Carbon loading in airway macrophages as a biomarker for individual exposure to particulate matter air pollution - A critical review

Analysis of particulate matter-induced alteration of genes and related signaling pathways in the respiratory system

Airborne particulate matter (PM) is a global environmental risk factor threatening human health and is a major cause of cardiovascular and respiratory disease-associated death. Current studies on PM exposure have been limited to large-scale cohort and epidemiological investigations, emphasizing the need for detailed individual-level studies to uncover specific differentially expressed genes and their associated signaling mechanisms. Herein, we revealed that PM exposure significantly upregulated inflammatory and immune responses, such as cytokine-mediated signaling pathways, complement system, and the activation and migration of immune cells in gene set enrichment analysis of our RNA sequencing (RNAseq) data. Remarkably, we discovered that the broad gene expression and signaling pathways mediated by macrophages were predominantly expressed in the respiratory system following PM exposure. Consistent with these observations, individual PMs, classified by aerodynamic size and origin, significantly promoted macrophage recruitment to the lungs in the mouse lung inflammation model. Additionally, we confirmed that RNAseq observations from the respiratory system were reproduced in murine bone marrow-derived macrophages and the alveolar macrophage cell line MH-S after individual PM exposure. Our findings demonstrated that PM exposure augmented broad inflammatory and immune responses in the respiratory system and suggested the reinforcement of global strategies for reducing particulate air pollution to prevent respiratory diseases and their exacerbation.

Association of pulmonary black carbon accumulation with cardiac fibrosis in residents of Sao Paulo, Brazil

Evidence suggests that myocardial interstitial fibrosis, resulting from cardiac remodeling, may possibly be influenced by mechanisms activated through the inhalation of airborne pollutants. However, limited studies have explored the relationship between lifetime exposure to carbon-based particles and cardiac fibrosis, specially using post-mortem samples. This study examined whether long-term exposure to air pollution (estimated by black carbon accumulated in the lungs) is associated with myocardial fibrosis in urban dwellers of megacity of Sao Paulo. Data collection included epidemiological and autopsy-based approaches. Information was obtained by interviewing the next of kin and through the pathologist's report. The individual index of exposure to carbon-based particles, which we designed as the fraction of black carbon (FBC), was estimated through quantification of particles on the macroscopic lung surface. Myocardium samples were collected for histopathological analysis to evaluate the fraction of cardiac fibrosis. The association between cardiac fibrosis and FBC, age, sex, smoking status and hypertension was assessed by means of multiple linear regression models. Our study demonstrated that the association of FBC with cardiac fibrosis is influenced by smoking status and hypertension. Among hypertensive individuals, the cardiac fibrosis fraction tended to increase with the increase of the FBC in both groups of smokers and non-smokers. In non-hypertensive individuals, the association between cardiac fibrosis fraction and FBC was observed primarily in smokers. Long-term exposure to tobacco smoke and environmental particles may contribute to the cardiac remodeling response in individuals with pre-existing hypertension. This highlights the importance of considering hypertension as an additional risk factor for the health effects of air pollution on the cardiovascular system. Moreover, the study endorses the role of autopsy to investigate the effects of urban environment and personal habits in determining human disease.

Application of artificial intelligence in quantifying lung deposition dose of black carbon in people with exposure to ambient combustion particles

BACKGROUND

Understanding lung deposition dose of black carbon is critical to fully reconcile epidemiological evidence of combustion particles induced health effects and inform the development of air quality metrics concerning black carbon. Macrophage carbon load (MaCL) is a novel cytology method that quantifies lung deposition dose of black carbon, however it has limited feasibility in large-scale epidemiological study due to the labor-intensive manual counting.

OBJECTIVE

To assess the association between MaCL and episodic elevation of combustion particles; to develop artificial intelligence based counting algorithm for MaCL assay.

METHODS

Sputum slides were collected during episodic elevation of ambient PM2.5 (n = 49, daily PM2.5 > 10 µg/m3 for over 2 weeks due to wildfire smoke intrusion in summer and local wood burning in winter) and low PM2.5 period (n = 39, 30-day average PM2.5 < 4 µg/m3) from the Lovelace Smokers cohort.

RESULTS

Over 98% individual carbon particles in macrophages had diameter <1 µm. MaCL levels scored manually were highly responsive to episodic elevation of ambient PM2.5 and also correlated with lung injury biomarker, plasma CC16. The association with CC16 became more robust when the assessment focused on macrophages with higher carbon load. A Machine-Learning algorithm for Engulfed cArbon Particles (MacLEAP) was developed based on the Mask Region-based Convolutional Neural Network. MacLEAP algorithm yielded excellent correlations with manual counting for number and area of the particles. The algorithm produced associations with ambient PM2.5 and plasma CC16 that were nearly identical in magnitude to those obtained through manual counting.

IMPACT STATEMENT

Understanding lung black carbon deposition is crucial for comprehending health effects of combustion particles. We developed "Machine-Learning algorithm for Engulfed cArbon Particles (MacLEAP)", the first artificial intelligence algorithm for quantifying airway macrophage black carbon. Our study bolstered the algorithm with more training images and its first use in air pollution epidemiology. We revealed macrophage carbon load as a sensitive biomarker for heightened ambient combustion particles due to wildfires and residential wood burning.

Activation of epithelial and inflammatory pathways in adolescent elite athletes exposed to intense exercise and air pollution

RATIONALE

Participation in high-intensity exercise in early life might act as stressor to the airway barrier.

OBJECTIVES

To investigate the effect of intense exercise and associated exposure to air pollution on the airway barrier in adolescent elite athletes compared with healthy controls and to study exercise-induced bronchoconstriction (EIB) in this population.

METHODS

Early-career elite athletes attending 'Flemish-Elite-Sports-Schools' (12-18 years) of 4 different sport disciplines (n=90) and control subjects (n=25) were recruited. Presence of EIB was tested by the eucapnic voluntary hyperventilation (EVH) test. Markers at mRNA and protein level; RNA-sequencing; carbon load in airway macrophages were studied on induced sputum samples.

RESULTS

444 genes were differentially expressed in sputum from athletes compared with controls, which were related to inflammation and epithelial cell damage and sputum samples of athletes contained significantly more carbon loaded airway macrophages compared with controls (24%, 95% CI 20% to 36%, p<0.0004). Athletes had significantly higher substance P (13.3 pg/mL, 95% CI 2.0 to 19.2) and calprotectin (1237 ng/mL, 95% CI 531 to 2490) levels as well as IL-6, IL-8 and TNF-α mRNA levels compared with controls (p<0.05). The incidence of EIB in athletes was 9%. The maximal fall in forced expiratory volume in 1 s (%) after EVH test in athletes was significantly associated with prior PM10 and PM2.5 exposure.

CONCLUSION

Early-career elite athletes showed increased markers of air pollution exposure, epithelial damage and airway inflammation compared with controls. Acute exposure to increased air pollution PM10 levels was linked to increased airway hyper-reactivity.

TRIAL REGISTRATION NUMBER

NCT03587675.

CXCL17 Attenuates Diesel Exhaust Emissions Exposure-Induced Lung Damage by Regulating Macrophage Function

Exposure to diesel exhaust emissions (DEE) is strongly linked to innate immune injury and lung injury, but the role of macrophage chemoattractant CXCL17 in the lung damage caused by DEE exposure remains unclear. In this study, whole-body plethysmography (WBP), inflammatory cell differential count, and histopathological analysis were performed to assess respiratory parameters, airway inflammation, and airway injury in C57BL/6 male mice exposed to DEE for 3 months. qRT-PCR, IHC (immunohistochemistry), and ELISA were performed to measure the CXCL17 expression in airway epithelium or BALF (bronchoalveolar lavage fluid) following DEE/Diesel exhaust particle (DEP) exposure. Respiratory parameters, airway inflammation, and airway injury were assessed in CXCL17-overexpressing mice through adeno-associated virus vector Type 5 (AAV5) infection. Additionally, an in vitro THP-1 and HBE co-culture system was constructed. Transwell assay was carried out to evaluate the effect of rh-CXCL17 (recombinant human protein-CXCL17) on THP-1 cell migration. Flow cytometry and qRT-PCR were conducted to assess the impacts of rh-CXCL17 on apoptosis and inflammation/remodeling of HBE cells. We found that the mice exposed to DEE showed abnormal respiratory parameters, accompanied by airway injury and remodeling (ciliary injury in airway epithelium, airway smooth muscle hyperplasia, and increased collagen deposition). Carbon content in airway macrophages (CCAM), but not the number of macrophages in BALF, increased significantly. CXCL17 expression significantly decreased in mice airways and HBE after DEE/DEP exposure. AAV5-CXCL17 enhanced macrophage recruitment and clearance of DEE in the lungs of mice, and it improved respiratory parameters, airway injury, and airway remodeling. In the THP-1/HBE co-culture system, rh-CXCL17 increased THP-1 cell migration while attenuating HBE cell apoptosis and inflammation/remodeling. Therefore, CXCL17 might attenuate DEE-induced lung damage by recruiting and activating pulmonary macrophages, which is expected to be a novel therapeutic target for DEE-associated lung diseases.

Diesel exhaust particles exposure induces liver dysfunction: Exploring predictive potential of human circulating microRNAs signature relevant to liver injury risk

Diesel exhaust particles (DEP) pollution should be taken seriously because it is an extensive environmental and occupational health concern. Exploring early effect biomarkers is crucial for monitoring and managing DEP-associated health risk assessment. Here, we found that serum levels of 67 miRNAs were dysregulated in DEP exposure group. Notably, 20 miRNAs were identified as each having a significant dose-response relationship with the internal exposure level of DEP. Further, we revealed that the DEP exposure could affect the liver function of subjects and that 7 miRNAs (including the well-known liver injury indicator, miR-122-5p) could serve as the novel epigenetic-biomarkers (epi-biomarkers) to reflect the liver-specific response to the DEP exposure. Importantly, an unprecedented prediction model using these 7 miRNAs was established for the assessment of DEP-induced liver injury risk. Finally, bioinformatic analysis indicated that the unique set of miRNA panel in serum might also contribute to the molecular mechanism of DEP exposure-induced liver damage. These results broaden our understanding of the adverse health outcomes of DEP exposure. Noteworthy, we believe this study could shed light on roles and functions of epigenetic biomarkers from environmental exposure to health outcomes by revealing the full chain of exposure-miRNAs-molecular pathways-disease evidence.

Impact of exposure to urban air pollution on grey squirrel (Sciurus carolinensis) lung health

The increased rate of global urbanisation has recently exacerbated the significant public health problem of traffic related air pollution. Despite the known significant impact on human health, little is known about the effects of air pollution on wildlife health. The lung is the primary target organ for the effects of exposure to air pollution, leading to lung inflammation, altering the lung epigenome, culminating in respiratory disease. In this study, we aimed to assess lung health and DNA methylation profiles in Eastern grey squirrel (Sciurus carolinensis) populations living across an urban-rural air pollution gradient. Squirrel lung health was assessed in four populations situated across the most polluted inner-city boroughs to the less polluted edges of Greater London. We also assessed lung DNA methylation across three London sites and a further two rural sites in Sussex and North Wales. Lung and tracheal diseases were present in 28% and 13% of the squirrels respectively. Specifically, focal inflammation (13%), focal macrophages with vacuolated cytoplasm (3%) and endogenous lipid pneumonia (3%). There was no significant difference in prevalence of lung, tracheal diseases, anthracosis (carbon presence) or lung DNA methylation levels between urban sites and urban and rural sites respectively or NO₂ levels. BALT (Bronchus-Associated Lymphoid Tissue) was significantly smaller in the site with highest NO₂ and contained the highest carbon loading compared to sites with lower NO₂, however differences in carbon loading in between sites were not significant. High pollution site individuals also had significantly higher numbers of alveolar macrophages which suggests that grey squirrels are exposed to and respond to traffic-related air pollution and further research is needed to understand the impact of traffic-related air pollutants on wildlife health.

PyCoCa:A quantifying tool of carbon content in airway macrophage for assessment the internal dose of particles

Given the lack of a comprehensive understanding of the complex metabolism and variable exposure environment, carbon particles in macrophages have become a potentially valuable biomarker to assess the exposure level of atmospheric particles, such as black carbon. However, the tedious and subjective quantification method limits the application of carbon particles as a valid biomarker. Aiming to obtain an accurate carbon particles quantification method, the deep learning and binarization algorithm were implemented to develop a quantitative tool for carbon content in airway macrophage (CCAM), named PyCoCa. Two types of macrophages, normal and foamy appearance, were applied for the development of PyCoCa. In comparison with the traditional methods, PyCoCa significantly improves the identification efficiency for over 100 times. Consistency assessment with the gold standard revealed that PyCoCa exhibits outstanding prediction ability with the Interclass Correlation Coefficient (ICC) values of over 0.80. And a proper fresh dye will enhance the performance of PyCoCa (ICC = 0.89). Subsequent sensitivity analysis confirmed an excellent performance regarding accuracy and robustness of PyCoCa under high/low exposure environments (sensitivity > 0.80). Furthermore, a successful application of our quantitative tool in cohort studies indicates that carbon particles induce macrophage foaming and the foaming decrease the carbon particles internalization in reverse. Our present study provides a robust and efficient tool to accurately quantify the carbon particles loading in macrophage for exposure assessment.

Black carbon content in airway macrophages is associated with increased severe exacerbations and worse COPD morbidity in SPIROMICS

BACKGROUND

Airway macrophages (AM), crucial for the immune response in chronic obstructive pulmonary disease (COPD), are exposed to environmental particulate matter (PM), which they retain in their cytoplasm as black carbon (BC). However, whether AM BC accurately reflects environmental PM2.5 exposure, and can serve as a biomarker of COPD outcomes, is unknown.

METHODS

We analyzed induced sputum from participants at 7 of 12 sites SPIROMICS sites for AM BC content, which we related to exposures and to lung function and respiratory outcomes. Models were adjusted for batch (first vs. second), age, race (white vs. non-white), income (<$35,000, $35,000~$74,999, ≥$75,000, decline to answer), BMI, and use of long-acting beta-agonist/long-acting muscarinic antagonists, with sensitivity analysis performed with inclusion of urinary cotinine and lung function as covariates.

RESULTS

Of 324 participants, 143 were current smokers and 201 had spirometric-confirmed COPD. Modeled indoor fine (< 2.5 μm in aerodynamic diameter) particulate matter (PM2.5) and urinary cotinine were associated with higher AM BC. Other assessed indoor and ambient pollutant exposures were not associated with higher AM BC. Higher AM BC was associated with worse lung function and odds of severe exacerbation, as well as worse functional status, respiratory symptoms and quality of life.

CONCLUSION

Indoor PM2.5 and cigarette smoke exposure may lead to increased AM BC deposition. Black carbon content in AMs is associated with worse COPD morbidity in current and former smokers, which remained after sensitivity analysis adjusting for cigarette smoke burden. Airway macrophage BC, which may alter macrophage function, could serve as a predictor of experiencing worse respiratory symptoms and impaired lung function.

Lung Effects of Household Air Pollution

Biomass fuel smoke, secondhand smoke, and oxides of nitrogen are common causes of household air pollution (HAP). Almost 2.4 billion people worldwide use solid fuels for cooking and heating, mostly in low- and middle-income countries. Wood combustion for household heating is also common in many areas of high-income countries, and minorities are particularly vulnerable. HAP in low- and middle-income countries is associated with asthma, acute respiratory tract infections in adults and children, chronic obstructive pulmonary disease, lung cancer, tuberculosis, and respiratory mortality. Although wood smoke exposure levels in high-income countries are typically lower than in lower-income countries, it is similarly associated with accelerated lung function decline, higher prevalence of airflow obstruction and chronic bronchitis, and higher all-cause and respiratory cause-specific mortality. Household air cleaners with high-efficiency particle filters have mixed effects on asthma and chronic obstructive pulmonary disease outcomes. Biomass fuel interventions in low-income countries include adding chimneys to cookstoves, improving biomass fuel combustion stoves, and switching fuel to liquid petroleum gas. Still, the impact on health outcomes is inconsistent. In high-income countries, strategies for reducing biomass fuel-related HAP are centered on community-level woodstove changeout programs, although the results are again inconsistent. In addition, initiatives to encourage home smoking bans have mixed success in households with children. Environmental solutions to reduce HAP have varying success in reducing pollutants and health problems. Improved understanding of indoor air quality factors and actions that prevent degradation or improve polluted indoor air may lead to enhanced environmental health policies, but health outcomes must be rigorously examined.

Role of Macrophages in Air Pollution Exposure Related Asthma

Asthma is a chronic inflammatory airway disease characterized by variable airflow obstruction, bronchial hyper-responsiveness, and airway inflammation. The chronic inflammation of the airway is mediated by many cell types, cytokines, chemokines, and inflammatory mediators. Research suggests that exposure to air pollution has a negative impact on asthma outcomes in adult and pediatric populations. Air pollution is one of the greatest environmental risks to health, and it impacts the lungs' innate and adaptive defense systems. A major pollutant in the air is particulate matter (PM), a complex component composed of elemental carbon and heavy metals. According to the WHO, 99% of people live in air pollution where air quality levels are lower than the WHO air quality guidelines. This suggests that the effect of air pollution exposure on asthma is a crucial health issue worldwide. Macrophages are essential in recognizing and processing any inhaled foreign material, such as PM. Alveolar macrophages are one of the predominant cell types that process and remove inhaled PM by secreting proinflammatory mediators from the lung. This review focuses on macrophages and their role in orchestrating the inflammatory responses induced by exposure to air pollutants in asthma.

Determinants of carbon load in airway macrophages in pregnant women

The airway macrophages carbon loading (AMCL) has been suggested to be a biomarker of the long-term exposure to air pollution; however, to date no study has characterized AMCL for the pregnancy period. Therefore, this study aimed to assess the determinants of AMCL during pregnancy in Iran, a middle-income country. This study was based on a sample of 234 pregnant women with term and normal vaginal delivery who were residing in Sabzevar, Iran (2019). We characterized 35 potential determinants of personal exposure to air pollution for each participant, including six personal, nine indoor, and 20 home-outdoor factors. We applied Deletion/Substitution/Addition algorithm to identify the most relevant determinants that could predict AMCL levels. The median (IQR) of AMCL level was 0.12 (0.30) μm² with a successful sputum induction in 82.9% (194) of participants. Ambient residential PM_2.5 levels were positively associated with higher AMCL levels. On the other hand, increased residential distance to the traffic lights, squares and ring-roads, the duration of opening window per day, and opening window during cooking were inversely associated with AMCL levels. Our findings provide novel insights on the different personal, indoor, and outdoor determinants of personal exposure to air pollution during pregnancy in a middle-income country.

Hazardous emissions and concentrations of toxic metalloids and trace elements in charcoals from six commonly used tropical timbers for carbonization

Carbonized wood is a biofuel from cellulose pyrolysis with frequent smoke and life-threatening carcinogenic emissions. Carbon monoxide (CO), particulate matter (PM_2.5), metalloids and trace elements from charcoals from six commonly used tropical timbers for carbonization in Donkorkrom (Ghana) were assessed. During combustion, Anogeissus leiocarpa charcoal emitted the least CO (4.28 ± 1.08 ppm) and PM_2.5 (3.83 ± 1.57 μg/m³), while particulate matter was greatest for Erythrophleum ivorense (28.05 ± 3.08 ppm) and Azadirachta indica (27.67 ± 4.17 μg/m³) charcoals. Erythrophleum ivorense charcoal produced much lead (16.90 ± 0.33 ppm), arsenic (1.97 ± 0.10 ppm) and mercury (0.58 ± 0.003 ppm) but the least chromium (0.11 ± 0.01 ppm) and zinc (2.85 ± 0.05 ppm). Nickel was greatest for A. indica charcoal (0.71 ± 0.01 ppm) and least for Vitellaria paradoxa (0.07 ± 0.004 ppm). Trace elements ranged from 342.01 ± 2.54 ppm (A. indica) to 978.47 ± 1.80 ppm (V. paradoxa) for potassium and 1.74 ± 0.02% (V. paradoxa) to 2.24 ± 0.10% (A. indica) for sulphur. Besides A. leiocarpa charcoal, which ranked safest during combustion, the high PM_2.5 and CO emissions make the other biofuels hazardous indoors. Kitchens need air filters to absorb these emissions together with the use of improved cook stoves. These carcinogenic metalloids would necessitate that their ashes be properly discarded without human contact. Yet, the charcoals would be much suitable as soil amendment bio-char for plant growth quality improvement.

Evaluating carbon content in airway macrophages as a biomarker of personal exposure to fine particulate matter and its acute respiratory effects

It remains unclear whether carbon content in airway macrophages (AM) can predict personal short-term exposure to fine particulate matter (PM_2.5) air pollution and its respiratory health effects. We aimed to evaluate the pathway from personal PM_2.5 exposure to adverse respiratory outcomes through AM carbon content. We designed a longitudinal panel study with 3 scheduled follow-ups among 113 non-smoking patients of chronic obstructive pulmonary disease in Shanghai, China, from April 2017 to January 2019. We quantified AM carbon content from induced sputum by image analysis, tested lung function and measured sputum levels of 4 pro-inflammatory cytokines and 2 anti-inflammatory cytokines. We applied the "meet in the middle" approach incorporating linear mixed-effect models to evaluate the associations from external PM_2.5 exposure to respiratory outcomes through AM carbon content. Our results indicated that personal exposure to PM_2.5 within 24 h was significantly associated with decreased forced expiratory volume in 1s and anti-inflammatory cytokines, as well as increased macrophages and pro-inflammatory cytokines. These changes were accompanied by increased areas of AM carbon and higher percentage of AM area occupied by carbon, both of which were associated with increased levels of pro-inflammatory cytokines and decreased levels of anti-inflammatory cytokines. Exposure to ambient black carbon and organic carbon in PM_2.5 within 2 days was significantly associated with increased AM carbon area and percentage of AM area occupied by carbon. Our findings reinforced the causality in respiratory health effects of PM_2.5 in which increased AM carbon content might serve as a valid exposure biomarker.

Small Airway Wall Thickening Assessed by Computerized Tomography Is Associated With Low Lung Function in Chinese Carbon Black Packers

Nanoscale carbon black as virtually pure elemental carbon can deposit deep in the lungs and cause pulmonary injury. Airway remodeling assessed using computed tomography (CT) correlates well with spirometry in patients with obstructive lung diseases. Structural airway changes caused by carbon black exposure remain unknown. Wall and lumen areas of sixth and ninth generations of airways in 4 lobes were quantified using end-inhalation CT scans in 58 current carbon black packers (CBPs) and 95 non-CBPs. Carbon content in airway macrophage (CCAM) in sputum was quantified to assess the dose-response. Environmental monitoring and CCAM showed a much higher level of elemental carbon exposure in CBPs, which was associated with higher wall area and lower lumen area with no change in total airway area for either airway generation. This suggested small airway wall thickening is a major feature of airway remodeling in CBPs. When compared with wall or lumen areas, wall area percent (WA%) was not affected by subject characteristics or lobar location and had greater measurement reproducibility. The effect of carbon black exposure status on WA% did not differ by lobes. CCAM was associated with WA% in a dose-dependent manner. CBPs had lower FEV1 (forced expiratory volume in 1 s) than non-CBPs and mediation analysis identified that a large portion (41-72%) of the FEV1 reduction associated with carbon black exposure could be explained by WA%. Small airway wall thickening as a major imaging change detected by CT may underlie the pathology of lung function impairment caused by carbon black exposure.

Chronic exposure to diesel exhaust may cause small airway wall thickening without lumen narrowing: a quantitative computerized tomography study in Chinese diesel engine testers

Background

Diesel exhaust (DE) is a major source of ultrafine particulate matters (PM) in ambient air and contaminates many occupational settings. Airway remodeling assessed using computerized tomography (CT) correlates well with spirometry in patients with obstructive lung diseases. Structural changes of small airways caused by chronic DE exposure is unknown. Wall and lumen areas of 6th and 9th generations of four candidate airways were quantified using end-inhalation CT scans in 78 diesel engine testers (DET) and 76 non-DETs. Carbon content in airway macrophage (CCAM) in sputum was quantified to assess the dose-response relationship.

Results

Environmental monitoring and CCAM showed a much higher PM exposure in DETs, which was associated with higher wall area and wall area percent for 6th generation of airways. However, no reduction in lumen area was identified. No study subjects met spirometry diagnosis of airway obstruction. This suggested that small airway wall thickening without lumen narrowing may be an early feature of airway remodeling in DETs. The effect of DE exposure status on wall area percent did not differ by lobes or smoking status. Although the trend test was of borderline significance between categorized CCAM and wall area percent, subjects in the highest CCAM category has a 14% increase in wall area percent for the 6th generation of airways compared to subjects in the lowest category. The impact of DE exposure on FEV1 can be partially explained by the wall area percent with mediation effect size equal to 20%, P_perm = 0.028).

Conclusions

Small airway wall thickening without lumen narrowing may be an early image feature detected by CT and underlie the pathology of lung injury in DETs. The pattern of changes in small airway dimensions, i.e., thicker airway wall without lumen narrowing caused by occupational DE exposure was different to that (i.e., thicker airway wall with lumen narrowing) seen in our previous study of workers exposed to nano-scale carbon black aerosol, suggesting constituents other than carbon cores may contribute to such differences. Our study provides some imaging indications of the understanding of the pulmonary toxicity of combustion derived airborne particulate matters in humans.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12989-021-00406-1.

Telomere length and outcome of treatment for pulmonary tuberculosis in a gold mining community

Telomere length (TL) is a marker of ageing and mitochondrial DNA (mtDNA) is an early marker of inflammation caused by oxidative stress. We determined TL and mtDNA content among active pulmonary tuberculosis (PTB) patients to assess if these cellular biomarkers differed between artisanal miners and non-miners, and to assess if they were predictive of treatment outcome. We conducted a prospective cohort study from August 2018 to May 2019 involving newly diagnosed PTB patients at three outpatient TB clinics in a rural Democratic Republic of Congo. We measured relative TL and mtDNA content in peripheral blood leukocytes (at inclusion) via qPCR and assessed their association with PTB treatment outcome. We included 129 patients (85 miners and 44 non-miners) with PTB (median age 40 years; range 5-71 years, 22% HIV-coinfected). For each increase in year and HIV-coinfection, TL shortened by - 0.85% (- 0.19 to - 0.52) (p ≤ 0.0001) and - 14% (- 28.22 to - 1.79) (p = 0.02) respectively. Independent of these covariates, patients with longer TL were more likely to have successful TB treatment [adjusted hazard ratio; 95% CI 1.27 for a doubling of leucocyte telomere length at baseline; 1.05-1.44] than patients with a shorter TL. Blood mtDNA content was not predictive for PTB outcome. For a given chronological age, PTB patients with longer telomeres at time of diagnosis were more likely to have successful PTB treatment outcome.

Emerging role of mitochondria in airborne particulate matter-induced immunotoxicity

The immune system is one of the primary targets of airborne particulate matter. Recent evidence suggests that mitochondria lie at the center of particulate matter-induced immunotoxicity. Particulate matter can directly interact with mitochondrial components (proteins, lipids, and nucleic acids) and impairs the vital mitochondrial processes including redox mechanisms, fusion-fission, autophagy, and metabolic pathways. These disturbances impede different mitochondrial functions including ATP production, which acts as an important platform to regulate immunity and inflammatory responses. Moreover, the mitochondrial DNA released into the cytosol or in the extracellular milieu acts as a danger-associated molecular pattern and triggers the signaling pathways, involving cGAS-STING, TLR9, and NLRP3. In the present review, we discuss the emerging role of mitochondria in airborne particulate matter-induced immunotoxicity and its myriad biological consequences in health and disease.

Prostaglandin E2 and phagocytosis of inhaled particulate matter by airway macrophages in cystic fibrosis

BACKGROUND

Exposure to particulate matter (PM) air pollution is associated with adverse health outcomes in children with cystic fibrosis (CF). Airway macrophages (AM) phagocytose and retain inhaled PM in vivo, and the area of carbon in AM reflects both inhaled PM dose and phagocytic function. Since airway prostaglandin-E₂ (PGE₂) is increased in CF, and PGE₂ suppresses AM phagocytosis, we sought evidence for PGE₂-mediated suppression of AM phagocytosis of inhaled carbonaceous PM in CF.

METHODS

After informed consent, urine was obtained from 20 controls and 24 CF children. In the subgroup of older children, at least one induced sputum was done in 20 controls and 19 CF children. Urinary tetranor PGEM, the major metabolite of PGE₂, and sputum PGE₂ were measured by mass spectrometry. The area of carbon in AM was determined by image analysis. Exposure to PM was assessed by modelling and personal monitoring. The effect of either PGE₂ or CF sputum supernatant on phagocytosis of diesel exhaust particle (DEP) by AM was assessed in vitro. Data were analysed by t-test.

RESULTS

Both urinary tetranor PGEM (P<0.05), and sputum PGE₂ (P<0.05) were increased in CF . Despite no difference in PM exposure between groups, the area of phagocytosed carbon by AM was decreased in children with CF (P<0.01). PGE₂ suppressed phagocytosis of DEP by AM from both controls and CF (P<0.0001). CF sputum supernatant suppressed phagocytosis of DEP by AM (P<0.0001) in a PGE₂-dependent manner.

CONCLUSION

Increased PGE₂ in the CF airway suppresses phagocytosis of inhaled PM by AM.

Rapid Recent Deforestation Incursion in a Vulnerable Indigenous Land in the Brazilian Amazon and Fire-Driven Emissions of Fine Particulate Aerosol Pollutants

Deforestation in the Brazilian Amazon is related to the use of fire to remove natural vegetation and install crop cultures or pastures. In this study, we evaluated the relation between deforestation, land-use and land-cover (LULC) drivers and fire emissions in the Apyterewa Indigenous Land, Eastern Brazilian Amazon. In addition to the official Brazilian deforestation data, we used a geographic object-based image analysis (GEOBIA) approach to perform the LULC mapping in the Apyterewa Indigenous Land, and the Brazilian biomass burning emission model with fire radiative power (3BEM_FRP) to estimate emitted particulate matter with a diameter less than 2.5 µm (PM2.5), a primary human health risk. The GEOBIA approach showed a remarkable advancement of deforestation, agreeing with the official deforestation data, and, consequently, the conversion of primary forests to agriculture within the Apyterewa Indigenous Land in the past three years (200 km2), which is clearly associated with an increase in the PM2.5 emissions from fire. Between 2004 and 2016 the annual average emission of PM2.5 was estimated to be 3594 ton year−1, while the most recent interval of 2017–2019 had an average of 6258 ton year−1. This represented an increase of 58% in the annual average of PM2.5 associated with fires for the study period, contributing to respiratory health risks and the air quality crisis in Brazil in late 2019. These results expose an ongoing critical situation of intensifying forest degradation and potential forest collapse, including those due to a savannization forest-climate feedback, within “protected areas” in the Brazilian Amazon. To reverse this scenario, the implementation of sustainable agricultural practices and development of conservation policies to promote forest regrowth in degraded preserves are essential.

Air pollution and its effects on the immune system

A well-functioning immune system is vital for a healthy body. Inadequate and excessive immune responses underlie diverse pathologies such as serious infections, metastatic malignancies and auto-immune conditions. Therefore, understanding the effects of ambient pollutants on the immune system is vital to understanding how pollution causes disease, and how that pathology could be abrogated. The immune system itself consists of multiple types of immune cell that act together to generate (or fail to generate) immune responses and in this article we review evidence of how air pollutants can affect different immune cell types such as particle-clearing macrophages, inflammatory neutrophils, dendritic cells that orchestrate adaptive immune responses and lymphocytes that enact those responses. Common themes that emerge are of the capacity of air pollutants to stimulate pro-inflammatory immune responses across multiple classes of immune cell. Air pollution can enhance T helper lymphocyte type 2 (Th2) and T helper lymphocyte type 17 (Th17) adaptive immune responses, as seen in allergy and asthma, and dysregulate anti-viral immune responses. The clinical effects of air pollution, in particular the known association between elevated ambient pollution and exacerbations of asthma and chronic obstructive pulmonary disease (COPD), are consistent with these identified immunological mechanisms. Further to this, as inhaled air pollution deposits primarily on the respiratory mucosa this review focuses on mechanisms of respiratory disease. However, as discussed in the article, air pollution also affects the wider immune system for example in the neonate and gastrointestinal tract. Whilst the many identified actions of air pollution on the immune system are notably diverse, immunological research does suggest potential strategies to ameliorate such effects, for example with vitamin D supplementation. An in-depth understanding of the immunological effects of ambient pollutants should hopefully yield new ideas on how to reduce the adverse health effects of air pollution.

Carbon content in airway macrophages and genomic instability in Chinese carbon black packers

Carbon black (CB) particulates as virtually pure elemental carbon can deposit deep in the lungs of humans. International Agency for Research on Cancer classified CB as a Group 2B carcinogen due to inconclusive human evidence. A molecular epidemiological study was conducted in an established cohort of CB packers (CBP) to assess associations between CB exposure and genomic instability in peripheral lymphocytes using cytokinesis-block micronucleus assay (CBMN). Carbon content in airway macrophages (CCAM) was quantified as a bio-effective dosimeter for chronic CB exposure. Dose-response observed in CBPs was compared to that seen in workers exposed to diesel exhaust. The association between CB exposure status and CBMN endpoints was identified in 85 CBPs and 106 non-CBPs from a 2012 visit and replicated in 127 CBPs and 105 non-CBPs from a 2018 visit. The proportion of cytoplasm area occupied by carbon particles in airway macrophages was over fivefold higher in current CBPs compared to non-CBPs and was associated with CBMN endpoints in a dose-dependent manner. CB aerosol and diesel exhaust shared the same potency of inducing genomic instability in workers. Circulatory pro-inflammatory factors especially TNF-α was found to mediate associations between CB exposure and CBMN endpoints. In vitro functional validation supported the role of TNF-α in inducing genomic instability. An estimated range of lower limits of benchmark dose of 4.19-7.28% of CCAM was recommended for risk assessment. Chronic CB exposure increased genomic instability in human circulation and this provided novel evidence supporting its reclassification as a human carcinogen.

Unrepaired DNA damage in macrophages causes elevation of particulate matter- induced airway inflammatory response

The inflammatory cascade can be initiated with the recognition of damaged DNA. Macrophages play an essential role in particulate matter (PM)-induced airway inflammation. In this study, we aim to explore the PM induced DNA damage response of macrophages and its function in airway inflammation. The DNA damage response and inflammatory response were assessed using bone marrow-derived macrophages following PM treatment and mouse model instilled intratracheally with PM. We found that PM induced significant DNA damage both in vitro and in vivo and simultaneously triggered a rapid DNA damage response, represented by nuclear RPA, 53BP1 and γH2AX foci formation. Genetic ablation or chemical inhibition of the DNA damage response sensor amplified the production of cytokines including Cxcl1, Cxcl2 and Ifn-γ after PM stimulation in bone marrow-derived macrophages. Similar to that seen in vitro, mice with myeloid-specific deletion of RAD50 showed higher levels of airway inflammation in response to the PM challenge, suggesting a protective role of DNA damage sensor during inflammation. These data demonstrate that PM exposure induces DNA damage and activation of DNA damage response sensor MRN complex in macrophages. Disruption of MRN complex lead to persistent, unrepaired DNA damage that causes elevated inflammatory response.

Urban airborne particle exposure impairs human lung and blood Mycobacterium tuberculosis immunity

RATIONALE

Associations between urban (outdoor) airborne particulate matter (PM) exposure and TB and potential biological mechanisms are poorly explored.

OBJECTIVES

To examine whether in vivo exposure to urban outdoor PM in Mexico City and in vitro exposure to urban outdoor PM2.5 (< 2.5 µm median aerodynamic diameter) alters human host immune cell responses to Mycobacterium tuberculosis.

METHODS

Cellular toxicity (flow cytometry, proliferation assay (MTS assay)), M. tuberculosis and PM2.5 phagocytosis (microscopy), cytokine-producing cells (Enzyme-linked immune absorbent spot (ELISPOT)), and signalling pathway markers (western blot) were examined in bronchoalveolar cells (BAC) and peripheral blood mononuclear cells (PBMC) from healthy, non-smoking, residents of Mexico City (n=35; 13 female, 22 male). In vivo-acquired PM burden in alveolar macrophages (AM) was measured by digital image analysis.

MEASUREMENTS AND MAIN RESULTS

In vitro exposure of AM to PM2.5 did not affect M. tuberculosis phagocytosis. High in vivo-acquired AM PM burden reduced constitutive, M. tuberculosis and PM-induced interleukin-1β production in freshly isolated BAC but not in autologous PBMC while it reduced constitutive production of tumour necrosis factor-alpha in both BAC and PBMC. Further, PM burden was positively correlated with constitutive, PM, M. tuberculosis and purified protein derivative (PPD)-induced interferon gamma (IFN-γ) in BAC, and negatively correlated with PPD-induced IFN-γ in PBMC.

CONCLUSIONS

Inhalation exposure to urban air pollution PM impairs important components of the protective human lung and systemic immune response against M. tuberculosis. PM load in AM is correlated with altered M. tuberculosis-induced cytokine production in the lung and systemic compartments. Chronic PM exposure with high constitutive expression of proinflammatory cytokines results in relative cellular unresponsiveness.

CO2, CO, hydrocarbon gases and PM2.5 emissions on dry season by deforestation fires in the Brazilian Amazonia

The rate of deforestation in Brazil increased by 29% between 2015 and 2016, resulting in an increase of greenhouse gas emissions (GHG) of 9%. Deforestation fires in the Amazonia are the main source of GHG in Brazil. In this work, amounts of CO₂, CO, main hydrocarbon gases and PM_2.5 emitted during deforestation fires, under real conditions directly in Brazilian Amazonia, were determined. A brief discussion of the relationship between the annual emission of CO₂ equivalent (CO_2,eq) and Paris Agreement was conducted. Experimental fires were carried out in Western Amazonia (Candeias do Jamari, Rio Branco and Cruzeiro do Sul) and results were compared with a previous fire carried out in Eastern Amazonia (Alta Floresta). The average total fresh biomass on the ground before burning and the total biomass consumption were estimated to be 591 ton ha^-1 and 33%, respectively. CO₂, CO, CH₄, and non-methane hydrocarbon (NMHC) average emission factors, for the four sites, were 1568, 140, 8, and 3 g kg^-1 of burned dry biomass, respectively. PM_2.5 showed large variation among the sites (0.9-16 g kg^-1). Emissions per hectare of forest were estimated as 216,696 kg of CO₂, 18,979 kg of CO, 1,058 kg of CH₄, and 496 kg of NMHC. The average annual emission of equivalent CO₂ was estimated as 301 ± 53 Mt year^-1 for the Brazilian Amazonia forest. From 2013, the estimated CO_2,eq showed a trend to increase in Amazon region. The present study is an alert and provides important information that can be used in the development of the public policies to control emissions and deforestation in the Brazilian Amazonia.

Histone modification in the lung injury and recovery of mice in response to PM2.5 exposure

Epidemiological and experimental studies have progressively provided a better knowledge of the underlying mechanisms by which fine particulate matter (PM_2.5) exerts its harmful health effects. However, limited studies focused on the effect and following recovery after the particulate exposure ended. In this study, we determined PM_2.5 exposure-caused effects on the lung and their recovery in mice after terminating aspiration, and clarified the possible molecular modification. The results revealed that PM_2.5 exposure for 4 weeks significantly decreased the lung function, and the changes returned to normal levels after 1-week recovery. However, we observed persistent particle alveolar load following 2-week recovery. Interestingly, the alterations of H3K27ac expression and related enzyme activities mimicked the changes of respiratory function during the process, and chromatin immunoprecipitation-seqences (ChIP-seq) suggested that these PM_2.5-associated differential H3K27ac markers participated in immune responses and chemokine signaling pathway with stat2 and bcar1 being two important genes. Consistently, the expression of pro-inflammatory cytokines and chemokines elevated after PM_2.5 exposure for 4-week, and reversed to normal levels following 2-week recovery. The study highlighted that PM_2.5 aspiration caused histone modification associated lung dysfunction and inflammation, and the action restored after exposure ending and 2-week recovery. Also, persistent particle alveolar load might be a long-term potential risk for lung diseases.

Urinary lead in relation to combustion-derived air pollution in urban environments. A longitudinal study of an international panel

BACKGROUND

Urinary lead (Pb) is generally considered to have limited use in biomonitoring environmental exposure to lead. Carbon load in airway macrophages (AM BC) is an internal marker to assess long-term exposure to combustion-derived aerosol particles. In urban environments, atmospheric Pb and black carbon may have common sources. We aimed to study the temporal change of urinary Pb (U-Pb) when exposure to outdoor air pollution changes, and the relationship between U-Pb and AM BC.

METHODS

A panel of 50 young healthy adults [mean (SD) 26.7 (5.2) years], including 17 long-term (>1 year) residents in Leuven, Belgium (BE), 15 and 18 newcomers (arrived <3 weeks) from low- and middle-income countries (LMIC) and high-income countries (HIC), respectively, underwent 8 repeated measurements at 6 weeks intervals. In urine spot samples obtained at 5 time points (T1, T2, T4, T6, T8), 24 trace elements were quantified by inductively coupled plasma-mass spectrometry. At each time point, AM BC was quantified as the median surface of black inclusions (in μm²) by means of image analysis of 25 macrophages obtained by induced sputum. Changes in urinary metal concentrations (with and without creatinine correction) and the relationship between U-Pb and AM BC were estimated using linear mixed models adjusted for covariates and potential confounders.

RESULTS

Only U-Pb differed between groups and exhibited significant time trends. Participants from the LMIC group had significantly higher initial U-Pb (1.18 μg/g creat) than the HIC group (0.44 μg/g creat) and BE group (0.45 μg/g creat). In the LMIC group, U-Pb decreased significantly with time by 0.061 μg/g creatinine per 30 days [95% confidence interval (CI): 0.034, 0.088]. U-Pb remained unchanged in the other two groups. An increase in AM BC of 1 μm² was associated with an increase in U-Pb of 0.369 μg/g creat (95% CI: 0.145, 0.593).

CONCLUSION

This panel study demonstrates that U-Pb may be a valid alternative to blood Pb for biomonitoring changes in exposure to lead, at least at group level. In addition, we identified a positive association between U-Pb and AM BC, a biomarker of exposure to traffic-related air pollution, suggesting the existence of common sources of Pb and black carbon in urban environments.

Carbon load in airway macrophages, DNA damage and lung function in taxi drivers exposed to traffic-related air pollution

To evaluate the potential applicability of carbon load in airway macrophages as a marker of exposure to traffic-related air pollution (TRAP) and its association with parameters of comet assay as a marker of DNA damage, and pulmonary function tests (PFTs) in the group of taxi drivers in Iran. One hundred four male taxi drivers with at least 1-year job history were randomly selected from registered drivers in the taxi union. Airway macrophages were obtained via sputum induction, and then the area of airway macrophages occupied by carbon was measured. DNA damage was determined by comet assay. PFTs were measured by the spirometer. Most of the participants (89.4%) were non-smoker. In this study, 52.7% of non-smoker participants were able to give a sample of sputum with macrophage. Carbon content of airway macrophages was 0.2 μm². There was no significant difference in pulmonary function and comet assay parameters in terms of smoking status. There was an inverse correlation between carbon load with each of comet assay and PFTs parameters, although not statistically significant. This study identified that long-term exposure to TRAP can be a risk factor for pulmonary disorders.

Environmental and behavioral determinants affecting the association of airway macrophages carbon load with distance to major roads and traffic density

Biomarkers are promising indicators to evaluate human exposure to air pollutants and to predict the health outcomes. Area of Airway macrophages that is occupied by Black Carbon could be used as a biomarker of personal long term exposure to traffic related air pollution. Association of airway macrophages carbon load with weighted average distance and environmental and subject-specific behavior are considered in this study. Sputum samples were taken from 160 healthy adult women and airway macrophages carbon load (AMCL) were determined in 93 subjects, which represent a success rate of 62% in sputum induction. Nearest distance of the subjects to major roads and average weighted distance were calculated for each subject. A questionnaire was field according to general and behavioral characteristics of the participants. There was not any significant difference (P-value >0.05) between induced and non-induced subjects. Subjects with indoor kitchen without separation wall, passive smokers and those with longer presence time in high traffic streets showed higher carbon area. Weighted average distance had a better association (β = -0.186, 95%CI: -0.139, -0.230, P-value = 0.00) with AMCL than nearest distance to major roads (β = -0.155, 95%CI: -0.109, -0.201, P-value = 0.19). Association of Weighted average distance with AMCL was interrupted in subjects with a garage connected to house environment, those with IK kitchen, those with a hood above the stove and passive smokers. The findings indicated that more generation and distribution of indoor air pollutants can completely enhance the internal exposure and indoor pollution has the same importance as outdoor pollution.

Mitochondrial DNA content in blood and carbon load in airway macrophages. A panel study in elderly subjects

BACKGROUND

Mitochondria are sensitive to air pollutants due to their lack of repair capacity. Changes in mitochondrial DNA copy number (mtDNAcn) or content is a proxy of mitochondrial damage and has been associated with recent exposure to traffic-derived air pollutants, nitrogen dioxide (NO₂) and black carbon (BC). Inhaled BC can be phagocytosed by airway macrophages (AMs), and its amount in AM reflects personal exposure to traffic-related air pollution.

OBJECTIVES

The present study investigated the relation between the internal marker AM BC and ambient NO₂ concentration and examined the associations of mtDNAcn with NO₂ and AM BC.

METHODS

A panel of 20 healthy retired participants (10 couples) living in Belgium underwent repeated assessments of health and air pollution exposure at 11 time points over one year. We increased exposure contrast temporarily by moving participants for 10 days to Milan, Italy (high exposure) and to Vindeln, Sweden (low exposure). Personal exposure to NO₂ was measured during 5 consecutive days prior to each assessment time point. The amount of BC was assessed by image analysis in AMs retrieved from induced sputum collected at 7 time points. Blood mtDNAcn was determined by qPCR at each time point. Associations between AM BC and NO₂, and of mtDNAcn with NO₂ and AM BC were estimated using linear mixed effect models adjusted for covariates and potential confounders.

RESULTS

Mean concentrations of 5-day average NO₂ were higher in Milan (64 μg/m³) and lower in Vindeln (4 μg/m³) than Belgium (26 μg/m³). Each 10 μg/m³ increment in NO₂ exposure during the last 5 days was associated with 0.07 μm² (95% CI: 0.001 to 0.012) increase in median area of AM BC. A 10 μg/m³ increase in NO₂ was associated with 3.9% (95% CI: 2.2 to 5.5%) decrease in mtDNAcn. Consistently, each 1 μm² increment in median area of AM BC was associated with 24.8% (95% CI: 6.8 to 39.3%) decrease in mtDNAcn.

CONCLUSION

In this quasi-experimental setting involving moving persons to places with high and low ambient air pollution, we found changes in AM BC according to ambient air pollution levels measured during the previous 5 days. Both higher ambient NO₂ and the internal lung BC load, paralleled mitochondrial compromises as exemplified by lower mtDNA content.

Outdoor air pollution and cystic fibrosis

Outdoor air pollution is increasingly identified as a contributor to respiratory and cardiovascular disease. Pro-inflammatory particles and gases are inhaled deep into the lungs, and are associated with impaired lung growth and exacerbations of chronic respiratory diseases. The magnitude of these effects are of interest to patients and families, and have been assessed in studies specific to CF. Using systematic review methodology, we sought to collate these studies in order to summarise the known effects of air pollution in cystic fibrosis, and to present information on decreasing personal air pollution exposures.

Cryptococcus neoformans Escape From Dictyostelium Amoeba by Both WASH-Mediated Constitutive Exocytosis and Vomocytosis

Cryptococcus neoformans is an environmental yeast that can cause opportunistic infections in humans. As infecting animals does not form part of its normal life-cycle, it has been proposed that the virulence traits that allow cryptococci to resist immune cells were selected through interactions with environmental phagocytes such as amoebae. Here, we investigate the interactions between C. neoformans and the social amoeba Dictyostelium discoideum. We show that like macrophages, D. discoideum is unable to kill C. neoformans upon phagocytosis. Despite this, we find that the yeast pass through the amoebae with an apparently normal phagocytic transit and are released alive by constitutive exocytosis after ~80 min. This is the canonical pathway in amoebae, used to dispose of indigestible material after nutrient extraction. Surprisingly however, we show that upon either genetic or pharmacological blockage of constitutive exocytosis, C. neoformans still escape from D. discoideum by a secondary mechanism. We demonstrate that constitutive exocytosis-independent egress is stochastic and actin-independent. This strongly resembles the non-lytic release of cryptococci by vomocytosis from macrophages, which do not perform constitutive exocytosis and normally retain phagocytosed material. Our data indicate that vomocytosis is functionally redundant for escape from amoebae, which thus may not be the primary driver for its evolutionary selection. Nonetheless, we show that vomocytosis of C. neoformans is mechanistically conserved in hosts ranging from amoebae to man, providing new avenues to understand this poorly-understood but important virulence mechanism.

Role of sputum biomarkers in the management of asthma

PURPOSE OF REVIEW

Airway inflammation is considered to be a cardinal feature of asthma. However, the type of airway inflammation is heterogeneous and airway inflammation may even be absent. Biomarkers may help to identify the inflammatory phenotype or endotype, especially now the time has come that targeted therapies enter daily practice.

RECENT FINDINGS

Sputum biomarkers have increased our insights into the different inflammatory asthma phenotypes, their response to treatment and their association with progression of disease. New endotypes of type 2 driven inflammation were identified using a multidimensional approach. A specific mast cell subtype has been linked with type 2 driven inflammation and response to inhaled corticosteroids. Advances have been made with regard to sputum cytokine analysis and might also help to guide future treatment of severe asthma.

SUMMARY

Identifying the target population for biological therapies will not be possible without the use of biomarkers. Optimized, easy-to-apply, automated methods for sputum analysis (cellular content or soluble markers) need to be developed for implementation of sputum biomarkers in daily clinical practice.

Carbon load in airway macrophages as a biomarker of exposure to particulate air pollution; a longitudinal study of an international Panel

Background

Carbon load in airway macrophages (AM) has been proposed as an internal marker to assess long-term exposure to combustion-derived pollutant particles. However, it is not known how this biomarker is affected by changes in exposure. We studied the clearance kinetics of black carbon (BC) in AM, obtained by sputum induction, in a one-year panel study.

Methods

AM BC was measured 8 times with 6 weeks intervals in healthy young subjects: 15 long-term residents in Leuven, Belgium (BE, mean annual PM₁₀ 20–30 μg/m³) and 30 newcomers having arrived recently (< 3 weeks) in Leuven from highly polluted cities (mean annual PM₁₀ > 50 μg/m³) in low and middle-income countries (LMIC, n = 15), or from low to moderately polluted cities in high-income countries (HIC, n = 15). The median and 90th percentile values of AM BC were quantified by image analysis of 25 macrophages per sputum sample; the carbonaceous nature of the black inclusions in AM was verified by Femtosecond Pulsed Laser Microscopy in 30 macrophages. We used a Bayesian hierarchical single-exponential decay model to describe the evolution of AM BC.

Results

In the LMIC group, the mean (95% credible interval) initial quantity (R₀) of median AM BC [1.122 (0.750–1.509) μm²] was higher than in the HIC group [0.387 (0.168–0.613) μm²] and BE group [0.275 (0.147–0.404) μm²]. Median AM BC content decreased in the LMIC group (decay constant 0.013 μm²/day), but remained stable over one year in the other two groups. In the LMIC group, clearance half-lives of 53 (30–99) and 116 (63–231) days, were calculated for median and 90th percentile AM BC, respectively.

Conclusions

In this real-life study of an international panel of healthy young subjects, we demonstrated that carbon load in airway macrophages obtained by induced sputum reflects past long-term exposure to particulate air pollution. Values of AM BC do not change over one year when exposure remains stable, but AM BC decreases upon moving from high to moderate exposure, with average half-lives of 53 and 116 days depending on the carbon load.

Electronic supplementary material

The online version of this article (10.1186/s12989-018-0250-8) contains supplementary material, which is available to authorized users.

Carbonaceous particulate matter on the lung surface from adults living in São Paulo, Brazil

Accumulation of carbonaceous particulate matter (PM) in the lung is associated with chronic disease. The amount of carbonaceous PM in airway macrophages is reported to be associated with exposure to both fossil fuel PM and cigarette smoke. However, the contribution of these exposures to carbonaceous PM at the lung surface is unclear.

Biomass smoke exposure as an occupational risk: cross-sectional study of respiratory health of women working as street cooks in Nigeria

OBJECTIVE

Little is known about respiratory health of women who are occupationally exposed to biomass smoke outside their homes. This study reports the exposure and respiratory health of street cooks in Ile-Ife, Nigeria.

METHODS

We assessed exposure to biomass smoke by questionnaire in 188 street cooks and 197 control women and by personal diffusive samplers to quantify volatile organic compounds (VOCs) in a subsample of the women. Respiratory symptoms were assessed by a standardised questionnaire, and pulmonary function was assessed by spirometry before and after bronchodilation. Regression analysis was conducted to compare the outcome between the two groups.

RESULTS

The study included 188 women (median age 40, IQR 30-50 years) who had worked as street cooks for a median of 7 years (IQR 3-15 years) and 197 control women with similar demographics. Benzene concentration in passive samplers worn by the street cooks was significantly higher compared with controls (median (IQR) 119.3 (82.7-343.7) µg/m³ vs 0.0 (0.0-51.2) µg/m³, p<0.001). The odds of reported respiratory symptoms were significantly higher among the street cooks than controls: cough (adjusted OR 4.4, 95% CI 2.2 to 8.5) and phlegm (adjusted OR 3.9, 95% CI 1.5 to 7.3). The street cooks also had higher odd of airway obstruction as measured by forced expiratory volume in 1 s/forced vital capacity <0.7: 11% 3% (adjusted OR of 3.3 (95% CI 1.3 to 8.7)).

CONCLUSIONS

This study provides evidence of adverse respiratory effects among street cooks using biomass fuels.

Biomarkers of the health outcomes associated with ambient particulate matter exposure

Epidemiologic evidence supports the positive association of cardiopulmonary morbidity and mortality, and lung cancer risk with exposure to airborne particulate matter (PM). Oxidative stress and inflammation have been proposed to be the major causal factors involved in mediating PM effects on both cardiovascular and pulmonary health outcomes. However, the mechanism whereby PM causes the health effects is not fully elucidated. To evaluate and investigate human exposure to PM, it is essential to have a specific, sensitive and robust characterization of individual exposure to PM. Biomarkers may mark important intermediate steps leading to overt health effects after PM exposure. Thus biomarkers are promising indicators, which could serve as representative measures of the exposure to PM for assessing the health impacts and understanding the mechanism. Indeed, a number of biomarkers are already in use in the field of epidemiological studies and toxicological research. However, we are facing now the challenges to select robust, specific and sensitive biomarkers, which can be employed in large-scale of population to assess the health risk and to monitor the effectiveness of interventions. In this review, we describe a range of biomarkers that are associated with air pollution exposure, particularly markers of oxidative stress, inflammatory factors, and microRNAs, as well as markers of pollutants metabolites. Understanding the nature of the association of these biomarkers with PM exposure may shed some light on the process of selecting biomarkers for large-scale population studies, developing novel preventative and therapeutic strategies.

Indoor particulate matter exposure is associated with increased black carbon content in airway macrophages of former smokers with COPD

INTRODUCTION

Exposure to fine particulate matter (PM2.5) is associated with worse morbidity in individuals with COPD. Inhaled PM is phagocytosed by airway macrophages (AM), and black carbon measured in AM may serve as a biomarker of air pollution exposure. As there is little data on how indoor PM exposure may influence AM black carbon content in those with respiratory disease, we investigated the association of indoor PM2.5 concentration to AM black carbon content in adults with COPD.

METHODS

Former smokers (>10 pack-years smoking history, quit date >1 year prior to enrollment) older than 40 years of age with moderate-severe COPD were eligible. Indoor air PM2.5 concentrations were measured over 5-7 days at baseline, 3 month, and 6 month intervals. Sputum induction was performed during clinic visits concordant with home monitoring. A total of 50 macrophages per sputum specimen were photographed and quantified using appropriate software by trained staff blinded to PM concentrations. Longitudinal analyses using generalized estimating equations were used to assess the relationship between indoor PM exposure and AM black carbon content.

RESULTS

Participants (n=20) were older (mean (SD) age 67 (4) years), predominantly Caucasian (85%) and male (70%), with an average smoking history of 52 pack-years and mean (SD) quit date of 13 (9) years prior to enrollment. The majority of daily time was reported to be spent indoors (>23h). Mean indoor PM2.5 concentration was 12.8 (13.5)µg/m(3). The mean area of black carbon quantified in airway macrophages was 1.2 (0.7)µm(2). In multivariate cross-sectional and longitudinal analyses, each 10µg/m(3) increase in indoor PM2.5 was significantly associated with a 0.26µm(2) and 0.19µm(2) increase in airway macrophage black carbon total area, respectively (p<0.05).

CONCLUSION

Higher indoor PM2.5 concentration is associated with an increase in black carbon content of AM in individuals with COPD. These data support the potential for AM black carbon content to be a useful non-invasive biomarker of exposure to indoor PM.

Incomplete lung recovery following sub-acute inhalation of combustion-derived ultrafine particles in mice

Background

Particulate matter (PM) is one of the six criteria pollutant classes for which National Ambient Air Quality Standards have been set by the United States Environmental Protection Agency. Exposures to PM have been correlated with increased cardio-pulmonary morbidity and mortality. Butadiene soot (BDS), generated from the incomplete combustion of 1,3-butadiene (BD), is both a model PM mixture and a real-life example of a petrochemical product of incomplete combustion. There are numerous events, including wildfires, accidents at refineries and tank car explosions that result in sub-acute exposure to high levels of airborne particles, with the people exposed facing serious health problems. These real-life events highlight the need to investigate the health effects induced by short-term exposure to elevated levels of PM, as well as to assess whether, and if so, how well these adverse effects are resolved over time. In the present study, we investigated the extent of recovery of mouse lungs 10 days after inhalation exposures to environmentally-relevant levels of BDS aerosols had ended.

Methods

Female BALB/c mice exposed to either HEPA-filtered air or to BDS (5 mg/m³ in HEPA filtered air, 4 h/day, 21 consecutive days) were sacrificed immediately, or 10 days after the final BDS exposure. Bronchoalveolar lavage fluid (BALF) was collected for cytology and cytokine analysis. Lung proteins and RNA were extracted for protein and gene expression analysis. Lung histopathology evaluation also was performed.

Results

Sub-acute exposures of mice to hydrocarbon-rich ultrafine particles induced: (1) BALF neutrophil elevation; (2) lung mucosal inflammation, and (3) increased BALF IL-1β concentration; with all three outcomes returning to baseline levels 10 days post-exposure. In contrast, (4) lung connective tissue inflammation persisted 10 days post-exposure; (5) we detected time-dependent up-regulation of biotransformation and oxidative stress genes, with incomplete return to baseline levels; and (6) we observed persistent particle alveolar load following 10 days of recovery.

Conclusion

These data show that 10 days after a 21-day exposure to 5 mg/m³ of BDS has ended, incomplete lung recovery promotes a pro-biotransformation, pro-oxidant, and pro-inflammatory milieu, which may be a starting point for potential long-term cardio-pulmonary effects.

Comparison of methods for the analysis of airway macrophage particulate load from induced sputum, a potential biomarker of air pollution exposure

Background

Air pollution is associated with a high burden or morbidity and mortality, but exposure cannot be quantified rapidly or cheaply. The particulate burden of macrophages from induced sputum may provide a biomarker. We compare the feasibility of two methods for digital quantification of airway macrophage particulate load.

Methods

Induced sputum samples were processed and analysed using ImageJ and Image SXM software packages. We compare each package by resources and time required.

Results

13 adequate samples were obtained from 21 patients. Median particulate load was 0.38 μm² (ImageJ) and 4.0 % of the total cellular area of macrophages (Image SXM), with no correlation between results obtained using the two methods (correlation coefficient = −0.42, p = 0.256). Image SXM took longer than ImageJ (median 26 vs 54 mins per participant, p = 0.008) and was less accurate based on visual assessment of the output images. ImageJ’s method is subjective and requires well-trained staff.

Conclusion

Induced sputum has limited application as a screening tool due to the resources required. Limitations of both methods compared here were found: the heterogeneity of induced sputum appearances makes automated image analysis challenging. Further work should refine methodologies and assess inter- and intra-observer reliability, if these methods are to be developed for investigating the relationship of particulate and inflammatory response in the macrophage.

The Effect of Aerobic Exercise in Ambient Particulate Matter on Lung Tissue Inflammation and Lung Cancer

Background:

Exposure to Air pollution PM10 results in lung inflammation increased risk of lung cancer. Regular aerobic exercise improves the inflammatory status in different lung diseases. However, the effects of long-term aerobic exercise on the pulmonary response to PM10 have not been investigated.

Objectives:

The present study evaluated the effect of aerobic exercise on the lung inflammatory and risk of lung cancer of rat exposed to PM10 carbon black.

Materials and Methods:

Twenty four adult male Wistar rats were divided into 4 groups: A: control (without exposure PM10 and aerobic exercise; n = 6), B: aerobic exercise (five times per week for 4 weeks; n = 6), C: exposure to PM10 carbon black (5 mg/m³; per rat; n = 6), D: and aerobic exercise concomitantly with exposure to PM10 carbon black (n = 6). The gene expression of TLR4, NF-κB and TNF-α were analyzed in lung tissue by Real time-PCR. In order to determine the significant differences between groups, one way ANOVA and LSD post hoc and Kruskal-Vallis test were used.

Results:

Aerobic exercise inhibited the PM10 -induced increase in the gene expression of TLR4, NF-κB and TNF-α. But there was significant different only between B and C groups for TNF-α and NF-κB (P = 0.047, 0.014, respectively).

Conclusions:

We conclude that four week aerobic exercise presents protective effects in a rat model of PM10 carbon black-induced lung inflammation and risk of lung cancer. Our results indicate a need for human studies that evaluate the lung Responses to aerobic exercise chronically performed in polluted areas.