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Amadou A, Giampiccolo C, Bibi Ngaleu F, Praud D, Coudon T, Grassot L, Faure E, Couvidat F, Frenoy P, Severi G, Romana Mancini F, Roy P, Fervers B. Multiple xenoestrogen air pollutants and breast cancer risk: Statistical approaches to investigate combined exposures effect. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 351:124043. [PMID: 38679129 DOI: 10.1016/j.envpol.2024.124043] [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: 08/07/2023] [Revised: 02/10/2024] [Accepted: 04/23/2024] [Indexed: 05/01/2024]
Abstract
Studies suggested that exposure to air pollutants, with endocrine disrupting (ED) properties, have a key role in breast cancer (BC) development. Although the population is exposed simultaneously to a mixture of multiple pollutants and ED pollutants may act via common biological mechanisms leading to synergic effects, epidemiological studies generally evaluate the effect of each pollutant separately. We aimed to assess the complex effect of exposure to a mixture of four xenoestrogen air pollutants (benzo-[a]-pyrene (BaP), cadmium, dioxin (2,3,7,8-Tétrachlorodibenzo-p-dioxin TCDD)), and polychlorinated biphenyl 153 (PCB153)) on the risk of BC, using three recent statistical methods, namely weighted quantile sum (WQS), quantile g-computation (QGC) and Bayesian kernel machine regression (BKMR). The study was conducted on 5222 cases and 5222 matched controls nested within the French prospective E3N cohort initiated in 1990. Annual average exposure estimates to the pollutants were assessed using a chemistry transport model, at the participants' residence address between 1990 and 2011. We found a positive association between the WQS index of the joint effect and the risk of overall BC (adjusted odds ratio (OR) = 1.10, 95% confidence intervals (CI): 1.03-1.19). Similar results were found for QGC (OR = 1.11, 95%CI: 1.03-1.19). Despite the association did not reach statistical significance in the BKMR model, we observed an increasing trend between the joint effect of the four pollutants and the risk of BC, when fixing other chemicals at their median concentrations. BaP, cadmium and PCB153 also showed positive trends in the multi-pollutant mixture, while dioxin showed a modest inverse trend. Despite we found a clear evidence of a positive association between the joint exposure to pollutants and BC risk only from WQS and QGC regression, we observed a similar suggestive trend using BKMR. This study makes a major contribution to the understanding of the joint effects of air pollution.
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Affiliation(s)
- Amina Amadou
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France.
| | - Camille Giampiccolo
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France; Service de Biostatistique-Bioinformatique, Pole Sante Publique, Hospices Civils de Lyon, Lyon, France; Laboratoire de Biometrie Et Biologie Evolutive, CNRS UMR 5558, Villeurbanne, France
| | - Fabiola Bibi Ngaleu
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France
| | - Delphine Praud
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France
| | - Thomas Coudon
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France
| | - Lény Grassot
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France
| | - Elodie Faure
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France
| | - Florian Couvidat
- National Institute for industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France
| | - Pauline Frenoy
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France
| | - Gianluca Severi
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France; Department of Statistics, Computer Science and Applications (DISIA), University of Florence, Italy
| | - Francesca Romana Mancini
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France.
| | - Pascal Roy
- Université Claude Bernard Lyon 1, Lyon, France; Service de Biostatistique-Bioinformatique, Pole Sante Publique, Hospices Civils de Lyon, Lyon, France; Laboratoire de Biometrie Et Biologie Evolutive, CNRS UMR 5558, Villeurbanne, France
| | - Béatrice Fervers
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France.
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Moore JM, Norris JM, Clark ML. Exposure to air pollutants and rheumatoid arthritis biomarkers: A scoping review. Semin Arthritis Rheum 2024; 65:152365. [PMID: 38232624 DOI: 10.1016/j.semarthrit.2024.152365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/20/2023] [Accepted: 01/03/2024] [Indexed: 01/19/2024]
Abstract
INTRODUCTION Rheumatoid arthritis (RA) is a common autoimmune disease with a complex and poorly understood etiology that includes genetic, hormonal, and environmental factors. OBJECTIVE Our objective was to assess current literature that investigated the association between exposure to environmental and occupational air pollutants and RA-related biomarkers rheumatoid factor (RF) and anti-citrullinated peptide antibody (ACPA). DESIGN PubMed and Web of Science were used to identify epidemiological studies that measured or estimated air pollution and at least one RA biomarker. Information was charted for comparison of evidence, including pollutant(s) studied, exposure assessment, biomarker measurement, analysis method, study population, size, dates, adjustment variables, and findings. RESULTS Several common air pollutants (including two mixtures) and a few dozen occupational inhalants were assessed in 13 eligible studies. Associations between industrial sulfur dioxide and particulate matter less than 2.5 µm in diameter with ACPA were observed most frequently, including associations between residential proximity to pollution sources and ACPA positivity. Consistency of associations with other pollutants was either not observed or limited to single studies. Three studies evaluated the modifying impact of SE alleles (a genetic factor associated with RA) and found that pollutant associations were stronger among participants positive for SE alleles. CONCLUSION Based on mixed results, there was no consistent link between any single pollutant and RA-related biomarker outcomes. Comparisons across studies were limited by differences in study populations (e.g., by RA status, by sociodemographic groups) and study design (including designs focused on different sources of air pollution, methodological approaches with varying levels of potential exposure misclassification, and assessments of inconsistent biomarker cut-points). However, given that multiple studies reported associations between exposure to air pollution and RA biomarkers, continued exploration utilizing studies that can be designed with a more robust causal framework, including continued consideration of effect modification by genetic status, may be necessary.
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Affiliation(s)
- Jillian M Moore
- Department of Environmental and Radiological Health Sciences, Colorado State University, 1681 Campus Delivery, Fort Collins, CO 80523, USA
| | - Jill M Norris
- Department of Epidemiology, Colorado School of Public Health, Aurora CO, USA
| | - Maggie L Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University, 1681 Campus Delivery, Fort Collins, CO 80523, USA.
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Hu H, Yang X, Chen Q, Huang X, Cao X, Zhang X, Xu Y. Causal association between air pollution and autoimmune diseases: a two-sample Mendelian randomization study. Front Public Health 2024; 12:1333811. [PMID: 38605869 PMCID: PMC11007215 DOI: 10.3389/fpubh.2024.1333811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/19/2024] [Indexed: 04/13/2024] Open
Abstract
Background In recent years, an increasing number of observational studies have reported the impact of air pollution on autoimmune diseases (ADs). However, no Mendelian randomization (MR) studies have been conducted to investigate the causal relationships. To enhance our understanding of causality, we examined the causal relationships between particulate matter (PM) and nitrogen oxides (NOx) and ADs. Methods We utilized genome-wide association study (GWAS) data on PM and NOx from the UK Biobank in European and East Asian populations. We also extracted integrated GWAS data from the Finnish consortium and the Japanese Biobank for two-sample MR analysis. We employed inverse variance weighted (IVW) analysis to assess the causal relationship between PM and NOx exposure and ADs. Additionally, we conducted supplementary analyses using four methods, including IVW (fixed effects), weighted median, weighted mode, and simple mode, to further investigate this relationship. Results In the European population, the results of MR analysis suggested a statistically significant association between PM2.5 and psoriasis only (OR = 3.86; 95% CI: 1.89-7.88; PIVW < 0.00625), while a potential association exists between PM2.5-10 and vitiligo (OR = 7.42; 95% CI: 1.02-53.94; PIVW < 0.05), as well as between PM2.5 and systemic lupus erythematosus (OR = 68.17; 95% CI: 2.17-2.1e+03; PIVW < 0.05). In East Asian populations, no causal relationship was found between air pollutants and the risk of systemic lupus erythematosus and rheumatoid arthritis (PIVW > 0.025). There was no pleiotropy in the results. Conclusion Our results suggest a causal association between PM2.5 and psoriasis in European populations. With the help of air pollution prevention and control, the harmful progression of psoriasis may be slowed.
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Affiliation(s)
- Haiping Hu
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, China
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xinxin Yang
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, China
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Qingquan Chen
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, China
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xinfeng Huang
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, China
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiangyu Cao
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, China
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiaoyang Zhang
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, China
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Youqiong Xu
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, China
- School of Public Health, Fujian Medical University, Fuzhou, China
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Guo Z, Xue H, Fan L, Wu D, Wang Y, Chung Y, Liao Y, Ruan Z, Du W. Differential effects of size-specific particulate matter on frailty transitions among middle-aged and older adults in China: findings from the China Health and Retirement Longitudinal Study (CHARLS), 2015-2018. Int Health 2024; 16:182-193. [PMID: 37161970 PMCID: PMC10939306 DOI: 10.1093/inthealth/ihad033] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 04/07/2023] [Accepted: 05/07/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND This study aimed to assess the long-term effects of size-specific particulate matter (PM) on frailty transitions in middle-aged and older Chinese adults. METHODS We included 13 910 participants ≥45 y of age from the China Health and Retirement Longitudinal Study (CHARLS) for 2015 and 2018 who were classified into three categories in 2015 according to their frailty states: robust, prefrail and frail. Air quality data were obtained from the National Urban Air Quality Real-time Publishing Platform. A two-level logistic regression model was used to examine the association between concentrations of PM and frailty transitions. RESULTS At baseline, the total number of robust, prefrail and frail participants were 7516 (54.0%), 4324 (31.1%) and 2070 (14.9%), respectively. Significant associations were found between PM concentrations and frailty transitions. For each 10 μg/m3 increase in the 3-y averaged 2.5-μm PM (PM2.5) concentrations, the risk of worsening in frailty increased in robust (odds ratio [OR] 1.06 [95% confidence interval {CI} 1.01 to 1.12]) and prefrail (OR 1.07 [95% CI 1.01 to 1.13]) participants, while the probability of improvement in frailty in prefrail (OR 0.91 [95% CI 0.84 to 0.98]) participants decreased. In addition, the associations of PM10 and coarse fraction of PM with frailty transitions showed similar patterns. CONCLUSIONS Long-term exposure to PM was associated with higher risks of worsening and lower risks of improvement in frailty among middle-aged and older adults in China.
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Affiliation(s)
- Zhen Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing 210009, China
| | - Hui Xue
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing 210009, China
| | - Lijun Fan
- Department of Medical Insurance, School of Public Health, Southeast University, Nanjing 210009, China
| | - Di Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing 210009, China
| | - Yiming Wang
- Department of Medical Insurance, School of Public Health, Southeast University, Nanjing 210009, China
| | - Younjin Chung
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Yilan Liao
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Zengliang Ruan
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing 210009, China
| | - Wei Du
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing 210009, China
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Meraz-Cruz N, Manzano-León N, Sandoval-Colin DE, García de León Méndez MDC, Quintana-Belmares R, Tapia LS, Osornio-Vargas AR, Buxton MA, O'Neill MS, Vadillo-Ortega F. Effects of PM 10 Airborne Particles from Different Regions of a Megacity on In Vitro Secretion of Cytokines by a Monocyte Line during Different Seasons. TOXICS 2024; 12:149. [PMID: 38393244 PMCID: PMC10892217 DOI: 10.3390/toxics12020149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Abstract
Several epidemiological studies have demonstrated that particulate matter (PM) in air pollution can be involved in the genesis or aggravation of different cardiovascular, respiratory, perinatal, and cancer diseases. This study assessed the in vitro effects of PM10 on the secretion of cytokines by a human monocytic cell line (THP-1). We compared the chemotactic, pro-inflammatory, and anti-inflammatory cytokines induced by PM10 collected for two years during three different seasons in five different Mexico City locations. MIP-1α, IP-10, MCP-1, TNF-α, and VEGF were the main secretion products after stimulation with 80 μg/mL of PM10 for 24 h. The THP-1 cells showed a differential response to PM10 obtained in the different sites of Mexico City. The PM10 from the north and the central city areas induced a higher pro-inflammatory cytokine response than those from the south. Seasonal pro-inflammatory cytokine secretion always exceeded anti-inflammatory secretion. The rainy-season-derived particles caused the lowest pro-inflammatory effects. We concluded that toxicological assessment of airborne particles provides evidence supporting their potential role in the chronic exacerbation of local or systemic inflammatory responses that may worsen the evolution of some chronic diseases.
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Affiliation(s)
- Noemi Meraz-Cruz
- Unidad de Vinculación Científica de la Facultad de Medicina, UNAM en el Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico
| | - Natalia Manzano-León
- Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
| | - Daniel Eduardo Sandoval-Colin
- Unidad de Vinculación Científica de la Facultad de Medicina, UNAM en el Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico
| | | | - Raúl Quintana-Belmares
- Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
| | - Laura Sevilla Tapia
- Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
| | - Alvaro R Osornio-Vargas
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Miatta A Buxton
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Marie S O'Neill
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Environmental Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Felipe Vadillo-Ortega
- Unidad de Vinculación Científica de la Facultad de Medicina, UNAM en el Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico
- Department of Environmental Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
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Qu R, Sun B, Jiang J, An Z, Li J, Wu H, Wu W, Song J. Short-term ozone exposure and serum neural damage biomarkers in healthy elderly adults: Evidence from a panel study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 905:167209. [PMID: 37730053 DOI: 10.1016/j.scitotenv.2023.167209] [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: 06/18/2023] [Revised: 08/28/2023] [Accepted: 09/17/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Although converging lines of research have pointed to the adverse neural effects of air pollution, evidence linking ozone (O3) and neural damage remains limited. OBJECTIVES To investigate the subclinical neural effects of short-term ozone (O3) exposure in elderly adults. METHODS A panel of healthy elderly individuals was recruited, and five repeated measurements were conducted from December 2018 to April 2019 in Xinxiang, China. Serum neural damage biomarkers, including brain-derived neurotrophic factor (BDNF), neurofilament light chain (NfL), neuron-specific enolase (NSE), protein gene product 9.5 (PGP9.5), and S100 calcium-binding protein B (S100B) were measured at each follow-up session. Personal O3 exposure levels were calculated based on outdoor monitoring and sampling times. A linear mixed-effects model was adopted to quantify the acute effect of O3 on serum neural damage biomarkers. Stratification analysis based on sex, education level, physical activity, and glutathione S-transferases (GST) gene polymorphism analysis was performed to explore their potential modifying effects. RESULTS A total of 34 healthy volunteers aged 63.7 ± 5.7 y were enlisted and completed the study. The concentration of the daily maximum 8-h average O3 (O3-8h) ranged from 19.5 to 160.5 μg/m3 during the study period. Regression analysis showed that short-term O3 exposure was associated positively with serum concentrations of neural damage biomarkers. A 10 μg/m3 increase in O3-8h exposure was associated with an increment of 74 % (95 % CI:1 %-146 %) and 197 % (95 % CI:39 %-356 %) in BDNF (lag 2 d) and NfL (lag 1 d), respectively. The stratification results suggest that males, people with lower education levels, lower physical activity, and GST theta 1 (GSTT1)-sufficient genotype might be marginally more vulnerable. CONCLUSIONS This study provides new evidence for the neural damage risk posed by O3 exposure, even at relatively low concentrations, which, therefore, requires that stringent air quality standards be developed and implemented.
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Affiliation(s)
- Rongrong Qu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Beibei Sun
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Jing Jiang
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Zhen An
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Juan Li
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Hui Wu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Weidong Wu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China.
| | - Jie Song
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China.
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Lee J, Weerasinghe-Mudiyanselage PDE, Kim B, Kang S, Kim JS, Moon C. Particulate matter exposure and neurodegenerative diseases: A comprehensive update on toxicity and mechanisms. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 266:115565. [PMID: 37832485 DOI: 10.1016/j.ecoenv.2023.115565] [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: 08/11/2023] [Revised: 09/30/2023] [Accepted: 10/08/2023] [Indexed: 10/15/2023]
Abstract
Exposure to particulate matter (PM) has been associated with a range of health impacts, including neurological abnormalities that affect neurodevelopment, neuroplasticity, and behavior. Recently, there has been growing interest in investigating the possible relationship between PM exposure and the onset and progression of neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, Huntington's disease, and multiple sclerosis. However, the precise mechanism by which PM affects neurodegeneration is still unclear, even though several epidemiological and animal model studies have provided mechanistic insights. This article presents a review of the current research on the neurotoxicity of PM and its impact on neurodegenerative diseases. This review summarizes findings from epidemiological and animal model studies collected through searches in Google Scholar, PubMed, Web of Science, and Scopus. This review paper also discusses the reported effects of PM exposure on the central nervous system and highlights research gaps and future directions. The information presented in this review may inform public health policies aimed at reducing PM exposure and may contribute to the development of new treatments for neurodegenerative diseases. Further mechanistic and therapeutic research will be needed to fully understand the relationship between PM exposure and neurodegenerative diseases.
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Affiliation(s)
- Jeongmin Lee
- Department of Veterinary Anatomy and Animal Behavior, College of Veterinary Medicine and BK21 FOUR program, Chonnam National University, Gwangju 61186, South Korea
| | - Poornima D E Weerasinghe-Mudiyanselage
- Department of Veterinary Anatomy and Animal Behavior, College of Veterinary Medicine and BK21 FOUR program, Chonnam National University, Gwangju 61186, South Korea
| | - Bohye Kim
- Department of Veterinary Anatomy and Animal Behavior, College of Veterinary Medicine and BK21 FOUR program, Chonnam National University, Gwangju 61186, South Korea
| | - Sohi Kang
- Department of Veterinary Anatomy and Animal Behavior, College of Veterinary Medicine and BK21 FOUR program, Chonnam National University, Gwangju 61186, South Korea
| | - Joong-Sun Kim
- Department of Veterinary Anatomy and Animal Behavior, College of Veterinary Medicine and BK21 FOUR program, Chonnam National University, Gwangju 61186, South Korea
| | - Changjong Moon
- Department of Veterinary Anatomy and Animal Behavior, College of Veterinary Medicine and BK21 FOUR program, Chonnam National University, Gwangju 61186, South Korea.
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Alhussaini AR, Aljabri MR, Al-Harbi ZT, Abdulrahman Almohammadi G, Al-Harbi TM, Bashir S. Air Pollution and Its Adverse Effects on the Central Nervous System. Cureus 2023; 15:e38927. [PMID: 37313075 PMCID: PMC10259194 DOI: 10.7759/cureus.38927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 06/15/2023] Open
Abstract
Air pollution is recognized as a significant public health problem and is associated with illnesses of the central nervous system (CNS) as well as neuroinflammation and neuropathology. Air pollution may cause chronic brain inflammation, white matter abnormalities, and microglia activation, which increases the risk of autism spectrum disorders, neurodegenerative disorders, stroke, and multiple sclerosis (MS). Methods: A literature review was done on "PubMed, EMBASE and Web of Science" on the relationship of air pollution with MS and stroke, using the keywords "air pollution" OR "pollution"; "ambient air pollution," "particulate matter, ozone, black carbon" AND "stroke" OR "cerebrovascular diseases," "multiple sclerosis," "neuroinflammation," or "neurodegeneration." Results: We first identified 128 articles and their related websites, of which 44 articles were further selected for analysis mainly based on study relevance, study quality and reliability, and date of publication. Further studies on air pollution and its adverse effects on the CNS are needed. The findings of such studies will support the development of appropriate preventive measures in the future.
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Affiliation(s)
| | | | - Zeyad T Al-Harbi
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | | | | | - Shahid Bashir
- Neuroscience, Neuroscience Center, King Fahad Specialist Hospital, Dammam, SAU
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Sedighi B, Haghdoost A, Jangipour Afshar P, Abna Z, Bahmani S, Jafari S. Multiple sclerosis and COVID-19: A retrospective study in Iran. PLoS One 2023; 18:e0283538. [PMID: 36952532 PMCID: PMC10035930 DOI: 10.1371/journal.pone.0283538] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 03/10/2023] [Indexed: 03/25/2023] Open
Abstract
OBJECTIVES Previous studies suggested a higher rate of COVID-19 infection in patients with multiple sclerosis than in the general population, and limited studies addressed the impact of COVID-19 and its vaccination in patients with multiple sclerosis in Iran. We decided to investigate the factors associated with COVID-19 infection, the effects and side effects of the COVID-19 vaccination in patients with multiple sclerosis (MS). METHODS We used the data of the patients with multiple sclerosis registered in a referral clinic in Kerman, one of the large cities in Iran (a population of 537,000 inhabitants), to explore the association between demographic variables, the history of COVID-19 vaccination, and the clinical outcomes. RESULTS Of the 367 participants in this study, 88.3% received the COVID-19 vaccine, 35.4% were confirmed COVID-19 cases, and the incidence of COVID-19 was much higher before vaccination (24.5% before vaccination versus 10.1% after vaccination). The multivariable logistic regression model showed that male gender (OR = 2.64, 95% confidence interval: 1.21, 5.74) and current employment (OR = 3.04, 95% confidence interval: 1.59, 5.80) were associated with an increased risk of COVID-19. The only factor associated with the adverse effects of COVID-19 vaccination was the type of vaccine (AstraZeneca). CONCLUSION Our findings showed that the vaccination protected MS cases considerably against COVID-19. In addition, the side effects of the vaccines were not noticeably high in these cases as well. Among all COVID-19 vaccines, AstraZeneca had the most common side effects, so people must be aware of them before vaccination. The male gender and employment were the most important variables in the prevalence of COVID-19 in patients with multiple sclerosis in our study.
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Affiliation(s)
- Behnaz Sedighi
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Aliakbar Haghdoost
- Institute for Futures Studies in Health, Modeling in Health Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Parya Jangipour Afshar
- Faculty of Public Health, Department of Biostatistics and Epidemiology, Kerman University of Medical Sciences, Kerman, Iran
| | - Zohre Abna
- Tehran University of Medical Sciences, Tehran, Iran
| | - Shamimeh Bahmani
- Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Simin Jafari
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
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10
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Ponzano M, Schiavetti I, Bergamaschi R, Pisoni E, Bellavia A, Mallucci G, Carmisciano L, Inglese M, Cordioli C, Marfia GA, Cocco E, Immovilli P, Pesci I, Scandellari C, Cavalla P, Radaelli M, Vianello M, Vitetta F, Montepietra S, Amato MP, Fioretti C, Filippi M, Sartori A, Caleri F, Clerico M, Gallo A, Conte A, Clerici R, De Luca G, Boneschi FM, Cantello R, Calabrese M, Tortorella C, Rovaris M, Verrengia EP, Patti F, Morra VB, Salvetti M, Sormani MP. The impact of PM2.5, PM10 and NO2 on Covid-19 severity in a sample of patients with multiple sclerosis: A case-control study. Mult Scler Relat Disord 2022; 68:104243. [PMID: 36288659 PMCID: PMC9581645 DOI: 10.1016/j.msard.2022.104243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/19/2022] [Accepted: 10/14/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Many studies investigated the association between air pollution and Covid-19 severity but the only study focusing on patients with Multiple Sclerosis (MS) exclusively evaluated exposure to PM2.5. We aim to study, in a sample of MS patients, the impact of long-term exposure to PM2.5, PM10 and NO2 on Covid-19 severity, described as occurrence of pneumonia. METHODS A 1:2 ratio case-control study was designed, differentiating cases and controls based on Covid-19 pneumonia. Associations between pollutants and outcome were studied using logistic regression. Weighted quantile sum (WQS) logistic regression was used to identify the individual contribution of each pollutant within the mixture; Least Absolute Shrinkage and Selection Operator (LASSO) penalized regression was performed to confirm the variable selection from WQS. All the analyses were adjusted for confounders selected a priori. RESULTS Of the 615 eligible patients, 491 patients provided detailed place of exposure and were included in the principal analysis. Higher concentrations of air pollutants were associated with increased odds of developing Covid-19 pneumonia (PM2.5: 3rd vs 1st tercile OR(95% CI)=2.26(1.29;3.96); PM10: 3rd vs 1st tercile OR(95% CI)=2.12(1.22;3.68); NO2: 3rd vs 1st tercile OR(95% CI)=2.12(1.21;3.69)). Pollutants were highly correlated with each other; WQS index was associated to an increased risk of pneumonia (β=0.44; p-value=0.004) and the main contributors to this association were NO2 (41%) and PM2.5 (34%). Consistently, Lasso method selected PM2.5 and NO2. CONCLUSIONS Higher long-term exposure to PM2.5, PM10 and NO2 increased the odds of Covid-19 pneumonia among MS patients and the most dangerous pollutants were NO2 and PM2.5.
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Affiliation(s)
- Marta Ponzano
- Department of Health Sciences, Section of Biostatistics, University of Genoa, Genoa, Italy.
| | - Irene Schiavetti
- Department of Health Sciences, Section of Biostatistics, University of Genoa, Genoa, Italy
| | | | - Enrico Pisoni
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Andrea Bellavia
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Giulia Mallucci
- Multiple Sclerosis Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Luca Carmisciano
- Department of Health Sciences, Section of Biostatistics, University of Genoa, Genoa, Italy
| | - Matilde Inglese
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Cinzia Cordioli
- Multiple Sclerosis Center, ASST Spedali Civili di Brescia, Montichiari, Italy
| | - Girolama Alessandra Marfia
- Department of Systems Medicine, Multiple Sclerosis Clinical and Research Unit, Tor Vergata University, Rome, Italy
| | - Eleonora Cocco
- Multiple Sclerosis Center, Ospedale Binaghi, Cagliari, Italy
| | - Paolo Immovilli
- Multiple Sclerosis Center, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | - Ilaria Pesci
- Multiple Sclerosis Center, UO Neurology, Fidenza, Fidenza, Italy
| | - Cinzia Scandellari
- IRCCS Institute of Neurological Sciences, UOSI Multiple Sclerosis Rehabilitation, Bologna, Italy
| | - Paola Cavalla
- MS Center, Department of Neuroscience, City of Health and Science University Hospital of Turin, Turin, Italy
| | - Marta Radaelli
- Department of Neurology and Multiple Sclerosis Center, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Marika Vianello
- Unit of Neurology, Ca' Fancello Hospital, AULSS2, Treviso, Italy
| | - Francesca Vitetta
- Neurology Unit, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Sara Montepietra
- Neurology Unit, Neuromotor and Rehabilitation Department, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | | | | | - Massimo Filippi
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Arianna Sartori
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, ASUGI, University of Trieste, Trieste, Italy
| | - Francesca Caleri
- Department of Neurology, MS Center, F. Tappeiner Hospital, Merano, Italy
| | - Marinella Clerico
- Clinical and Biological Sciences Department, University of Turin, Turin, Italy
| | - Antonio Gallo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, (NA), Italy
| | - Antonella Conte
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy; IRCCS Neuromed, Pozzilli, Italy
| | | | - Giovanna De Luca
- Institute for Advanced Biomedical Technologies (ITAB), Department of Neurosciences, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | | | - Roberto Cantello
- Movement Disorders Centre, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Massimiliano Calabrese
- Department of Neuroscience, Biomedicine and Movement, The Multiple Sclerosis Center of the University Hospital of Verona, Verona, Italy
| | - Carla Tortorella
- Department of Neurosciences, S. Camillo-Forlanini Hospital, Rome, Italy
| | | | | | - Francesco Patti
- Department of Medical and Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania
| | - Vincenzo Brescia Morra
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Federico II University, Naples, Italy
| | - Marco Salvetti
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy; Unit of Neurology, IRCCS Neuromed, Pozzilli, Isernia, Italy
| | - Maria Pia Sormani
- Department of Health Sciences, Section of Biostatistics, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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11
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Yu YY, Jin H, Lu Q. Effect of polycyclic aromatic hydrocarbons on immunity. J Transl Autoimmun 2022; 5:100177. [PMID: 36561540 PMCID: PMC9763510 DOI: 10.1016/j.jtauto.2022.100177] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 09/06/2022] [Accepted: 11/25/2022] [Indexed: 12/02/2022] Open
Abstract
Nearly a quarter of the total number of deaths in the world are caused by unhealthy living or working environments. Therefore, we consider it significant to introduce the effect of a widely distributed component of air/water/food-source contaminants, polycyclic aromatic hydrocarbons (PAHs), on the human body, especially on immunity in this review. PAHs are a large class of organic compounds containing two or more benzene rings. PAH exposure could occur in most people through breath, smoke, food, and direct skin contact, resulting in both cellular immunosuppression and humoral immunosuppression. PAHs usually lead to the exacerbation of autoimmune diseases by regulating the balance of T helper cell 17 and regulatory T cells, and promoting type 2 immunity. However, the receptor of PAHs, aryl hydrocarbon receptor (AhR), appears to exhibit duality in the immune response, which seems to explain some seemingly opposite experimental results. In addition, PAH exposure was also able to exacerbate allergic reactions and regulate monocytes to a certain extent. The specific regulation mechanisms of immune system include the assistance of AhR, the activation of the CYP-ROS axis, the recruitment of intracellular calcium, and some epigenetic mechanisms. This review aims to summarize our current understanding on the impact of PAHs in the immune system and some related diseases such as cancer, autoimmune diseases (rheumatoid arthritis, type 1 diabetes, multiple sclerosis, and systemic lupus erythematosus), and allergic diseases (asthma and atopic dermatitis). Finally, we also propose future research directions for the prevention or treatment on environmental induced diseases.
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Affiliation(s)
- Yang-yiyi Yu
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital, Central South University, Changsha, China,Research Unit of Key Technologies of Immune-related Skin Diseases Diagnosis and Treatment, Chinese Academy of Medical Sciences (2019RU027), Changsha, China
| | - Hui Jin
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital, Central South University, Changsha, China,Research Unit of Key Technologies of Immune-related Skin Diseases Diagnosis and Treatment, Chinese Academy of Medical Sciences (2019RU027), Changsha, China,Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China,Corresponding author. Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital, Central South University, Changsha, China.
| | - Qianjin Lu
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital, Central South University, Changsha, China,Research Unit of Key Technologies of Immune-related Skin Diseases Diagnosis and Treatment, Chinese Academy of Medical Sciences (2019RU027), Changsha, China,Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China,Key Laboratory of Basic and Translational Research on Immune-Mediated Skin Diseases, Chinese Academy of Medical Sciences, Nanjing, China,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, Jiangsu, 210042, China,Corresponding author. Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital, Central South University, Changsha, China.
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12
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Fu C, Kuang D, Zhang H, Ren J, Chen J. Different components of air pollutants and neurological disorders. Front Public Health 2022; 10:959921. [PMID: 36518583 PMCID: PMC9742385 DOI: 10.3389/fpubh.2022.959921] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/24/2022] [Indexed: 11/29/2022] Open
Abstract
The harmful effects of air pollution can cause various diseases. Most research on the hazards of air pollution focuses on lung and cardiovascular diseases. In contrast, the impact of air pollution on neurological disorders is not widely recognized. Air pollution can cause various neurological conditions and diseases, such as neural inflammation, neurodegeneration, and cerebrovascular barrier disorder; however, the mechanisms underlying the neurological diseases induced by various components of air pollutants remain unclear. The present paper summarizes the effects of different components of air pollutants, including particulate matter, ozone, sulfur oxides, carbon oxides, nitrogen oxides, and heavy metals, on the nervous system and describes the impact of various air pollutants on neurological disorders, providing ideas for follow-up research.
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Affiliation(s)
- Chunlia Fu
- Department of Emergency Intensive Care Unit, Affiliated Dongguan People's Hospital, Southern Medical University, Dongguan, China
| | - Daibing Kuang
- Department of Emergency Intensive Care Unit, Affiliated Dongguan People's Hospital, Southern Medical University, Dongguan, China
| | - He Zhang
- School of Public Health, Guangdong Medical University, Dongguan, China
| | - Jinxin Ren
- The Second Clinical Medical College, Guangdong Medical University, Dongguan, China
| | - Jialong Chen
- School of Public Health, Guangdong Medical University, Dongguan, China
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13
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Abstract
Social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are the non-medical factors that influence health outcomes. Evidence indicates that health behaviours, comorbidities and disease-modifying therapies all contribute to multiple sclerosis (MS) outcomes; however, our knowledge of the effects of social determinants — that is, the ‘risks of risks’ — on health has not yet changed our approach to MS. Assessing and addressing social determinants of health could fundamentally improve health and health care in MS; this approach has already been successful in improving outcomes in other chronic diseases. In this narrative Review, we identify and discuss the body of evidence supporting an effect of many social determinants of health, including racial background, employment and social support, on MS outcomes. It must be noted that many of the published studies were subject to bias, and screening tools and/or practical interventions that address these social determinants are, for the most part, lacking. The existing work does not fully explore the potential bidirectional and complex relationships between social determinants of health and MS, and the interpretation of findings is complicated by the interactions and intersections among many of the identified determinants. On the basis of the reviewed literature, we consider that, if effective interventions targeting social determinants of health were available, they could have substantial effects on MS outcomes. Therefore, funding for and focused design of studies to evaluate and address social determinants of health are urgently needed. Here, the authors discuss the potential effects of social determinants of health on multiple sclerosis risk and outcomes. They suggest that addressing these determinants of health could substantially improve the lives of individuals with multiple sclerosis and call for more research. Addressing an individual’s social determinants of health — that is, the conditions under which they are born, grow, live, work and age — could provide opportunities to reduce the burden of living with multiple sclerosis (MS). Individual factors that may influence MS-related outcomes include sex, gender and sexuality, race and ethnicity, education and employment, socioeconomic status, and domestic abuse. Societal infrastructures, including access to food, health care and social support, can also affect MS-related outcomes. Awareness of the specific circumstances of a patient with MS might help neurologists deliver better care. Social determinants of health are not static and can change according to wider sociopolitical contexts, as highlighted by the COVID-19 pandemic. Rigorous studies of interventions to ameliorate the effects of poor social determinants on people with MS are urgently needed.
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14
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Gałuszka-Bulaga A, Hajto J, Borczyk M, Gołda S, Piechota M, Korostyński M, Rutkowska-Zapała M, Latacz P, Guła Z, Korkosz M, Pera J, Słowik A, Siedlar M, Baran J. Transcriptional Response of Blood Mononuclear Cells from Patients with Inflammatory and Autoimmune Disorders Exposed to "Krakow Smog". Cells 2022; 11:cells11162586. [PMID: 36010662 PMCID: PMC9406644 DOI: 10.3390/cells11162586] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/10/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022] Open
Abstract
Despite the general awareness of the need to reduce air pollution, the efforts were undertaken in Poland to eliminate the pollutants and their harmful effect on human health seem to be insufficient. Moreover, the latest data indicate that the city of Krakow is at the forefront of the most polluted cities worldwide. Hence, in this report, we investigated the impact of particulate matter isolated from the air of Krakow (PM KRK) on the gene expression profile of peripheral blood mononuclear cells (PBMCs) in healthy donors (HD) and patients with atherosclerosis (AS), rheumatoid arthritis (RA) and multiple sclerosis (MS), after in vitro exposure. Blood samples were collected in two seasons, differing in the concentration of PM in the air (below or above a daily limit of 50 µg/m3 for PM 10). Data show that PBMCs exposed in vitro to PM KRK upregulated the expression of genes involved, among others, in pro-inflammatory response, cell motility, and regulation of cell metabolism. The transcriptional effects were observed predominantly in the group of patients with AS and MS. The observed changes seem to be dependent on the seasonal concentration of PM in the air of Krakow and may suggest their important role in the progression of AS, MS, and RA in the residents of Krakow.
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Affiliation(s)
- Adrianna Gałuszka-Bulaga
- Department of Clinical Immunology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Jacek Hajto
- Laboratory of Pharmacogenomics, Department of Molecular Neuropharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 31-343 Krakow, Poland
| | - Małgorzata Borczyk
- Laboratory of Pharmacogenomics, Department of Molecular Neuropharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 31-343 Krakow, Poland
| | - Sławomir Gołda
- Laboratory of Pharmacogenomics, Department of Molecular Neuropharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 31-343 Krakow, Poland
| | - Marcin Piechota
- Laboratory of Pharmacogenomics, Department of Molecular Neuropharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 31-343 Krakow, Poland
| | - Michał Korostyński
- Laboratory of Pharmacogenomics, Department of Molecular Neuropharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 31-343 Krakow, Poland
| | - Magdalena Rutkowska-Zapała
- Department of Clinical Immunology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Paweł Latacz
- Department of Clinical Neurology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Zofia Guła
- Department of Rheumatology and Immunology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Mariusz Korkosz
- Department of Rheumatology and Immunology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Joanna Pera
- Department of Clinical Neurology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Agnieszka Słowik
- Department of Clinical Neurology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Maciej Siedlar
- Department of Clinical Immunology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Jarek Baran
- Department of Clinical Immunology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland
- Correspondence: ; Tel.: +48-12-65-82-011
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15
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Rivas-Arancibia S, Hernández-Orozco E, Rodríguez-Martínez E, Valdés-Fuentes M, Cornejo-Trejo V, Pérez-Pacheco N, Dorado-Martínez C, Zequeida-Carmona D, Espinosa-Caleti I. Ozone Pollution, Oxidative Stress, Regulatory T Cells and Antioxidants. Antioxidants (Basel) 2022; 11:antiox11081553. [PMID: 36009272 PMCID: PMC9405302 DOI: 10.3390/antiox11081553] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/31/2022] [Accepted: 08/05/2022] [Indexed: 12/06/2022] Open
Abstract
Ozone pollution, is a serious health problem worldwide. Repeated exposure to low ozone doses causes a loss of regulation of the oxidation–reduction systems, and also induces a chronic state of oxidative stress. This fact is of special importance for the regulation of different systems including the immune system and the inflammatory response. In addition, the oxidation–reduction balance modulates the homeostasis of these and other complex systems such as metabolism, survival capacity, cell renewal, and brain repair, etc. Likewise, it has been widely demonstrated that in chronic degenerative diseases, an alteration in the oxide-reduction balance is present, and this alteration causes a chronic loss in the regulation of the immune response and the inflammatory process. This is because reactive oxygen species disrupt different signaling pathways. Such pathways are related to the role of regulatory T cells (Treg) in inflammation. This causes an increase in chronic deterioration in the degenerative disease over time. The objective of this review was to study the relationship between environmental ozone pollution, the chronic state of oxidative stress and its effect on Treg cells, which causes the loss of regulation in the inflammatory response as well as the role played by antioxidant systems in various pathologies.
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16
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Seasonal Variations in the Concentration of Particulate Matter in the Air of Cracow Affect the Magnitude of CD4+ T Cell Subsets Cytokine Production in Patients with Inflammatory and Autoimmune Disorders. ATMOSPHERE 2022. [DOI: 10.3390/atmos13040529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Recently, the increased prevalence of chronic civilization diseases triggered by environmental pollution has been observed. In this context, the role of air pollution in the pathogenesis of autoimmune and/or inflammatory disorders is poorly elucidated. Here, we asked whether seasonal changes in the air quality of the city of Cracow affect the polarization of T cell subsets in healthy donors (HD) and patients with rheumatoid arthritis (RA), multiple sclerosis (MS), and atherosclerosis (AS). Peripheral blood mononuclear cells (PBMCs) from HD and patients were exposed in vitro to particulate matter isolated from the air of Cracow (PM CRC). Blood samples were collected in two seasons (winter and summer), with differences in air concentration of particulate matter of 10 μm (PM10) (below or above a daily limit of 50 µg/m3). The obtained data showed a significantly elevated frequency of CD4+ lymphocytes specific for IFN-γ and IL-17A after the exposure of PBMCs to PM CRC. This was observed for all patients’ groups and HD. In the case of patients, this effect was dependent on the seasonal concentration of PM in the air, paradoxically being less pronounced in the season with a higher concentration of air pollution. These observations may suggest the role of air pollution on the course of inflammatory and autoimmune disorders.
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17
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Ziaei A, Lavery AM, Shao XM, Adams C, Casper TC, Rose J, Candee M, Weinstock-Guttman B, Aaen G, Harris Y, Graves J, Benson L, Gorman M, Rensel M, Mar S, Lotze T, Greenberg B, Chitnis T, Hart J, Waldman AT, Barcellos LF, Waubant E. Gene-environment interactions increase the risk of pediatric-onset multiple sclerosis associated with ozone pollution. Mult Scler 2022; 28:1330-1339. [PMID: 35000467 DOI: 10.1177/13524585211069926] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND We previously reported a relationship between air pollutants and increased risk of pediatric-onset multiple sclerosis (POMS). Ozone is an air pollutant that may play a role in multiple sclerosis (MS) pathoetiology. CD86 is the only non-HLA gene associated with POMS for which expression on antigen-presenting cells (APCs) is changed in response to ozone exposure. OBJECTIVES To examine the association between county-level ozone and POMS, and the interactions between ozone pollution, CD86, and HLA-DRB1*15, the strongest genetic variant associated with POMS. METHODS Cases and controls were enrolled in the Environmental and Genetic Risk Factors for Pediatric MS study of the US Network of Pediatric MS Centers. County-level-modeled ozone data were acquired from the CDC's Environmental Tracking Network. Participants were assigned ozone values based on county of residence. Values were categorized into tertiles based on healthy controls. The association between ozone tertiles and having MS was assessed by logistic regression. Interactions between tertiles of ozone level and the GG genotype of the rs928264 (G/A) single nucleotide polymorphism (SNP) within CD86, and the presence of DRB1*15:01 (DRB1*15) on odds of POMS were evaluated. Models were adjusted for age, sex, genetic ancestry, and mother's education. Additive interaction was estimated using relative excess risk due to interaction (RERI) and attributable proportions (APs) of disease were calculated. RESULTS A total of 334 POMS cases and 565 controls contributed to the analyses. County-level ozone was associated with increased odds of POMS (odds ratio 2.47, 95% confidence interval (CI): 1.69-3.59 and 1.95, 95% CI: 1.32-2.88 for the upper two tertiles, respectively, compared with the lowest tertile). There was a significant additive interaction between high ozone tertiles and presence of DRB1*15, with a RERI of 2.21 (95% CI: 0.83-3.59) and an AP of 0.56 (95% CI: 0.33-0.79). Additive interaction between high ozone tertiles and the CD86 GG genotype was present, with a RERI of 1.60 (95% CI: 0.14-3.06) and an AP of 0.37 (95% CI: 0.001-0.75) compared to the lowest ozone tertile. AP results indicated that approximately half of the POMS risk in subjects can be attributed to the possible interaction between higher county-level ozone carrying either DRB1*15 or the CD86 GG genotype. CONCLUSIONS In addition to the association between high county-level ozone and POMS, we report evidence for additive interactions between higher county-level ozone and DRB1*15 and the CD86 GG genotype. Identifying gene-environment interactions may provide mechanistic insight of biological processes at play in MS susceptibility. Our work suggests a possible role of APCs for county-level ozone-induced POMS risk.
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Affiliation(s)
- Amin Ziaei
- University of California, San Francisco, San Francisco, CA, USA
| | - Amy M Lavery
- Division of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Xiaorong Ma Shao
- Genetic Epidemiology and Genomics Laboratory, Divisions of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Cameron Adams
- Genetic Epidemiology and Genomics Laboratory, Divisions of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | | | - John Rose
- The University of Utah, Salt Lake City, UT, USA
| | | | | | - Greg Aaen
- Loma Linda University Children's Hospital, Loma Linda, CA, USA
| | | | | | - Leslie Benson
- Pediatric Multiple Sclerosis and Related Disorders Program, Boston Children's Hospital, Boston, MA, USA
| | - Mark Gorman
- Pediatric Multiple Sclerosis and Related Disorders Program, Boston Children's Hospital, Boston, MA, USA
| | | | - Soe Mar
- Washington University in St. Louis, St. Louis, MO, USA
| | - Tim Lotze
- Texas Children's Hospital, Houston, TX, USA
| | | | - Tanuja Chitnis
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Janace Hart
- University of California, San Francisco, San Francisco, CA, USA
| | - Amy T Waldman
- Division of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Lisa F Barcellos
- Genetic Epidemiology and Genomics Laboratory, Divisions of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
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18
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Lotfi F, Mansourian M, Mirmoayyeb O, Najdaghi S, Shaygannejad V, Esmaeil N. Association of Exposure to Particulate Matters and Multiple Sclerosis: A Systematic Review and Meta-Analysis. Neuroimmunomodulation 2022; 29:21-27. [PMID: 34134109 DOI: 10.1159/000516559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 04/13/2021] [Indexed: 11/19/2022] Open
Abstract
The association between air pollution and multiple sclerosis (MS) is not entirely clear. This meta-analysis was aimed at determining the correlation between particulate matter (PM)2.5, PM10, and MS incidence/relapse. The literature search was performed in EMBASE, Web of Science, PubMed, and the gray literature. Sixteen articles were retrieved, and ten articles were included and evaluated. Three measures of association were used for the meta-analysis: odds ratio (cross-sectional and case-control studies), incidence rate ratio, or hazard ratio (cohort studies). Meta-analysis of those 3 studies on PM2.5 indicated that exposure to PM2.5 was associated with MS relapse and incidence ([95% confidence interval; CI] 1.178 [1.102, 1.279]), p > 0.05. Also, assessment of risk ratio for all studies showed a correlation between PMs (PM10 and PM2.5) and MS incidence and relapse ([95% CI] 1.28, [1.13-1.43]) p < 0.05. Collectively, we found that PM exposure (PM10 and PM2.5) in MS patients associates with the occurrence and relapse of disease.
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Affiliation(s)
- Fatemeh Lotfi
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Mansourian
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omid Mirmoayyeb
- Isfahan Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Soroush Najdaghi
- Isfahan Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Cancer Immunology Project, Universal Education and Research Network (USERN), Tehran, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Vahid Shaygannejad
- Department of Neurology, Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nafiseh Esmaeil
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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19
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Farahmandfard MA, Naghibzadeh-Tahami A, Khanjani N. Ambient air pollution and multiple sclerosis: a systematic review. REVIEWS ON ENVIRONMENTAL HEALTH 2021; 36:535-544. [PMID: 34821118 DOI: 10.1515/reveh-2020-0079] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/09/2020] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Some studies have shown that environmental risk factors, including air pollution, might be related to the incidence or recurrence of multiple sclerosis (MS). This systematic review was conducted to investigate the relation between air pollution and MS. METHODS A systematic search was conducted in PubMed, Scopus, Science Direct, Embase, and Web of Science; until January 2020 with no restrictions. The search strategy was conducted with air pollution key words such as CO, PM2.5, PM10, SO2, and NO2, for exposure and the key word "Multiple sclerosis" as the outcome. RESULTS Eventually, after applying the inclusion and exclusion criteria, 17 articles were included. The methodologies and outcomes reported were heterogeneous and different metrics had been used in the results; therefore conducting a meta-analysis was not possible. Eight studies had analyzed the relation between particulate matter (PM) and the prevalence or relapse of MS and had observed a significant relation. NO2 and NOx were associated with recurrence or prevalence of MS in three studies. But, in three cohort studies, no association was observed between air pollution and recurrence or occurrence of MS. CONCLUSIONS The results of this systematic review show that outdoor air pollution, especially PM and nitrogen oxides might be related to the prevalence or relapse of MS.
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Affiliation(s)
- Mohammad Amin Farahmandfard
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Social Determinants of Health Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Narges Khanjani
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
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20
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Tang C, Li QR, Mao YM, Xia YR, Guo HS, Wang JP, Shuai ZW, Ye DQ. Association between ambient air pollution and multiple sclerosis: a systemic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:58142-58153. [PMID: 34109523 DOI: 10.1007/s11356-021-14577-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 05/21/2021] [Indexed: 06/12/2023]
Abstract
Recently, increasing attention has been paid to the effects of air pollutants on autoimmune diseases. The results of relationship between ambient air pollution and multiple sclerosis (MS) showed a variety of differences. Thus, the purpose of this study is to further clarify and quantify the relationship between ambient air pollutants and MS through meta-analysis. Through electronic literature search, literature related to our research topic was collected in Cochrane Library, Embase, and PubMed till August 18, 2020, according to certain criteria. Pooled risk estimate and 95% confidence intervals (95%CI) were calculated by random-effect model analysis. After removing copies, browsing titles and abstracts, and reading full text, 6 studies were finally included. The results showed that only particulate matter (PM) with aerodynamic diameter ≤ 10 (PM10) was related to MS (pooled HR = 1.058, 95% CI = 1.050-1.066), and no correlation was found between PM with aerodynamic diameter < 2.5 (PM2.5), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3), benzene (C6H6), major road < 50 m, and MS. There was no publication bias, and the heterogeneity analysis results were stable. PM10 is correlated with the disease MS, while other pollution is not connected with MS. Therefore, it is important for MS patients to take personal protection against particulate pollution and avoid exposure to higher levels of PM.
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Affiliation(s)
- Chao Tang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Qing-Ru Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yan-Mei Mao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yuan-Rui Xia
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Heng-Sheng Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Jun-Ping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Zong-Wen Shuai
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Dong-Qing Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
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21
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Bergamaschi R, Montomoli C. Air pollution is a risk factor for multiple sclerosis - Yes. Mult Scler 2021; 27:2137-2138. [PMID: 34676793 DOI: 10.1177/13524585211035953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Roberto Bergamaschi
- Multiple Sclerosis Research Centre, IRCCS Mondino Foundation, via Mondino 2, 27100 Pavia, Italy
| | - Cristina Montomoli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
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22
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Zarghami A, Li Y, Claflin SB, van der Mei I, Taylor BV. Role of environmental factors in multiple sclerosis. Expert Rev Neurother 2021; 21:1389-1408. [PMID: 34494502 DOI: 10.1080/14737175.2021.1978843] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Environmental factors play a significant role in the pathogenesis and progression of multiple sclerosis (MS), either acting alone or by interacting with other environmental or genetic factors. This cumulative exposure to external risk factors is highly complex and highly variable between individuals. AREAS COVERED We narratively review the current evidence on the role of environment-specific risk factors in MS onset and progression, as well as the effect of gene-environment interactions and the timing of exposure We have reviewed the latest literature, by Ovid Medline, retrieving the most recently published systematic reviews and/or meta-analyses and more recent studies not previously included in meta-analyses or systematic reviews. EXPERT OPINION There is some good evidence supporting the impact of some environmental risk factors in increasing the risk of developing MS. Tobacco smoking, low vitamin D levels and/or low sun exposure, Epstein Barr Virus (EBV) seropositivity and a history of infectious mononucleosis may increase the risk of developing MS. Additionally, there is some evidence that gene-smoking, gene-EBV, and smoking-EBV interactions additively affect the risk of MS onset. However, the evidence for a role of other environmental factors in MS progression is limited. Finally, there is some evidence that tobacco smoking, insufficient vitamin D levels and/or sun exposure have impacts on MS phenotypes and various markers of disease activity including relapse, disability progression and MRI findings. Clearly the effect of environmental factors on MS disease course is an area that requires significantly more research.
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Affiliation(s)
- Amin Zarghami
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Ying Li
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Suzi B Claflin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Ingrid van der Mei
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Bruce V Taylor
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
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23
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Abbaszadeh S, Tabary M, Aryannejad A, Abolhasani R, Araghi F, Khaheshi I, Azimi A. Air pollution and multiple sclerosis: a comprehensive review. Neurol Sci 2021. [PMID: 34341860 DOI: 10.1007/s10072-021-05508-4.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Multiple sclerosis (MS) is an inflammatory, autoimmune demyelinating disorder of the central nervous system (CNS), leading to progressive functional impairments, and many intrinsic and acquired factors are believed to be associated with its development and relapse. In terms of environmental factors, air pollution has gained much attention during recent decades, as chronic exposure to ambient air pollution seems to increase the level of some pro-inflammatory markers in the human brain, which can lead to neuroinflammation, neurodegeneration, and blood-brain barrier (BBB) breakdown. These events may also be associated with the risk of MS development and relapse. In this review, we aimed to summarize recent findings around the impact of air pollutants, including particulate matter (PM10, PM2.5, and ultra-fine particles), gaseous pollutants (carbon monoxide [CO], nitrogen oxides [NOx], sulfur dioxide [SO2], and ozone [O3]), and heavy metals, on MS development and relapse.
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Affiliation(s)
- Sahand Abbaszadeh
- Students Research Committee, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Mohammadreza Tabary
- Experimental Medicine Research Center, Tehran University of Medical Sciences, 13145-784, Tehran, Iran.
| | - Armin Aryannejad
- Experimental Medicine Research Center, Tehran University of Medical Sciences, 13145-784, Tehran, Iran
| | | | - Farnaz Araghi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Isa Khaheshi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirreza Azimi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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24
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Abbaszadeh S, Tabary M, Aryannejad A, Abolhasani R, Araghi F, Khaheshi I, Azimi A. Air pollution and multiple sclerosis: a comprehensive review. Neurol Sci 2021; 42:4063-4072. [PMID: 34341860 DOI: 10.1007/s10072-021-05508-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/22/2021] [Indexed: 01/27/2023]
Abstract
Multiple sclerosis (MS) is an inflammatory, autoimmune demyelinating disorder of the central nervous system (CNS), leading to progressive functional impairments, and many intrinsic and acquired factors are believed to be associated with its development and relapse. In terms of environmental factors, air pollution has gained much attention during recent decades, as chronic exposure to ambient air pollution seems to increase the level of some pro-inflammatory markers in the human brain, which can lead to neuroinflammation, neurodegeneration, and blood-brain barrier (BBB) breakdown. These events may also be associated with the risk of MS development and relapse. In this review, we aimed to summarize recent findings around the impact of air pollutants, including particulate matter (PM10, PM2.5, and ultra-fine particles), gaseous pollutants (carbon monoxide [CO], nitrogen oxides [NOx], sulfur dioxide [SO2], and ozone [O3]), and heavy metals, on MS development and relapse.
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Affiliation(s)
- Sahand Abbaszadeh
- Students Research Committee, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Mohammadreza Tabary
- Experimental Medicine Research Center, Tehran University of Medical Sciences, 13145-784, Tehran, Iran.
| | - Armin Aryannejad
- Experimental Medicine Research Center, Tehran University of Medical Sciences, 13145-784, Tehran, Iran
| | | | - Farnaz Araghi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Isa Khaheshi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirreza Azimi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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25
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Seasonal variation in autoimmune encephalitis: A multi-center retrospective study. J Neuroimmunol 2021; 359:577673. [PMID: 34333343 DOI: 10.1016/j.jneuroim.2021.577673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/14/2021] [Accepted: 07/21/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The aim of this study was to examine the seasonal distribution in clinical onset of autoimmune encephalitis (AE) in a multi-center cohort in China. METHODS This retrospective study consecutively recruited patients with new-onset definite neuronal surface antibody-associated AE between January 2015 and December 2020 from 3 tertiary hospitals. Demographic and clinical characteristics of the participants were comprehensively collected. Statistical analyses were performed using R. RESULTS Of the 184 patients of AE in our database, 149 (81.0%) were included in the final analysis. The median age of onset was 40.0 years, and 66 (44.3%) patients were female. AE predominantly started in autumn (47, 31.5%) and summer (43, 28.9%) months. Summer-autumn predominance of the clinical onsets was also present in the anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis group (54, 60.0%) and anti-leucine-rich glioma inactivated 1 (LGI1) encephalitis group (20, 76.9%). No obvious seasonal variations were observed among gender, onset age, disease duration, prodromal symptoms, clinical type of initial symptoms, and disease severity by the time of admission. CONCLUSION This study suggested summer-autumn predominance of the clinical onsets in patients with AE, especially anti-NMDAR and anti-LGI1 encephalitis. Therefore, clinicians should have a high index of suspicion for AE in encephalopathy patients in summer and autumn period.
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26
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Echevarría-Lucas L, Senciales-González JM, Medialdea-Hurtado ME, Rodrigo-Comino J. Impact of Climate Change on Eye Diseases and Associated Economical Costs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7197. [PMID: 34281132 PMCID: PMC8297364 DOI: 10.3390/ijerph18137197] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/25/2021] [Accepted: 07/02/2021] [Indexed: 01/22/2023]
Abstract
Climate change generates negative impacts on human health. However, little is known about specific impacts on eye diseases, especially in arid and semi-arid areas where increases in air temperatures are expected. Therefore, the main goals of this research are: (i) to highlight the association between common eye diseases and environmental factors; and (ii) to analyze, through the available literature, the health expenditure involved in combating these diseases and the savings from mitigating the environmental factors that aggravate them. Mixed methods were used to assess the cross-variables (environmental factors, eye diseases, health costs). Considering Southern Spain as an example, our results showed that areas with similar climatic conditions could increase eye diseases due to a sustained increase in temperatures and torrential rains, among other factors. We highlight that an increase in eye diseases in Southern Spain is conditioned by the effects of climate change by up to 36.5%; the economic burden of the main eye diseases, extrapolated to the rest of the country, would represent an annual burden of 0.7% of Spain's Gross Domestic Product. In conclusion, the increase in eye diseases has a strong economic and social impact that could be reduced with proper management of the effects of climate change. We propose a new concept: disease sink, defined as any climate change mitigation action which reduces the incidence or morbidity of disease.
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Affiliation(s)
- Lucía Echevarría-Lucas
- Ophthalmology Service of Axarquía Hospital, 29700 Vélez-Málaga, Spain; (L.E.-L.); (M.E.M.-H.)
| | | | | | - Jesús Rodrigo-Comino
- Department of Regional Geographical Analysis and Physical Geography, University of Granada, 18010 Granada, Spain
- Department of Physical Geography, University of Trier, 54296 Trier, Germany
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27
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Zhang Z, Yao M, Wu W, Zhao X, Zhang J. Spatiotemporal assessment of health burden and economic losses attributable to short-term exposure to ground-level ozone during 2015-2018 in China. BMC Public Health 2021; 21:1069. [PMID: 34090376 PMCID: PMC8178864 DOI: 10.1186/s12889-021-10751-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 04/05/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Ground-level ozone (O3) pollution is currently the one of the severe environmental problems in China. Although existing studies have quantified the O3-related health impact and economic loss, few have focused on the acute health effects of short-term exposure to O3 and have been limited to a single temporal and spatial dimension. METHODS Based on the O3 concentration obtained from ground monitoring networks in 334 Chinese cities in 2015-2018, this study used a two-stage exposure parameter weighted Log-linear exposure-response function to estimate the cause-specific mortality for short-term exposure to O3. RESULTS The value of statistical life (VSL) method that were used to calculate the economic loss at the city-level. Our results show that in China, the national all-cause mortality attributed to O3 was 0.27(95% CI: 0.14-0.55) to 0.39 (95% CI: 0.20-0.67) million across 2015-2018. The estimated economic loss caused by O3 was 387.76 (95% CI: 195.99-904.50) to 594.08 (95% CI: 303.34-1140.65) billion CNY, accounting for 0.52 to 0.69% of total reported GDP. Overall, the O3 attributed health and economic burden has begun to decline in China since 2017. However, highly polluted areas still face severe burden, and undeveloped areas suffer from high GDP losses. CONCLUSIONS There are substantial health impacts and economic losses related to short-term O3 exposure in China. The government should pay attention to the emerging ozone pollution, and continue to strengthen the intervention in traditional priority areas while solving the pollution problem in non-priority areas.
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Affiliation(s)
- Zihan Zhang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16 Section 3, Renmin South Road, Chengdu, 610044, China
| | - Minghong Yao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16 Section 3, Renmin South Road, Chengdu, 610044, China
| | - Wenjing Wu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16 Section 3, Renmin South Road, Chengdu, 610044, China
| | - Xing Zhao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16 Section 3, Renmin South Road, Chengdu, 610044, China.
| | - Juying Zhang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16 Section 3, Renmin South Road, Chengdu, 610044, China.
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28
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Januel E, Dessimond B, Colette A, Annesi-Maesano I, Stankoff B. Fine Particulate Matter Related to Multiple Sclerosis Relapse in Young Patients. Front Neurol 2021; 12:651084. [PMID: 34093398 PMCID: PMC8176031 DOI: 10.3389/fneur.2021.651084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/13/2021] [Indexed: 12/25/2022] Open
Abstract
Objective: Particulate matter (PM) of aerodynamic diameter smaller than 10 μm (PM10) has been associated with multiple sclerosis (MS) relapse. However, the impact of smaller PM with a greater ability to penetrate human organism has never been assessed. We evaluated the impact of PM smaller than 2.5 μm (PM2.5) on the risk of MS relapse. Material and Methods: In a case-crossover study, we included 2,109 consecutive hospitalizations likely due to MS relapse in day hospital in 5 MS centers in the Paris area from January 2009 to December 2013. For each hospitalization, the natural logarithm of the average weekly PM2.5 concentrations (μg/m3) at the patient's residence address during each of the 6 weeks (week[0] to week[−5]) preceding admission was compared with the concentration during the previous week, using a conditional logistic regression adjusted on temperature, flu-like syndrome rate, pollen count, and holiday period. Results: PM2.5 average concentration during week[−3] was significantly associated with the risk of hospitalization for MS relapse [OR = 1.21 (CI 1.01;1.46)]. The association was stronger in patients younger than 30 years [OR=1.77 (CI 1.10; 2.83)]. Conclusion: Our study demonstrates an association between exposure to PM2.5 and MS relapse, particularly in young people.
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Affiliation(s)
- Edouard Januel
- Assistance Publique des Hôpitaux de Paris, APHP, Hôpital Saint Antoine, Neurology Department, Paris, France
| | - Boris Dessimond
- Sorbonne Université and INSERM, Épidémiologie des maladies Allergiques et Respiratoires, Institut Pierre Louis d'Epidémiologie et Santé Publique, Paris, France
| | - Augustin Colette
- Atmospheric Modelling and Environmental Mapping Unit, INERIS, BP2, Verneuil-en-Halatte, France
| | - Isabella Annesi-Maesano
- Sorbonne Université and INSERM, Épidémiologie des maladies Allergiques et Respiratoires, Institut Pierre Louis d'Epidémiologie et Santé Publique, Paris, France
| | - Bruno Stankoff
- Assistance Publique des Hôpitaux de Paris, APHP, Hôpital Saint Antoine, Neurology Department, Paris, France.,Sorbonne Universités, Brain and Spine Institute, ICM, Hôpital de la Pitié Salpêtrière, Inserm UMR-S 1127, CNRS UMR 7225, Paris, France
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29
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Noorimotlagh Z, Azizi M, Pan HF, Mami S, Mirzaee SA. Association between air pollution and Multiple Sclerosis: A systematic review. ENVIRONMENTAL RESEARCH 2021; 196:110386. [PMID: 33129851 DOI: 10.1016/j.envres.2020.110386] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/18/2020] [Accepted: 10/22/2020] [Indexed: 06/11/2023]
Abstract
Air pollution is a major public health threat. The present study is the first systematic review (SR) to determine the association of exposure to air pollution and Multiple Sclerosis (MS) Progression. A Literature search was carried out using relevant keywords within several international databases. A comprehensive literature search was carried out systematically and yielded 24 eligible studies concerning the relationship of exposure to air pollution including criteria air pollutants such as particulate matter, NOx and SOx, CO2, traffic noise, etc. and MS disease. The results of the included studies reveal that there was a significant relationship between exposure to air pollution and MS development and progression. Although the effect of air pollution in the pathogenesis of MS is notfully known, according to the results of the included studies exposure to polluted air can stimulate several mechanisms that act as risk factors for developing MS and for having disease relapses or neurological disability. The major potential mechanism is Dysimmune inflammatory responses subsequent oxidative stress (OS), which leads to neuroinflammation and breakdown of the normal balance between immunity and self-tolerance. Air pollutants induce and sustain chemical reactions that produce reactive oxygen species (ROSs) and nitrogen reactive species (RNSs) which can initiate inflammatory cascades via the redox-sensitive mitogen-activated protein kinase (MAPK) and NF-κB that recruit and activate neutrophils, monocytes, and dendritic cells that stimulate the adaptive immune responses such as Th1 and Th17 inflammatory responses. The uncontrolled inflammatory responses following these events cause cell death and the release of self-antigens capable of stimulating the production of auto-aggressive T-cells via enhancing antigen presentation and facilitate entry of these cells to the central nervous system. Thus, oxidative stress is the culprit in the systemic inflammation and immune imbalance development and progression, powerful risk factors in MS.
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Affiliation(s)
- Zahra Noorimotlagh
- Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran; Department of Environmental Health Engineering, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Mahdieh Azizi
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Sanaz Mami
- Department of Immunology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
| | - Seyyed Abbas Mirzaee
- Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran; Department of Environmental Health Engineering, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran.
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30
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Kazemi Moghadam V, Dickerson AS, Shahedi F, Bazrafshan E, Seyedhasani SN, Sarmadi M. Association of the global distribution of multiple sclerosis with ultraviolet radiation and air pollution: an ecological study based on GBD data. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:17802-17811. [PMID: 33403633 DOI: 10.1007/s11356-020-11761-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/18/2020] [Indexed: 06/12/2023]
Abstract
Given the growing global trend of multiple sclerosis (MS), this study was designed to evaluate environmental determinates of the worldwide distribution of MS in the presence of socioeconomic and geographic indices. MS data was obtained from the Institute for Health Metrics and Evaluation website. The air pollution parameters, including particles with aerodynamic diameter less than 2.5 μm (PM2.5), tropospheric ozone, and solid fuel use, were acquired from global burden of disease resources and the World Health Organization. Ultraviolet index (UVI) values were obtained from the Tropospheric Emission Monitoring Internet Service website. Correlation and linear regression analyses were used to investigate the relationship between air pollution and environmental parameters with MS variables. The average prevalence and incidence rates in countries with high UVI were 5.17 and 0.25 per 100,000, respectively, and in countries with low UVI were 101.37 and 0.78, respectively. The results showed negative associations between prevalence, incidence and mortality of MS with ozone concentrations (β = - 1.04, - 0.04, and - 0.01 respectively; P < 0.01). Also, the fully adjusted model showed significant negative correlation of UVI with the MS variables in the presence of other variables (P < 0.01). Our findings demonstrated that UVI had the strongest significant inverse association with MS distribution. Consequently, vitamin D intake may be a major contributor to MS development. However, this study showed a slight influence of air pollution on the prevalence of MS in the presence of other parameters. Given the inconsistent results of previous studies, further studies may be required.
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Affiliation(s)
- Vahid Kazemi Moghadam
- Department of Environmental Health Engineering, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Aisha S Dickerson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Fateme Shahedi
- Department of Radiology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
- Neuroscience Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Edris Bazrafshan
- Department of Environmental Health Engineering, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Seyedeh Nahid Seyedhasani
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
- Department of Health Information Technology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Mohammad Sarmadi
- Neuroscience Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
- Department of Environmental Health Engineering, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
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31
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Parolisi R, Montarolo F, Pini A, Rovelli S, Cattaneo A, Bertolotto A, Buffo A, Bollati V, Boda E. Exposure to fine particulate matter (PM 2.5) hampers myelin repair in a mouse model of white matter demyelination. Neurochem Int 2021; 145:104991. [PMID: 33587955 DOI: 10.1016/j.neuint.2021.104991] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/05/2021] [Accepted: 02/10/2021] [Indexed: 12/31/2022]
Abstract
Epidemiological studies show a strong association between exposure to air pollution - and particularly to particulate matter (PM) -, increased prevalence of Multiple Sclerosis (MS) and higher rates of hospital admissions for MS and MS relapses. Besides having immunomodulatory effects and sustaining a systemic oxidative-inflammatory response, PM may participate in MS pathogenesis by targeting also Central Nervous System (CNS)-specific processes, such as myelin repair. Here we show that, in a mouse model of lysolecithin-induced demyelination of the subcortical white matter, post-injury exposure to fine PM hampers remyelination, disturbs oligodendroglia differentiation dynamics and promotes astroglia and microglia reactivity. These findings support the view that exposure to fine PM can contribute to demyelinating pathologies by targeting the endogenous regenerative capability of the CNS tissue.
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Affiliation(s)
- Roberta Parolisi
- Department of Neuroscience Rita Levi-Montalcini, University of Turin, Italy; Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Turin, Regione Gonzole, 10, 10043, Orbassano (Turin), Italy
| | - Francesca Montarolo
- Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Turin, Regione Gonzole, 10, 10043, Orbassano (Turin), Italy; Neurobiology Unit, Neurology-CReSM (Regional Referring Center of Multiple Sclerosis), AOU San Luigi Gonzaga, Regione Gonzole 10, 10043, Orbassano, Italy; Department of Molecular Biotechnology and Health Sciences, University of Turin, via Nizza 52, 10126, Turin, Italy
| | - Alessandro Pini
- Department of Clinical and Experimental Medicine, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
| | - Sabrina Rovelli
- Department of Science and High Technology, University of Insubria, 22100, Como, Italy
| | - Andrea Cattaneo
- Department of Science and High Technology, University of Insubria, 22100, Como, Italy
| | - Antonio Bertolotto
- Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Turin, Regione Gonzole, 10, 10043, Orbassano (Turin), Italy; Neurobiology Unit, Neurology-CReSM (Regional Referring Center of Multiple Sclerosis), AOU San Luigi Gonzaga, Regione Gonzole 10, 10043, Orbassano, Italy
| | - Annalisa Buffo
- Department of Neuroscience Rita Levi-Montalcini, University of Turin, Italy; Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Turin, Regione Gonzole, 10, 10043, Orbassano (Turin), Italy
| | - Valentina Bollati
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Enrica Boda
- Department of Neuroscience Rita Levi-Montalcini, University of Turin, Italy; Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Turin, Regione Gonzole, 10, 10043, Orbassano (Turin), Italy.
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32
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Bergamaschi R, Monti MC, Trivelli L, Mallucci G, Gerosa L, Pisoni E, Montomoli C. PM 2.5 exposure as a risk factor for multiple sclerosis. An ecological study with a Bayesian mapping approach. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:2804-2809. [PMID: 32894443 PMCID: PMC7788018 DOI: 10.1007/s11356-020-10595-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/23/2020] [Indexed: 06/11/2023]
Abstract
Some environmental factors are associated with an increased risk of multiple sclerosis (MS). Air pollution could be a main one. This study was conducted to investigate the association of particulate matter 2.5 (PM2.5) concentrations with MS prevalence in the province of Pavia, Italy. The overall MS prevalence in the province of Pavia is 169.4 per 100,000 inhabitants. Spatial ground-level PM2.5 gridded data were analysed, by municipality, for the period 2010-2016. Municipalities were grouped by tertiles according to PM2.5 concentration. Ecological regression and Bayesian statistics were used to analyse the association between PM2.5 concentrations, degree of urbanization, deprivation index and MS risk. MS risk was higher among persons living in areas with an average winter PM2.5 concentration above the European annual limit value (25 μg/m3). The Bayesian map revealed sizeable MS high-risk clusters. The study found a relationship between low MS risk and lower PM2.5 levels, strengthening the suggestion that air pollution may be one of the environmental risk factors for MS.
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Affiliation(s)
- Roberto Bergamaschi
- Multiple Sclerosis Centre, IRCCS Mondino Foundation, via Mondino 2, 27100, Pavia, Italy
| | - Maria Cristina Monti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Leonardo Trivelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Giulia Mallucci
- Multiple Sclerosis Centre, IRCCS Mondino Foundation, via Mondino 2, 27100, Pavia, Italy.
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.
| | - Leonardo Gerosa
- Multiple Sclerosis Centre, IRCCS Mondino Foundation, via Mondino 2, 27100, Pavia, Italy
| | - Enrico Pisoni
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Cristina Montomoli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
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33
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Sommer AJ, Leray E, Lee Y, Bind MAC. Assessing environmental epidemiology questions in practice with a causal inference pipeline: An investigation of the air pollution-multiple sclerosis relapses relationship. Stat Med 2020; 40:1321-1335. [PMID: 33327039 DOI: 10.1002/sim.8843] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/13/2020] [Accepted: 11/19/2020] [Indexed: 11/06/2022]
Abstract
When addressing environmental health-related questions, most often, only observational data are collected for ethical or practical reasons. However, the lack of randomized exposure often prevents the comparison of similar groups of exposed and unexposed units. This design barrier leads the environmental epidemiology field to mainly estimate associations between environmental exposures and health outcomes. A recently developed causal inference pipeline was developed to guide researchers interested in estimating the effects of plausible hypothetical interventions for policy recommendations. This article illustrates how this multistaged pipeline can help environmental epidemiologists reconstruct and analyze hypothetical randomized experiments by investigating whether an air pollution reduction intervention decreases the risk of multiple sclerosis relapses in Alsace region, France. The epidemiology literature reports conflicted findings on the relationship between air pollution and multiple sclerosis. Some studies found significant associations, whereas others did not. Two case-crossover studies reported significant associations between the risk of multiple sclerosis relapses and the exposure to air pollutants in the Alsace region. We use the same study population as these epidemiological studies to illustrate how appealing this causal inference approach is to estimate the effects of hypothetical, but plausible, environmental interventions.
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Affiliation(s)
- Alice J Sommer
- Department of Statistics, Harvard University, Cambridge, Massachusetts.,Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig-Maximilians-University München, Munich, Germany.,Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany.,Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH)
| | - Emmanuelle Leray
- University of Rennes, EHESP French School of Public Health, REPERES Pharmacoepidemiology and Health Services Research EA, 7449, Rennes, France
| | - Young Lee
- Department of Statistics, Harvard University, Cambridge, Massachusetts
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Cortese A, Lova L, Comoli P, Volpe E, Villa S, Mallucci G, La Salvia S, Romani A, Franciotta D, Bollati V, Basso S, Guido I, Quartuccio G, Battistini L, Cereda C, Bergamaschi R. Air pollution as a contributor to the inflammatory activity of multiple sclerosis. J Neuroinflammation 2020; 17:334. [PMID: 33158438 PMCID: PMC7645903 DOI: 10.1186/s12974-020-01977-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 10/01/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Air pollution has been recently identified as a risk factor for multiple sclerosis. Aim of this study was to investigate the immunological mechanism underlying the clinical association between air pollution, namely exposure to particulate matter 10 (PM10), and inflammatory activity of multiple sclerosis (MS) METHODS: Daily recording of PM10 was obtained by monitors depending on the residence of subjects. Expression of molecules involved in activation, adhesion, and migration of T lymphocytes were tested by flow cytometry in 57 MS patients and 19 healthy controls. We next assessed in vitro the effect of PM10 on expression of C-C chemokine receptors 6 (CCR6) by peripheral blood mononuclear cells (PBMCs), on cytokine production by monocyte-derived dendritic cells (mdDC), and on T cell polarization in PBMC/mdDC mixed cultures. RESULTS We identified a significant correlation between mean PM10 levels and expression of CCR6 CD4+ T circulating cells in MS patients. This was paralleled by the observation in vitro of a higher level of CCR6 expression on PBMC following treatment with increased doses of particulate matter. Moreover, in mdDC cultures, particulate matter induced the secretion by mdDC of Th17 polarizing IL1 beta, IL6, and IL23 and, in mdDC/PBMC mixed cultures, enhanced generation of IL17-producing T cells. CONCLUSIONS Ex vivo and in vitro studies support the pro-inflammatory role of PM in MS, by upregulating expression of CCR6 on circulating CD4+ T cells and inducing in innate immune cells the production of Th17 polarizing cytokines. Therefore, we speculate that in MS respiratory exposure to PM10 may induce the production in the lung of autoreactive Th17 lymphocytes and boost their migratory properties through the blood-brain barrier.
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Affiliation(s)
- Andrea Cortese
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy. .,Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, Queen Square, London, UK.
| | | | | | | | | | - Giulia Mallucci
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy. .,IRCCS Mondino Foundation, Pavia, Italy.
| | | | | | | | | | - Sabrina Basso
- IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
| | - Ilaria Guido
- IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
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35
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Air Pollution-Related Brain Metal Dyshomeostasis as a Potential Risk Factor for Neurodevelopmental Disorders and Neurodegenerative Diseases. ATMOSPHERE 2020. [DOI: 10.3390/atmos11101098] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Increasing evidence links air pollution (AP) exposure to effects on the central nervous system structure and function. Particulate matter AP, especially the ultrafine (nanoparticle) components, can carry numerous metal and trace element contaminants that can reach the brain in utero and after birth. Excess brain exposure to either essential or non-essential elements can result in brain dyshomeostasis, which has been implicated in both neurodevelopmental disorders (NDDs; autism spectrum disorder, schizophrenia, and attention deficit hyperactivity disorder) and neurodegenerative diseases (NDGDs; Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, and amyotrophic lateral sclerosis). This review summarizes the current understanding of the extent to which the inhalational or intranasal instillation of metals reproduces in vivo the shared features of NDDs and NDGDs, including enlarged lateral ventricles, alterations in myelination, glutamatergic dysfunction, neuronal cell death, inflammation, microglial activation, oxidative stress, mitochondrial dysfunction, altered social behaviors, cognitive dysfunction, and impulsivity. Although evidence is limited to date, neuronal cell death, oxidative stress, and mitochondrial dysfunction are reproduced by numerous metals. Understanding the specific contribution of metals/trace elements to this neurotoxicity can guide the development of more realistic animal exposure models of human AP exposure and consequently lead to a more meaningful approach to mechanistic studies, potential intervention strategies, and regulatory requirements.
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36
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Seasonal variation in relapse of neuromyelitis optica spectrum disorders: A retrospective study in China. J Neuroimmunol 2020; 347:577351. [DOI: 10.1016/j.jneuroim.2020.577351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/10/2020] [Accepted: 07/27/2020] [Indexed: 02/01/2023]
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Affiliation(s)
- Mattia Rosso
- Ann Romney Center for Neurologic Disease, Harvard Medical School, Boston, Massachusetts
| | - Tanuja Chitnis
- Ann Romney Center for Neurologic Disease, Harvard Medical School, Boston, Massachusetts
- Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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38
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Identifying the culprits in neurological autoimmune diseases. J Transl Autoimmun 2019; 2:100015. [PMID: 32743503 PMCID: PMC7388404 DOI: 10.1016/j.jtauto.2019.100015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/27/2019] [Accepted: 09/03/2019] [Indexed: 12/16/2022] Open
Abstract
The target organ of neurological autoimmune diseases (NADs) is the central or peripheral nervous system. Multiple sclerosis (MS) is the most common NAD, whereas Guillain-Barré syndrome (GBS), myasthenia gravis (MG), and neuromyelitis optica (NMO) are less common NADs, but the incidence of these diseases has increased exponentially in the last few years. The identification of a specific culprit in NADs is challenging since a myriad of triggering factors interplay with each other to cause an autoimmune response. Among the factors that have been associated with NADs are genetic susceptibility, epigenetic mechanisms, and environmental factors such as infection, microbiota, vitamins, etc. This review focuses on the most studied culprits as well as the mechanisms used by these to trigger NADs. Neurological autoimmune diseases are caused by a complex interaction between genes, environmental factors, and epigenetic deregulation. Infectious agents can cause an autoimmune reaction to myelin epitopes through molecular mimicry and/or bystander activation. Gut microbiota dysbiosis contributes to neurological autoimmune diseases. Smoking increases the risk of NADs through inflammatory signaling pathways, oxidative stress, and Th17 differentiation. Deficiency in vitamin D favors NAD development through direct damage to the central and peripheral nervous system.
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39
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Waubant E, Lucas R, Mowry E, Graves J, Olsson T, Alfredsson L, Langer‐Gould A. Environmental and genetic risk factors for MS: an integrated review. Ann Clin Transl Neurol 2019; 6:1905-1922. [PMID: 31392849 PMCID: PMC6764632 DOI: 10.1002/acn3.50862] [Citation(s) in RCA: 151] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 12/11/2022] Open
Abstract
Recent findings have provided a molecular basis for the combined contributions of multifaceted risk factors for the onset of multiple sclerosis (MS). MS appears to start as a chronic dysregulation of immune homeostasis resulting from complex interactions between genetic predispositions, infectious exposures, and factors that lead to pro-inflammatory states, including smoking, obesity, and low sun exposure. This is supported by the discovery of gene-environment (GxE) interactions and epigenetic alterations triggered by environmental exposures in individuals with particular genetic make-ups. It is notable that several of these pro-inflammatory factors have not emerged as strong prognostic indicators. Biological processes at play during the relapsing phase of the disease may result from initial inflammatory-mediated injury, while risk factors for the later phase of MS, which is weighted toward neurodegeneration, are not yet well defined. This integrated review of current evidence guides recommendations for clinical practice and highlights research gaps.
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Affiliation(s)
| | - Robyn Lucas
- National Centre for Epidemiology and Population Health, Research School of Population HealthAustralian National UniversityCanberraAustralia
| | - Ellen Mowry
- Department of Neurology and EpidemiologyJohns Hopkins UniversityBaltimoreMaryland
| | | | - Tomas Olsson
- Department of NeurologyKarolinska Institutet, Department of Clinical NeuroscienceStockholmSweden
| | - Lars Alfredsson
- Department of EpidemiologyInstitute of Environmental Medicine, Karolinska InstitutetStockholmSweden
| | - Annette Langer‐Gould
- Clinical & Translational NeuroscienceKaiser Permanente/Southern California Permanente Medical GroupLos AngelesCalifornia
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40
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Corona-Vázquez T, Flores Rivera JDJ, RodríguezViolante M, Cervantes-Arriaga A. Air Pollution, Multiple Sclerosis and its Relevance to Mexico City. Arch Med Res 2019; 50:111-112. [PMID: 31495387 DOI: 10.1016/j.arcmed.2019.07.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/19/2019] [Accepted: 07/15/2019] [Indexed: 11/30/2022]
Abstract
Long-term exposure to air pollution has been linked with the development of neurodegenerative diseases. The proposed mechanisms include neuroinflammation and brain oxidative stress. Multiple sclerosis (MS) is a neurodegenerative disease with an auto-immune physiopathology and some studies have associated it with long-term exposure to airborne particulate matter. In this opinion we discuss the current body of knowledge regarding air pollution and the risk of MS as well as MS relapses. Also, its relevance in the case of Mexico City is discussed.
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Affiliation(s)
- Teresa Corona-Vázquez
- Instituto Nacional de Neurología y Neurocirugía, Unidad Clínica de Investigación en Enfermedades Neurodegenerativas, Ciudad de México, Mexico
| | - Jose De Jesus Flores Rivera
- Instituto Nacional de Neurología y Neurocirugía, Unidad Clínica de Investigación en Enfermedades Neurodegenerativas, Ciudad de México, Mexico
| | - Mayela RodríguezViolante
- Instituto Nacional de Neurología y Neurocirugía, Unidad Clínica de Investigación en Enfermedades Neurodegenerativas, Ciudad de México, Mexico
| | - Amin Cervantes-Arriaga
- Instituto Nacional de Neurología y Neurocirugía, Unidad Clínica de Investigación en Enfermedades Neurodegenerativas, Ciudad de México, Mexico.
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41
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Emerging role of air pollution in autoimmune diseases. Autoimmun Rev 2019; 18:607-614. [PMID: 30959217 DOI: 10.1016/j.autrev.2018.12.010] [Citation(s) in RCA: 171] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 12/23/2018] [Indexed: 02/07/2023]
Abstract
Autoimmune diseases (ADs) are a broad spectrum of disorders featured by the body's immune responses being directed against its own tissues, resulting in prolonged inflammation and subsequent tissue damage. Recently, the exposure to ambient air pollution has been implicated in the occurrence and development of ADs. Mechanisms linking air pollution exposures and ADs mainly include systemic inflammation, increased oxidative stress, epigenetic modifications induced by exposures and immune response caused by airway damage. The lung may be an autoimmunity initiation site in autoimmune diseases (ADs). Air pollutants can bind to the Aryl hydrocarbon receptor (AHR) to regulate Th17 and Treg cells. Oxidative stress and inducible bronchus associated lymphoid tissue caused by the pollutants can influence T, B cells, resulting in the production of proinflammatory cytokines. These cytokines stimulate B cell and dendritic cells, resulting in a lot of antibodies and self-reactive T lymphocytes. Moreover, air pollutants may induce epigenetic changes to contribute to ADs. In this review, we will concern the associations between air pollution and immune-inflammatory responses, as well as mechanisms linking air pollution exposure and autoimmunity. In addition, we focus on the potential roles of air pollution in major autoimmune diseases including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), multiple sclerosis (MS), and type 1 diabetes mellitus (T1DM).
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42
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O'Driscoll CA, Mezrich JD. The Aryl Hydrocarbon Receptor as an Immune-Modulator of Atmospheric Particulate Matter-Mediated Autoimmunity. Front Immunol 2018; 9:2833. [PMID: 30574142 PMCID: PMC6291477 DOI: 10.3389/fimmu.2018.02833] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 11/16/2018] [Indexed: 12/22/2022] Open
Abstract
This review examines the current literature on the effects of atmospheric particulate matter (PM) on autoimmune disease and proposes a new role for the aryl hydrocarbon receptor (AHR) as a modulator of T cells in PM-mediated autoimmune disease. There is a significant body of literature regarding the strong epidemiologic correlations between PM exposures and worsened autoimmune diseases. Genetic predispositions account for 30% of all autoimmune disease leaving environmental factors as major contributors. Increases in incidence and prevalence of autoimmune disease have occurred concurrently with an increase in air pollution. Currently, atmospheric PM is considered to be the greatest environmental health risk worldwide. Atmospheric PM is a complex heterogeneous mixture composed of diverse adsorbed organic compounds such as polycyclic aromatic hydrocarbons (PAHs) and dioxins, among others. Exposure to atmospheric PM has been shown to aggravate several autoimmune diseases. Despite strong correlations between exposure to atmospheric PM and worsened autoimmune disease, the mechanisms underlying aggravated disease are largely unknown. The AHR is a ligand activated transcription factor that responds to endogenous and exogenous ligands including toxicants present in PM, such as PAHs and dioxins. A few studies have investigated the effects of atmospheric PM on AHR activation and immune function and demonstrated that atmospheric PM can activate the AHR, change cytokine expression, and alter T cell differentiation. Several studies have found that the AHR modulates the balance between regulatory and effector T cell functions and drives T cell differentiation in vitro and in vivo using murine models of autoimmune disease. However, there are very few studies on the role of AHR in PM-mediated autoimmune disease. The AHR plays a critical role in the balance of effector and regulatory T cells and in autoimmune disease. With increased incidence and prevalence of autoimmune disease occurring concurrently with increases in air pollution, potential mechanisms that drive inflammatory and exacerbated disease need to be elucidated. This review focuses on the AHR as a potential mechanistic target for modulating T cell responses associated with PM-mediated autoimmune disease providing the most up-to-date literature on the role of AHR in autoreactive T cell function and autoimmune disease.
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Affiliation(s)
- Chelsea A O'Driscoll
- Division of Transplantation, Department of Surgery, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States.,Molecular and Environmental Toxicology Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Joshua D Mezrich
- Division of Transplantation, Department of Surgery, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
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Bai L, Burnett RT, Kwong JC, Hystad P, van Donkelaar A, Brook JR, Tu K, Copes R, Goldberg MS, Martin RV, Murray BJ, Kopp A, Chen H. Long-term exposure to air pollution and the incidence of multiple sclerosis: A population-based cohort study. ENVIRONMENTAL RESEARCH 2018; 166:437-443. [PMID: 29940476 DOI: 10.1016/j.envres.2018.06.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 05/22/2018] [Accepted: 06/01/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Evidence of the adverse neurological effects of exposure to ambient air pollution is emerging, but little is known about its effect on the development of multiple sclerosis (MS), the most common autoimmune disease of the central nervous system. OBJECTIVES To investigate the associations between MS incidence and long-term exposures to fine particles (PM2.5), nitrogen dioxide (NO2), and ozone (O3) METHODS: We conducted a population-based cohort study to investigate the associations between long-term exposures to PM2.5, NO2, and O3 and the incidence of MS. Our study population included all Canadian-born residents aged 20-40 years who lived in the province of Ontario, Canada from 2001 to 2013. Incident MS was ascertained from a validated registry. We assigned estimates of annual concentrations of these pollutants to the residential postal codes of subjects for each year during the 13 years of follow-up. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for each pollutant separately using random-effects Cox proportional hazards models. We conducted various sensitivity analyses, such as lagging exposure up to 5 years and adjusting for access to neurological care, annual average temperature, and population density. RESULTS Between 2001 and 2013, we identified 6203 incident cases of MS. The adjusted HR of incident MS was 0.96 (95% CI: 0.86-1.07) for PM2.5, 0.91(95% CI: 0.81-1.02) for NO2, and 1.09 (95% CI: 0.98-1.23) for O3. These results were robust to various sensitivity analyses conducted. CONCLUSIONS In this large population-based cohort, we did not observe significant associations between MS incidence and long-term exposures to PM2.5, NO2, and O3 in adults in Ontario, 2001-2013.
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Affiliation(s)
- Li Bai
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | | | - Jeffrey C Kwong
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Public Health Ontario, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis, USA
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, Canada
| | - Jeffrey R Brook
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Air Quality Research Division, Environment and Climate Change Canada, Toronto, ON, Canada
| | - Karen Tu
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Toronto Western Hospital Family Health Team, University Health Network, Canada
| | - Ray Copes
- Public Health Ontario, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Mark S Goldberg
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, Canada; Harvard-Smithsonian Center for Astrophysics, Cambridge, MA, USA
| | - Brian J Murray
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Alexander Kopp
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Hong Chen
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Public Health Ontario, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
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44
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Lavery AM, Waubant E, Casper TC, Roalstad S, Candee M, Rose J, Belman A, Weinstock-Guttman B, Aaen G, Tillema JM, Rodriguez M, Ness J, Harris Y, Graves J, Krupp L, Charvet L, Benson L, Gorman M, Moodley M, Rensel M, Goyal M, Mar S, Chitnis T, Schreiner T, Lotze T, Greenberg B, Kahn I, Rubin J, Waldman AT. Urban air quality and associations with pediatric multiple sclerosis. Ann Clin Transl Neurol 2018; 5:1146-1153. [PMID: 30349849 PMCID: PMC6186930 DOI: 10.1002/acn3.616] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 05/12/2018] [Accepted: 06/01/2018] [Indexed: 01/26/2023] Open
Abstract
Background We previously identified air quality as a risk factor of interest for pediatric multiple sclerosis. The purpose of this study is to more closely examine the association between the six criteria air pollutants and pediatric MS as well as identify specific areas of toxic release using data from the Toxic Release Inventory. Methods Pediatric MS cases (N = 290) and healthy controls (N = 442) were included as part of an ongoing case-control study. We used the National Emissions Inventory system to estimate particulate exposure by county of residence for each participant. Proximity to Toxic Release Inventory (TRI) sites was also assessed using ArcGIS mapping tools. Risk-Screening Environmental Indicators (RSEI) classified counties at risk to exposure of environmental toxic releases. Results Fine particulate matter (PM 2.5), carbon monoxide (CO), sulfur dioxide (SO 2), and lead air emissions were associated with increased odds for pediatric MS (P < 0.01) for those residing within 20 miles of an MS center. Most study participants (75%) resided within 5 miles of at least one TRI site; however, the mean total pounds of stack air releases was higher for sites near MS cases (81,000 tons) compared to those near healthy controls (35,000 tons, P = 0.002). Average RSEI scores did not differ significantly between cases and controls. Conclusion Out of several air pollutants examined, we show that fine particulate matter and three other criteria pollutants (SO 2, CO, and lead) were statistically associated with higher odds for pediatric MS.
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Affiliation(s)
- Amy M Lavery
- Division of Child Neurology Children's Hospital of Philadelphia Philadelphia Pennsylvania
| | | | | | | | | | - John Rose
- University of Utah Salt Lake City Utah
| | | | | | - Greg Aaen
- Loma Linda University Children's Hospital Loma Linda California
| | | | | | - Jayne Ness
- University of Alabama Tuscaloosa Alabama
| | | | - Jennifer Graves
- University of California San Francisco San Francisco California
| | - Lauren Krupp
- New York University Medical Center New York New York
| | - Leigh Charvet
- New York University Medical Center New York New York
| | - Leslie Benson
- Boston Children's Pediatric MS Center Boston Massachusetts
| | - Mark Gorman
- Boston Children's Pediatric MS Center Boston Massachusetts
| | | | | | - Manu Goyal
- Washington University in St. Louis St. Louis Missouri
| | - Soe Mar
- Washington University in St. Louis St. Louis Missouri
| | - Tanuja Chitnis
- Brigham and Women's Hospital Harvard Medical School Boston Massachusetts
| | | | - Tim Lotze
- Texas Children's Hospital Houston Texas
| | | | - Ilana Kahn
- Children's National Medical Center Washington District of Columbia
| | | | - Amy T Waldman
- Division of Child Neurology Children's Hospital of Philadelphia Philadelphia Pennsylvania
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