Short-term effects of size-fractionated particulate matters and their constituents on renal function in children: A panel study

Short-term exposure to fine particulate matter and its constituents may affect renal function via oxidative stress: A longitudinal panel study

Exposure to fine particulate matter (PM_2.5) has been reported to increase the risks of chronic kidney disease. However, limited research has assessed the effect of PM_2.5 and its constituents on renal function, and the underlying mechanism has not been well characterized. We aimed to evaluate the association of PM_2.5 and its constituents with kidney indicators and to explore the roles of systematic oxidative stress and inflammation in the association. We conducted a longitudinal panel study among 35 healthy adults before-, intra- and after-the 2019 Wuhan Military World Games. We repeatedly measured 6 renal function parameters and 5 circulating biomarkers of oxidative stress and inflammation at 6 rounds of follow-ups. We monitored hourly personal PM_2.5 concentrations with 3 consecutive days and measured 10 metals (metalloids) and 16 polycyclic aromatic hydrocarbons (PAHs) components. The linear mixed-effect models were applied to examine the association between PM_2.5 and renal function parameters, and the mediation analysis was performed to explore potential bio-pathways. PM_2.5 concentrations across Wuhan showed a slight decrease during the Military Games. We observed significant associations between elevated blood urea nitrogen (BUN) levels and PM_2.5 and its several metals and PAHs components. For an interquartile range (IQR) increase of PM_2.5, BUN increased 0.42 mmol/L (95% CI: 0.14 to 0.69). On average, an IQR higher of lead (Pb), cadmium (Cd), arsenic (As), selenium (Se), thallium (Tl) and Indeno (1,2,3-cd) pyrene (IPY) were associated with 0.90, 0.65, 0.29, 0.27, 0.26 and 0.90 mmol/L increment of BUN, respectively. Moreover, superoxide dismutase was positively associated with PM_2.5 and mediated 18.24% association. Our research indicated that exposure to PM_2.5 might affect renal function by activating oxidative stress pathways, in which the constituents of Pb, Cd, As, Se, Tl and IPY might contribute to the associations.

Critical windows of perinatal particulate matter (PM2.5) exposure and preadolescent kidney function

Air pollution exposure, especially particulate matter ≤2.5 μm in diameter (PM2.5), is associated with poorer kidney function in adults and children. Perinatal exposure may occur during susceptible periods of nephron development. We used distributed lag nonlinear models (DLNMs) to examine time-varying associations between early life daily PM2.5 exposure (periconceptional through age 8 years) and kidney parameters in preadolescent children aged 8-10 years. Participants included 427 mother-child dyads enrolled in the PROGRESS birth cohort study based in Mexico City. Daily PM2.5 exposure was estimated at each participant's residence using a validated satellite-based spatio-temporal model. Kidney function parameters included estimated glomerular filtration rate (eGFR), serum cystatin C, and blood urea nitrogen (BUN). Models were adjusted for child's age, sex and body mass index (BMI) z-score, as well as maternal education, indoor smoking report and seasonality (prenatal models were additionally adjusted for average first year of life PM2.5 exposure). We also tested for sex-specific effects. Average perinatal PM2.5 was 22.7 μg/m3 and ranged 16.4-29.3 μg/m3. Early pregnancy PM2.5 exposures were associated with higher eGFR in preadolescence. Specifically, we found that PM2.5 exposure between weeks 1-18 of gestation was associated with increased preadolescent eGFR, whereas exposure in the first 14 months of life after birth were associated with decreased eGFR. Specifically, a 5 μg/m3 increase in PM2.5 during the detected prenatal window was associated with a cumulative increase in eGFR of 4.44 mL/min/1.732 (95%CI: 1.37, 7.52), and during the postnatal window we report a cumulative eGFR decrease of -10.36 mL/min/1.732 (95%CI: -17.68, -3.04). We identified perinatal windows of susceptibility to PM2.5 exposure with preadolescent kidney function parameters. Follow-up investigating PM2.5 exposure with peripubertal kidney function trajectories and risk of kidney disease in adulthood will be critical.

Urinary phthalate metabolites mixture, serum cytokines and renal function in children: A panel study

Epidemiological evidence regarded the relations of phthalates with children's renal function and its underlying mechanism were largely unknown. We conducted a panel study using 287 paired urine-blood samples by repeated measurements of 103 children (4-13 years) across 3 seasons to explore effects of urinary phthalate metabolites on estimated glomerular filtration rate (eGFR) and the potential role of multiple cytokines. We found that mono-ethyl phthalate (MEP), monobutyl phthalate (MBP), mono-benzyl phthalate (MBzP) and mono-n-octyl phthalate (MOP) were significantly associated with eGFR reduction. Compared with the lowest quartile, MBP, MBzP and MEP in the third and fourth quartiles exhibited a graded decrease in eGFR. Meanwhile, weighted quantile sum regression analyses showed an inverse association of metabolites mixture with eGFR, to which MEP, MBzP, MOP were the major contributors. MEP also remained robust in multiple-phthalate model. Age and weight status might modify such relationships with significant interactions. Furthermore, eGFR related phthalate metabolites were associated with increased multiple cytokines, and CCL27, CXCL1 might be potential mediators between MEP and eGFR with mild mediated proportions. Accordingly, urinary phthalate metabolites were related to eGFR reduction in dose-response manner and multiple cytokines elevation, of which CCL27 and CXCL1 might partly mediate phthalate-associated decreased renal function among children.

Association of personal fine particulate matter and its respiratory tract depositions with blood pressure in children: From two panel studies

Evidence is limited regarding the acute effects of personal fine particulate matter (PM_2.5) exposure and its respiratory tract depositions on the alteration of children's blood pressure (BP). We conducted 2 longitudinal panel studies in 2 cities to evaluate the relations of 72-h real-time personal PM_2.5 exposure and its depositions in 3 respiratory tract regions over different lag times with BP and the risk of prehypertension and hypertension among 286 children aged 4-12 years. We found the strongest effects of PM_2.5 exposure on increased BP and risk of prehypertension and hypertension at lag 2 day, in dose-response manner, even when PM_2.5 below Chinese Ambient Air Quality Standard (CAAQS) Grade II. Moreover, compared to PM_2.5, tracheobronchial and alveolar depositions displayed more evident effects on BP outcomes. Interestingly, all above relationships were stronger among children in Guangzhou with lower PM_2.5 and its deposited doses than those in Weinan. Additionally, boys and those with daily extra-school activity ≥ 1 h were more susceptible to PM_2.5-induced BP effects with significant interactions. Our results highlighted that short-term PM_2.5 exposure and its respiratory tract depositions were dose-responsive related to higher BP, prevalence of prehypertension and hypertension among children, even when PM_2.5 below CAAQS II.