growing number of studies have shown that exposure to air pollutants such as particulate matter and gases can cause cardiovascular, neurodegenerative and psychiatric diseases. The severity of the changes depends on several factors such as exposure time, age and gender. Inflammation has been considered as one of the main factors associated with the generation of these diseases. Here we present some cellular mechanisms activated by air pollution that may represent risk factors for epilepsy and drug resistance associated to epilepsy.

A model of lipid dysregulation and altered nutrient status in Alzheimer's disease

INTRODUCTION

Dysregulated lipid metabolism and nutrient status are thought to play a role in the pathophysiology of Alzheimer's disease (AD). However, the precise involvement is not well understood, and it remains unclear exactly how such dysregulated lipid metabolism and altered nutrient status, especially changes in phosphatidylcholine, B12, and folate, are connected to the hallmark pathology in AD (i.e., amyloidogenesis).

METHODS

We have postulated that genetic susceptibility (i.e., APOE ε4/ε4) to environmental exposure to emissions of nitrous oxide (N2O) could underlie the onset of AD and its early neuropsychiatric correlates.

RESULTS AND DISCUSSION

The current theoretical editorial describes, using clinical, preclinical, and in vitro evidences, how this model contributes not only to amyloidogenesis but also other nonopioid effects, specifically altered lipid metabolism, depletion of vitamin B12, and disruption of the folate-mediated one carbon metabolic pathway.

Air pollution and brain health: defining the research agenda

PURPOSE OF REVIEW

The literature on air pollution and brain health is rapidly expanding and it is a universal finding that greater exposure to air pollution is associated with worse outcomes, whatever the measure of brain health used (clinical dementia, neuroimaging correlates, or cognitive impairment). However, there are a number of important questions which the studies currently published are not able to answer: when in the life course does exposure to air pollution most have the most impact?; which pollutant(s) or components are most important?; and since dementia describes a heterogeneous group of conditions, which is most affected by exposure to air pollution?

RECENT FINDINGS

We briefly review and discuss the nine articles which have been published so far in 2018, so recently that they were not included in the four review articles also published this year. We highlight the variation in estimates of air pollution used but the consistency in deriving them from residential address (with or without some knowledge of an individual's previous home locations).

SUMMARY

We are now at the stage when the research agenda needs to be agreed and we believe these three questions should be the focus of future research.

EDTA Chelation Therapy for the Treatment of Neurotoxicity

Neurotoxicity can be caused by numerous direct agents, of which toxic metals, organophosphorus pesticides, air pollution, radiation and electromagnetic fields, neurotoxins, chemotherapeutic and anesthetic drugs, and pathogens are the most important. Other indirect causes of neurotoxicity are cytokine and/or reactive oxygen species production and adoptive immunotherapy. The development of neurodegenerative diseases has been associated with neurotoxicity. Which arms are useful to prevent or eliminate neurotoxicity? The chelating agent calcium disodium ethylenediaminetetraacetic acid (EDTA)-previously used to treat cardiovascular diseases-is known to be useful for the treatment of neurodegenerative diseases. This review describes how EDTA functions as a therapeutic agent for these diseases. Some case studies are reported to confirm our findings.

Long-Term Exposure to Ambient Hydrocarbons Increases Dementia Risk in People Aged 50 Years and above in Taiwan

BACKGROUND

Alzheimer's disease, the most common cause of dementia among the elderly, is a progressive and irreversible neurodegenerative disease. Exposure to air pollutants is known to have adverse effects on human health, however, little is known about hydrocarbons in the air that can trigger a dementia event.

OBJECTIVE

We aimed to investigate whether long-term exposure to airborne hydrocarbons increases the risk of developing dementia.

METHOD

The present cohort study included 178,085 people aged 50 years and older in Taiwan. Cox proportional hazards regression analysis was used to fit the multiple pollutant models for two targeted pollutants, including total hydrocarbons and non-methane hydrocarbons, and estimated the risk of dementia.

RESULTS

Before controlling for multiple pollutants, hazard ratios with 95% confidence intervals for the overall population were 7.63 (7.28-7.99, p <0.001) at a 0.51-ppm increases in total hydrocarbons, and 2.94 (2.82-3.05, p <0.001) at a 0.32-ppm increases in non-methane hydrocarbons. The highest adjusted hazard ratios for different multiple-pollutant models of each targeted pollutant were statistically significant (p <0.001) for all patients: 11.52 (10.86-12.24) for total hydrocarbons and 9.73 (9.18-10.32) for non-methane hydrocarbons.

CONCLUSION

Our findings suggest that total hydrocarbons and non-methane hydrocarbons may be contributing to dementia development.

Tainted air: The link between pollution and Alzheimer's disease

In this issue of the Biomedical Journal, we learn how air pollution may contribute to cognitive decline and even increase risk for Alzheimer's disease. We also highlight original research documenting the body's response to infection with a common oral pathogen. Finally, we learn how a cellular antioxidant protein protects against mitochondrial dysfunction in Parkinson's disease.