The role of the PM2.5-associated metals in pathogenesis of child Mycoplasma Pneumoniae infections: a systematic review

Disease types and pathogenic mechanisms induced by PM2.5 in five human systems: An analysis using omics and human disease databases

Atmospheric fine particulate matter (PM2.5) can harm various systems in the human body. Due to limitations in the current understanding of epidemiology and toxicology, the disease types and pathogenic mechanisms induced by PM2.5 in various human systems remain unclear. In this study, the disease types induced by PM2.5 in the respiratory, circulatory, endocrine, and female and male urogenital systems have been investigated and the pathogenic mechanisms identified at molecular level. The results reveal that PM2.5 is highly likely to induce pulmonary emphysema, reperfusion injury, malignant thyroid neoplasm, ovarian endometriosis, and nephritis in each of the above systems respectively. The most important co-existing gene, cellular component, biological process, molecular function, and pathway in the five systems targeted by PM2.5 are Fos proto-oncogene (FOS), extracellular matrix, urogenital system development, extracellular matrix structural constituent conferring tensile strength, and ferroptosis respectively. Differentially expressed genes that are significantly and uniquely targeted by PM2.5 in each system are BTG2 (respiratory), BIRC5 (circulatory), NFE2L2 (endocrine), TBK1 (female urogenital) and STAT1 (male urogenital). Important disease-related cellular components, biological processes, and molecular functions are specifically induced by PM2.5. For example, response to wounding, blood vessel morphogenesis, body morphogenesis, negative regulation of response to endoplasmic reticulum stress, and response to type I interferon are the top uniquely existing biological processes in each system respectively. PM2.5 mainly acts on key disease-related pathways such as the PD-L1 expression and PD-1 checkpoint pathway in cancer (respiratory), cell cycle (circulatory), apoptosis (endocrine), antigen processing and presentation (female urogenital), and neuroactive ligand-receptor interaction (male urogenital). This study provides a novel analysis strategy for elucidating PM2.5-related disease types and is an important supplement to epidemiological investigation. It clarifies the risks of PM2.5 exposure, elucidates the pathogenic mechanisms, and provides scientific support for promoting the precise prevention and treatment of PM2.5-related diseases.

Impact of black soot emissions on public health in Niger Delta, Nigeria: understanding the severity of the problem

Rivers State, Niger Delta, Nigeria often referred to as the 'treasure bed of the nation' is the seat of crude oil production activities with the accompanying environmental degradation. The severity of the environmental pollution and contaminated air quality took a new turn for the worse in November 2016, when the residents of Port Harcourt city, Rivers State, a major oil producing State experienced for the first time, aerosol deposition of plumes of black soot. This systematic review paper is aimed at quantifying the severity of this public health challenge. Using appropriate search words, the following databases SCOPUS, PUBMED, Google Scholar, and AJOL were searched from 1990 to 2022 to enable comparative analyses of data before and after the emergence of black soot deposition. Air-related morbidities and mortalities such as cerebrospinal meningitis (CSM), chronic bronchitis, measles, pertussis, hemoptysis, cough, pulmonary tuberculosis, pneumonia, and upper respiratory tract infection (URTI), pneumonia, eye irritation, conjunctivitis, traumatic skin outgrowth, cancers, cardiovascular diseases, and child deformities were compared with levels of air pollutants and particulate matter. The results showed that Port Harcourt city's ambient air quality data were above the standard National Ambient Air Quality data and that of other regulatory agencies having higher levels of both inorganic and organic pollutants. There were significant relationships between air pollutants concentration with morbidities. These correlations were significant in the period covering 2016-2022. Consequently, it is concluded that the black soot emissions in Port Harcourt city, Nigeria has worsened the public health situation in the city.

Contribution of Particulates to Airborne Disease Transmission and Severity: A Review

The emergence of coronavirus disease 2019 (COVID-19) has catalyzed great interest in the spread of airborne pathogens. Airborne infectious diseases are classified into viral, bacterial, and fungal infections. Environmental factors can elevate their transmission and lethality. Air pollution has been reported as the leading environmental cause of disease and premature death worldwide. Notably, ambient particulates of various components and sizes are harmful pollutants. There are two prominent health effects of particles in the atmosphere: (1) particulate matter (PM) penetrates the respiratory tract and adversely affects health, such as heart and respiratory diseases; and (2) bioaerosols of particles act as a medium for the spread of pathogens in the air. Particulates contribute to the occurrence of infectious diseases by increasing vulnerability to infection through inhalation and spreading disease through interactions with airborne pathogens. Here, we focus on the synergistic effects of airborne particulates on infectious disease. We outline the concepts and characteristics of bioaerosols, from their generation to transformation and circulation on Earth. Considering that microorganisms coexist with other particulates as bioaerosols, we investigate studies examining respiratory infections associated with airborne PM. Furthermore, we discuss four factors (meteorological, biological, physical, and chemical) that may impact the influence of PM on the survival of contagious pathogens in the atmosphere. Our review highlights the significant role of particulates in supporting the transmission of infectious aerosols and emphasizes the need for further research in this area.

Oxidative stress is the pivot for PM2.5-induced lung injury

Fine particulate matter (PM2.5) is a primary air pollutant recognized worldwide as a serious threat to public health. PM2.5, which has a diameter of less than 2.5 μm, is known to cause various diseases, including cardiovascular, respiratory, metabolic, and neurological diseases. Studies have shown that the respiratory system is particularly susceptible to PM2.5 as it is the first line of defense against external pollutants. PM2.5 can cause oxidative stress, which is triggered by the catalyzation of biochemical reactions, the activation of oxidases and metabolic enzymes, and mitochondrial dysfunction, all of which can lead to lung injury and aggravate various respiratory diseases including chronic obstructive pulmonary disease (COPD), asthma, pulmonary fibrosis, and cancer. Oxidative stress plays a crucial role in the harmful effects and mechanisms of PM2.5 on the respiratory system by activating several detrimental pathways related to inflammation and cellular damage. However, experimental studies have shown that antioxidative therapy methods can effectively cure PM2.5-induced lung injury. This review aims to clarify how PM2.5 induces oxidative stress and the mechanisms by which it is involved in the aggravation of various lung diseases. Additionally, we have listed antioxidant treatments to protect against PM2.5-induced lung injury.

Efficacy and Influencing Factors of Sangju Cough Mixture in the Adjuvant Treatment of Adult Patients with Mycoplasma pneumoniae Infection: A Retrospective Study

Purpose

Sangju-Yin, supplemented with some drugs, has frequently demonstrated therapeutic efficacy against colds, albeit its effect on Mycoplasma pneumoniae (MP) infection remains unknown. Therefore, we aimed to elucidate the treatment efficacy and influencing factors of a Sangju cough mixture on MP infection in adults.

Patients and Methods

Between January 2021 and December 2022, 150 adult patients with MP infection at the Lishui Hospital of Traditional Chinese Medicine Affiliated with Zhejiang University of Traditional Chinese Medicine were assigned to the treatment (administered Sangju cough mixture and moxifloxacin tablets) or the control (administered moxifloxacin tablets) groups.

Results

When compared with the control group, the treatment group exhibited significantly improved traditional Chinese medicine syndrome scores, increased CD4+ T cell levels, and decreased CD8+ T cell levels (all P < 0.05). After 7 days of treatment, the negative conversion rate of the MP-specific immunoglobulin M (MP-IgM) antibody of the treatment group was not significantly different from that of the control group (P > 0.05); however, after 14 days of treatment, the rate was significantly higher in the treatment group (P < 0.05). The univariate regression analysis revealed that combined chronic respiratory disease, failure to take Sangju cough mixture, combined pneumonia, Nutritional Risk Screening 2002 (NRS 2002) score of at least 3 points, and age were associated with the negative conversion of the MP-IgM antibody (all P < 0.05). Nevertheless, the multivariate regression model revealed that the NRS 2002 score of at least 3 points was not an independent risk factor (P > 0.05).

Conclusion

Sangju cough mixture can improve symptoms, accelerate the negative conversion time of MP-IgM antibody, and promote rehabilitation of the patients.

Air pollutants in bronchoalveolar lavage fluid and pulmonary tuberculosis: A mediation analysis of gene-specific methylation

Particulate matter (PM) exposure could alter the risk of tuberculosis, but the underlying mechanism is still unclear. We enrolled 132 pulmonary tuberculosis (PTB) patients and 30 controls. Bronchoalveolar lavage fluid samples were collected from all participants to detect organochlorine pesticides, polycyclic aromatic hydrocarbons, metal elements, and DNA methylation of immunity-related genes. We observed that γ-HCH, Bap, Sr, Ag, and Sn were related to an increased risk of PTB, while Cu and Ba had a negative effect. IFN-γ, IL-17A, IL-2, and IL-23 had a higher level in the PTB group, while IL-4 was lower. The methylation of 18 CpG sites was statistically associated with PTB risk. The methylation at the IL-4_06_121 site showed a significant mediating role on γ-HCH, Sr, and Sn. Our study suggests that PM exposure can increase the risk of tuberculosis by affecting DNA methylation and cytokine expression.

Transcriptomics profile of human bronchial epithelial cells exposed to ambient fine particles and influenza virus (H3N2)

Fine particulate matter (PM2.5) pollution remains a major threat to public health. As the physical barrier against inhaled air pollutants, airway epithelium is a primary target for PM2.5 and influenza viruses, two major environmental insults. Recent studies have shown that PM2.5 and influenza viruses may interact to aggravate airway inflammation, an essential event in the pathogenesis of diverse pulmonary diseases. Airway epithelium plays a critical role in lung health and disorders. Thus far, the mechanisms for the interactive effect of PM2.5 and the influenza virus on gene transcription of airway epithelial cells have not been fully uncovered. In this present pilot study, the transcriptome sequencing approach was introduced to identify responsive genes following individual and co-exposure to PM2.5 and influenza A (H3N2) viruses in a human bronchial epithelial cell line (BEAS-2B). Enrichment analysis revealed the function of differentially expressed genes (DEGs). Specifically, the DEGs enriched in the xenobiotic metabolism by the cytochrome P450 pathway were linked to PM2.5 exposure. In contrast, the DEGs enriched in environmental information processing and human diseases, such as viral protein interaction with cytokines and cytokine receptors and epithelial cell signaling in bacterial infection, were significantly related to H3N2 exposure. Meanwhile, co-exposure to PM2.5 and H3N2 affected G protein-coupled receptors on the cell surface. Thus, the results from this study provides insights into PM2.5- and influenza virus-induced airway inflammation and potential mechanisms.

Unique regulatory roles of ncRNAs changed by PM2.5 in human diseases

PM_2.5 is a type of particulate matter with an aerodynamic diameter smaller than 2.5 µm, and exposure to PM_2.5 can adversely damage human health. PM_2.5 may impair health through oxidative stress, inflammatory reactions, immune function alterations and chromosome or DNA damage. Through increasing in-depth studies, researchers have found that noncoding RNAs (ncRNAs), particularly microRNAs (miRNAs), circular RNAs (circRNAs) as well as long noncoding RNAs (lncRNAs), might play significant roles in PM_2.5-related human diseases via some of the abovementioned mechanisms. Therefore, in this review, we mainly discuss the regulatory function of ncRNAs altered by PM_2.5 in human diseases and summarize the potential molecular mechanisms. The findings reveal that these ncRNAs might induce or promote diseases via inflammation, the oxidative stress response, cell autophagy, apoptosis, cell junction damage, altered cell proliferation, malignant cell transformation, disruption of synaptic function and abnormalities in the differentiation and status of immune cells. Moreover, according to a bioinformatics analysis, the altered expression of potential genes caused by these ncRNAs might be related to the development of some human diseases. Furthermore, some ncRNAs, including lncRNAs, miRNAs and circRNAs, or processes in which they are involved may be used as biomarkers for relevant diseases and potential targets to prevent these diseases. Additionally, we performed a meta-analysis to identify more promising diagnostic ncRNAs as biomarkers for related diseases.

4,7-Didehydro-neophysalin B Protects Rat Lung Epithelial Cells against Hydrogen Peroxide-Induced Oxidative Damage through Nrf2-Mediated Signaling Pathway

The administration of 4,7-didehydro-neophysalin B is expected to be a promising strategy for mitigating oxidative stress in respiratory diseases. This study was aimed at investigating the efficacy of 4,7-didehydro-neophysalin B for apoptosis resistance of rat lung epithelial cells (RLE-6TN) to oxidative stress and evaluating its underlying mechanism of action. The RLE-6TN cells treated with hydrogen peroxide (H₂O₂) were divided into five groups, and 4,7-didehydro-neophysalin B was administered into it. To evaluate its mechanism of action, the expression of oxidative stress and apoptotic proteins was investigated. 4,7-Didehydro-neophysalin B significantly inhibited H₂O₂-induced RLE-6TN cell damage. It also activated the Nrf2 signaling pathway which was evident from the increased transcription of antioxidant responsive of KLF9, NQO1, Keap-1, and HO-1. Nrf2 was found to be a potential target of 4,7-didehydro-neophysalin B. The protein levels of Bcl-2 and Bcl-xL were increased while Bax and p53 were decreased significantly. Flow cytometry showed that 4,7-didehydro-neophysalin B protected RLE-6TN cells from apoptosis and has improved the oxidative damage. This study provided a promising evidence that 4,7-didehydro-neophysalin B can be a therapeutic option for oxidative stress in respiratory diseases.

Analysis of mycoplasma pneumoniae infection among children with respiratory tract infections in hospital in Chengdu from 2014 to 2020

BACKGROUND

Respiratory tract infection (RTIs) is one of common diseases among the children. In recent years, the incidence of mycoplasma pneumoniae (M. pneumoniae) infection rate has been increasing, which cause respiratory tract infection. This study sought to analyze the epidemiological characteristics of M. pneumoniae hospitalized children with RTIs to provide a theoretical basis for clinical diagnosis and treatments in Chengdu, China.

METHODS

The data of 22,882 cases of children who had been hospitalized for RTIs were collected. M. pneumoniae immunoglobulin M (IgM) antibody was detected using the indirect immunofluorescence method and passive agglutination method. The demographic features of patients, clinical diagnoses and laboratory data were also analyzed.

RESULTS

A total of 4,213 children tested positive for M. pneumoniae. The total positive rate was 18.41% (18.30% for males and 22.72% for females). Female children had statistically significant higher positive rates than male children (χ²=198.078, P<0.01). The positive rates of M. pneumoniae differed significantly among children of different ages (F=162.7532, P<0.01). The incidence rate of M. pneumoniae in 2017 and 2019 was significantly higher than the average (F=538.95, P<0.01). There were higher M. pneumoniae positive rates from April to May, and September to October (P<0.05) in 2016, 2017, 2018, and 2019. There was no correlation between M. pneumoniae infection and temperature and humidity (P>0.05). There was negative correlation with PM_2.5 (particulate matter in the air <2.5 µm) (R=-0.293, P<0.01) and PM₁₀ (particulate matter in the air <10 µm). (R=-0.285, P<0.01). There were significant differences in the constituent ratios of cases of M. pneumoniae infection between in 2020 and other years (F=159.35, P<0.01). Bronchopneumonia accounted for the highest proportion of cases, followed by acute bronchitis and the exacerbation of asthma in 2020.

CONCLUSIONS

The epidemiological distribution of M. pneumoniae in children with RTIs in Chengdu was found to be related to gender, age, year and month; however, no relationship was found to temperature and humidity. There was a higher M. pneumoniae positive rate in children with bronchial pneumonia and asthma in cases. The prevention measures used to control Coronavirus Disease 2019 (COVID-19) also effectively controlled the M. pneumoniae infection rate.

Ambient PM2.5 and its chemical constituents on lifetime-ever pneumonia in Chinese children: A multi-center study

The long-term effects of ambient PM_2.5 and chemical constituents on childhood pneumonia were still unknown. A cross-sectional study was conducted in 30,315 children in the China Children, Homes, Health (CCHH) project, involving 205 preschools in six cities in China, to investigate the long-term effects of PM_2.5 constituents on lifetime-ever diagnosed pneumonia. Information on the lifetime-ever pneumonia and demographics were collected by validated questionnaires. The lifetime annual average ambient PM_2.5, ozone and five main PM_2.5 constituents, including SO₄^2-, NO₃^-, NH₄⁺, organic matter (OM) and black carbon (BC), were estimated according to preschool addresses by a combination of satellite remote sensing, chemical transport modeling and ground-based monitors. The prevalence of lifetime-ever diagnosed pneumonia was 34.5% across six cities and differed significantly among cities (p = 0.004). The two-level logistic regression models showed that the adjusted odds ratio for PM_2.5 (per 10 µg/m³) and its constituents (per 1 µg/m³)-SO₄^2-, NO₃^-, NH₄⁺, and OM were 1.12 (95% CI:1.07-1.18), 1.02 (1.00-1.04), 1.06 (1.04-1.09), 1.05 (1.03-1.07) and 1.09 (1.06-1.12), respectively. Children in urban area, aged < 5 years and breastfeeding time < 6 months enhanced the risks of pneumonia. Our study provided robust results that long-term levels of ambient PM_2.5 and its constituents increased the risk of childhood pneumonia, especially NH₄⁺, NO₃^- and OM.

Impact of air pollutants on pediatric admissions for Mycoplasma pneumonia: a cross-sectional study in Shanghai, China

BACKGROUND

Children are especially vulnerable to pneumonia and the effects of air pollution. However, little is known about the impacts of air pollutants on pediatric admissions for Mycoplasma pneumonia. This study was conducted to investigate the impacts of air pollutants on pediatric hospital admissions for Mycoplasma pneumonia in Shanghai, China.

METHODS

A cross-sectional design was applied to explore the association between pediatric hospital admissions and levels of air pollutants (fine particulate matter, particulate matter, ozone, sulfur dioxide, nitrogen dioxide, and carbon monoxide). Data on hospital admissions for pneumonia and levels of ambient air pollutants were obtained for the period of 2015 to 2018. Associations between pediatric admissions for Mycoplasma pneumonia and ambient air pollutants were calculated using logistic regression and described by the odds ratio and relevant 95% confidence interval. The hysteresis effects of air pollutants from the day of hospital admission to the previous 7 days were evaluated in single-pollutant models and multi-pollutant models with adjustments for weather variables and seasonality. Lag 0 was defined as the day of hospital admission, lag 1 was defined as the day before hospital admission, and so forth.

RESULTS

In the single-pollutant models (without adjustment for other pollutants), pediatric hospital admissions for pneumonia were positively associated with elevated concentrations of nitrogen dioxide and fine particulate matter. A 0.5% increase in daily admissions per 10-μg/m3 increase in the nitrogen dioxide level occurred at lag 1 and lag 2, and a 0.3% increase in daily admissions per 10-μg/m3 increase in fine particulate matter occurred at lag 1. In the multi-pollutant models, nitrogen dioxide and fine particulate matter remained significant after inclusion of particulate matter, ozone, sulfur dioxide, and carbon monoxide.

CONCLUSIONS

This study illustrated that higher levels of nitrogen dioxide and fine particulate matter increase the risk of pediatric hospitalization for Mycoplasma pneumonia in Shanghai, China. These findings imply that the high incidence of Mycoplasma pneumonia in children in Asia might be attributed to the high concentration of specific air pollutants in Asia.

Air Pollution Emissions 2008-2018 from Australian Coal Mining: Implications for Public and Occupational Health

Occupational exposure limits for respirable coal dust are based on exposure during working hours, but coal miners may experience additional community-based exposures during nonworking hours. We analyzed Australia National Pollutant Inventory (NPI) data for the years 2008–2018 to estimate air pollutants (metals, nitrogen oxides, particulate matter ≤ 10 micrometers (PM10) and ≤2.5 micrometers (PM2.5)) originating from coal mines. PM10 levels from community-based air monitors in Queensland and New South Wales were also compared between mining and nonmining communities. Results indicated that tons of coal mined increased over the study period, and that levels of particulate matter, metals, and nitrogen oxides increased significantly over time as well. Coal mines accounted for 42.1% of national PM10 air emissions from NPI sites. PM2.5 from coal mines accounted for 19.5% of the national total, metals for 12.1%, and nitrogen oxides for 10.1%. Coal mining occurred in 57 different post codes; the 20 coal-mining post codes with the highest PM10 emissions were home to 160,037 people. Emissions of all studied pollutants were significantly higher from coal mining sites than from other types of NPI sites. Results from community-based air monitoring stations indicated significantly higher population PM10 exposure in coal mining communities than in nonmining communities. The health of the public at large is impacted by coal mining, but to the extent that miners also live near coal mining operations, their total exposure is underestimated by consideration of exposure only during working hours.

Source apportionment of primary and secondary PM2.5: Associations with pediatric respiratory disease emergency department visits in the U.S. State of Georgia

We developed a hybrid chemical transport model and receptor model (CTM-RM) to conduct source apportionment of both primary and secondary PM_2.5 (particulate matter ≤2.5 μm in diameter) at 36 km resolution throughout the U.S. State of Georgia for the years 2005 and 2007. This novel source apportionment model enabled us to estimate and compare associations of short-term changes in 12 PM_2.5 source concentrations (agriculture, biogenic, coal, dust, fuel oil, metals, natural gas, non-road mobile diesel, non-road mobile gasoline, on-road mobile diesel, on-road mobile gasoline, and all other sources) with emergency department (ED) visits for pediatric respiratory diseases. ED visits for asthma (N = 49,651), pneumonia (N = 25,558), and acute upper respiratory infections (acute URI, N = 235,343) among patients aged ≤18 years were obtained from patient claims records. Using a case-crossover study, we estimated odds ratios per interquartile range (IQR) increase for 3-day moving average PM_2.5 source concentrations using conditional logistic regression, matching on day-of-week, month, and year, and adjusting for average temperature, humidity, and holidays. We fit both single-source and multi-source models. We observed positive associations between several PM_2.5 sources and ED visits for asthma, pneumonia, and acute URI. For example, for asthma, per IQR increase in the source contribution in the single-source model, odds ratios were 1.022 (95% CI: 1.013, 1.031) for dust; 1.050 (95% CI: 1.036, 1.063) for metals, and 1.091 (95% CI: 1.064, 1.119) for natural gas. These sources comprised 5.7%, 2.2%, and 6.3% of total PM_2.5 mass, respectively. PM_2.5 from metals and natural gas were positively associated with all three respiratory outcomes. In addition, non-road mobile diesel was positively associated with pneumonia and acute URI.

Ambient particulate matter pollution and adult hospital admissions for pneumonia in urban China: A national time series analysis for 2014 through 2017

BACKGROUND

The effects of ambient particulate matter (PM) pollution on pneumonia in adults are inconclusive, and few scientific data on a national scale have been generated in low- or middle-income countries, despite their much higher PM concentrations. We aimed to examine the association between PM levels and hospital admissions for pneumonia in Chinese adults.

METHODS AND FINDINGS

A nationwide time series study was conducted in China between 2014 and 2017. Information on daily hospital admissions for pneumonia for 2014-2017 was collected from the database of Urban Employee Basic Medical Insurance (UEBMI), which covers 282.93 million adults. Associations of PM concentrations and hospital admissions for pneumonia were estimated for each city using a quasi-Poisson regression model controlling for time trend, temperature, relative humidity, day of the week, and public holiday and then pooled by random-effects meta-analysis. Meta-regression models were used to investigate potential effect modifiers, including cities' annual-average air pollutants concentrations, temperature, relative humidity, gross domestic product (GDP) per capita, and coverage rates by the UEBMI. More than 4.2 million pneumonia admissions were identified in 184 Chinese cities during the study period. Short-term elevations in PM concentrations were associated with increased pneumonia admissions. At the national level, a 10-μg/m3 increase in 3-day moving average (lag 0-2) concentrations of PM2.5 (PM ≤2.5 μm in aerodynamic diameter) and PM10 (PM ≤10 μm in aerodynamic diameter) was associated with 0.31% (95% confidence interval [CI] 0.15%-0.46%, P < 0.001) and 0.19% (0.11%-0.30%, P < 0.001) increases in hospital admissions for pneumonia, respectively. The effects of PM10 were stronger in cities with higher temperatures (percentage increase, 0.031%; 95% CI 0.003%-0.058%; P = 0.026) and relative humidity (percentage increase, 0.011%; 95% CI 0%-0.022%; P = 0.045), as well as in the elderly (percentage increase, 0.10% [95% CI 0.02%-0.19%] for people aged 18-64 years versus 0.32% [95% CI 0.22%-0.39%] for people aged ≥75 years; P < 0.001). The main limitation of the present study was the unavailability of data on individual exposure to PM pollution.

CONCLUSIONS

Our findings suggest that there are significant short-term associations between ambient PM levels and increased hospital admissions for pneumonia in Chinese adults. These findings support the rationale that further limiting PM concentrations in China may be an effective strategy to reduce pneumonia-related hospital admissions.

Association of ambient air pollution with lengths of hospital stay for hanoi children with acute lower-respiratory infection, 2007-2016

INTRODUCTION

The association between ambient air pollution and length of hospital stay (LOS) for children with lower-respiratory infection is unclear.

MATERIALS AND METHODS

The association was examined using admission data for 75,432 children in Hanoi, aged 0-5 years, hospitalized with acute lower-respiratory infection (ALRI) and daily air pollutant levels in Hanoi between 2007 and 2016. We estimated the odds ratio of being discharged for an interquartile range (IQR) increment (IQR) of ambient pollutants during one to four days prior to admission date. We used pooled logistic regression models including a B-spline function of calendar time and terms describing the baseline odds, adjusting for meteorological factors, age, gender, residential location, week-day of admission, discharge on weekends or holidays, and number of respiratory hospitalizations one day prior to the discharge date.

RESULTS

An IQR increase in O₃ concentrations (85.8 μg/m³) was associated with a 5% (95%CI: 2%-8%) decrease in the odds of discharge from hospital among children with ALRI. Results were similar for PM₁₀, but only for children aged 2-5 years. For the other pollutants, corresponding associations were close to null or in the opposite direction. For example, increase in CO was associated with shorter LOS.

CONCLUSIONS

Our study provides the first investigation of the associations between lengths of hospital stays and air pollutant levels prior to hospitalization in Asian children. Increased levels of O₃ prior to admission predicted prolonged hospitalizations. The inconsistencies in the findings for other pollutants call for further investigations.

Role of iron and oxidative stress in the exacerbation of allergic inflammation in murine lungs caused by urban particulate matter <2.5 μm and desert dust

Simultaneous exposure of lipopolysaccharide (LPS) and urban particulate matter <2.5 μm (PM2.5) or desert dust exacerbated murine asthma. In the present study, the role of iron (Fe) contained in particles and oxidative stress was investigated using Fe chelator deferoxamine (DFO) and oxidative stress scavenger N-acetylcysteine (NAC) in a murine asthma model exacerbated by LPS + PM2.5 or LPS + Asian sand dust (ASD). When BALB/c mice were intratracheally challenged with ovalbumin (OVA) + LPS and either urban PM2.5 or ASD, LPS + PM2.5 and LPS + ASD caused exacerbation of OVA-induced lung eosinophilia along with T-helper 2 cytokine and eosinophil-relevant chemokine production in bronchoalveolar lavage fluid as well as the production of OVA-specific IgE in serum. LPS + PM2.5 with NAC tended to reduce the lung eosinophilia compared to the LPS + PM2.5 host, whereas LPS + PM2.5 with DFO did not reduce them. LPS + ASD with NAC moderately reduced the lung eosinophilia compared to the LPS + ASD host. LPS + ASD with DFO drastically reduced the lung eosinophilia compared to the LPS + ASD host. The concentration of Fe in urban PM2.5 and ASD were almost the same. However, the concentrations of trace metals Pb, Cu, As, Ni, Cr, Mo, Sb, Co, Se and Cd were greater in PM2.5 than in ASD. These results suggested that Fe and oxidative stress are at least partly involved in lung eosinophilia exacerbation caused by LPS + ASD. However, trace metals (except Fe) might also be involved in lung eosinophilia exacerbated by LPS + PM2.5.

Source Apportionment and Influencing Factor Analysis of Residential Indoor PM2.5 in Beijing

In order to identify the sources of indoor PM2.5 and to check which factors influence the concentration of indoor PM2.5 and chemical elements, indoor concentrations of PM2.5 and its related elements in residential houses in Beijing were explored. Indoor and outdoor PM2.5 samples that were monitored continuously for one week were collected. Indoor and outdoor concentrations of PM2.5 and 15 elements (Al, As, Ca, Cd, Cu, Fe, K, Mg, Mn, Na, Pb, Se, Tl, V, Zn) were calculated and compared. The median indoor concentration of PM2.5 was 57.64 μg/m³. For elements in indoor PM2.5, Cd and As may be sensitive to indoor smoking, Zn, Ca and Al may be related to indoor sources other than smoking, Pb, V and Se may mainly come from outdoor. Five factors were extracted for indoor PM2.5 by factor analysis, explained 76.8% of total variance, outdoor sources contributed more than indoor sources. Multiple linear regression analysis for indoor PM2.5, Cd and Pb was performed. Indoor PM2.5 was influenced by factors including outdoor PM2.5, smoking during sampling, outdoor temperature and time of air conditioner use. Indoor Cd was affected by factors including smoking during sampling, outdoor Cd and building age. Indoor Pb concentration was associated with factors including outdoor Pb and time of window open per day, building age and RH. In conclusion, indoor PM2.5 mainly comes from outdoor sources, and the contributions of indoor sources also cannot be ignored. Factors associated indoor and outdoor air exchange can influence the concentrations of indoor PM2.5 and its constituents.

Identification of a novel toll gene (Shtoll3) from the freshwater crab Sinopotamon henanense and its expression pattern changes in response to cadmium followed by Aeromonas hydrophila infection

Toll signaling is essential for expression of immune genes which are important for defense against bacterial, fungal and viral infections in invertebrates. Although several toll genes have been identified in the crustaceans, none of them has been investigated in freshwater crab Sinopotamon henanense. Moreover, the effect of cadmium (Cd) on toll gene expression has never been examined on the freshwater crabs which live in the sediments and are prone to heavy metal bioaccumulation. Our transcriptomic analysis of hepatopancreas tissue reveals that toll3 gene expression has been decreased when treated with Cd. In this study, we cloned one toll gene (hereby designated Shtoll3) from the crab. The full-length cDNA of Shtoll3 was 4488 bp, with an ORF of 3693 bp encoding a putative protein of 1230 amino acids, a 5'-untranslated region of 414 bp and a 3'-untranslated region of 781 bp. Phylogenetic analysis showed that ShToll3 was clustered into the group of DmToll8. The tissue distribution results showed that Shtoll3 was expressed widely in different tissues, with the highest in gills, and the lowest in hemocytes. Shtoll3 expression was down-regulated only in midguts after Aeromonas hydrophila infection. With Cd presence, Shtoll3 expression in response to A. hydrophila were up-regulated in midguts and gills, which was further confirmed by western blotting analysis. Moreover, the mRNA level of two antimicrobial peptides (AMPs) crustin and c-lys, which possibly responded to Cd and A. hydrophila stimulation through Shtoll3, were analysised. Thus, we conclude that Cd changes the susceptibility of Shtoll3 to A. hydrophila infection in gills and midguts. This suggest that Shtoll3 may contribute to the innate immune defense of S. henanense to A. hydrophila and Cd can modify the immune function in epithelium.

Temperature drop and the risk of asthma: a systematic review and meta-analysis

The relationship between asthma and temperature changes remains controversial. The aim of this study was to investigate the association between temperature changes and the risk of asthma. A total of 26 studies (combined total number of subjects N > 26 million), covering 13 countries and Costa Rica, were identified by using a series of keywords in different combinations and searching the papers in PubMed, EMBSEA, Web of Science, MEDLINE, AIM, LILACS, and WPRIM before February 2016. Most of the papers were published in English. Random-effects meta-analyses were performed to evaluate the effect of temperature drop on risk of asthma. Several secondary analyses were also calculated based on stratification for different age, season, latitude, and region on risk of asthma. The odds ratio (OR) estimate between temperature drop and asthma was 1.05 (95% CI 1.02, 1.08) in the meta-analysis. For children, the overall OR was 1.09 (95% CI 1.03, 1.15). Dose-effect analyses showed stronger associations in asthma risk for each 1°1 °C decrement in short-term temperature (OR 1.055, 95% CI 1.00, 1.11). Further stratifications showed that winter (OR 1.03, 95% CI 1.01, 105) and low latitude (OR 1.72, 95% CI 1.23, 2.41) have a statistically significant association with the increased risk of asthma. Exposure of people to short-term temperature drop (per 1 °C decrement) was significantly associated with the risk of lower respiratory tract infections (LRTI) with asthma (OR 1.02, 95% CI 1.00, 1.04). Results suggest an adverse effect of temperature drop on asthma risk, especially in children and low-latitude areas. It may be opportune to consider the preventive actions against temperature drop, including simple face masks, to decrease the risk of asthma.

Association of ambient Particulate matter 2.5 with intensive care unit admission due to pneumonia: a distributed lag non-linear model

Air pollution in China has become a major environmental problem. There is a lack of evidence on the impact of haze (especially PM2.5) on intensive care unit admission due to pneumonia (ICUp). We hypothesized that PM2.5 was independently associated with ICUp and there was a non-linear time lag effect. All ICU admissions occurred from January 1, 2014 to December 31, 2016 in Sir Run-Run Shaw hospital were included in the study. The primary reasons for admission were categorized into pneumonia and non-pneumonia. Distributed lag non-linear model (DLNM) was built to account for the effect of air quality parameters in both value and temporal lag dimensions. There was a total of 7487 ICU admissions during the study period, including 391 admissions due to pneumonia. The DLNM showed that the relative risk (RR) of ICUp increased with PM2.5 concentrations. At a PM2.5 concentration of 200 mcg/m3, the RR increased from 1.06 (95% CI: 0.57-1.95) at day 0 to 1.40 (95% CI: 1.05-1.86) at day 3, and returned normal at day 6 (RR: 1.13; 95% CI: 0.83-1.55). The study showed that PM2.5 was independently associated with the risk of ICUp, and the maximum effect occurred at 3 to 4 days after exposure.

The Toxicological Mechanisms of Environmental Soot (Black Carbon) and Carbon Black: Focus on Oxidative Stress and Inflammatory Pathways

The environmental soot and carbon blacks (CBs) cause many diseases in humans, but their underlying mechanisms of toxicity are still poorly understood. Both are formed after the incomplete combustion of hydrocarbons but differ in their constituents and percent carbon contents. For the first time, “Sir Percival Pott” described soot as a carcinogen, which was subsequently confirmed by many others. The existing data suggest three main types of diseases due to soot and CB exposures: cancer, respiratory diseases, and cardiovascular dysfunctions. Experimental models revealed the involvement of oxidative stress, DNA methylation, formation of DNA adducts, and Aryl hydrocarbon receptor activation as the key mechanisms of soot- and CB-induced cancers. Metals including Si, Fe, Mn, Ti, and Co in soot also contribute in the reactive oxygen species (ROS)-mediated DNA damage. Mechanistically, ROS-induced DNA damage is further enhanced by eosinophils and neutrophils via halide (Cl⁻ and Br⁻) dependent DNA adducts formation. The activation of pulmonary dendritic cells, T helper type 2 cells, and mast cells is crucial mediators in the pathology of soot- or CB-induced respiratory disease. Polyunsaturated fatty acids (PUFAs) were also found to modulate T cells functions in respiratory diseases. Particularly, telomerase reverse transcriptase was found to play the critical role in soot- and CB-induced cardiovascular dysfunctions. In this review, we propose integrated mechanisms of soot- and CB-induced toxicity emphasizing the role of inflammatory mediators and oxidative stress. We also suggest use of antioxidants and PUFAs as protective strategies against soot- and CB-induced disorders.

Decreased vaccine antibody titers following exposure to multiple metals and metalloids in e-waste-exposed preschool children

We explored acquired immunity resulting from vaccination in 3 to 7-year-old children, chronically exposed to multiple heavy metals and metalloids, in an e-waste recycling area (Guiyu, China). Child blood levels of ten heavy metals and metalloids, including lead (Pb), arsenic (As), mercury (Hg), chromium (Cr), cadmium (Cd), manganese (Mn), nickel (Ni), copper (Cu), zinc (Zn) and selenium (Se), and seven vaccine antibodies (diphtheria, pertussis, tetanus, hepatitis B, Japanese encephalitis, polio, measles) were measured. The exposed group had higher levels of blood Pb, Mn, Cu, Zn and Cr compared to the reference group (P < 0.05). Levels of all vaccine antibodies in the exposed group were significantly lower than in the reference group (P < 0.01). All vaccine antibodies negatively correlated with blood concentrations of Cu, Zn and Pb, based on spearman rank correlation analysis. Multiple logistic regression and univariate analyses identified the location of residence (Guiyu), high blood Pb (>10 μg/dL) and high blood Cu and Zn (upper median value of each group) to be inversely associated with seven antibody titers. Antibody titers increased with age, BMI, high blood Mn (>15 μg/L), and high blood Cd and Ni (upper median value of each group). Results suggest multiple heavy metal and metalloid exposure, especially to Pb, Zn and Cu, may be a risk factor inhibiting the development of child immunity, resulting in decreased child antibody levels against vaccines.