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Mansouri R, Lavigne E, Talarico R, Smargiassi A, Rodriguez-Villamizar LA, Villeneuve PJ. Residential surrounding greenness and the incidence of childhood asthma: Findings from a population-based cohort in Ontario, Canada. ENVIRONMENTAL RESEARCH 2024; 249:118316. [PMID: 38301756 DOI: 10.1016/j.envres.2024.118316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/03/2024]
Abstract
Several epidemiological studies have investigated the possible role that living in areas with greater amounts of greenspace has on the incidence of childhood asthma. These findings have been inconsistent, and few studies explored the relevance of timing of exposure. We investigated the role of residential surrounding greenness on the risk of incident asthma using a population-based retrospective cohort study. We included 982,131 singleton births in Ontario, Canada between 2006 and 2013. Two measures of greenness, the Normalized Difference Vegetation Index (NDVI) and the Green View Index (GVI), were assigned to the residential histories of these infants from pregnancy through to 12 years of age. Longitudinally-based diagnoses of asthma were determined by using provincial administrative health data. The extended Cox hazards model was used to characterize associations between greenness measures and asthma (up to age 12 years) while adjusting for several risk factors. In a fully adjusted model, that included a term for traffic-related air pollution (NO2), we found no association between an interquartile range increase (0.08) of the NDVI during childhood and asthma incidence (HR = 0.99; 95 % CI = 0.99-1.01). In contrast, we found that an 0.08 increase in NDVI during childhood reduced the risk of asthma in children 7-12 years of age by 14 % (HR = 0.86, 95 % CI:0.79-0.95). Seasonal differences in the association between greenness and asthma were noted. Our findings suggest that residential proximity to greenness reduces the risk of asthma in children aged 7-12.
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Affiliation(s)
- Razieh Mansouri
- Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, Canada.
| | - Eric Lavigne
- Air Health Science Division, Health Canada, 960 Carling Avenue, Ottawa, Ontario, Canada.
| | - Robert Talarico
- Institute for Clinical Evaluative Sciences, 1053 Carling Avenue, Ottawa, Ontario, Canada.
| | - Audrey Smargiassi
- Center for Public Health Research (CReSP), University of Montreal and CIUSSS Du Centre-Sud-de-l'Île-de-Montréal, 7101 Av Du Parc, Montreal, Quebec, Canada.
| | - Laura A Rodriguez-Villamizar
- Department of Public Health, Universidad Industrial de Santander, Carrera 32 29-31, Bucaramanga, Colombia; Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, Canada.
| | - Paul J Villeneuve
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, Canada.
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Davidson SR, Idris MY, Awad CS, Henriques King M, Westney GE, Ponce M, Rodriguez AD, Lipsey KL, Flenaugh EL, Foreman MG. Race Adjustment of Pulmonary Function Tests in the Diagnosis and Management of COPD: A Scoping Review. Int J Chron Obstruct Pulmon Dis 2024; 19:969-980. [PMID: 38708410 PMCID: PMC11067926 DOI: 10.2147/copd.s430249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 02/21/2024] [Indexed: 05/07/2024] Open
Abstract
Aim Increasing evidence suggests that the inclusion of self-identified race in clinical decision algorithms may perpetuate longstanding inequities. Until recently, most pulmonary function tests utilized separate reference equations that are race/ethnicity based. Purpose We assess the magnitude and scope of the available literature on the negative impact of race-based pulmonary function prediction equations on relevant outcomes in African Americans with COPD. Methods We performed a scoping review utilizing an English language search on PubMed/Medline, Embase, Scopus, and Web of Science in September 2022 and updated it in December 2023. We searched for publications regarding the effect of race-specific vs race-neutral, race-free, or race-reversed lung function testing algorithms on the diagnosis of COPD and COPD-related physiologic and functional measures. Joanna Briggs Institute (JBI) guidelines were utilized for this scoping review. Eligibility criteria: The search was restricted to adults with COPD. We excluded publications on other lung disorders, non-English language publications, or studies that did not include African Americans. The search identified publications. Ultimately, six peer-reviewed publications and four conference abstracts were selected for this review. Results Removal of race from lung function prediction equations often had opposite effects in African Americans and Whites, specifically regarding the severity of lung function impairment. Symptoms and objective findings were better aligned when race-specific reference values were not used. Race-neutral prediction algorithms uniformly resulted in reclassifying severity in the African Americans studied. Conclusion The limited literature does not support the use of race-based lung function prediction equations. However, this assertion does not provide guidance for every specific clinical situation. For African Americans with COPD, the use of race-based prediction equations appears to fall short in enhancing diagnostic accuracy, classifying severity of impairment, or predicting subsequent clinical events. We do not have information comparing race-neutral vs race-based algorithms on prediction of progression of COPD. We conclude that the elimination of race-based reference values potentially reduces underestimation of disease severity in African Americans with COPD.
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Affiliation(s)
- Sean Richard Davidson
- Pulmonary and Critical Care Medicine Division, Department of Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | - Muhammed Y Idris
- Clinical Research Center, Morehouse School of Medicine, Atlanta, GA, USA
- Center of Excellence for the Validation of Digital Health Technologies and Clinical Algorithms, Morehouse School of Medicine, Atlanta, GA, USA
| | - Christopher S Awad
- Clinical Research Center, Morehouse School of Medicine, Atlanta, GA, USA
| | - Marshaleen Henriques King
- Pulmonary and Critical Care Medicine Division, Department of Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | - Gloria E Westney
- Pulmonary and Critical Care Medicine Division, Department of Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | - Mario Ponce
- Pulmonary and Critical Care Medicine Division, Department of Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | - Anny D Rodriguez
- Clinical Research Center, Morehouse School of Medicine, Atlanta, GA, USA
| | - Kim L Lipsey
- Bernard Becker Medical Library, Washington University in St. Louis, St. Louis, MO, USA
| | - Eric L Flenaugh
- Pulmonary and Critical Care Medicine Division, Department of Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | - Marilyn G Foreman
- Pulmonary and Critical Care Medicine Division, Department of Medicine, Morehouse School of Medicine, Atlanta, GA, USA
- Center of Excellence for the Validation of Digital Health Technologies and Clinical Algorithms, Morehouse School of Medicine, Atlanta, GA, USA
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Henley K, Tresselt E, Hook JS, Patel PA, Gill MA, Moreland JG. Granular Insights: Neutrophil Predominance and Elastase Release in Severe Asthma Exacerbations in a Pediatric Cohort. Cells 2024; 13:533. [PMID: 38534377 DOI: 10.3390/cells13060533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 03/28/2024] Open
Abstract
The chronic inflammatory component of asthma is propagated by granulocytes, including neutrophils and eosinophils, in the peripheral circulation and airway. Previous studies have suggested that these cells have an altered expression of adhesion-related molecules and a propensity for the release of granule contents that may contribute to tissue damage and enhance inflammatory complications in patients with status asthmaticus. The goal of this prospective cohort study at a tertiary care pediatric hospital with a large population of asthma patients was to assess the role of granulocyte-based inflammation in the development of asthma exacerbation. Subjects were enrolled from two patient populations: those with mild-to-moderate asthma exacerbations seen in the emergency department and those with severe asthma admitted to the intensive care unit (PICU). Clinical data were collected, and blood was drawn. Granulocytes were immediately purified, and the phenotype was assessed, including the expression of cell surface markers, elastase release, and cytokine production. Severe asthmatics admitted to the PICU displayed a significantly higher total neutrophil count when compared with healthy donors. Moreover, little to no eosinophils were found in granulocyte preparations from severe asthmatics. Circulating neutrophils from severe asthmatics admitted to the PICU displayed significantly increased elastase release ex vivo when compared with the PMN from healthy donors. These data suggest that the neutrophil-based activation and release of inflammatory products displayed by severe asthmatics may contribute to the propagation of asthma exacerbations.
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Affiliation(s)
- Kirstin Henley
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Erin Tresselt
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Jessica S Hook
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Parth A Patel
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Michelle A Gill
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Jessica G Moreland
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- Department of Microbiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Peng S, Wang W, Zhang R, Wu C, Pan X, Huang Z. Nano-Formulations for Pulmonary Delivery: Past, Present, and Future Perspectives. Pharmaceutics 2024; 16:161. [PMID: 38399222 PMCID: PMC10893528 DOI: 10.3390/pharmaceutics16020161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
With the development of nanotechnology and confronting the problems of traditional pharmaceutical formulations in treating lung diseases, inhalable nano-formulations have attracted interest. Inhalable nano-formulations for treating lung diseases allow for precise pulmonary drug delivery, overcoming physiological barriers, improving aerosol lung deposition rates, and increasing drug bioavailability. They are expected to solve the difficulties faced in treating lung diseases. However, limited success has been recorded in the industrialization translation of inhalable nano-formulations. Only one relevant product has been approved by the FDA to date, suggesting that there are still many issues to be resolved in the clinical application of inhalable nano-formulations. These systems are characterized by a dependence on inhalation devices, while the adaptability of device formulation is still inconclusive, which is the most important issue impeding translational research. In this review, we categorized various inhalable nano-formulations, summarized the advantages of inhalable nano-formulations over conventional inhalation formulations, and listed the inhalable nano-formulations undergoing clinical studies. We focused on the influence of inhalation devices on nano-formulations and analyzed their adaptability. After extensive analysis of the drug delivery mechanisms, technical processes, and limitations of different inhalation devices, we concluded that vibrating mesh nebulizers might be most suitable for delivering inhalable nano-formulations, and related examples were introduced to validate our view. Finally, we presented the challenges and outlook for future development. We anticipate providing an informative reference for the field.
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Affiliation(s)
- Siyuan Peng
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510275, China
| | - Wenhao Wang
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510275, China
| | - Rui Zhang
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510275, China
| | - Chuanbin Wu
- College of Pharmacy, Jinan University, Guangzhou 510632, China
| | - Xin Pan
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510275, China
| | - Zhengwei Huang
- College of Pharmacy, Jinan University, Guangzhou 510632, China
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