Acute kidney damage by PM2.5 exposure in a rat model

A unified framework for assessing interaction effects among environmental exposures in epidemiologic studies: A case study on temperature, air pollution, and kidney-related conditions in New York state

BACKGROUND

There are various methods to assess interaction effects. However, current methods have limitations, and quantification of interaction effects is rarely performed. This study aimed to develop a unified quantitative framework for assessing interaction effects.

METHODS

We proposed a novel framework using log-linear models with a product term(s) across the exposures that generates parametric bi-variate association and interaction effect surfaces and allows flexible functional forms for exposures in the interaction term(s). In a case study, we assessed the interaction effects between temperature and air pollution (i.e., PM2.5, NO2, and O3) on risk for kidney-related conditions in New York State (2007-2016) using a case-crossover design with conditional logistic models. Our measures of exposure were the moving averages at lag 0-5 days for air pollution (linear) and daytime mean outdoor wet-bulb globe temperature (WBGT; using a natural cubic spline).

RESULTS

We derived closed-form expressions for the magnitude of multiplicative interaction effects (the joint relative risk divided by the product of the two conditional relative risks) and their uncertainties. In the case study, we found a Bonferroni-corrected significant multiplicative interaction effect (IE) between outdoor WBGT at the 99th percentile (median as the reference) and (1) PM2.5 (per 5 μg/m3 increase, IE = 1.052; 95 % confidence interval [CI]: 1.019, 1.087) for acute kidney failure and (2) O3 (per 5 ppb increase; IE = 1.022; 95 % CI: 1.008, 1.036) for urolithiasis (the latter being inconclusive based on the sensitivity analysis).

CONCLUSIONS

Our framework allows different functional forms of exposure variables in the interaction term, quantifies the magnitudes of entire-exposure-range (in addition to discrete exposure level) multiplicative interaction effects and their uncertainties in a categorical or continuous (linear or non-linear) manner, and harmonizes the two-way evaluation of effect modification. The case study underscores co-consideration of heat and air pollution when estimating health burden and designing heat/pollution alert systems.

Associations between short-term exposure to PM2.5, NO2 and O3 pollution and kidney-related conditions and the role of temperature-adjustment specification: A case-crossover study in New York state

Epidemiologic evidence on the relationship between air pollution and kidney disease remains inconclusive. We evaluated associations between short-term exposure to PM_2.5, NO₂ and O₃ and unplanned hospital visits for seven kidney-related conditions (acute kidney failure [AKF], urolithiasis, glomerular diseases [GD], renal tubulo-interstitial diseases, chronic kidney disease, dysnatremia, and volume depletion; n = 1,209,934) in New York State (2007-2016). We applied a case-crossover design with conditional logistic regression, controlling for temperature, dew point temperature, wind speed, and solar radiation. We used a three-pollutant model at lag 0-5 days of exposure as our main model. We also assessed the influence of model adjustment using different specifications of temperature by comparing seven temperature metrics (e.g., dry-bulb temperature, heat index) and five intraday temperature measures (e.g., daily mean, daily minimum, nighttime mean), according to model performance and association magnitudes between air pollutants and kidney-related conditions. In our main models, we adjusted for daytime mean outdoor wet-bulb globe temperature, which showed good model performance across all kidney-related conditions. We observed the odds ratios (ORs) for 5 μg/m³ increase in daily mean PM_2.5 to be 1.013 (95% confidence interval [CI]: 1.001, 1.025) for AKF, 1.107 (95% CI: 1.018, 1.203) for GD, and 1.027 (95% CI: 1.015, 1.038) for volume depletion; and the OR for 5 ppb increase in daily 1-hour maximum NO₂ to be 1.014 (95% CI; 1.008, 1.021) for AKF. We observed no associations with daily 8-hour maximum O₃ exposure. Association estimates varied by adjustment for different intraday temperature measures: estimates adjusted for measures with poorer model performance resulted in the greatest deviation from estimates adjusted for daytime mean, especially for AKF and volume depletion. Our findings indicate that short-term exposure to PM_2.5 and NO₂ is a risk factor for specific kidney-related conditions and underscore the need for careful adjustment of temperature in air pollution epidemiologic studies.

Pectin alleviates the pulmonary inflammatory response induced by PM2.5 from a pig house by modulating intestinal microbiota

This study aimed to investigate whether dietary fiber pectin can alleviate PM_2.5-induced pulmonary inflammation and the potential mechanism. PM_2.5 samples were collected from a nursery pig house. The mice were divided into three groups: the control group, PM_2.5 group and PM_2.5 + pectin group. The mice in the PM_2.5 group were intratracheally instilled with PM_2.5 suspension twice a week for four consecutive weeks, and those in the PM_2.5 + pectin group were subject to the same PM_2.5 exposure, but fed with a basal diet supplemented with 5% pectin. The results showed that body weight and feed intake were not different among the treatments (p > 0.05). However, supplementation with pectin relieved PM_2.5-induced pulmonary inflammation, presenting as slightly restored lung morphology, decreased mRNA expression levels of IL-1β, IL-6 and IL-17 in the lung, decreased MPO content in bronchoalveolar lavage fluid (BLAF), and even decreased protein levels of IL-1β and IL-6 in the serum (p < 0.05). Dietary pectin altered the composition of the intestinal microbiota, increasing the relative abundance of Bacteroidetes and decreasing the ratio of Firmicutes/Bacteroidetes. At the genus level, short-chain fatty acid (SCFA)-producing bacteria, such as Bacteroides, Anaerotruncus, Prevotella 2, Parabacteroides, Ruminococcus 2 and Butyricimonas, were enriched in the PM_2.5 +pectin group. Accordingly, dietary pectin increased the concentrations of SCFAs, including acetate, propionate, butyrate and valerate, in mice. In conclusion, dietary fermentable fiber pectin can relieve PM_2.5-induced pulmonary inflammation via alteration of intestinal microbiota composition and SCFA production. This study provides a new insight into reducing the health risk associated with PM_2.5 exposure.

Overview of PM2.5 and health outcomes: Focusing on components, sources, and pollutant mixture co-exposure

PM_2.5 varies in source and composition over time and space as a complicated mixture. Consequently, the health effects caused by PM_2.5 varies significantly over time and generally exhibit significant regional variations. According to numerous studies, a notable relationship exists between PM_2.5 and the occurrence of many diseases, such as respiratory, cardiovascular, and nervous system diseases, as well as cancer. Therefore, a comprehensive understanding of the effect of PM_2.5 on human health is critical. The toxic effects of various PM_2.5 components, as well as the overall toxicity of PM_2.5 are discussed in this review to provide a foundation for precise PM_2.5 emission control. Furthermore, this review summarizes the synergistic effect of PM_2.5 and other pollutants, which can be used to draft effective policies.

Associations between long-term exposure to ambient fine particulate pollution with the decline of kidney function and hyperuricemia: a longitudinal cohort study

Evidence of associations between ambient fine particulate matter (PM_2.5) and risks of decline of kidney function and hyperuricemia is limited. We aimed to investigate the associations between long-term exposure to PM_2.5 with decline of kidney function and hyperuricemia in China. We conducted a two-stage study based on China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015. Cox proportional hazard regression models and restricted cubic splines were used to evaluate the associations of PM_2.5 with risks of decline of kidney function and hyperuricemia. Latent class trajectory models (LCTM) were used to identify trajectories of PM_2.5 from 2011 to 2015 in the sensitivity analysis. A total of 9760 participants were included in baseline analysis, and 5902 participants were in follow-up analysis. PM_2.5 was associated with the risks of decline of kidney function [hazard ratio (HR): 2.14; 95% confidence interval (CI): (1.03, 4.44)] and hyperuricemia [HR 1.40 (95% CI: 1.10, 1.79)] in the second quartile group versus the lowest quartile group of PM_2.5. We also observed nonlinear relationships between PM_2.5 and the risks of the decline of kidney function and hyperuricemia (P_non-linear < 0.001). In sensitivity analysis, four trajectory groups were identified. "Maintaining a high PM_2.5" [odds ratio (OR): 2.20; 95%CI: (1.78, 2.73)] and "moderately high starting PM_2.5 then steadily decreased" [OR (95%CI): 5.15 (1.55, 16.13)] were associated with hyperuricemia risk, using "low starting PM_2.5 then steadily decreased" trajectory as reference. In conclusion, improved air quality is essential for prevention of decline of kidney function and hyperuricemia.

The impact of PM2.5 on kidney

PM2.5 poses a severe risk to kidneys, inducing kidney function decline, increasing the risk of suffering from chronic kidney diseases and promoting the occurrence and development of various renal tumors. The mechanism of PM2.5-induced renal injury may involve oxidative stress, inflammatory response, and cytotoxicity. This paper elaborated PM2.5-induced kidney damage and the corresponding possible mechanism so as to raise awareness of air pollution and reduce the damage to human body.

Exposure to ambient particulate matter and hyperuricemia: An eight-year prospective cohort study on male traffic officers in China

BACKGROUND AND OBJECTIVES

Studies on the effects of airborne particulates of diameter ≤ 1 µm (PM₁), airborne particulates of diameter ≤ 2.5 µm (PM_2.5) and airborne particulates of diameter ranges from 1 to 2.5 µm (PM_1-2.5) on incidence of hyperuricemia are limited. We aimed to investigate the associations between PM₁, PM_2.5, and PM_1-2.5 and hyperuricemia among male traffic officers.

METHODS

We conducted a prospective cohort study of 1460 traffic officers without hyperuricemia in Guangzhou, China from 2009 to 2016. Exposures of PM₁ and PM_2.5 were estimated with a spatiotemporal model. PM_1-2.5 concentrations were calculated by subtracting PM₁ from PM_2.5 concentrations. Cox's proportional hazards regressions models were used to examine the association between PM₁, PM_2.5, and PM_1-2.5 and hyperuricemia, adjusted for potential confounders. Associations between PM₁, PM_2.5, and PM_1-2.5 and serum uric acid (SUA) levels were evaluated with multiple linear regression models.

RESULTS

Hazard ratios (HRs) and 95% confidence intervals (CIs) of hyperuricemia associated with 10 μg/m³ increment in PM₁, PM_2.5, and PM_1-2.5 were 1.67 (95% CI:1.30-2.36), 1.49 (95% CI: 1.27-1.75), and 2.18 (95% CI: 1.58-3.02), respectively. The SUA concentrations increased by 12.23 μmol/L (95% CI: 5.91-18.56), 6.93 μmol/L (95% CI: 3.02-10.84), and 8.72 μmol/L (95% CI: 0.76-16.68) per 10 μg/m³ increase in PM₁, PM_2.5, and PM_1-2.5, respectively. Stratified analyses indicated the positive associations of PM_2.5 and PM_1-2.5 with SUA levels were stronger in non-smokers, and PM₁, PM_2.5, and PM_1-2.5 with SUA levels were stronger in non-drinkers.

CONCLUSION

Long-term PM₁, PM_2.5, and PM_1-2.5 exposures may increase the risk of hyperuricemia and elevate SUA levels among male traffic officers, especially in non-smokers and non-drinkers.

Environmental Exposures and Kidney Disease

Accumulating evidence underscores the large role played by the environment in the health of communities and individuals. We review the currently known contribution of environmental exposures and pollutants on kidney disease and its associated morbidity. We review air pollutants, such as particulate matter; water pollutants, such as trace elements, per- and polyfluoroalkyl substances, and pesticides; and extreme weather events and natural disasters. We also discuss gaps in the evidence that presently relies heavily on observational studies and animal models, and propose using recently developed analytic methods to help bridge the gaps. With the expected increase in the intensity and frequency of many environmental exposures in the decades to come, an improved understanding of their potential effect on kidney disease is crucial to mitigate potential morbidity and mortality.

Pentraxin 3 mediates early inflammatory response and EMT process in human tubule epithelial cells induced by PM2.5

Pentraxin 3 (PTX3) is a multifunctional molecule that mainly expressed in response to proinflammatory stimuli under physiological and pathological conditions. It is produced in tubule epithelial cells that is involved in the innate immune response and inflammatory reactions in the kidney. However, its role in fine particulate matter (PM2.5)-induced renal injury associated with inflammation remains to be investigated. As a result of PM2.5 exposure, the levels of interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α levels were increased in HK-2 cells. Notably, the mesenchymal phenotypes with migratory abilities of HK-2 cells were found following PM2.5 exposure. The elevated expressions of PTX3 mRNA and protein in response to PM2.5 were tested by RT-PCR and Western blotting respectively. Further determinate the role of PTX3 by siRNA showed lack of PTX3 could increase IL-6 production and promote epithelial-mesenchymal transition (EMT) process, as evidenced by decreased expressions of E-cadherin, and increased expressions of N-cadherin and α-SMA in HK-2 cells following PM2.5 exposure. Our study indicates that PTX3 mediates early inflammatory response and EMT in PM2.5-exposed HK-2 cells, suggesting a counter-regulatory role of PTX3 in the early course of tubule cell injury induced by PM2.5.

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

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

The influence of PM2.5 exposure on kidney diseases

The harm of air pollution to public health has become a research hotspot, especially atmospheric fine-particulate matter (PM_2.5). In recent years, epidemiological investigations have confirmed that PM_2.5 is closely related to chronic kidney disease and membranous nephropathy Basic research has demonstrated that PM_2.5 has an impact on the normal function of the kidneys through accumulation in the kidney, endothelial dysfunction, abnormal renin-angiotensin system, and immune complex deposition. Moreover, the mechanism of PM_2.5 damage to the kidney involves inflammation, oxidative stress, apoptosis, DNA damage, and autophagy. In this review, we summarized the latest developments in the effects of PM_2.5 on kidney disease in human and animal studies, so as to provide new ideas for the prevention and treatment of kidney disease.

Associations of Carbonaceous Compounds and Water-Soluble Inorganic Ions in Ambient PM2.5 with Renal Function in Older Individuals: The China BAPE Study

Exposure to fine particulate matter (PM_2.5) is proven to be associated with a decline in renal function. However, few studies have explored the acute renal damage from carbonaceous compounds and water-soluble inorganic ions (WSIIs), which constitute the bulk of total PM_2.5 mass. We examined the acute effect of these constituents of ambient PM_2.5 on renal function in older Chinese individuals. Seventy-one healthy people aged 60-69 years from Jinan, China, were enrolled and visited monthly and asked to complete survey questionnaires, undergo physical exams, and provide blood samples. The hourly concentrations of organic carbon, elemental carbon (EC), and WSIIs in ambient PM_2.5 were collected from a fixed-site monitoring station. The association between PM_2.5 constituents and estimated glomerular filtration rate (eGFR) was evaluated using linear mixed-effects models after controlling for a series of covariates. We observed that ambient carbonaceous compounds and WSIIs were associated with a significant decline in renal function. The interquartile range increased in the 24 h moving average of carbonaceous compounds, and WSIIs in ambient PM_2.5 were associated with -13.11% [95% confidence interval (95% CI): -19.49, -6.21%] to -0.81% (95% CI: -4.17, 2.67%) changes in eGFR. We found significant associations between EC, chlorine (Cl^-), sodium (Na⁺), and magnesium (Mg²⁺) and eGFR in single-pollutant, constituent-PM_2.5, and residual-constituent models with a lag period of 0-24 h. This study demonstrated that carbonaceous compounds and WSIIs in PM_2.5 were inversely associated with renal function.