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Peters S, Bouma F, Hoek G, Janssen N, Vermeulen R. Air pollution exposure and mortality from neurodegenerative diseases in the Netherlands: A population-based cohort study. ENVIRONMENTAL RESEARCH 2024; 259:119552. [PMID: 38964584 DOI: 10.1016/j.envres.2024.119552] [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: 03/07/2024] [Revised: 07/01/2024] [Accepted: 07/02/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Long-term exposure to ambient air pollution has been linked with all-cause mortality and cardiovascular and respiratory diseases. Suggestive associations between ambient air pollutants and neurodegeneration have also been reported, but due to the small effect and relatively rare outcomes evidence is yet inconclusive. Our aim was to investigate the associations between long-term air pollution exposure and mortality from neurodegenerative diseases. METHODS A Dutch national cohort of 10.8 million adults aged ≥30 years was followed from 2013 until 2019. Annual average concentrations of air pollutants (ultra-fine particles (UFP), nitrogen dioxide (NO2), fine particles (PM2.5 and PM10) and elemental carbon (EC)) were estimated at the home address at baseline, using land-use regression models. The outcome variables were mortality due to amyotrophic lateral sclerosis (ALS), Parkinson's disease, non-vascular dementia, Alzheimer's disease, and multiple sclerosis (MS). Hazard ratios (HR) were estimated using Cox models, adjusting for individual and area-level socio-economic status covariates. RESULTS We had a follow-up of 71 million person-years. The adjusted HRs for non-vascular dementia were significantly increased for NO2 (1.03; 95% confidence interval (CI) 1.02-1.05) and PM2.5 (1.02; 95%CI 1.01-1.03) per interquartile range (IQR; 6.52 and 1.47 μg/m3, respectively). The association with PM2.5 was also positive for ALS (1.02; 95%CI 0.97-1.07). These associations remained positive in sensitivity analyses and two-pollutant models. UFP was not associated with any outcome. No association with air pollution was found for Parkinson's disease and MS. Inverse associations were found for Alzheimer's disease. CONCLUSION Our findings, using a cohort of more than 10 million people, provide further support for associations between long-term exposure to air pollutants (PM2.5 and particularly NO2) and mortality of non-vascular dementia. No associations were found for Parkinson and MS and an inverse association was observed for Alzheimer's disease.
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Affiliation(s)
- Susan Peters
- Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, the Netherlands.
| | - Femke Bouma
- Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, the Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, the Netherlands
| | - Nicole Janssen
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, the Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
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2
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Kular L. The lung-brain axis in multiple sclerosis: Mechanistic insights and future directions. Brain Behav Immun Health 2024; 38:100787. [PMID: 38737964 PMCID: PMC11087231 DOI: 10.1016/j.bbih.2024.100787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/23/2024] [Accepted: 05/02/2024] [Indexed: 05/14/2024] Open
Abstract
Multiple sclerosis is a chronic inflammatory demyelinating disease of the central nervous system with progressive lifelong disability. Current treatments are particularly effective at the early inflammatory stage of the disease but associate with safety concerns such as increased risk of infection. While clinical and epidemiological evidence strongly support the role of a bidirectional communication between the lung and the brain in MS in influencing disease risk and severity, the exact processes underlying such relationship appear complex and not fully understood. This short review aims to summarize key findings and future perspectives that might provide new insights into the mechanisms underpinning the lung-brain axis in MS.
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Affiliation(s)
- Lara Kular
- Department of Clinical Neuroscience, Karolinska Institutet, Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
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3
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Schumacher SM, Doyle WJ, Hill K, Ochoa-Repáraz J. Gut microbiota in multiple sclerosis and animal models. FEBS J 2024. [PMID: 38817090 DOI: 10.1111/febs.17161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 04/15/2024] [Accepted: 05/10/2024] [Indexed: 06/01/2024]
Abstract
Multiple sclerosis (MS) is a chronic central nervous system (CNS) neurodegenerative and neuroinflammatory disease marked by a host immune reaction that targets and destroys the neuronal myelin sheath. MS and correlating animal disease models show comorbidities, including intestinal barrier disruption and alterations of the commensal microbiome. It is accepted that diet plays a crucial role in shaping the microbiota composition and overall gastrointestinal (GI) tract health, suggesting an interplay between nutrition and neuroinflammation via the gut-brain axis. Unfortunately, poor host health and diet lead to microbiota modifications that could lead to significant responses in the host, including inflammation and neurobehavioral changes. Beneficial microbial metabolites are essential for host homeostasis and inflammation control. This review will highlight the importance of the gut microbiota in the context of host inflammatory responses in MS and MS animal models. Additionally, microbial community restoration and how it affects MS and GI barrier integrity will be discussed.
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Affiliation(s)
| | - William J Doyle
- Department of Biological Sciences, Boise State University, ID, USA
| | - Kristina Hill
- Department of Biological Sciences, Boise State University, ID, USA
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4
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López-Granero C, Polyanskaya L, Ruiz-Sobremazas D, Barrasa A, Aschner M, Alique M. Particulate Matter in Human Elderly: Higher Susceptibility to Cognitive Decline and Age-Related Diseases. Biomolecules 2023; 14:35. [PMID: 38254635 PMCID: PMC10813119 DOI: 10.3390/biom14010035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
This review highlights the significant impact of air quality, specifically particulate matter (PM), on cognitive decline and age-related diseases in the elderly. Despite established links to other pathologies, such as respiratory and cardiovascular illnesses, there is a pressing need for increased attention to the association between air pollution and cognitive aging, given the rising prevalence of neurocognitive disorders. PM sources are from diverse origins, including industrial activities and combustion engines, categorized into PM10, PM2.5, and ultrafine PM (UFPM), and emphasized health risks from both outdoor and indoor exposure. Long-term PM exposure, notably PM2.5, has correlated with declines in cognitive function, with a specific vulnerability observed in women. Recently, extracellular vesicles (EVs) have been explored due to the interplay between them, PM exposure, and human aging, highlighting the crucial role of EVs, especially exosomes, in mediating the complex relationship between PM exposure and chronic diseases, particularly neurological disorders. To sum up, we have compiled the pieces of evidence that show the potential contribution of PM exposure to cognitive aging and the role of EVs in mediating PM-induced cognitive impairment, which presents a promising avenue for future research and development of therapeutic strategies. Finally, this review emphasizes the need for policy changes and increased public awareness to mitigate air pollution, especially among vulnerable populations such as the elderly.
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Affiliation(s)
- Caridad López-Granero
- Department of Psychology and Sociology, University of Zaragoza, 44003 Teruel, Spain; (C.L.-G.); (D.R.-S.); (A.B.)
| | - Leona Polyanskaya
- Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal;
- Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Diego Ruiz-Sobremazas
- Department of Psychology and Sociology, University of Zaragoza, 44003 Teruel, Spain; (C.L.-G.); (D.R.-S.); (A.B.)
| | - Angel Barrasa
- Department of Psychology and Sociology, University of Zaragoza, 44003 Teruel, Spain; (C.L.-G.); (D.R.-S.); (A.B.)
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Matilde Alique
- Departamento de Biología de Sistemas, Universidad de Alcalá, Alcalá de Henares, 28871 Madrid, Spain
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
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5
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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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6
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Dinov D, Brenton JN. Environmental Influences on Risk and Disease Course in Pediatric Multiple Sclerosis. Semin Pediatr Neurol 2023; 46:101049. [PMID: 37451747 PMCID: PMC10351032 DOI: 10.1016/j.spen.2023.101049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/21/2023] [Accepted: 04/23/2023] [Indexed: 07/18/2023]
Abstract
Pediatric multiple sclerosis (MS) accounts for 3%-10% of all patients diagnosed with MS. Complex interplay between environmental factors impacts the risk for MS and may also affect disease course. Many of these environmental factors are shared with adult-onset MS. However, children with MS are in closer temporal proximity to the biological onset of MS and have less confounding environmental exposures than their adult counterparts. Environmental factors that contribute to MS risk include: geographical latitude, viral exposures, obesity, vitamin deficiencies, smoking, air pollution, perinatal factors, gut microbiome, and diet. More recently, research efforts have shifted to studying the impact of these risk determinants on the clinical course of MS. In this article we will examine relevant environmental risk determinants of pediatric MS and review the current knowledge on how these factors may contribute to pediatric MS disease evolution.
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Affiliation(s)
- Darina Dinov
- Department of Neurology, Virginia Commonwealth University, Richmond, VA
| | - James Nicholas Brenton
- Division of Child Neurology, Department of Neurology, University of Virginia, Charlottesville, VA.
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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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Hedström AK, Segersson D, Hillert J, Stridh P, Kockum I, Olsson T, Bellander T, Alfredsson L. Association between exposure to combustion-related air pollution and multiple sclerosis risk. Int J Epidemiol 2023:6984751. [PMID: 36629499 DOI: 10.1093/ije/dyac234] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Smoking and occupational pulmonary irritants contribute to multiple sclerosis (MS) development. We aimed to study the association between ambient air pollution and MS risk and potential interaction with the human leukocyte antigen (HLA)-DRB1*15:01 allele. METHODS Exposure to combustion-related air pollution was estimated as outdoor levels of nitrogen oxides (NOx) at the participants' residence locations, by spatially resolved dispersion modelling for the years 1990-18. Using two population-based case-control studies (6635 cases, 8880 controls), NOx levels were associated with MS risk by calculating odds ratios (OR) with 95% confidence intervals (CI) using logistic regression models. Interaction between high NOx levels and the HLA-DRB1*15:01 allele regarding MS risk was calculated by the attributable proportion due to interaction (AP). In addition, a register study was performed comprising all MS cases in Sweden who had received their diagnosis between 1993 and 2018 (n = 22 173), with 10 controls per case randomly selected from the National Population register. RESULTS Residential air pollution was associated with MS risk. NOx levels (3-year average) exceeding the 90th percentile (24.6 µg/m3) were associated with an OR of 1.37 (95% CI 1.10-1.76) compared with levels below the 25th percentile (5.9 µg/m3), with a trend of increasing risk of MS with increasing levels of NOx (P <0.0001). A synergistic effect was observed between high NOx levels (exceeding the lower quartile among controls) and the HLA-DRB1*15:01 allele regarding MS risk (AP 0.26, 95% CI 0.13-0.29). CONCLUSIONS Our findings indicate that moderate levels of combustion-related ambient air pollution may play a role in MS development.
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Affiliation(s)
- Anna Karin Hedström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - David Segersson
- Air Quality Research Unit, Swedish Meteorological and Hydrological Institute, Norrköping, Sweden.,Department of Environmental Science, Stockholm University, Stockholm, Sweden
| | - Jan Hillert
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Pernilla Stridh
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Kockum
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Lars Alfredsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
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9
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Khreis H, Bredell C, Wai Fung K, Hong L, Szybka M, Phillips V, Abbas A, Lim YH, Jovanovic Andersen Z, Woodcock J, Brayne C. Impact of long-term air pollution exposure on incidence of neurodegenerative diseases: A protocol for a systematic review and exposure-response meta-analysis. ENVIRONMENT INTERNATIONAL 2022; 170:107596. [PMID: 36308811 DOI: 10.1016/j.envint.2022.107596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Ambient air pollution is a pervasive and ubiquitous hazard, which has been linked to premature morbidity and a growing number of morbidity endpoints. Air pollution may be linked to neurodegeneration, and via this or other pathways, to neurodegenerative diseases. Emerging evidence suggests that air pollution may contribute to neurodegenerative diseases such as dementia, Parkinson's Disease (PD), Multiple Sclerosis (MS) and Motor Neuron Diseases (MND), although this evidence remains inconsistent and very limited for MS and MND. In addition, this evidence base is rapidly emerging and would benefit from a wide and critical synthesis, including a better understanding of heterogeneity. OBJECTIVES In this paper, we present a protocol for a systematic review and meta-analysis and specify our methods a priori. The main aim of the planned systematic review is to answer the question of whether long-term exposure (>1 year) to ambient (outdoor) air pollution (exposure, compared to lower exposure) increases the risk of adult (population) incidence of neurodegenerative diseases (outcomes) in epidemiological observational studies (study design). Another aim is to meta-analyze the associations between long-term exposure to ambient air pollutants and the risk of the selected outcomes and assess the shape of exposure-response functions. To set the stage for the proposed work, we also overview the existing epidemiological evidence in this protocol, but do not critically evaluate it, as these results will be fully presented in the planned systematic review. SEARCH AND STUDY ELIGIBILITY We will search the electronic databases Medline (via Ovid), Embase (via Ovid), Cochrane Library, Cinahl (via Ebscohost), Global Health (via Ebscohost), PsycINFO (via Ebscohost), Scopus, Web of Science (Core Collection), from inception to October 2022. Eligible studies must contain primary research investigating the link between 1-year + exposure to any outdoor air pollutant, from any source, and dementia, PD, MS, and MND, or dementia subtypes: Alzheimer's Disease, vascular dementia, and mixed dementia. The search strategy and eligibility criteria are pre-determined and described in full in this protocol. STUDY APPRAISAL AND SYNTHESIS METHODS Articles will be stored and screened using Rayyan QCRI. Title and abstract screening, full text review, data extraction, risk of bias assessment and data preparation for statistical analysis will be conducted independently by two reviewers using pre-defined forms and criteria, described in this protocol. All these steps will also be piloted and the forms and/or methods adapted if issues arise. Meta-analysis and assessment of the shape of the exposure-response functions will be conducted if four independent exposure-outcomes pairs are available, and the remainder of results will be synthesized in the forms of tables and via a narrative summary. Certainty in the body of evidence will be assessed using the OHAT approach. This protocol describes the planned analysis and synthesis a priori and serves to increase transparency and impact of this systematic review and meta-analysis.
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Affiliation(s)
- Haneen Khreis
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge CB2 0SL, United Kingdom.
| | - Christiaan Bredell
- University of Cambridge School of Clinical Medicine, Cambridge CB2 0SL, United Kingdom
| | - Kwan Wai Fung
- University of Cambridge School of Clinical Medicine, Cambridge CB2 0SL, United Kingdom
| | - Lucy Hong
- University of Cambridge School of Clinical Medicine, Cambridge CB2 0SL, United Kingdom
| | - Magdalena Szybka
- University of Cambridge School of Clinical Medicine, Cambridge CB2 0SL, United Kingdom
| | - Veronica Phillips
- University of Cambridge Medical Library, University of Cambridge School of Clinical Medicine, Hills Rd, Cambridge CB2 0SP, United Kingdom
| | - Ali Abbas
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge CB2 0SL, United Kingdom
| | - Youn-Hee Lim
- Section of Environmental and Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 15 Øster Farimagsgade 5, 1014 Copenhagen, Denmark
| | - Zorana Jovanovic Andersen
- Section of Environmental and Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 15 Øster Farimagsgade 5, 1014 Copenhagen, Denmark
| | - James Woodcock
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge CB2 0SL, United Kingdom
| | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge CB2 0SR, United Kingdom
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10
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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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11
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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 PMCID: PMC9256753 DOI: 10.1177/13524585211069926] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [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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12
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Mohammadi MJ, Zarea K, Hatamzadeh N, Salahshouri A, Sharhani A. Toxic Air Pollutants and Their Effect on Multiple Sclerosis: A Review Study. Front Public Health 2022; 10:898043. [PMID: 35875044 PMCID: PMC9299435 DOI: 10.3389/fpubh.2022.898043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Toxic air pollutants are one of the main factors that have the effect of synergism to increase the incidence of multiple sclerosis (MS). This review aims to investigate the effects of toxic air pollutants on the occurrence of multiple sclerosis (MS). A narrative review of the literature was done from 2000 to 2022 based on various databases such as Google Scholar, Web of Science, Springer, PubMed, and Science Direct. In this study, according to the databases, three hundred and sixty articles were retrieved. Of these, 28 studies were screened after review and 14 full-text articles entered into the analysis process. Finally, 9 articles were selected in this study. According to the finding of this study, toxic air pollutants including polycyclic aromatic hydrocarbons (PAHs), heavy metals (HM), volatile organic compounds (VOCs), particulate matter (PM), and gases are the main agents that cause the development and spread of chronic diseases such as respiratory and cardiovascular diseases, chronic obstructive pulmonary disease (COPD), and multiple sclerosis. The result of this study showed that the main sources of emission of toxic air pollutants include industries, cars, power plants, and the excessive consumption of fossil fuels. In general, the inhalation of high concentration of toxic air pollutants can increase the risk of chronic diseases and multiple sclerosis.
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Affiliation(s)
- Mohammad Javad Mohammadi
- Department of Environmental Health Engineering, School of Public Health and Environmental Technologies Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kourosh Zarea
- Department of Nursing, Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nasser Hatamzadeh
- Department of Health Promotion and Education, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Arash Salahshouri
- Department of Health Promotion and Education, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Asaad Sharhani
- Department of Biostatistics and Epidemiology, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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13
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Cristaldi A, Fiore M, Oliveri Conti G, Pulvirenti E, Favara C, Grasso A, Copat C, Ferrante M. Possible association between PM 2.5 and neurodegenerative diseases: A systematic review. ENVIRONMENTAL RESEARCH 2022; 208:112581. [PMID: 34979121 DOI: 10.1016/j.envres.2021.112581] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
Air pollution is one of the most serious environmental problems that afflict our planet and one of the greatest risk factors for human health. In particular, PM2.5 is able to cross the blood-alveolar and blood-brain barriers, thus increasing the onset of respiratory, cardiovascular and neurodegenerative diseases. Neurodegenerative disease is a progressive neuronal dysfunction that leads to neuronal lesions in both structure and function, and includes several diseases such as Alzheimer's disease (AD), Parkinson's disease (PD), vascular dementia (VaD), multiple sclerosis (MS), and others. We carried out a systematic review using PRISMA approach to investigate on the possible association between exposure to PM2.5 and neurodegenerative diseases. The international databases (PubMed, Science Direct, Web of Sciences) were used to find published studies on the topic. The search period was between January 2011 and June 2021. About 2000 full research articles were selected, and finally, we included 20 full-research articles. Selected studies have highlighted how PM2.5 exposure can be associated with the onset of neurodegenerative diseases (AD, PD, MS, VaD). This association depends not only on age, PM2.5 levels and exposure time, but also on exposure to other air pollutants, proximity to areas with high vehicular traffic, and the presence of comorbidities. Exposure to PM2.5 promotes neuroinflammation processes, because through breathing the particles can reach the nasal epithelial mucosa and transferred to the brain through the olfactory bulb. Furthermore, exposure to PM2.5 has been associated with an increased expression of markers of neurodegenerative diseases (e.g. alpha-synuclein or beta-amyloid), which can contribute to the etiopathogenesis of neurodegenerative diseases. Although many studies have revealed the pathological relationship between PM2.5 exposure and cognitive impairment, the potential cellular and molecular mechanisms of PM2.5 leading to neurodegenerative disease remain not entirely clear, and then, further studies need to be carried out on the topic.
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Affiliation(s)
- Antonio Cristaldi
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 87, Catania, 95123, Italy
| | - Maria Fiore
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 87, Catania, 95123, Italy
| | - Gea Oliveri Conti
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 87, Catania, 95123, Italy.
| | - Eloise Pulvirenti
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 87, Catania, 95123, Italy
| | - Claudia Favara
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 87, Catania, 95123, Italy
| | - Alfina Grasso
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 87, Catania, 95123, Italy
| | - Chiara Copat
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 87, Catania, 95123, Italy
| | - Margherita Ferrante
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 87, Catania, 95123, Italy
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14
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Adami G, Pontalti M, Cattani G, Rossini M, Viapiana O, Orsolini G, Benini C, Bertoldo E, Fracassi E, Gatti D, Fassio A. Association between long-term exposure to air pollution and immune-mediated diseases: a population-based cohort study. RMD Open 2022; 8:rmdopen-2021-002055. [PMID: 35292563 PMCID: PMC8969049 DOI: 10.1136/rmdopen-2021-002055] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/15/2022] [Indexed: 12/18/2022] Open
Abstract
Objective Environmental air pollution has been associated with disruption of the immune system at a molecular level. The primary aim of the present study was to describe the association between long-term exposure to air pollution and risk of developing immune-mediated conditions. Methods We conducted a retrospective observational study on a nationwide dataset of women and men. Diagnoses of various immune-mediated diseases (IMIDs) were retrieved. Data on the monitoring of particulate matter (PM)10 and PM2.5 concentrations were retrieved from the Italian Institute of Environmental Protection and Research. Generalised linear models were employed to determine the relationship between autoimmune diseases prevalence and PM. Results 81 363 subjects were included in the study. We found a positive association between PM10 and the risk of autoimmune diseases (ρ+0.007, p 0.014). Every 10 µg/m3 increase in PM10 concentration was associated with an incremental 7% risk of having autoimmune disease. Exposure to PM10 above 30 µg/m3 and PM2.5 above 20 µg/m3 was associated with a 12% and 13% higher risk of autoimmune disease, respectively (adjusted OR (aOR) 1.12, 95% CI 1.05 to 1.20, and aOR 1.13, 95% CI 1.06 to 1.20). Exposure to PM10 was associated with an increased risk of rheumatoid arthritis; exposure to PM2.5 was associated with an increased risk of rheumatoid arthritis, connective tissue diseases (CTDs) and inflammatory bowel diseases (IBD). Conclusion Long-term exposure to air pollution was associated with higher risk of developing autoimmune diseases, in particular rheumatoid arthritis, CTDs and IBD. Chronic exposure to levels above the threshold for human protection was associated with a 10% higher risk of developing IMIDs.
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Affiliation(s)
- Giovanni Adami
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Marco Pontalti
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Giorgio Cattani
- Italian Institute for Environmental Protection and Research, Rome, Italy
| | - Maurizio Rossini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Ombretta Viapiana
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Giovanni Orsolini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Camilla Benini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Eugenia Bertoldo
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Elena Fracassi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Davide Gatti
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Angelo Fassio
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
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15
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Balboni E, Filippini T, Crous-Bou M, Guxens M, Erickson LD, Vinceti M. The association between air pollutants and hippocampal volume from magnetic resonance imaging: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2022; 204:111976. [PMID: 34478724 DOI: 10.1016/j.envres.2021.111976] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 07/31/2021] [Accepted: 08/24/2021] [Indexed: 06/13/2023]
Abstract
Growing epidemiological evidence suggests that air pollution may increase the risk of cognitive decline and neurodegenerative disease. A hallmark of neurodegeneration and an important diagnostic biomarker is volume reduction of a key brain structure, the hippocampus. We aimed to investigate the possibility that outdoor air nitrogen dioxide (NO2) and particulate matter with diameter ≤2.5 μm (PM2.5) and ≤10 μm (PM10) adversely affect hippocampal volume, through a meta-analysis. We considered studies that assessed the relation between outdoor air pollution and hippocampal volume by structural magnetic resonance imaging in adults and children, searching in Pubmed and Scopus databases from inception through July 13, 2021. For inclusion, studies had to report the correlation coefficient along with its standard error or 95% confidence interval (CI) between air pollutant exposure and hippocampal volume, to use standard space for neuroimages, and to consider at least age, sex and intracranial volume as covariates or effect modifiers. We meta-analyzed the data with a random-effects model, considering separately adult and child populations. We retrieved four eligible studies in adults and two in children. In adults, the pooled summary β regression coefficients of the association of PM2.5, PM10 and NO2 with hippocampal volume showed respectively a stronger association (summary β -7.59, 95% CI -14.08 to -1.11), a weaker association (summary β -2.02, 95% CI -4.50 to 0.47), and no association (summary β -0.44, 95% CI -1.27 to 0.40). The two studies available for children, both carried out in preadolescents, did not show an association between PM2.5 and hippocampal volume. The inverse association between PM2.5 and hippocampal volume in adults appeared to be stronger at higher mean PM2.5 levels. Our results suggest that outdoor PM2.5 and less strongly PM10 could adversely affect hippocampal volume in adults, a phenomenon that may explain why air pollution has been related to memory loss, cognitive decline, and dementia.
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Affiliation(s)
- Erica Balboni
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN); Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Medical Physics Unit, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN); Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Marta Crous-Bou
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain; Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO) - Bellvitge Biomedical Research Institute (IDIBELL). L'Hospitalet de Llobregat, Barcelona, Spain; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Mònica Guxens
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Lance D Erickson
- Department of Sociology, Brigham Young University, Provo, UT, USA
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN); Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
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16
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Han B, Li X, Ai RS, Deng SY, Ye ZQ, Deng X, Ma W, Xiao S, Wang JZ, Wang LM, Xie C, Zhang Y, Xu Y, Zhang Y. Atmospheric particulate matter aggravates CNS demyelination through involvement of TLR-4/NF-kB signaling and microglial activation. eLife 2022; 11:72247. [PMID: 35199645 PMCID: PMC8893720 DOI: 10.7554/elife.72247] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/18/2022] [Indexed: 11/24/2022] Open
Abstract
Atmospheric Particulate Matter (PM) is one of the leading environmental risk factors for the global burden of disease. Increasing epidemiological studies demonstrated that PM plays a significant role in CNS demyelinating disorders; however, there is no direct testimony of this, and yet the molecular mechanism by which the occurrence remains unclear. Using multiple in vivo and in vitro strategies, in the present study we demonstrate that PM exposure aggravates neuroinflammation, myelin injury, and dysfunction of movement coordination ability via boosting microglial pro-inflammatory activities, in both the pathological demyelination and physiological myelinogenesis animal models. Indeed, pharmacological disturbance combined with RNA-seq and ChIP-seq suggests that TLR-4/NF-kB signaling mediated a core network of genes that control PM-triggered microglia pathogenicity. In summary, our study defines a novel atmospheric environmental mechanism that mediates PM-aggravated microglia pathogenic activities, and establishes a systematic approach for the investigation of the effects of environmental exposure in neurologic disorders.
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Affiliation(s)
- Bing Han
- Shaanxi Normal University, Xi'an, China
| | - Xing Li
- Shaanxi Normal University, Xi'an, China
| | | | | | | | - Xin Deng
- Shaanxi Normal University, Xi'an, China
| | - Wen Ma
- Shaanxi Normal University, Xi'an, China
| | - Shun Xiao
- Shaanxi Normal University, Xi'an, China
| | | | - Li-Mei Wang
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chong Xie
- Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yan Zhang
- Shaanxi Normal University, Xi'an, China
| | - Yan Xu
- Shaanxi Normal University, Xi'an, China
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17
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Adivi A, JoAnn L, Simpson N, McDonald JD, Lund AK. Traffic-generated air pollution - Exposure mediated expression of factors associated with demyelination in a female apolipoprotein E -/- mouse model. Neurotoxicol Teratol 2022; 90:107071. [PMID: 35016995 PMCID: PMC8904307 DOI: 10.1016/j.ntt.2022.107071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 12/31/2021] [Accepted: 01/06/2022] [Indexed: 11/29/2022]
Abstract
Epidemiology studies suggest that exposure to ambient air pollution is associated with demyelinating diseases in the central nervous system (CNS), including multiple sclerosis (MS). The pathophysiology of MS results from an autoimmune response involving increased inflammation and demyelination in the CNS, which is higher in young (adult) females. Exposure to traffic-generated air pollution is associated with neuroinflammation and other detrimental outcomes in the CNS; however, its role in the progression of pathologies associated with demyelinating diseases has not yet been fully characterized in a female model. Thus, we investigated the effects of inhalation exposure to mixed vehicle emissions (MVE) in the brains of both ovary-intact (ov+) and ovariectomized (ov-) female Apolipoprotein (ApoE-/-) mice. Ov + and ov- ApoE-/- mice were exposed via whole-body inhalation to either filtered air (FA, controls) or mixed gasoline and diesel vehicle emissions (MVE: 200 PM μg/m3) for 6 h/d, 7 d/wk., for 30 d. We then analyzed MVE-exposure mediated alterations in myelination, the presence of CD4+ and CD8+ T cells, reactive oxygen species (ROS), myelin oligodendrocyte protein (MOG), and expression of estrogen (ERα and ERβ) and progesterone (PROA/B) receptors in the CNS. MVE-exposure mediated significant alterations in myelination across multiple regions in the cerebrum, as well as increased CD4+ and CD8+ staining. There was also an increase in ROS production in the CNS of MVE-exposed ov- and ov + ApoE-/- mice. Ov- mice displayed a reduction in cerebral ERα mRNA expression, compared to ov + mice; however, MVE exposure resulted in an even further decrease in ERα expression, while ERβ and PRO A/B were unchanged across groups. These findings collectively suggest that inhaled MVE-exposure may mediate estrogen receptor expression alterations associated with increased CD4+/CD8+ infiltration, regional demyelination, and ROS production in the CNS of female ApoE-/- mice.
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Affiliation(s)
- Anna Adivi
- Advanced Environmental Research Institute, Department of Biological Sciences, University of North Texas, Denton, TX, USA, 76201
| | - Lucero JoAnn
- Advanced Environmental Research Institute, Department of Biological Sciences, University of North Texas, Denton, TX, USA, 76201
| | - Nicholas Simpson
- Advanced Environmental Research Institute, Department of Biological Sciences, University of North Texas, Denton, TX, USA, 76201
| | - Jacob D McDonald
- Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA, 87108
| | - Amie K. Lund
- Advanced Environmental Research Institute, Department of Biological Sciences, University of North Texas, Denton, TX, USA, 76201.,Corresponding author at: University of North Texas, EESAT – 215, 1704 W. Mulberry, Denton, TX 76201,
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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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Delgado-García G, Corona T. Air pollution is a risk factor for multiple sclerosis - No. Mult Scler 2021; 27:2138-2139. [PMID: 34676786 DOI: 10.1177/13524585211026875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Guillermo Delgado-García
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada/Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Teresa Corona
- Laboratorio Clínico de Enfermedades Neurodegenerativas, Instituto Nacional de Neurología y Neurocirugía, Av. Insurgentes Sur 3877, La Fama, Tlalpan, Ciudad de México 14269, México.,Laboratorio Clínico de Enfermedades Neurodegenerativas, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, Mexico
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22
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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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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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24
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Shin S, Bai L, Burnett RT, Kwong JC, Hystad P, van Donkelaar A, Lavigne E, Weichenthal S, Copes R, Martin RV, Kopp A, Chen H. Air Pollution as a Risk Factor for Incident Chronic Obstructive Pulmonary Disease and Asthma. A 15-Year Population-based Cohort Study. Am J Respir Crit Care Med 2021; 203:1138-1148. [PMID: 33147059 DOI: 10.1164/rccm.201909-1744oc] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Rationale: Current evidence on the relationship between long-term exposure to air pollution and new onset of chronic lung disease is inconclusive.Objectives: To examine associations of incident chronic obstructive pulmonary disease (COPD) and adult-onset asthma with past exposure to fine particulate matter ≤ 2.5 μm in diameter (PM2.5), nitrogen dioxide (NO2), ozone (O3), and the redox-weighted average of NO2 and O3 (Ox) and characterize the concentration-response relationship.Methods: We conducted a population-based cohort study of all Ontarians, aged 35-85 years, from 2001 to 2015. A 3-year moving average of residential exposures to selected pollutants with a 1-year lag were estimated during follow-up. We used Cox proportional hazard models and Aalen additive-hazard models to quantify the pollution-disease associations and characterized the shape of these relationships using newly developed nonlinear risk models.Measurements and Main Results: Among 5.1 million adults, we identified 340,733 and 218,005 incident cases of COPD and asthma, respectively. We found positive associations of COPD with PM2.5 per interquartile-range (IQR) increase of 3.4 μg/m3 (hazard ratio, 1.07; 95% confidence interval, 1.06-1.08), NO2 per IQR increase of 13.9 ppb (1.04; 1.02-1.05), O3 per IQR increase of 6.3 ppb (1.04; 1.03-1.04), and Ox per IQR increase of 4.4 ppb (1.03; 1.03-1.03). By contrast, we did not find strong evidence linking these pollutants to adult-onset asthma. In addition, we quantified that each IQR increase in pollution exposure yielded 3.0 (2.4-3.6), 3.2 (2.0-4.3), 1.9 (1.3-2.5), and 2.3 (1.7-2.9) excess cases of COPD per 100,000 adults for PM2.5, NO2, O3, and Ox, respectively. Furthermore, most pollutant-COPD relationships exhibited supralinear shapes.Conclusions: Air pollution was associated with a higher incidence of COPD but was not associated with a higher incidence of adult-onset asthma.
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Affiliation(s)
- Saeha Shin
- Public Health Ontario, Toronto, Ontario, Canada
| | - Li Bai
- ICES, Toronto, Ontario, Canada
| | - Richard T Burnett
- Environmental Health Science and Research Bureau, Population Studies Division, and
| | - Jeffrey C Kwong
- Public Health Ontario, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Department of Family and Community Medicine and.,Centre for Vaccine Preventable Diseases.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Perry Hystad
- College of Public Health and Human Studies, Oregon State University, Corvallis, Oregon
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Energy, Environmental, and Chemical Engineering, Washington University in St. Louis, St. Louis, Missouri
| | - Eric Lavigne
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; and
| | - Scott Weichenthal
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Ray Copes
- Public Health Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Energy, Environmental, and Chemical Engineering, Washington University in St. Louis, St. Louis, Missouri
| | | | - Hong Chen
- Public Health Ontario, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Environmental Health Science and Research Bureau, Population Studies Division, and.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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25
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Klompmaker JO, Janssen NAH, Bloemsma LD, Marra M, Lebret E, Gehring U, Hoek G. Effects of exposure to surrounding green, air pollution and traffic noise with non-accidental and cause-specific mortality in the Dutch national cohort. Environ Health 2021; 20:82. [PMID: 34261495 PMCID: PMC8281461 DOI: 10.1186/s12940-021-00769-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/05/2021] [Indexed: 05/20/2023]
Abstract
BACKGROUND Everyday people are exposed to multiple environmental factors, such as surrounding green, air pollution and traffic noise. These exposures are generally spatially correlated. Hence, when estimating associations of surrounding green, air pollution or traffic noise with health outcomes, the other exposures should be taken into account. The aim of this study was to evaluate associations of long-term residential exposure to surrounding green, air pollution and traffic noise with mortality. METHODS We followed approximately 10.5 million adults (aged ≥ 30 years) living in the Netherlands from 1 January 2013 until 31 December 2018. We used Cox proportional hazard models to evaluate associations of residential surrounding green (including the average Normalized Difference Vegetation Index (NDVI) in buffers of 300 and 1000 m), annual average ambient air pollutant concentrations [including particulate matter (PM2.5), nitrogen dioxide (NO2)] and traffic noise with non-accidental and cause-specific mortality, adjusting for potential confounders. RESULTS In single-exposure models, surrounding green was negatively associated with all mortality outcomes, while air pollution was positively associated with all outcomes. In two-exposure models, associations of surrounding green and air pollution attenuated but remained. For respiratory mortality, in a two-exposure model with NO2 and NDVI 300 m, the HR of NO2 was 1.040 (95%CI: 1.022, 1.059) per IQR increase (8.3 µg/m3) and the HR of NDVI 300 m was 0.964 (95%CI: 0.952, 0.976) per IQR increase (0.14). Road-traffic noise was positively associated with lung cancer mortality only, also after adjustment for air pollution or surrounding green. CONCLUSIONS Lower surrounding green and higher air pollution were associated with a higher risk of non-accidental and cause-specific mortality. Studies including only one of these correlated exposures may overestimate the associations with mortality of that exposure.
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Affiliation(s)
- Jochem O. Klompmaker
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Nicole A. H. Janssen
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
| | - Lizan D. Bloemsma
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Marten Marra
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
| | - Erik Lebret
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
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Vita R, Di Bari F, Capodicasa G, Perelli S, Bonanno AM, Ieni A, Moleti M, Vermiglio F, Tuccari G, Benvenga S. Rates of lymphocytic thyroiditis and ultrasound features of citologically-interrogated thyroid nodules based on the area of residence in a Sicily province. Endocrine 2021; 72:744-757. [PMID: 33063274 DOI: 10.1007/s12020-020-02521-z] [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: 07/02/2020] [Accepted: 10/03/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To verify the prevalence of autoimmune thyroiditis (AIT) and the ultrasound characteristics (composition and volume) of thyroid nodules with respect to the area of residence in the province of Messina, some areas having environmental issues. METHODS Fine-needle aspiration-interrogated nodules (n = 902) of 809 patients were evaluated upon stratification into 8 areas of residence. RESULTS Overall, women were younger than men (55.3 ± 14.0 vs. 58.6 ± 12.6 years, P = 0.0083). Patients residing in three areas (one hosting two garbage dumps, one hosting a petrochemical complex and a thermoelectrical power plant, and one hosting several ceramic factories [CFA]) were younger than those residing in the city of Messina (MEA) (52.9 ± 13.4 vs. 57.7 ± 13.6 years, P < 0.0001). Also, patients residing in those three areas had a greater rate of AIT, diagnosed either ultrasonographically/serologically (22.2% of patients) or cytologically (26.3% of nodules), compared with MEA (11.7% of patients, P = 0.0007 or 20.2% of nodules, P = 0.0815). Rates of AIT ranged 12.5-28.6% in the remaining four areas. Overall, nodules in women were smaller than in men (3.6 ± 5.7 vs. 6.1 ± 9.4 ml, P = 0.0006). Compared with the other seven areas, patients living in CFA had the largest nodules (6.8 ± 6.8 ml, P = 0.0040-0.0291), with the nodule volume being inversely correlated to patient's age (r = -0.4955, P = 0.0431). CONCLUSION Rates of AIT and associated ultrasound features of thyroid nodules vary in different areas of our province. Further studies correlating these rates and features with exposure to specific toxicants are warranted.
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Affiliation(s)
- Roberto Vita
- Department of Clinical and Experimental Medicine, University of Messina, Viale Gazzi, 98125, Messina, Italy.
| | - Flavia Di Bari
- Department of Clinical and Experimental Medicine, University of Messina, Viale Gazzi, 98125, Messina, Italy
| | - Giovanni Capodicasa
- Department of Clinical and Experimental Medicine, University of Messina, Viale Gazzi, 98125, Messina, Italy
| | - Sarah Perelli
- Department of Clinical and Experimental Medicine, University of Messina, Viale Gazzi, 98125, Messina, Italy
| | - Anna Maria Bonanno
- Department of Human Pathology of Adult and Evolutive Age Gaetano Barresi - Section of Pathological Anatomy, University of Messina, Viale Gazzi, 98125, Messina, Italy
| | - Antonio Ieni
- Department of Human Pathology of Adult and Evolutive Age Gaetano Barresi - Section of Pathological Anatomy, University of Messina, Viale Gazzi, 98125, Messina, Italy
| | - Mariacarla Moleti
- Department of Clinical and Experimental Medicine, University of Messina, Viale Gazzi, 98125, Messina, Italy
| | - Francesco Vermiglio
- Department of Clinical and Experimental Medicine, University of Messina, Viale Gazzi, 98125, Messina, Italy
- Interdepartmental Program on New Models of Multidisciplinary Management in Endocrinology, University Hospital, A.O.U. Policlinico G. Martino, Viale Gazzi, 98125, Messina, Italy
| | - Giovanni Tuccari
- Department of Human Pathology of Adult and Evolutive Age Gaetano Barresi - Section of Pathological Anatomy, University of Messina, Viale Gazzi, 98125, Messina, Italy
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, Viale Gazzi, 98125, Messina, Italy
- Master Program on Childhood, Adolescent and Women's Endocrine Health, University of Messina, Viale Gazzi, 98125, Messina, Italy
- Interdepartmental Program of Molecular & Clinical Endocrinology and Women's Endocrine Health, University Hospital, A.O.U. Policlinico G. Martino, Viale Gazzi, 98125, Messina, Italy
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Elgabsi M, Novack L, Yarza S, Elgabsi M, Shtein A, Ifergane G. An impact of air pollution on moderate to severe relapses among multiple sclerosis patients. Mult Scler Relat Disord 2021; 53:103043. [PMID: 34126372 DOI: 10.1016/j.msard.2021.103043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/26/2021] [Accepted: 05/17/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system with both a genetic and environmental component. OBJECTIVE In the current study, we examined an association between incidence of MS moderate to severe relapses and exposure to air pollutants and meteorological exposures. METHODS We enrolled MS patients in Southern Israel during 2000-2017. Exposure assessment relied on satellite-based model of exposure to particulate matter of size <2.5 and 10 microns (PM2.5, PM10) and temperature at a spatial resolution of 1 km (Kloog et al., 2015). The information on exposure to nitrogen dioxide (NO2), sulfur dioxide (SO2) and ozone (O3) levels was completed from the database of the monitoring stations. We analyzed the data using a semi-ecological approach. The monthly incidence of MS-related relapses requiring hospitalization as a function of environmental factors was analyzed by time-series technique, adjusting to sex, age and smoking. We also used a case-crossover approach to compare environmental exposure of a patient on the day of the relapse with the exposure on the relapse-free days. All estimates were adjusted to the heat index and were divided by IQR. RESULTS There were 287 MS patients in the study, with an average age of 52.8 ± 16.7 years, 37% of them (107) being under 40. Mostly female (66.2%), and 13.6% of the patients smoking (47% non-smoking and 39.4% unknown). PM2.5 was independently associated with MS relapses within the non-smoking population [Relative Risk (RR)=1.28, 95%CI:1.01-1.62]. O3 was found adversely associated with MS relapses among patients younger than 40 [RR=1.58, 95%CI 1.03-4.43]. Based on the case-crossover approach, relapses were associated with elevated levels of PM10 and NO2 in all subjects [Odds Ratio (OR)=1.05, 95%CI:1.00-1.11; OR=1.85, 95%CI: 1.28-2.68, respectively]. An adverse association with PM2.5 was observed in non-smokers [OR 1.12, 95%CI 1.00-1.25]. CONCLUSIONS The findings show that MS relapses are adversely associated with an ambient exposure to PM and NO2.
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Affiliation(s)
- Miri Elgabsi
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Lena Novack
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | - Shaked Yarza
- Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | | | - Alexandra Shtein
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Gal Ifergane
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Department of Neurology, Soroka University Medical Center, Beer-Sheva, Israel
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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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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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Almasi-Hashiani A, Sahraian MA, Eskandarieh S. Evidence of an increased prevalence of multiple sclerosis: a population-based study of Tehran registry during 1999-2018. BMC Neurol 2020; 20:169. [PMID: 32359352 PMCID: PMC7195783 DOI: 10.1186/s12883-020-01747-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 04/23/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The epidemiological characteristics of multiple sclerosis (MS) have been investigated in various studies, which have revealed that the prevalence of MS varies across countries. The present study was conducted to investigate the longitudinal prevalence of MS in Tehran, Iran. METHODS The present population-based study was conducted in Tehran, the capital of Iran from 1999 to 2018 based on the annual report data provided by the Iranian MS Society (IMSS) registry system. The age-standardized and crude prevalence were estimated using population data presented by the Statistical Centre of Iran. RESULTS A total of 21,580 MS cases were registered and included in the analysis. Among the participant patients, 24.99% (5393) and 75.01% (16,187) of cases were male and female, respectively. The mean age of MS onset was 28.8 years (S.D: 8.7). The age-standardized prevalence (ASP) of MS increased from 73.7 (95%CI: 72.1-75.2) per 100,000 people in 2006 to 137.6 (95% CI: 135.7-139.5) per 100,000 people in 2018. The ASP of MS in 2018 was estimated to be 67.9 (95%CI: 66.0-69.8) and 207.3 (95%CI: 204.0-210.7) per 100,000 people among males and females, respectively. The age-standardized female-to-male ratio of MS ranged from 3.7 (in 2010) to 2.06 (in 2017). CONCLUSION The findings of this study suggested that the prevalence of MS in Tehran province is relatively high, and the occurrence of the disease is more common in the age groups under 40 years as compared with older-aged groups. In line with reports provided for various regions of the world, the prevalence of MS was higher among women. Similarly, the findings of this study revealed that the female-to-male ratio was 2.14 in 2018.
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Affiliation(s)
- Amir Almasi-Hashiani
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Sina Hospital, Hassan Abad square, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Sina Hospital, Hassan Abad square, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
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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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Cohen JA, Trojano M, Mowry EM, Uitdehaag BMJ, Reingold SC, Marrie RA. Leveraging real-world data to investigate multiple sclerosis disease behavior, prognosis, and treatment. Mult Scler 2020; 26:23-37. [PMID: 31778094 PMCID: PMC6950891 DOI: 10.1177/1352458519892555] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 11/10/2019] [Indexed: 12/21/2022]
Abstract
Randomized controlled clinical trials and real-world observational studies provide complementary information but with different validity. Some clinical questions (disease behavior, prognosis, validation of outcome measures, comparative effectiveness, and long-term safety of therapies) are often better addressed using real-world data reflecting larger, more representative populations. Integration of disease history, clinician-reported outcomes, performance tests, and patient-reported outcome measures during patient encounters; imaging and biospecimen analyses; and data from wearable devices increase dataset utility. However, observational studies utilizing these data are susceptible to many potential sources of bias, creating barriers to acceptance by regulatory agencies and the medical community. Therefore, data standardization and validation within datasets, harmonization across datasets, and application of appropriate analysis methods are important considerations. We review approaches to improve the scope, quality, and analyses of real-world data to advance understanding of multiple sclerosis and its treatment, as an example of opportunities to better support patient care and research.
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Affiliation(s)
- Jeffrey A Cohen
- Department of Neurology, Mellen Center for
Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland
Clinic, Cleveland, OH, USA
| | - Maria Trojano
- Department of Basic Medical Sciences,
Neurosciences and Sense Organs, University of Bari “Aldo Moro,” Bari,
Italy
| | - Ellen M Mowry
- Department of Neurology, School of Medicine, The
Johns Hopkins University, Baltimore, MD, USA
| | - Bernard MJ Uitdehaag
- Department of Neurology, Amsterdam University
Medical Center, Amsterdam, The Netherlands
| | | | - Ruth Ann Marrie
- Departments of Internal Medicine (Neurology) and
Community Health Sciences, Rady Faculty of Health Sciences, Max Rady College
of Medicine, University of Manitoba, Winnipeg, MB, Canada
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Fernandes MJS, Carletti CO, Sierra de Araújo LF, Santos RC, Reis J. Respiratory gases, air pollution and epilepsy. Rev Neurol (Paris) 2019; 175:604-613. [PMID: 31519304 DOI: 10.1016/j.neurol.2019.07.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 07/21/2019] [Accepted: 07/23/2019] [Indexed: 12/29/2022]
Abstract
A growing number of studies have shown that exposure to air pollutants such as particulate matter and gases can cause cardiovascular, neurodegenerative and psychiatric diseases. The severity of the changes depends on several factors such as exposure time, age and gender. Inflammation has been considered as one of the main factors associated with the generation of these diseases. Here we present some cellular mechanisms activated by air pollution that may represent risk factors for epilepsy and drug resistance associated to epilepsy.
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Affiliation(s)
- M J S Fernandes
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
| | - C O Carletti
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - L F Sierra de Araújo
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - R C Santos
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - J Reis
- Service de Neurologie, Centre Hospitalier Universitaire, Hôpital de Hautepierre, 1, avenue Molière, 67200 Strasbourg, France
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Tateo F, Grassivaro F, Ermani M, Puthenparampil M, Gallo P. PM2.5 levels strongly associate with multiple sclerosis prevalence in the Province of Padua, Veneto Region, North-East Italy. Mult Scler 2018; 25:1719-1727. [DOI: 10.1177/1352458518803273] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background: Incidence and prevalence trends of multiple sclerosis (MS) in the Province of Padua, North-East Italy, suggest that environmental factors may be associated with increased MS risk. Objective: To investigate the association of PM2.5 with MS prevalence in one of the most polluted geographical area of Italy. Methods: In total, 1435 Italian MS patients residing in the Province of Padua were enrolled. The province surface was classified into urban areas, isolated villages, industrialized places, and countryside. Satellite-derived dust-free and sea salt-free PM2.5 concentrations (annual average 1998–2015, μg/m3) allowed the identification of 18 classes of territorial sections with statistically evaluable numbers of inhabitants. Possible correlations between residential locality types, PM2.5 concentrations, and MS prevalence were investigated. Results: MS prevalence was significantly ( p < 0.0001) higher in urban areas (ranging from 219 in Padua City to 169/100,000 in other urban areas) compared to isolated villages (116/100,000) or rural domains (109/100,000) and strongly correlated with the annual average concentration of PM2.5 ( r = 0.81, p < 0.001). Regression analysis further associated MS cases with PM.2.5 average concentration ( β = 0.11, p < 0.001). Conclusion: In the Province of Padua, MS prevalence is strongly associated with PM2.5 exposure suggesting that air pollutants may be one of the possible environmental risk factors for MS.
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Affiliation(s)
- Fabio Tateo
- Institute of Geosciences and Earth Resources, National Research Council of Italy, Department of Geosciences, Università degli Studi di Padova, Padova, Italy
| | - Francesca Grassivaro
- Multiple Sclerosis Centre, Department of Neurosciences (DNS), Università degli Studi di Padova, Padova, Italy
| | - Mario Ermani
- Department of Neurosciences (DNS), Università degli Studi di Padova, Padova, Italy
| | - Marco Puthenparampil
- Multiple Sclerosis Centre, Department of Neurosciences (DNS), Università degli Studi di Padova, Padova, Italy
| | - Paolo Gallo
- Multiple Sclerosis Centre, Department of Neurosciences (DNS), Università degli Studi di Padova, Padova, Italy
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