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Peden DB. Respiratory Health Effects of Air Pollutants. Immunol Allergy Clin North Am 2024; 44:15-33. [PMID: 37973257 DOI: 10.1016/j.iac.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Air pollution is a risk factor for asthma and respiratory infection. Avoidance of air pollution is the best approach to mitigating the impacts of pollution. Personal preventive strategies are possible, but policy interventions are the most effective ways to prevent pollution and its effect on asthma and respiratory infection.
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Affiliation(s)
- David B Peden
- Division of Pediatric Allergy & Immunology and, Center for Environmental Medicine, Asthma and Lung Biology, The School of Medicine, The University of North Carolina at Chapel Hill, UNC School of Medicine, 104 Mason Farm Road, CB#7310, Chapel Hill, NC 27599-7310, USA.
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2
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Perryman AN, Kim HYH, Payton A, Rager JE, McNell EE, Rebuli ME, Wells H, Almond M, Antinori J, Alexis NE, Porter NA, Jaspers I. Plasma sterols and vitamin D are correlates and predictors of ozone-induced inflammation in the lung: A pilot study. PLoS One 2023; 18:e0285721. [PMID: 37186612 PMCID: PMC10184915 DOI: 10.1371/journal.pone.0285721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/27/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Ozone (O3) exposure causes respiratory effects including lung function decrements, increased lung permeability, and airway inflammation. Additionally, baseline metabolic state can predispose individuals to adverse health effects from O3. For this reason, we conducted an exploratory study to examine the effect of O3 exposure on derivatives of cholesterol biosynthesis: sterols, oxysterols, and secosteroid (25-hydroxyvitamin D) not only in the lung, but also in circulation. METHODS We obtained plasma and induced sputum samples from non-asthmatic (n = 12) and asthmatic (n = 12) adult volunteers 6 hours following exposure to 0.4ppm O3 for 2 hours. We quantified the concentrations of 24 cholesterol precursors and derivatives by UPLC-MS and 30 cytokines by ELISA. We use computational analyses including machine learning to determine whether baseline plasma sterols are predictive of O3 responsiveness. RESULTS We observed an overall decrease in the concentration of cholesterol precursors and derivatives (e.g. 27-hydroxycholesterol) and an increase in concentration of autooxidation products (e.g. secosterol-B) in sputum samples. In plasma, we saw a significant increase in the concentration of secosterol-B after O3 exposure. Machine learning algorithms showed that plasma cholesterol was a top predictor of O3 responder status based on decrease in FEV1 (>5%). Further, 25-hydroxyvitamin D was positively associated with lung function in non-asthmatic subjects and with sputum uteroglobin, whereas it was inversely associated with sputum myeloperoxidase and neutrophil counts. CONCLUSION This study highlights alterations in sterol metabolites in the airway and circulation as potential contributors to systemic health outcomes and predictors of pulmonary and inflammatory responsiveness following O3 exposure.
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Affiliation(s)
- Alexia N. Perryman
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Hye-Young H. Kim
- Department of Chemistry, Vanderbilt University, Nashville, TN, United States of America
| | - Alexis Payton
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Julia E. Rager
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Erin E. McNell
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Meghan E. Rebuli
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Heather Wells
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Martha Almond
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Jamie Antinori
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Neil E. Alexis
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Ned A. Porter
- Department of Chemistry, Vanderbilt University, Nashville, TN, United States of America
| | - Ilona Jaspers
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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3
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Wise SK, Damask C, Roland LT, Ebert C, Levy JM, Lin S, Luong A, Rodriguez K, Sedaghat AR, Toskala E, Villwock J, Abdullah B, Akdis C, Alt JA, Ansotegui IJ, Azar A, Baroody F, Benninger MS, Bernstein J, Brook C, Campbell R, Casale T, Chaaban MR, Chew FT, Chambliss J, Cianferoni A, Custovic A, Davis EM, DelGaudio JM, Ellis AK, Flanagan C, Fokkens WJ, Franzese C, Greenhawt M, Gill A, Halderman A, Hohlfeld JM, Incorvaia C, Joe SA, Joshi S, Kuruvilla ME, Kim J, Klein AM, Krouse HJ, Kuan EC, Lang D, Larenas-Linnemann D, Laury AM, Lechner M, Lee SE, Lee VS, Loftus P, Marcus S, Marzouk H, Mattos J, McCoul E, Melen E, Mims JW, Mullol J, Nayak JV, Oppenheimer J, Orlandi RR, Phillips K, Platt M, Ramanathan M, Raymond M, Rhee CS, Reitsma S, Ryan M, Sastre J, Schlosser RJ, Schuman TA, Shaker MS, Sheikh A, Smith KA, Soyka MB, Takashima M, Tang M, Tantilipikorn P, Taw MB, Tversky J, Tyler MA, Veling MC, Wallace D, Wang DY, White A, Zhang L. International consensus statement on allergy and rhinology: Allergic rhinitis - 2023. Int Forum Allergy Rhinol 2023; 13:293-859. [PMID: 36878860 DOI: 10.1002/alr.23090] [Citation(s) in RCA: 72] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/11/2022] [Accepted: 09/13/2022] [Indexed: 03/08/2023]
Abstract
BACKGROUND In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR-Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR-Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence-based findings and recommendation from the full document. METHODS ICAR-Allergic Rhinitis 2023 employed established evidence-based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus was performed for each topic. The final document was then collated and includes the results of this work. RESULTS ICAR-Allergic Rhinitis 2023 includes 10 major content areas and 144 individual topics related to AR. For a substantial proportion of topics included, an aggregate grade of evidence is presented, which is determined by collating the levels of evidence for each available study identified in the literature. For topics in which a diagnostic or therapeutic intervention is considered, a recommendation summary is presented, which considers the aggregate grade of evidence, benefit, harm, and cost. CONCLUSION The ICAR-Allergic Rhinitis 2023 update provides a comprehensive evaluation of AR and the currently available evidence. It is this evidence that contributes to our current knowledge base and recommendations for patient evaluation and treatment.
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Affiliation(s)
- Sarah K Wise
- Otolaryngology-HNS, Emory University, Atlanta, Georgia, USA
| | - Cecelia Damask
- Otolaryngology-HNS, Private Practice, University of Central Florida, Lake Mary, Florida, USA
| | - Lauren T Roland
- Otolaryngology-HNS, Washington University, St. Louis, Missouri, USA
| | - Charles Ebert
- Otolaryngology-HNS, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Joshua M Levy
- Otolaryngology-HNS, Emory University, Atlanta, Georgia, USA
| | - Sandra Lin
- Otolaryngology-HNS, University of Wisconsin, Madison, Wisconsin, USA
| | - Amber Luong
- Otolaryngology-HNS, McGovern Medical School of the University of Texas, Houston, Texas, USA
| | - Kenneth Rodriguez
- Otolaryngology-HNS, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Ahmad R Sedaghat
- Otolaryngology-HNS, University of Cincinnati, Cincinnati, Ohio, USA
| | - Elina Toskala
- Otolaryngology-HNS, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | - Baharudin Abdullah
- Otolaryngology-HNS, Universiti Sains Malaysia, Kubang, Kerian, Kelantan, Malaysia
| | - Cezmi Akdis
- Immunology, Infectious Diseases, Swiss Institute of Allergy and Asthma Research, Davos, Switzerland
| | - Jeremiah A Alt
- Otolaryngology-HNS, University of Utah, Salt Lake City, Utah, USA
| | | | - Antoine Azar
- Allergy/Immunology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Fuad Baroody
- Otolaryngology-HNS, University of Chicago, Chicago, Illinois, USA
| | | | | | - Christopher Brook
- Otolaryngology-HNS, Harvard University, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Raewyn Campbell
- Otolaryngology-HNS, Macquarie University, Sydney, NSW, Australia
| | - Thomas Casale
- Allergy/Immunology, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Mohamad R Chaaban
- Otolaryngology-HNS, Cleveland Clinic, Case Western Reserve University, Cleveland, Ohio, USA
| | - Fook Tim Chew
- Allergy/Immunology, Genetics, National University of Singapore, Singapore, Singapore
| | - Jeffrey Chambliss
- Allergy/Immunology, University of Texas Southwestern, Dallas, Texas, USA
| | - Antonella Cianferoni
- Allergy/Immunology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | | | | | - Anne K Ellis
- Allergy/Immunology, Queens University, Kingston, ON, Canada
| | | | - Wytske J Fokkens
- Otorhinolaryngology, Amsterdam University Medical Centres, Amsterdam, Netherlands
| | | | - Matthew Greenhawt
- Allergy/Immunology, Pediatrics, University of Colorado, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Amarbir Gill
- Otolaryngology-HNS, University of Michigan, Ann Arbor, Michigan, USA
| | - Ashleigh Halderman
- Otolaryngology-HNS, University of Texas Southwestern, Dallas, Texas, USA
| | - Jens M Hohlfeld
- Respiratory Medicine, Fraunhofer Institute for Toxicology and Experimental Medicine ITEM, Hannover Medical School, German Center for Lung Research, Hannover, Germany
| | | | - Stephanie A Joe
- Otolaryngology-HNS, University of Illinois Chicago, Chicago, Illinois, USA
| | - Shyam Joshi
- Allergy/Immunology, Oregon Health and Science University, Portland, Oregon, USA
| | | | - Jean Kim
- Otolaryngology-HNS, Johns Hopkins University, Baltimore, Maryland, USA
| | - Adam M Klein
- Otolaryngology-HNS, Emory University, Atlanta, Georgia, USA
| | - Helene J Krouse
- Otorhinolaryngology Nursing, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Edward C Kuan
- Otolaryngology-HNS, University of California Irvine, Orange, California, USA
| | - David Lang
- Allergy/Immunology, Cleveland Clinic, Cleveland, Ohio, USA
| | | | | | - Matt Lechner
- Otolaryngology-HNS, University College London, Barts Health NHS Trust, London, UK
| | - Stella E Lee
- Otolaryngology-HNS, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Victoria S Lee
- Otolaryngology-HNS, University of Illinois Chicago, Chicago, Illinois, USA
| | - Patricia Loftus
- Otolaryngology-HNS, University of California San Francisco, San Francisco, California, USA
| | - Sonya Marcus
- Otolaryngology-HNS, Stony Brook University, Stony Brook, New York, USA
| | - Haidy Marzouk
- Otolaryngology-HNS, State University of New York Upstate, Syracuse, New York, USA
| | - Jose Mattos
- Otolaryngology-HNS, University of Virginia, Charlottesville, Virginia, USA
| | - Edward McCoul
- Otolaryngology-HNS, Ochsner Clinic, New Orleans, Louisiana, USA
| | - Erik Melen
- Pediatric Allergy, Karolinska Institutet, Stockholm, Sweden
| | - James W Mims
- Otolaryngology-HNS, Wake Forest University, Winston Salem, North Carolina, USA
| | - Joaquim Mullol
- Otorhinolaryngology, Hospital Clinic Barcelona, Barcelona, Spain
| | - Jayakar V Nayak
- Otolaryngology-HNS, Stanford University, Palo Alto, California, USA
| | - John Oppenheimer
- Allergy/Immunology, Rutgers, State University of New Jersey, Newark, New Jersey, USA
| | | | - Katie Phillips
- Otolaryngology-HNS, University of Cincinnati, Cincinnati, Ohio, USA
| | - Michael Platt
- Otolaryngology-HNS, Boston University, Boston, Massachusetts, USA
| | | | | | - Chae-Seo Rhee
- Rhinology/Allergy, Seoul National University Hospital and College of Medicine, Seoul, Korea
| | - Sietze Reitsma
- Otolaryngology-HNS, University of Amsterdam, Amsterdam, Netherlands
| | - Matthew Ryan
- Otolaryngology-HNS, University of Texas Southwestern, Dallas, Texas, USA
| | - Joaquin Sastre
- Allergy, Fundacion Jiminez Diaz, University Autonoma de Madrid, Madrid, Spain
| | - Rodney J Schlosser
- Otolaryngology-HNS, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Theodore A Schuman
- Otolaryngology-HNS, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Marcus S Shaker
- Allergy/Immunology, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Aziz Sheikh
- Primary Care, University of Edinburgh, Edinburgh, Scotland
| | - Kristine A Smith
- Otolaryngology-HNS, University of Utah, Salt Lake City, Utah, USA
| | - Michael B Soyka
- Otolaryngology-HNS, University of Zurich, University Hospital of Zurich, Zurich, Switzerland
| | - Masayoshi Takashima
- Otolaryngology-HNS, Houston Methodist Academic Institute, Houston, Texas, USA
| | - Monica Tang
- Allergy/Immunology, University of California San Francisco, San Francisco, California, USA
| | | | - Malcolm B Taw
- Integrative East-West Medicine, University of California Los Angeles, Westlake Village, California, USA
| | - Jody Tversky
- Allergy/Immunology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Matthew A Tyler
- Otolaryngology-HNS, University of Minnesota, Minneapolis, Minnesota, USA
| | - Maria C Veling
- Otolaryngology-HNS, University of Texas Southwestern, Dallas, Texas, USA
| | - Dana Wallace
- Allergy/Immunology, Nova Southeastern University, Ft. Lauderdale, Florida, USA
| | - De Yun Wang
- Otolaryngology-HNS, National University of Singapore, Singapore, Singapore
| | - Andrew White
- Allergy/Immunology, Scripps Clinic, San Diego, California, USA
| | - Luo Zhang
- Otolaryngology-HNS, Beijing Tongren Hospital, Beijing, China
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4
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Alexis NE, Zhou LY, Burbank AJ, Almond M, Hernandez ML, Mills KH, Noah TL, Wells H, Zhou H, Peden DB. Development of a screening protocol to identify persons who are responsive to wood smoke particle-induced airway inflammation with pilot assessment of GSTM1 genotype and asthma status as response modifiers. Inhal Toxicol 2022; 34:329-339. [PMID: 35968917 PMCID: PMC10519374 DOI: 10.1080/08958378.2022.2110334] [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: 01/25/2022] [Accepted: 07/28/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND We are currently screening human volunteers to determine their sputum polymorphonuclear neutrophil (PMN) response 6- and 24-hours following initiation of exposure to wood smoke particles (WSP). Inflammatory responders (≥10% increase in %PMN) are identified for their subsequent participation in mitigation studies against WSP-induced airways inflammation. In this report we compared responder status (<i>N</i> = 52) at both 6 and 24 hr time points to refine/expand its classification, assessed the impact of the GSTM1 genotype, asthma status and sex on responder status, and explored whether sputum soluble phase markers of inflammation correlate with PMN responsiveness to WSP. RESULTS Six-hour responders tended to be 24-hour responders and vice versa, but 24-hour responders also had significantly increased IL-1beta, IL-6, IL-8 at 24 hours post WSP exposure. The GSTM1 null genotype significantly (<i>p</i> < 0.05) enhanced the %PMN response by 24% in the 24-hour responders and not at all in the 6 hours responders. Asthma status enhanced the 24 hour %PMN response in the 6- and 24-hour responders. In the entire cohort (not stratified by responder status), we found a significant, but very small decrease in FVC and systolic blood pressure immediately following WSP exposure and sputum %PMNs were significantly increased and associated with sputum inflammatory markers (IL-1beta, IL-6, IL-8, and PMN/mg) at 24 but not 6 hours post exposure. Blood endpoints in the entire cohort showed a significant increase in %PMN and PMN/mg at 6 but not 24 hours. Sex had no effect on %PMN response. CONCLUSIONS The 24-hour time point was more informative than the 6-hour time point in optimally and expansively defining airway inflammatory responsiveness to WSP exposure. GSTM1 and asthma status are significant effect modifiers of this response. These study design and subject parameters should be considered before enrolling volunteers for proof-of-concept WSP mitigation studies.
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Affiliation(s)
- Neil E Alexis
- Center for Environmental Medicine, Asthma and Lung Biology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
- Division of Allergy & Immunology, Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Laura Y Zhou
- Center for Environmental Medicine, Asthma and Lung Biology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Allison J Burbank
- Division of Allergy & Immunology, Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
- Children's Research Institute, Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Martha Almond
- Center for Environmental Medicine, Asthma and Lung Biology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Michelle L Hernandez
- Division of Allergy & Immunology, Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
- Children's Research Institute, Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Katherine H Mills
- Division of Allergy & Immunology, Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Terry L Noah
- Center for Environmental Medicine, Asthma and Lung Biology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
- Division of Pulmonology, Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Heather Wells
- Center for Environmental Medicine, Asthma and Lung Biology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Haibo Zhou
- Center for Environmental Medicine, Asthma and Lung Biology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
- Children's Research Institute, Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - David B Peden
- Center for Environmental Medicine, Asthma and Lung Biology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
- Division of Allergy & Immunology, Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
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Lee KI, Chung YJ, Mo JH. The impact of air pollution on allergic rhinitis. ALLERGY ASTHMA & RESPIRATORY DISEASE 2021. [DOI: 10.4168/aard.2021.9.1.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Ki-Il Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon, Korea
| | - Young-Jun Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Korea
| | - Ji-Hun Mo
- Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Korea
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Rouadi PW, Idriss SA, Naclerio RM, Peden DB, Ansotegui IJ, Canonica GW, Gonzalez-Diaz SN, Rosario Filho NA, Ivancevich JC, Hellings PW, Murrieta-Aguttes M, Zaitoun FH, Irani C, Karam MR, Bousquet J. Immunopathological features of air pollution and its impact on inflammatory airway diseases (IAD). World Allergy Organ J 2020; 13:100467. [PMID: 33042360 PMCID: PMC7534666 DOI: 10.1016/j.waojou.2020.100467] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/31/2020] [Accepted: 09/11/2020] [Indexed: 12/14/2022] Open
Abstract
Air pollution causes significant morbidity and mortality in patients with inflammatory airway diseases (IAD) such as allergic rhinitis (AR), chronic rhinosinusitis (CRS), asthma, and chronic obstructive pulmonary disease (COPD). Oxidative stress in patients with IAD can induce eosinophilic inflammation in the airways, augment atopic allergic sensitization, and increase susceptibility to infection. We reviewed emerging data depicting the involvement of oxidative stress in IAD patients. We evaluated biomarkers, outcome measures and immunopathological alterations across the airway mucosal barrier following exposure, particularly when accentuated by an infectious insult.
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Key Words
- AR, Allergic rhinitis
- Air pollution
- Antioxidant
- COPD, Chronic obstructive pulmonary disease
- CRS, Chronic rhinosinusitis
- DEP, Diesel exhaust particles
- IAD, Inflammatory airway diseases
- IL, Interleukin
- ILC, Innate lymphoid cells
- Inflammatory airway disease
- NOx, Nitrogen oxides
- Oxidative stress biomarkers
- PAH, Polycyclic aromatic hydrocarbons
- PM, Particulate matter
- ROS, Reactive oxygen species
- TBS, Tobacco smoke
- TLR, Toll-like receptors
- Tobacco smoke
- Treg, Regulatory T cell
- VOCs, Volatile organic compounds
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Affiliation(s)
- Philip W. Rouadi
- Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon
| | - Samar A. Idriss
- Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon
| | - Robert M. Naclerio
- Johns Hopkins University Department of Otolaryngology - Head and Neck Surgery, Baltimore, MD, USA
| | - David B. Peden
- UNC Center for Environmental Medicine, Asthma, and Lung Biology, Division of Allergy, Immunology and Rheumatology, Department of Pediatrics UNS School of Medicine, USA
| | - Ignacio J. Ansotegui
- Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
| | | | - Sandra Nora Gonzalez-Diaz
- University Autonoma de Nuevo Leon Facultad de Medicina y Hospital Universitario U.A.N.L, Monterrey, NL, c.p. 64460, México
| | | | - Juan Carlos Ivancevich
- Faculty of Medicine, Universidad del Salvador, Buenos Aires, Argentina and Head of Allergy and Immunology at the Santa Isabel Clinic, Buenos Aires, Argentina
| | - Peter W. Hellings
- Department of Otorhinolaryngology, University Hospitals Leuven, Leuven, Belgium
- Department of Otorhinolaryngology, Academic Medical Center Amsterdam, The Netherlands - Department Otorhinolaryngology, University Hospital Ghent, Belgium
| | | | - Fares H. Zaitoun
- LAUMC Rizk Hospital, Otolaryngology-Allergy Department, Beirut, Lebanon
| | - Carla Irani
- Department of Internal Medicine and Infectious Diseases, St Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Marilyn R. Karam
- Division of Rheumatology, Allergy and Clinical Immunology, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Jean Bousquet
- INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France
- University Versailles St-Quentin-en-Yvelines, France
- Allergy-Centre-Charité, Charité–Universitätsmedizin Berlin, Berlin, Germany
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7
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International expert consensus on the management of allergic rhinitis (AR) aggravated by air pollutants: Impact of air pollution on patients with AR: Current knowledge and future strategies. World Allergy Organ J 2020; 13:100106. [PMID: 32256939 PMCID: PMC7132263 DOI: 10.1016/j.waojou.2020.100106] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 01/17/2020] [Accepted: 01/23/2020] [Indexed: 02/07/2023] Open
Abstract
Allergic rhinitis affects the quality of life of millions of people worldwide. Air pollution not only causes morbidity, but nearly 3 million people per year die from unhealthy indoor air exposure. Furthermore, allergic rhinitis and air pollution interact. This report summarizes the discussion of an International Expert Consensus on the management of allergic rhinitis aggravated by air pollution. The report begins with a review of indoor and outdoor air pollutants followed by epidemiologic evidence showing the impact of air pollution and climate change on the upper airway and allergic rhinitis. Mechanisms, particularly oxidative stress, potentially explaining the interactions between air pollution and allergic rhinitis are discussed. Treatment for the management of allergic rhinitis aggravated by air pollution primarily involves treating allergic rhinitis by guidelines and reducing exposure to pollutants. Fexofenadine a non-sedating oral antihistamine improves AR symptoms aggravated by air pollution. However, more efficacy studies on other pharmacological therapy of coexisting AR and air pollution are currently lacking.
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Key Words
- AER, Allergic eosinophilic rhinitis
- AP, Activator protein
- AR, Allergic rhinitis
- ARE, Antioxidant response element
- Air pollutants
- Air pollution
- Allergic rhinitis
- Antioxidant enzymes
- CFS, Chronic fatigue syndrome
- CO, Carbon monoxide
- COPD, Chronic obstructive pulmonary disease
- Climate change
- DAMP, Damage-associated molecular patterns
- DEP, Diesel exhaust particles
- ECAT, Elemental carbon attributable to traffic
- ECP, Eosinophil cationic protein
- GSH-Px, Glutathione peroxidase
- HDM, House dust mites
- HEPA, High efficiency particulate air
- HO, Hemeoxygenase
- HVAC, Heating, ventilation and air conditioning
- IAP, Indoor air pollution
- IAQ, Indoor air quality
- INS, Intranasal steroids
- Indoor air quality
- LDH, Lactate dehydrogenase
- MCP, Monocyte chemotactic protein
- MSQPCR, Mold specific quantitative PCR
- NAR, Non allergic rhinitis
- NF-κβ, Nuclear factor kappa β
- NO2, Nitrogen dioxide
- NOx, Nitric oxides
- Nrf2, Nuclear factor erythroid-2 related factor
- O3, Ozone
- OAP, Outdoor air pollution
- Occupational rhinitis
- Oxidative stress
- PAMP, Pathogen-associated molecular patterns
- PM, Particulate matter
- PON, Paraoxonase
- RNS, Reactive nitrosative species
- ROS, Reactive oxygen species
- SO2, Sulphur dioxide
- SOD, Superoxide dismutase
- TLR, Toll like receptor
- TNF, Tumor necrosis factor
- TOS, Total oxidative status
- TRAP, Traffic related air pollutants
- UFP, Ultra-fine particles
- VOCs, Volatile organic compound
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8
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Hu Y, Xu Z, Jiang F, Li S, Liu S, Wu M, Yan C, Tan J, Yu G, Hu Y, Yin Y, Tong S. Relative impact of meteorological factors and air pollutants on childhood allergic diseases in Shanghai, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 706:135975. [PMID: 31841850 DOI: 10.1016/j.scitotenv.2019.135975] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 12/05/2019] [Accepted: 12/05/2019] [Indexed: 05/03/2023]
Abstract
BACKGROUND Non-optimal weather conditions and air pollution pose a significant threat to children's health. However, the relative impact of different environmental exposures on childhood allergic diseases remains unclear. OBJECTIVES This study aimed to quantify the relative impact of meteorological factors and air pollutants on childhood allergic diseases in Shanghai, China. METHODS Data on clinical visits due to childhood asthma, allergic rhinitis (AR) and atopic dermatitis (AD) from 2007 to 2017 in Shanghai were collected from Shanghai Children's Medical Center and Xinhua Hospital. The meteorological data (i.e. daily mean temperature, temperature difference, air pressure, air pressure difference, precipitation, relative humidity, sunshine and wind speed) for the same period were obtained from the Shanghai Meteorological Center. Air pollution data (PM10, PM2.5, NO2, SO2 and O3) were provided by the Shanghai Environmental Protection Agency. Quasi-Poisson regression with distributed lag non-linear models and Poisson regression combined with generalized linear models were used to assess the relative impact of meteorological factors and air pollutants on childhood allergic diseases. RESULTS There were a total of 2,410,392 cases of childhood allergic diseases, including 975,771 asthma, 646,975 AR and 787,646 AD. Most of environmental factors were significantly associated with childhood allergic diseases. Daily mean temperature (standard β: -0.076 (95% confidence interval (CI): -0.086, -0.067)) and air pressure (standard β: 0.075 (95% CI: 0.068, 0.082)) seemed to play more important roles than other environmental factors in the occurrence of these allergic diseases. The numbers of these allergic diseases attributable to an interquartile range (IQR) change in meteorological factors also appeared to be greater than those attributable to an IQR change in air pollutants. CONCLUSIONS Both climatic variation and air pollution were associated with childhood allergic diseases, but the former appeared to play a more important role in the occurrence of these diseases. These findings may have significant implications for the development of tailored strategies to prevent these rapidly-increasing diseases worldwide.
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Affiliation(s)
- Yabin Hu
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhiwei Xu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shenghui Li
- School of Public Health, Shanghai Jiaotong University, Shanghai, China
| | - Shijian Liu
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Meiqin Wu
- Shanghai Key Laboratory of Environmental and Child Health, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chonghuai Yan
- Shanghai Key Laboratory of Environmental and Child Health, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | | | - Guangjun Yu
- Shanghai Children's Hospital, Shanghai, China
| | - Yi Hu
- Shanghai Children's Hospital, Shanghai, China
| | - Yong Yin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
| | - Shilu Tong
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China; School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China.
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9
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Patella V, Florio G, Magliacane D, Giuliano A, Crivellaro MA, Di Bartolomeo D, Genovese A, Palmieri M, Postiglione A, Ridolo E, Scaletti C, Ventura MT, Zollo A. Urban air pollution and climate change: "The Decalogue: Allergy Safe Tree" for allergic and respiratory diseases care. Clin Mol Allergy 2018; 16:20. [PMID: 30214380 PMCID: PMC6134633 DOI: 10.1186/s12948-018-0098-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 08/27/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND According to the World Health Organization, air pollution is closely associated with climate change and, in particular, with global warming. In addition to melting of ice and snow, rising sea level, and flooding of coastal areas, global warming is leading to a tropicalization of temperate marine ecosystems. Moreover, the effects of air pollution on airway and lung diseases are well documented as reported by the World Allergy Organization. METHODS Scientific literature was searched for studies investigating the effect of the interaction between air pollution and climate change on allergic and respiratory diseases. RESULTS Since 1990s, a multitude of articles and reviews have been published on this topic, with many studies confirming that the warming of our planet is caused by the "greenhouse effect" as a result of increased emission of "greenhouse" gases. Air pollution is also closely linked to global warming: the emission of hydrocarbon combustion products leads to increased concentrations of biological allergens such as pollens, generating a mixture of these particles called particulate matter (PM). The concept is that global warming is linked to the emission of hydrocarbon combustion products, since both carbon dioxide and heat increase pollen emission into the atmosphere, and all these particles make up PM10. However, the understanding of the mechanisms by which PM affects human health is still limited. Therefore, several studies are trying to determine the causes of global warming. There is also evidence that increased concentrations of air pollutants and pollens can activate inflammatory mediators in the airways. Our Task Force has prepared a Decalogue of rules addressing public administrators, which aims to limit the amount of allergenic pollen in the air without sacrificing public green areas. CONCLUSIONS Several studies underscore the significant risks of global warming on human health due to increasing levels of air pollution. The impact of climate change on respiratory diseases appears well documented. The last decades have seen a rise in the concentrations of pollens and pollutants in the air. This rise parallels the increase in the number of people presenting with allergic symptoms (e.g., allergic rhinitis, conjunctivitis, and asthma), who often require emergency medical care. Our hope is that scientists from different disciplines will work together with institutions, pharmaceutical companies and lay organizations to limit the adverse health effects of air pollution and global warming.
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Affiliation(s)
- Vincenzo Patella
- Division Allergy and Clinical Immunology, Department of Medicine ASL Salerno, “Santa Maria della Speranza” Hospital, Battipaglia, Salerno, Italy
- Postgraduate Program in Allergy and Clinical Immunology–University of Naples Federico II, Naples, Italy
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
| | - Giovanni Florio
- Division Allergy and Clinical Immunology, Department of Medicine ASL Salerno, “Santa Maria della Speranza” Hospital, Battipaglia, Salerno, Italy
- Postgraduate Program in Allergy and Clinical Immunology–University of Naples Federico II, Naples, Italy
| | - Diomira Magliacane
- Division Allergy and Clinical Immunology, Department of Medicine ASL Salerno, “Santa Maria della Speranza” Hospital, Battipaglia, Salerno, Italy
| | - Ada Giuliano
- Laboratory of Environmental Analysis, Department of Public Health, ASL Salerno, Salerno, Italy
| | - Maria Angiola Crivellaro
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Daniela Di Bartolomeo
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- Association of International Culture, Athena of Paestum, Capaccio-Paestum, Salerno, Italy
| | - Arturo Genovese
- Postgraduate Program in Allergy and Clinical Immunology–University of Naples Federico II, Naples, Italy
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
| | - Mario Palmieri
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- Former Primary of Unit of Pediatry, Hospital of Eboli, Salerno, Italy
| | - Amedeo Postiglione
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- International Court of the Environment Foundation (ICEF), Rome, Italy
| | - Erminia Ridolo
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Cristina Scaletti
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- Unit of Internal Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Maria Teresa Ventura
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Anna Zollo
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- Department of Studies and Researches, Movimento Ecologista Europeo FareAmbiente, Rome, Italy
| | - Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC)
- Division Allergy and Clinical Immunology, Department of Medicine ASL Salerno, “Santa Maria della Speranza” Hospital, Battipaglia, Salerno, Italy
- Postgraduate Program in Allergy and Clinical Immunology–University of Naples Federico II, Naples, Italy
- Air Pollution and Climate Change Task Force of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
- Laboratory of Environmental Analysis, Department of Public Health, ASL Salerno, Salerno, Italy
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
- Association of International Culture, Athena of Paestum, Capaccio-Paestum, Salerno, Italy
- Former Primary of Unit of Pediatry, Hospital of Eboli, Salerno, Italy
- International Court of the Environment Foundation (ICEF), Rome, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Unit of Internal Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
- Department of Studies and Researches, Movimento Ecologista Europeo FareAmbiente, Rome, Italy
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10
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Goodman JE, Zu K, Loftus CT, Lynch HN, Prueitt RL, Mohar I, Shubin SP, Sax SN. Short-term ozone exposure and asthma severity: Weight-of-evidence analysis. ENVIRONMENTAL RESEARCH 2018; 160:391-397. [PMID: 29059621 DOI: 10.1016/j.envres.2017.10.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 09/15/2017] [Accepted: 10/11/2017] [Indexed: 06/07/2023]
Abstract
To determine whether evidence indicates that short-term exposure to ambient concentrations of ozone in the United States can affect asthma severity, we systematically reviewed published controlled human exposure, epidemiology, and animal toxicity studies. The strongest evidence for a potential causal relationship came from epidemiology studies reporting increased emergency department visits and hospital admissions for asthma following elevated ambient ozone concentrations. However, while controlled exposure studies reported lung function decrements and increased asthma symptoms following high ozone exposures 160-400 parts per billion [ppb]), epidemiology studies evaluating similar outcomes reported less consistent results. Animal studies showed changes in pulmonary function at high ozone concentrations (> 500ppb), although there is substantial uncertainty regarding the relevance of these animal models to human asthma. Taken together, the weight of evidence indicates that there is at least an equal likelihood that either explanation is true, i.e., the strength of the evidence for a causal relationship between short-term exposure to ambient ozone concentrations and asthma severity is "equipoise and above."
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Affiliation(s)
| | - Ke Zu
- Gradient, 20 University Rd., Cambridge, MA, United States
| | | | | | | | - Isaac Mohar
- Gradient, 600 Stewart St., Seattle, WA, United States
| | | | - Sonja N Sax
- Gradient, 20 University Rd., Cambridge, MA, United States
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11
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Wicher SA, Lawson KL, Jacoby DB, Fryer AD, Drake MG. Ozone-induced eosinophil recruitment to airways is altered by antigen sensitization and tumor necrosis factor- α blockade. Physiol Rep 2017; 5:e13538. [PMID: 29242307 PMCID: PMC5742702 DOI: 10.14814/phy2.13538] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 10/23/2017] [Accepted: 10/23/2017] [Indexed: 01/21/2023] Open
Abstract
Ozone is an atmospheric pollutant that causes lung inflammation and airway hyperresponsiveness. Ozone's effects occur in two distinct phases that are mediated by different populations of eosinophils. In the acute phase 1 day after exposure, mature airway-resident eosinophils alter parasympathetic nerve function that results in airway hyperresponsiveness. At this time point, the severity of hyperresponsiveness correlates with the number of eosinophils in close proximity to airway nerves, but not with eosinophils in bronchoalveolar lavage. Three days later, newly divided eosinophils are recruited to airways by a tumor necrosis factor-α-dependent mechanism. These new eosinophils paradoxically attenuate ozone-induced airway hyperresponsiveness. Ozone's effects on airway tissue eosinophils and nerve-associated eosinophils 3 days after exposure are unknown. Thus, we tested ozone's effects on eosinophils in airway subepithelium and around airway nerves 1 and 3 days after ozone in nonsensitized and ovalbumin-sensitized guinea pigs with or without the tumor necrosis factor-α antagonist, etanercept, and compared changes in eosinophils with ozone-induced airway hyperresponsiveness. More eosinophils were present in small, noncartilaginous airways and along small airway nerves compared to large cartilaginous airways in all treatment groups. The number of airway and nerve-associated eosinophils were unaffected 1 day after ozone exposure, whereas significantly fewer airway eosinophils were present 3 days later. Airway and nerve-associated eosinophils were also decreased in small airways 3 days after ozone in sensitized animals. These changes were blocked by etanercept. Airway eosinophils, but not nerve-associated or bronchoalveolar lavage eosinophils correlated with airway hyperresponsiveness 3 days after ozone. Our findings indicate ozone causes persistent alterations in airway eosinophils and reinforce the importance of characterizing eosinophils' effects within distinct airway compartments.
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Affiliation(s)
- Sarah A Wicher
- Department of Physiology and Pharmacology, Oregon Health & Sciences University, Portland, Oregon
| | - Katy L Lawson
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health & Science University, Portland, Oregon
| | - David B Jacoby
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Allison D Fryer
- Department of Physiology and Pharmacology, Oregon Health & Sciences University, Portland, Oregon
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Matthew G Drake
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health & Science University, Portland, Oregon
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12
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Burbank AJ, Duran CG, Pan Y, Burns P, Jones S, Jiang Q, Yang C, Jenkins S, Wells H, Alexis N, Kesimer M, Bennett WD, Zhou H, Peden DB, Hernandez ML. Gamma tocopherol-enriched supplement reduces sputum eosinophilia and endotoxin-induced sputum neutrophilia in volunteers with asthma. J Allergy Clin Immunol 2017; 141:1231-1238.e1. [PMID: 28736267 DOI: 10.1016/j.jaci.2017.06.029] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 06/05/2017] [Accepted: 06/14/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND We and others have shown that the gamma tocopherol (γT) isoform of vitamin E has multiple anti-inflammatory and antioxidant actions and that γT supplementation reduces eosinophilic and endotoxin (LPS)-induced neutrophilic airway inflammation in animal models and healthy human volunteers. OBJECTIVE We sought to determine whether γT supplementation reduces eosinophilic airway inflammation and acute neutrophilic response to inhaled LPS challenge in volunteers with asthma. METHODS Participants with mild asthma were enrolled in a double-blinded, placebo-controlled crossover study to assess the effect of 1200 mg of γT daily for 14 days on sputum eosinophils, mucins, and cytokines. We also assessed the effect on acute inflammatory response to inhaled LPS challenge following γT treatment, focusing on changes in sputum neutrophilia, mucins, and cytokines. Mucociliary clearance was measured using gamma scintigraphy. RESULTS Fifteen subjects with mild asthma completed both arms of the study. Compared with placebo, γT notably reduced pre-LPS challenge sputum eosinophils and mucins, including mucin 5AC and reduced LPS-induced airway neutrophil recruitment 6 and 24 hours after challenge. Mucociliary clearance was slowed 4 hours postchallenge in the placebo group but not in the γT treatment group. Total sputum mucins (but not mucin 5AC) were reduced at 24 hours postchallenge during γT treatment compared with placebo. CONCLUSIONS When compared with placebo, γT supplementation for 14 days reduced inflammatory features of asthma, including sputum eosinophils and mucins, as well as acute airway response to inhaled LPS challenge. Larger scale clinical trials are needed to assess the efficacy of γT supplements as a complementary or steroid-sparing treatment for asthma.
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Affiliation(s)
- Allison J Burbank
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC; Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of North Carolina, Chapel Hill, NC.
| | - Charity G Duran
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC
| | - Yinghao Pan
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Patricia Burns
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC
| | - Susan Jones
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC
| | - Qing Jiang
- Department of Nutrition Science, Purdue University, West Lafayette, Ind
| | - Chao Yang
- Department of Nutrition Science, Purdue University, West Lafayette, Ind
| | - Sha'Leema Jenkins
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC
| | - Heather Wells
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC
| | - Neil Alexis
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC; Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of North Carolina, Chapel Hill, NC
| | - Mehmet Kesimer
- Department of Pathology and Laboratory Medicine, Cystic Fibrosis/Pulmonary Research and Treatment Center, Marsico Lung Institute, University of North Carolina, Chapel Hill, NC
| | - William D Bennett
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC
| | - Haibo Zhou
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - David B Peden
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC; Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of North Carolina, Chapel Hill, NC
| | - Michelle L Hernandez
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC; Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of North Carolina, Chapel Hill, NC
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13
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Frampton MW, Balmes JR, Bromberg PA, Stark P, Arjomandi M, Hazucha MJ, Rich DQ, Hollenbeck-Pringle D, Dagincourt N, Alexis N, Ganz P, Zareba W, Costantini MG. Multicenter Ozone Study in oldEr Subjects (MOSES): Part 1. Effects of Exposure to Low Concentrations of Ozone on Respiratory and Cardiovascular Outcomes. Res Rep Health Eff Inst 2017; 2017:1-107. [PMID: 31898880 PMCID: PMC7266375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
INTRODUCTION Exposure to air pollution is a well-established risk factor for cardiovascular morbidity and mortality. Most of the evidence supporting an association between air pollution and adverse cardiovascular effects involves exposure to particulate matter (PM). To date, little attention has been paid to acute cardiovascular responses to ozone, in part due to the notion that ozone causes primarily local effects on lung function, which are the basis for the current ozone National Ambient Air Quality Standards (NAAQS). There is evidence from a few epidemiological studies of adverse health effects of chronic exposure to ambient ozone, including increased risk of mortality from cardiovascular disease. However, in contrast to the well-established association between ambient ozone and various nonfatal adverse respiratory effects, the observational evidence for impacts of acute (previous few days) increases in ambient ozone levels on total cardiovascular mortality and morbidity is mixed. Ozone is a prototypic oxidant gas that reacts with constituents of the respiratory tract lining fluid to generate reactive oxygen species (ROS) that can overwhelm antioxidant defenses and cause local oxidative stress. Pathways by which ozone could cause cardiovascular dysfunction include alterations in autonomic balance, systemic inflammation, and oxidative stress. These initial responses could lead ultimately to arrhythmias, endothelial dysfunction, acute arterial vasoconstriction, and procoagulant activity. Individuals with impaired antioxidant defenses, such as those with the null variant of glutathione S-transferase mu 1 (GSTM1), may be at increased risk for acute health effects. The Multicenter Ozone Study in oldEr Subjects (MOSES) was a controlled human exposure study designed to evaluate whether short-term exposure of older, healthy individuals to ambient levels of ozone induces acute cardiovascular responses. The study was designed to test the a priori hypothesis that short-term exposure to ambient levels of ozone would induce acute cardiovascular responses through the following mechanisms: autonomic imbalance, systemic inflammation, and development of a prothrombotic vascular state. We also postulated a priori the confirmatory hypothesis that exposure to ozone would induce airway inflammation, lung injury, and lung function decrements. Finally, we postulated the secondary hypotheses that ozone-induced acute cardiovascular responses would be associated with: (a) increased systemic oxidative stress and lung effects, and (b) the GSTM1-null genotype. METHODS The study was conducted at three clinical centers with a separate Data Coordinating and Analysis Center (DCAC) using a common protocol. All procedures were approved by the institutional review boards (IRBs) of the participating centers. Healthy volunteers 55 to 70 years of age were recruited. Consented participants who successfully completed the screening and training sessions were enrolled in the study. All three clinical centers adhered to common standard operating procedures (SOPs) and used common tracking and data forms. Each subject was scheduled to participate in a total of 11 visits: screening visit, training visit, and three sets of exposure visits, each consisting of the pre-exposure day, the exposure day, and the post-exposure day. The subjects spent the night in a nearby hotel the night of the pre-exposure day. On exposure days, the subjects were exposed for three hours in random order to 0 ppb ozone (clean air), 70 ppb ozone, and 120 ppm ozone, alternating 15 minutes of moderate exercise with 15 minutes of rest. A suite of cardiovascular and pulmonary endpoints was measured on the day before, the day of, and up to 22 hours after, each exposure. The endpoints included: (1) electrocardiographic changes (continuous Holter monitoring: heart rate variability [HRV], repolarization, and arrhythmia); (2) markers of inflammation and oxidative stress (C-reactive protein [CRP], interleukin-6 [IL-6], 8-isoprostane, nitrotyrosine, and P-selectin); (3) vascular function measures (blood pressure [BP], flow-mediated dilatation [FMD] of the brachial artery, and endothelin-1 [ET-1]; (4) venous blood markers of platelet activation, thrombosis, and microparticle-associated tissue factor activity (MP-TFA); (5) pulmonary function (spirometry); (6) markers of airway epithelial cell injury (increases in plasma club cell protein 16 [CC16] and sputum total protein); and (7) markers of lung inflammation in sputum (polymorphonuclear leukocytes [PMN], IL-6, interleukin-8 [IL-8], and tumor necrosis factor-alpha [TNF-α]). Sputum was collected only at 22 hours after exposure. The analyses of the continuous electrocardiographic monitoring, the brachial artery ultrasound (BAU) images, and the blood and sputum samples were carried out by core laboratories. The results of all analyses were submitted directly to the DCAC. The variables analyzed in the statistical models were represented as changes from pre-exposure to post-exposure (post-exposure minus pre-exposure). Mixed-effect linear models were used to evaluate the impact of exposure to ozone on the prespecified primary and secondary continuous outcomes. Site and time (when multiple measurements were taken) were controlled for in the models. Three separate interaction models were constructed for each outcome: ozone concentration by subject sex; ozone concentration by subject age; and ozone concentration by subject GSTM1 status (null or sufficient). Because of the issue of multiple comparisons, the statistical significance threshold was set a priori at P < 0.01. RESULTS Subject recruitment started in June 2012, and the first subject was randomized on July 25, 2012. Subject recruitment ended on December 31, 2014, and testing of all subjects was completed by April 30, 2015. A total of 87 subjects completed all three exposures. The mean age was 59.9 ± 4.5 years, 60% of the subjects were female, 88% were white, and 57% were GSTM1 null. Mean baseline body mass index (BMI), BP, cholesterol (total and low-density lipoprotein), and lung function were all within the normal range. We found no significant effects of ozone exposure on any of the primary or secondary endpoints for autonomic function, repolarization, ST segment change, or arrhythmia. Ozone exposure also did not cause significant changes in the primary endpoints for systemic inflammation (CRP) and vascular function (systolic blood pressure [SBP] and FMD) or secondary endpoints for systemic inflammation and oxidative stress (IL-6, P-selectin, and 8-isoprostane). Ozone did cause changes in two secondary endpoints: a significant increase in plasma ET-1 (P = 0.008) and a marginally significant decrease in nitrotyrosine (P = 0.017). Lastly, ozone exposure did not affect the primary prothrombotic endpoints (MP-TFA and monocyte-platelet conjugate count) or any secondary markers of prothrombotic vascular status (platelet activation, circulating microparticles [MPs], von Willebrand factor [vWF], or fibrinogen.). Although our hypothesis focused on possible acute cardiovascular effects of exposure to low levels of ozone, we recognized that the initial effects of inhaled ozone involve the lower airways. Therefore, we looked for: (a) changes in lung function, which are known to occur during exposure to ozone and are maximal at the end of exposure; and (b) markers of airway injury and inflammation. We found an increase in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV₁) after exposure to 0 ppb ozone, likely due to the effects of exercise. The FEV₁ increased significantly 15 minutes after 0 ppb exposure (85 mL; 95% confidence interval [CI], 64 to 106; P < 0.001), and remained significantly increased from pre-exposure at 22 hours (45 mL; 95% CI, 26 to 64; P < 0.001). The increase in FVC followed a similar pattern. The increase in FEV₁ and FVC were attenuated in a dose-response manner by exposure to 70 and 120 ppb ozone. We also observed a significant ozone-induced increase in the percentage of sputum PMN 22 hours after exposure at 120 ppb compared to 0 ppb exposure (P = 0.003). Plasma CC16 also increased significantly after exposure to 120 ppb (P < 0.001). Sputum IL-6, IL-8, and TNF-α concentrations were not significantly different after ozone exposure. We found no significant interactions with sex, age, or GSTM1 status regarding the effect of ozone on lung function, percentage of sputum PMN, or plasma CC16. CONCLUSIONS In this multicenter clinical study of older healthy subjects, ozone exposure caused concentration-related reductions in lung function and presented evidence for airway inflammation and injury. However, there was no convincing evidence for effects on cardiovascular function. Blood levels of the potent vasoconstrictor, ET-1, increased with ozone exposure (with marginal statistical significance), but there were no effects on BP, FMD, or other markers of vascular function. Blood levels of nitrotyrosine decreased with ozone exposure, the opposite of our hypothesis. Our study does not support acute cardiovascular effects of low-level ozone exposure in healthy older subjects. Inclusion of only healthy older individuals is a major limitation, which may affect the generalizability of our findings. We cannot exclude the possibility of effects with higher ozone exposure concentrations or more prolonged exposure, or the possibility that subjects with underlying vascular disease, such as hypertension or diabetes, would show effects under these conditions.
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Affiliation(s)
- M W Frampton
- University of Rochester Medical Center, Rochester, New York
| | | | | | - P Stark
- New England Research Institute, Watertown, Massachusetts
| | | | | | - D Q Rich
- University of Rochester Medical Center, Rochester, New York
| | | | - N Dagincourt
- New England Research Institute, Watertown, Massachusetts
| | - N Alexis
- University of North Carolina, Chapel Hill
| | - P Ganz
- University of California, San Francisco
| | - W Zareba
- University of Rochester Medical Center, Rochester, New York
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14
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Short-Term Associations between Air Pollution Concentrations and Respiratory Health-Comparing Primary Health Care Visits, Hospital Admissions, and Emergency Department Visits in a Multi-Municipality Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14060587. [PMID: 28561792 PMCID: PMC5486273 DOI: 10.3390/ijerph14060587] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 05/17/2017] [Accepted: 05/27/2017] [Indexed: 12/04/2022]
Abstract
Acute effects of air pollution on respiratory health have traditionally been investigated with data on inpatient admissions, emergency room visits, and mortality. In this study, we aim to describe the total acute effects of air pollution on health care use for respiratory symptoms (ICD10-J00-J99). This will be done by investigating primary health care (PHC) visits, inpatient admissions, and emergency room visits together in five municipalities in southern Sweden, using a case-crossover design. Between 2005 and 2010, there were 81,019 visits to primary health care, 38,217 emergency room visits, and 25,271 inpatient admissions for respiratory symptoms in the study area. There was a 1.85% increase (95% CI: 0.52 to 3.20) in the number of primary health care visits associated with a 10 µg/m3 increase in nitrogen dioxide (NO2) levels in Malmö, but not in the other municipalities. Air pollution levels were generally not associated with emergency room visits or inpatient admissions, with one exception (in Helsingborg there was a 2.52% increase in emergency room visits for respiratory symptoms associated with a 10 µg/m3 increase in PM10). In conclusion, the results give weak support for short-term effects of air pollution on health care use associated with respiratory health symptoms in the study area.
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Falcón-Rodríguez CI, Rosas-Pérez I, Segura-Medina P. Relación de los mecanismos inmunológicos del asma y la contaminación ambiental. REVISTA DE LA FACULTAD DE MEDICINA 2017. [DOI: 10.15446/revfacmed.v65n2.59954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. Se calcula que más de 300 millones de personas alrededor del mundo padecen asma y se estima que para el año 2025 esta cifra se incremente a 400 millones debido a los contaminantes criterio. Sin embargo, dadas sus limitaciones, los estudios epidemiológicos son controversiales sobre la contaminación y el desarrollo de asma.Objetivos. Describir las diferencias y similitudes de la respuesta inmunológica de pacientes asmáticos y los modelos animales de asma alérgica después de la exposición a contaminantes criterio y elementos biológicos, para así identificar los factores inmunológicos relacionados con el desarrollo de asma.Materiales y método. Se realizó una búsqueda sistemática en las bases de datos sobre asma y los diferentes contaminantes criterio.Resultados. La respuesta Th2 es activada por la inhalación de ozono, dióxido de nitrógeno, azufre y la exposición aguda a material particulado, mientras que el contacto con ciertos tipos de pólenes y glucanos y la exposición crónica de partículas incrementa la respuesta Th1, la cual inhibe a la respuesta Th2 produciendo un “efecto protector”.Conclusiones. La respuesta Th1 podría causar baja o nula asociación entre la exposición a contaminación y el desarrollo de asma en las diferentes ciudades, adicionando de esta manera otra limitación a los estudios epidemiológicos.
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Lee H, Kim EK, Kim HY, Kim TI. Effects of Exposure to Ozone on the Ocular Surface in an Experimental Model of Allergic Conjunctivitis. PLoS One 2017; 12:e0169209. [PMID: 28046113 PMCID: PMC5207719 DOI: 10.1371/journal.pone.0169209] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 12/13/2016] [Indexed: 12/30/2022] Open
Abstract
Based on previous findings that ozone can induce an inflammatory response in the ocular surface of an animal model and in cultured human conjunctival epithelial cells, we investigated whether exposure to ozone exacerbates symptoms of allergic conjunctivitis. We evaluated the effects of exposure to ozone on conjunctival chemosis, conjunctival injection, corneal and conjunctival fluorescein staining scores, production of inflammatory cytokines in tears, and aqueous tear production in a mouse model of allergic conjunctivitis. To validate our in vivo results, we used interleukin (IL)-1α-pretreated conjunctival epithelial cells as an in vitro substitute for the mouse model. We evaluated whether exposure to ozone increased the inflammatory response and altered oxidative status and mitochondrial function in IL-1α-pretreated conjunctival epithelial cells. In the in vivo study, ozone induced increases in conjunctival chemosis, conjunctival injection, corneal and conjunctival fluorescein staining scores, and production of inflammatory cytokines, accompanied by a decrease in tear volume. In the in vitro study, exposure to ozone led to additional increases in IL-6 and tumor necrosis factor-α mRNA levels, which were already induced by treatment with IL-1α. Ozone did not induce any changes in cell viability. Pretreatment with IL-1α increased the expression of manganese superoxide dismutase, and exposure to ozone led to additional increments in the expression of this antioxidant enzyme. Ozone did not induce any changes in mitochondrial activity or expression of mitochondrial enzymes and proteins related to mitochondrial function, with the exception of phosphor-mammalian target of rapamycin. Treatment with butylated hydroxyanisole, a free radical scavenger, attenuated the ozone-induced increases in IL-6 expression in IL-1α-pretreated conjunctival epithelial cells. Therefore, we conclude that exposure to ozone exacerbates the detrimental effects on the integrity of the ocular surface caused by conjunctival allergic reactions, and further increases the inflammatory response in IL-1α-pretreated conjunctival epithelial cells.
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Affiliation(s)
- Hun Lee
- Department of Ophthalmology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, South Korea
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Eung Kweon Kim
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
- Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Hee Young Kim
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
- Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Tae-im Kim
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
- Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, South Korea
- * E-mail:
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Zuo L, Lucas K, Fortuna CA, Chuang CC, Best TM. Molecular Regulation of Toll-like Receptors in Asthma and COPD. Front Physiol 2015; 6:312. [PMID: 26617525 PMCID: PMC4637409 DOI: 10.3389/fphys.2015.00312] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 10/19/2015] [Indexed: 11/13/2022] Open
Abstract
Asthma and chronic obstructive pulmonary disease (COPD) have both been historically associated with significant morbidity and financial burden. These diseases can be induced by several exogenous factors, such as pathogen-associated molecular patterns (PAMPs) (e.g., allergens and microbes). Endogenous factors, including reactive oxygen species, and damage-associated molecular patterns (DAMPs) recognized by toll-like receptors (TLRs), can also result in airway inflammation. Asthma is characterized by the dominant presence of eosinophils, mast cells, and clusters of differentiation (CD)4+ T cells in the airways, while COPD typically results in the excessive formation of neutrophils, macrophages, and CD8+ T cells in the airways. In both asthma and COPD, in the respiratory tract, TLRs are the primary proteins of interest associated with the innate and adaptive immune responses; hence, multiple treatment options targeting TLRs are being explored in an effort to reduce the severity of the symptoms of these disorders. TLR-mediated pathways for both COPD and asthma have their similarities and differences with regards to cell types and the pro-inflammatory cytotoxins present in the airway. Because of the complex TLR cascade, a variety of treatments have been used to minimize airway hypersensitivity and promote bronchodilation. Although unsuccessful at completely alleviating COPD and severe asthmatic symptoms, new studies are focused on possible targets within the TLR cascade to ameliorate airway inflammation.
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Affiliation(s)
- Li Zuo
- Radiologic Sciences and Respiratory Therapy Division, The Ohio State University Wexner Medical Center, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, Ohio State University Columbus, OH, USA ; Interdisciplinary Biophysics Graduate Program, The Ohio State University Columbus, OH, USA
| | - Kurt Lucas
- Multiphase Chemistry Department, Max Planck Institute for Chemistry Mainz, Germany
| | - Christopher A Fortuna
- Radiologic Sciences and Respiratory Therapy Division, The Ohio State University Wexner Medical Center, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, Ohio State University Columbus, OH, USA
| | - Chia-Chen Chuang
- Radiologic Sciences and Respiratory Therapy Division, The Ohio State University Wexner Medical Center, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, Ohio State University Columbus, OH, USA ; Interdisciplinary Biophysics Graduate Program, The Ohio State University Columbus, OH, USA
| | - Thomas M Best
- Division of Sports Medicine, Department of Family Medicine, Sports Health and Performance Institute, The Ohio State University Wexner Medical Center Columbus, OH, USA
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Aleman MM, Kesic MJ, Mills KH, Peden DB, Hernandez ML. The IL-1 axis is associated with airway inflammation after O3 exposure in allergic asthmatic patients. J Allergy Clin Immunol 2015; 136:1099-101.e2. [PMID: 25959670 PMCID: PMC4600417 DOI: 10.1016/j.jaci.2015.03.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 03/10/2015] [Accepted: 03/20/2015] [Indexed: 01/23/2023]
Affiliation(s)
- Maria M Aleman
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Matthew J Kesic
- Doctor of Physical Therapy Program, Methodist University, Fayetteville, NC
| | - Katherine H Mills
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - David B Peden
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Michelle L Hernandez
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC.
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Inflammatory and repair pathways induced in human bronchoalveolar lavage cells with ozone inhalation. PLoS One 2015; 10:e0127283. [PMID: 26035830 PMCID: PMC4452717 DOI: 10.1371/journal.pone.0127283] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 04/14/2015] [Indexed: 02/07/2023] Open
Abstract
Background Inhalation of ambient levels of ozone causes airway inflammation and epithelial injury. Methods To examine the responses of airway cells to ozone-induced oxidative injury, 19 subjects (7 with asthma) were exposed to clean air (0ppb), medium (100ppb), and high (200ppb) ambient levels of ozone for 4h on three separate occasions in a climate-controlled chamber followed by bronchoscopy with bronchoalveolar lavage (BAL) 24h later. BAL cell mRNA expression was examined using Affymetrix GeneChip Microarray. The role of a differentially expressed gene (DEG) in epithelial injury was evaluated in an in vitro model of injury [16HBE14o- cell line scratch assay]. Results Ozone exposure caused a dose-dependent up-regulation of several biologic pathways involved in inflammation and repair including chemokine and cytokine secretion, activity, and receptor binding; metalloproteinase and endopeptidase activity; adhesion, locomotion, and migration; and cell growth and tumorigenesis regulation. Asthmatic subjects had 1.7- to 3.8-fold higher expression of many DEGs suggestive of increased proinflammatory and matrix degradation and remodeling signals. The most highly up-regulated gene was osteopontin, the protein level of which in BAL fluid increased in a dose-dependent manner after ozone exposure. Asthmatic subjects had a disproportionate increase in non-polymerized osteopontin with increasing exposure to ozone. Treatment with polymeric, but not monomeric, osteopontin enhanced the migration of epithelial cells and wound closure in an α9β1 integrin-dependent manner. Conclusions Expression profiling of BAL cells after ozone exposure reveals potential regulatory genes and pathways activated by oxidative stress. One DEG, osteopontin, promotes epithelial wound healing in an in vitro model of injury.
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Air pollution and asthma: how can a public health concern inform the care of individual patients? Ann Allergy Asthma Immunol 2015; 113:343-6. [PMID: 25256028 DOI: 10.1016/j.anai.2014.07.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 07/17/2014] [Accepted: 07/20/2014] [Indexed: 01/21/2023]
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21
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Body mass index correlates with pollutant-induced interleukin-1β in sputum and blood. Ann Allergy Asthma Immunol 2014; 114:251-3. [PMID: 25524746 DOI: 10.1016/j.anai.2014.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 10/22/2014] [Accepted: 11/19/2014] [Indexed: 11/21/2022]
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McSharry C, Spears M, Chaudhuri R, Cameron EJ, Husi H, Thomson NC. Increased sputum endotoxin levels are associated with an impaired lung function response to oral steroids in asthmatic patients. J Allergy Clin Immunol 2014; 134:1068-75. [PMID: 25262463 DOI: 10.1016/j.jaci.2014.08.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 07/25/2014] [Accepted: 08/12/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Airway endotoxin might contribute to corticosteroid insensitivity in asthmatic patients. OBJECTIVE Because cigarette smoke contains endotoxin, we tested the hypothesis that sputum endotoxin concentrations are increased in cigarette smokers and that endotoxin concentrations are associated with corticosteroid insensitivity in asthmatic patients. METHODS Sixty-nine asthmatic patients (never smokers, smokers, and exsmokers) and 20 healthy subjects (never smokers and smokers) were recruited. Fifty-three asthmatic patients received a 2-week course of oral dexamethasone. Serum and induced sputum endotoxin and cytokine concentrations were quantified by using an enzyme immunoassay. RESULTS Median (interquartile range [IQR]) sputum endotoxin concentration were not significantly different between asthmatic never smokers (184 endotoxin units [EU]/mL; IQR, 91-310 EU/mL), exsmokers (123 EU/mL; IQR, 39-207 EU/mL), and smokers (177 EU/mL; IQR, 41-772 EU/mL; P = .703) and healthy subjects (164 EU/mL; IQR, 106-373 EU/mL). The lung function response to oral corticosteroids decreased with increasing sputum endotoxin concentrations in the never smokers (linear regression α = .05, Spearman r = -0.503, P = .009) but not in smokers (α = .587, r = -0.282, P = .257), as confirmed by using multiple regression analysis. Asthmatic smokers had higher concentrations of serum endotoxin than asthmatic nonsmokers (0.25 EU/mL [IQR, 0.09-0.39 EU/mL] vs 0.08 EU/mL [IQR, 0.05-0.19 EU/mL], P = .042) unrelated to steroid insensitivity or serum cytokine concentrations. In the asthmatic group sputum endotoxin concentrations correlated with sputum IL-1 receptor antagonist concentrations (r = 0.510, P < .001), and serum endotoxin concentrations significantly correlated with sputum IL-6, IL-8, and chemokine motif ligand 2 concentrations. CONCLUSION Asthmatic smokers have similar sputum endotoxin concentrations compared with those of asthmatic never smokers. The association between higher sputum endotoxin levels and an impaired lung function response to oral corticosteroids, particularly in asthmatic never smokers, suggests that airway endotoxin might contribute to corticosteroid insensitivity in asthmatic patients.
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Affiliation(s)
- Charles McSharry
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom.
| | - Mark Spears
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom
| | - Rekha Chaudhuri
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom
| | - Euan J Cameron
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom
| | - Holger Husi
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Neil C Thomson
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom
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Alexis NE, Carlsten C. Interplay of air pollution and asthma immunopathogenesis: a focused review of diesel exhaust and ozone. Int Immunopharmacol 2014; 23:347-55. [PMID: 25194677 DOI: 10.1016/j.intimp.2014.08.009] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 08/12/2014] [Indexed: 12/20/2022]
Abstract
Controlled human exposure experiments with diesel exhaust particles (DEPs) and ozone serve to illustrate the important role pollutants play in modulating both allergic mechanisms and immune responses to affect the immunopathogenesis of airway diseases such as asthma. For DEP, evidence is stronger for the exacerbation of existing asthma rather than for the development of new disease. To the extent that this enhancement occurs, the augmentation of Th2-type immunity seems to be a common element. For ozone, neutrophilic inflammation, altered immune cell phenotype and function and oxidative stress are all marked responses that likely contribute to underlying immune-inflammatory features of asthma. Evidence is also emerging that unique gene signatures and epigenetic control of immune and inflammatory-based genes are playing important roles in the magnitude of the impact ozone is having on respiratory health. Indeed, the interplay between air pollutants such as DEP and ozone and asthma immunopathogenesis is an ongoing concern in terms of understanding how exposure to these agents can lead to worsening of disease. To this end, asthmatics may be pre-disposed to the deleterious effects of pollutants like ozone, having constitutively modified host defense functions and gene signatures. Although this review has utilized DEP and ozone as example pollutants, more research is needed to better understand the interplay between air pollution in general and asthma immumopathogenesis.
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Affiliation(s)
- Neil E Alexis
- Center for Environmental Medicine Asthma and Lung Biology, Department of Pediatrics, UNC Chapel Hill, Chapel Hill, NC, United States.
| | - Chris Carlsten
- Department of Medicine and School of Population and Public Health, University of British Columbia, Canada
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Kucuksezer UC, Zekiroglu E, Kasapoglu P, Adin-Cinar S, Aktas-Cetin E, Deniz G. A stimulatory role of ozone exposure on human natural killer cells. Immunol Invest 2013; 43:1-12. [PMID: 24063543 DOI: 10.3109/08820139.2013.810240] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Ozone is claimed to have beneficial effects. While studies revealed the safe therapeutic use of ozone, there are conflicting results for the link between immune system and ozone encounter. Natural killer (NK) cells are important sentinels of immunity with their cytotoxic activity and immune-regulatory potentials. This study aimed to investigate the effects of direct ozone encountering on human immune system, at cellular level. Survival, proliferative capacity and subset content of peripheral blood mononuclear cells (PBMC) were analysed. PBMC of healthy donors (n=5, mean age: 27±6 years) were exposed to 1, 5, 10 and 50 µg/mL doses of medical ozone, directly injected into culture wells, once, initially. 1 and 5 µg/mL doses didn't show toxic effects while 10 and 50 µg/mL doses were toxic. PBMC were cultured for 5 days following 1 and 5 µg/mL ozone encountering. 1 µg/mL dose increased numbers of CD3-CD16+/56+ NK cells among PBMC. Following stimulation with ozone, no difference was observed in basal and phytohemaglutinin-stimulated proliferative capacity. 1 and 5 µg/mL doses of ozone were found to increase NK cytotoxicity. These data indicates influential effects of transient ozone exposure on NK cells, which in turn may have a role in control of immune responses.
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Affiliation(s)
- Umut Can Kucuksezer
- Department of Immunology, Institute of Experimental Medicine (DETAE), Istanbul University , 34393, Istanbul , Turkey
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Abstract
Last year's "Advances in pediatric asthma: moving forward" concluded the following: "Now is also the time to utilize information recorded in electronic medical records to develop innovative disease management plans that will track asthma over time and enable timely decisions on interventions in order to maintain control that can lead to disease remission and prevention." This year's summary will focus on recent advances in pediatric asthma on modifying disease activity, preventing asthma exacerbations, managing severe asthma, and risk factors for predicting and managing early asthma, as indicated in Journal of Allergy and Clinical Immunology publications in 2012. Recent reports continue to shed light on methods to improve asthma management through steps to assess disease activity, tools to standardize outcome measures in asthma, genetic markers that predict risk for asthma and appropriate treatment, and interventions that alter the early presentation of asthma to prevent progression. We are well on our way to creating a pathway around wellness in asthma care and also to use new tools to predict the risk for asthma and take steps to not only prevent asthma exacerbations but also to prevent the early manifestations of the disease and thus prevent its evolution to severe asthma.
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Affiliation(s)
- Stanley J Szefler
- Division of Pediatric Clinical Pharmacology, Department of Pediatrics, National Jewish Health, Denver, CO 80206, USA.
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The effect of environmental oxidative stress on airway inflammation. Curr Opin Allergy Clin Immunol 2012; 12:133-9. [PMID: 22306553 DOI: 10.1097/aci.0b013e32835113d6] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE OF REVIEW Asthma is an inflammatory respiratory condition with significantly associated morbidity and mortality that is increasing in prevalence. Air pollution is an important factor in both the development of asthma and in asthma exacerbations. Oxidative stress as a result of exposure to air pollution and underlying genetic polymorphisms that may play a role in susceptibility to this oxidative stress are the subject of current investigation. This article reviews the data regarding the effects of air pollution on the innate immune response and potential clinical and treatment implications of how genetic polymorphisms affect this response. RECENT FINDINGS Recent investigation reveals how pollutant-induced oxidative stress impacts airway inflammatory responses. Work by our study group demonstrates that asthmatic patients have an exaggerated inflammatory response to air pollution-induced oxidative stress. New trials investigating antioxidants as potential therapeutic interventions may target this specific issue. SUMMARY Air pollution plays a critical role in asthma and may affect certain patients more than others. Further investigation into the genetic polymorphisms that affect inflammatory responses may help target patient populations at greatest risk for air pollution-induced asthma and may provide new therapeutic options for these patient populations.
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