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Brustad N, Thorsen J, Pedersen CET, Ali M, Kyvsgaard J, Brandt S, Lehtimäki J, Prince N, Følsgaard NV, Lasky-Su J, Stokholm J, Bønnelykke K, Chawes B. Urban metabolic and airway immune profiles increase the risk of infections in early childhood. Thorax 2024:thorax-2024-221460. [PMID: 39117420 DOI: 10.1136/thorax-2024-221460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 06/30/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND Infections in childhood remain a leading global cause of child mortality and environmental exposures seem crucial. We investigated whether urbanicity at birth was associated with the risk of infections and explored underlying mechanisms. METHODS Children (n=633) from the COPSAC2010 mother-child cohort were monitored daily with symptom diaries of infection episodes during the first 3 years and prospectively diagnosed with asthma until age 6 years. Rural and urban environments were based on the CORINE land cover database. Child airway immune profile was measured at age 4 weeks. Maternal and child metabolomics profiling were assessed at pregnancy week 24 and at birth, respectively. RESULTS We observed a mean (SD) total number of infections of 16.3 (8.4) consisting mainly of upper respiratory infections until age 3 years. Urban versus rural living increased infection risk (17.1 (8.7) vs 15.2 (7.9), adjusted incidence rate ratio; 1.15 (1.05-1.26), p=0.002) and altered the child airway immune profile, which increased infection risk (principal component 1 (PC1): 1.03 (1.00-1.06), p=0.038 and PC2: 1.04 (1.01-1.07), p=0.022). Urban living also altered the maternal and child metabolomic profiles, which also increased infection risk. The association between urbanicity and infection risk was partly mediated through the maternal metabolomic and child airway immune profiles. Finally, urbanicity increased the risk of asthma by age 6 years, which was mediated through early infection load (pACME<0.001). CONCLUSION This study suggests urbanicity as an independent risk factor for early infections partly explained by changes in the early metabolic and immunological development with implications for later risk of asthma.
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Affiliation(s)
- Nicklas Brustad
- Copenhagen Prospective Studies on Asthma in Childhood, Gentofte, Denmark
| | - Jonathan Thorsen
- Copenhagen Prospective Studies on Asthma in Childhood, Gentofte, Denmark
| | | | - Mina Ali
- University of Copenhagen, Kobenhavn, Denmark
| | - Julie Kyvsgaard
- Copenhagen Prospective Studies on Asthma in Childhood, Gentofte, Denmark
- Department of Pediatrics, Slagelse Sygehus, Næstved, Denmark
| | - Sarah Brandt
- Copenhagen Prospective Studies on Asthma in Childhood, Gentofte, Denmark
| | | | - Nicole Prince
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Jessica Lasky-Su
- Brigham and Women's Hospital Channing Division of Network Medicine, Boston, Massachusetts, USA
| | - Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood, Gentofte, Denmark
| | - Klaus Bønnelykke
- Copenhagen University Hospital, Gentofte, Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen, Denmark
| | - Bo Chawes
- University of Copenhagen, Kobenhavn, Denmark
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Forastiere F, Spadaro JV, Ancona C, Jovanovic Andersen Z, Cozzi I, Gumy S, Loncar D, Mudu P, Medina S, Perez Velasco R, Walton H, Zhang J, Krzyzanowski M. Choices of morbidity outcomes and concentration-response functions for health risk assessment of long-term exposure to air pollution. Environ Epidemiol 2024; 8:e314. [PMID: 39045486 PMCID: PMC11265782 DOI: 10.1097/ee9.0000000000000314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 05/14/2024] [Indexed: 07/25/2024] Open
Abstract
Background Air pollution health risk assessment (HRA) has been typically conducted for all causes and cause-specific mortality based on concentration-response functions (CRFs) from meta-analyses that synthesize the evidence on air pollution health effects. There is a need for a similar systematic approach for HRA for morbidity outcomes, which have often been omitted from HRA of air pollution, thus underestimating the full air pollution burden. We aimed to compile from the existing systematic reviews and meta-analyses CRFs for the incidence of several diseases that could be applied in HRA. To achieve this goal, we have developed a comprehensive strategy for the appraisal of the systematic reviews and meta-analyses that examine the relationship between long-term exposure to particulate matter with an aerodynamic diameter smaller than 2.5 µm (PM2.5), nitrogen dioxide (NO2), or ozone (O3) and incidence of various diseases. Methods To establish the basis for our evaluation, we considered the causality determinations provided by the US Environmental Protection Agency Integrated Science Assessment for PM2.5, NO2, and O3. We developed a list of pollutant/outcome pairs based on these assessments and the evidence of a causal relationship between air pollutants and specific health outcomes. We conducted a comprehensive literature search using two databases and identified 75 relevant systematic reviews and meta-analyses for PM2.5 and NO2. We found no relevant reviews for long-term exposure to ozone. We evaluated the reliability of these studies using an adaptation of the AMSTAR 2 tool, which assesses various characteristics of the reviews, such as literature search, data extraction, statistical analysis, and bias evaluation. The tool's adaptation focused on issues relevant to studies on the health effects of air pollution. Based on our assessment, we selected reviews that could be credible sources of CRF for HRA. We also assessed the confidence in the findings of the selected systematic reviews and meta-analyses as the sources of CRF for HRA. We developed specific criteria for the evaluation, considering factors such as the number of included studies, their geographical distribution, heterogeneity of study results, the statistical significance and precision of the pooled risk estimate in the meta-analysis, and consistency with more recent studies. Based on our assessment, we classified the outcomes into three lists: list A (a reliable quantification of health effects is possible in an HRA), list B+ (HRA is possible, but there is greater uncertainty around the reliability of the CRF compared to those included on list A), and list B- (HRA is not recommended because of the substantial uncertainty of the CRF). Results In our final evaluation, list A includes six CRFs for PM2.5 (asthma in children, chronic obstructive pulmonary disease, ischemic heart disease events, stroke, hypertension, and lung cancer) and three outcomes for NO2 (asthma in children and in adults, and acute lower respiratory infections in children). Three additional outcomes (diabetes, dementia, and autism spectrum disorders) for PM2.5 were included in list B+. Recommended CRFs are related to the incidence (onset) of the diseases. The International Classification of Diseases, 10th revision codes, age ranges, and suggested concentration ranges are also specified to ensure consistency and applicability in an HRA. No specific suggestions were given for ozone because of the lack of relevant systematic reviews. Conclusion The suggestions formulated in this study, including CRFs selected from the available systematic reviews, can assist in conducting reliable HRAs and contribute to evidence-based decision-making in public health and environmental policy. Future research should continue to update and refine these suggestions as new evidence becomes available and methodologies evolve.
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Affiliation(s)
- Francesco Forastiere
- National Research Council, IFT, Palermo, Italy
- Environmental Research Group, Imperial College, London, United Kingdom
| | - Joseph V. Spadaro
- World Health Organization, Headquarters, Geneva, Switzerland
- Spadaro Environmental Research Consultants (SERC), Philadelphia, Pennsylvania
| | - Carla Ancona
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit Roma 1, Rome, Italy
| | | | - Ilaria Cozzi
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit Roma 1, Rome, Italy
| | - Sophie Gumy
- World Health Organization, Headquarters, Geneva, Switzerland
| | - Dejan Loncar
- World Health Organization, Headquarters, Geneva, Switzerland
| | - Pierpaolo Mudu
- World Health Organization (WHO), European Center for Environment and Health, Bonn, Germany
| | | | - Roman Perez Velasco
- World Health Organization (WHO), European Center for Environment and Health, Bonn, Germany
| | - Heather Walton
- Environmental Research Group, Imperial College, London, United Kingdom
- National Institute of Health Research Health Protection Research Unit on Environmental Exposures and Health at Imperial College London, London, United Kingdom
| | - Jiawei Zhang
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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3
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Varghese D, Clemens T, McMurray A, Pinnock H, Grigg J, Cunningham S. Near-fatal and fatal asthma and air pollution: are we missing an opportunity to ask key questions? Arch Dis Child 2024; 109:616-619. [PMID: 37949644 DOI: 10.1136/archdischild-2023-325548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/22/2023] [Indexed: 11/12/2023]
Abstract
There is an increasing body of evidence supporting the link between asthma attacks and air pollution in children. To our knowledge, there has only been one reported case of a fatal asthma attack in a child associated with air pollution and this was in the UK. This article considers why there is a lack of evidence on fatal/near-fatal asthma and air pollution. We also explore three challenges. First, fatal and near-fatal asthma events are rare and not yet well understood. Second, measuring and interpreting personal exposure to air pollution with sufficient temporal and spatial detail are challenging to interpret in the context of individual fatal or near-fatal asthma attacks. Third, current studies are not designed to answer the question of whether or to what extent air pollution is associated with fatal/near-fatal asthma attacks in children. Conclusive evidence is not yet available and systems of data collection for both air pollution and fatal and near-fatal asthma attacks should be enhanced to ensure risk can be determined and impact minimised.
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Affiliation(s)
- Deepa Varghese
- Child Life and Health, University of Edinburgh, Edinburgh, UK
- Asthma UK Centre for Applied Research, University of Edinburgh, Edinburgh, UK
| | - Tom Clemens
- School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Ann McMurray
- Department of Respiratory and Sleep Medicine, Royal Hospital for Children and Young People, Edinburgh, UK
| | - Hilary Pinnock
- Asthma UK Centre for Applied Research, University of Edinburgh, Edinburgh, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Jonathan Grigg
- Centre for Child Health, Blizard Institute, Queen Mary University of London, London, UK, London, UK
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4
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Adgent MA, Buth E, Noroña-Zhou A, Szpiro AA, Loftus CT, Moore PE, Wright RJ, Barrett ES, LeWinn KZ, Zhao Q, Nguyen R, Karr CJ, Bush NR, Carroll KN. Maternal stressful life events during pregnancy and childhood asthma and wheeze. Ann Allergy Asthma Immunol 2024; 132:594-601.e3. [PMID: 38122928 PMCID: PMC11069451 DOI: 10.1016/j.anai.2023.12.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/28/2023] [Accepted: 12/03/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Studies have linked prenatal maternal psychosocial stress to childhood wheeze/asthma but have rarely investigated factors that may mitigate risks. OBJECTIVE To investigate associations between prenatal stress and childhood wheeze/asthma, evaluating factors that may modify stress effects. METHODS Participants included 2056 mother-child dyads from Environmental influences on Child Health Outcomes (ECHO)-PATHWAYS, a consortium of 3 prospective pregnancy cohorts (the Conditions Affecting Neurocognitive Development and Learning in Early Childhood study, The Infant Development and Environment Study, and a subset of the Global Alliance to Prevent Prematurity and Stillbirth study) from 6 cities. Maternal stressful life events experienced during pregnancy (PSLEs) were reported using the Pregnancy Risk Assessment Monitoring System Stressful Life Events questionnaire. Parents reported child wheeze/asthma outcomes at age 4 to 6 years using standardized questionnaires. We defined outcomes as ever asthma, current wheeze, current asthma, and strict asthma. We used modified Poisson regression with robust standard errors (SEs) to estimate risk ratios (RRs) and 95% CI per 1-unit increase in PSLE, adjusting for confounders. We evaluated effect modification by child sex, maternal history of asthma, maternal childhood traumatic life events, neighborhood-level resources, and breastfeeding. RESULTS Overall, we observed significantly elevated risk for current wheeze with increasing PSLE (RR, 1.09 [95% CI, 1.03-1.14]), but not for other outcomes. We observed significant effect modification by child sex for strict asthma (P interaction = .03), in which risks were elevated in boys (RR, 1.10 [95% CI, 1.02-1.19]) but not in girls. For all other outcomes, risks were significantly elevated in boys and not in girls, although there was no statistically significant evidence of effect modification. We observed no evidence of effect modification by other factors (P interactions > .05). CONCLUSION Risk of adverse childhood respiratory outcomes is higher with increasing maternal PSLEs, particularly in boys.
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Affiliation(s)
| | - Erin Buth
- University of Washington, Seattle WA
| | | | | | | | | | | | - Emily S. Barrett
- Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute; Piscataway NJ
| | - Kaja Z. LeWinn
- University of California San Francisco, San Francisco CA
| | - Qi Zhao
- University of Tennessee Health Sciences Center, Memphis TN
| | | | | | - Nicole R. Bush
- University of California San Francisco, San Francisco CA
| | - Kecia N. Carroll
- Vanderbilt University Medical Center, Nashville TN
- Icahn School of Medicine at Mount Sinai, New York NY
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5
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Georas SN, Khurana S. Update on asthma biology. J Allergy Clin Immunol 2024; 153:1215-1228. [PMID: 38341182 DOI: 10.1016/j.jaci.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/17/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024]
Abstract
This is an exciting time to be conducting asthma research. The recent development of targeted asthma biologics has validated the power of basic research to discover new molecules amenable to therapeutic intervention. Advances in high-throughput sequencing are providing a wealth of "omics" data about genetic and epigenetic underpinnings of asthma, as well as about new cellular interacting networks and potential endotypes in asthma. Airway epithelial cells have emerged not only as key sensors of the outside environment but also as central drivers of dysregulated mucosal immune responses in asthma. Emerging data suggest that the airway epithelium in asthma remembers prior encounters with environmental exposures, resulting in potentially long-lasting changes in structure and metabolism that render asthmatic individuals susceptible to subsequent exposures. Here we summarize recent insights into asthma biology, focusing on studies using human cells or tissue that were published in the past 2 years. The studies are organized thematically into 6 content areas to draw connections and spur future research (on genetics and epigenetics, prenatal and early-life origins, microbiome, immune and inflammatory pathways, asthma endotypes and biomarkers, and lung structural alterations). We highlight recent studies of airway epithelial dysfunction and response to viral infections and conclude with a framework for considering how bidirectional interactions between alterations in airway structure and mucosal immunity can lead to sustained lung dysfunction in asthma.
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Affiliation(s)
- Steve N Georas
- Division of Pulmonary and Critical Care Medicine, University of Rochester Medical Center, Rochester, NY.
| | - Sandhya Khurana
- Division of Pulmonary and Critical Care Medicine, University of Rochester Medical Center, Rochester, NY
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Kicic-Starcevich E, Hancock DG, Iosifidis T, Agudelo-Romero P, Caparros-Martin JA, Karpievitch YV, Silva D, Turkovic L, Le Souef PN, Bosco A, Martino DJ, Kicic A, Prescott SL, Stick SM. Airway epithelium respiratory illnesses and allergy (AERIAL) birth cohort: study protocol. FRONTIERS IN ALLERGY 2024; 5:1349741. [PMID: 38666051 PMCID: PMC11043573 DOI: 10.3389/falgy.2024.1349741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
Introduction Recurrent wheezing disorders including asthma are complex and heterogeneous diseases that affect up to 30% of all children, contributing to a major burden on children, their families, and global healthcare systems. It is now recognized that a dysfunctional airway epithelium plays a central role in the pathogenesis of recurrent wheeze, although the underlying mechanisms are still not fully understood. This prospective birth cohort aims to bridge this knowledge gap by investigating the influence of intrinsic epithelial dysfunction on the risk for developing respiratory disorders and the modulation of this risk by maternal morbidities, in utero exposures, and respiratory exposures in the first year of life. Methods The Airway Epithelium Respiratory Illnesses and Allergy (AERIAL) study is nested within the ORIGINS Project and will monitor 400 infants from birth to 5 years. The primary outcome of the AERIAL study will be the identification of epithelial endotypes and exposure variables that influence the development of recurrent wheezing, asthma, and allergic sensitisation. Nasal respiratory epithelium at birth to 6 weeks, 1, 3, and 5 years will be analysed by bulk RNA-seq and DNA methylation sequencing. Maternal morbidities and in utero exposures will be identified on maternal history and their effects measured through transcriptomic and epigenetic analyses of the amnion and newborn epithelium. Exposures within the first year of life will be identified based on infant medical history as well as on background and symptomatic nasal sampling for viral PCR and microbiome analysis. Daily temperatures and symptoms recorded in a study-specific Smartphone App will be used to identify symptomatic respiratory illnesses. Discussion The AERIAL study will provide a comprehensive longitudinal assessment of factors influencing the association between epithelial dysfunction and respiratory morbidity in early life, and hopefully identify novel targets for diagnosis and early intervention.
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Affiliation(s)
| | - David G. Hancock
- Wal-yan RespiratoryResearch Centre, Telethon Kids Institute, Perth, WA, Australia
- Department of Respiratory and Sleep Medicine, Perth Children’s Hospital, Nedlands, WA, Australia
- School of Medicine, The University of Western Australia, Nedlands, WA, Australia
| | - Thomas Iosifidis
- Wal-yan RespiratoryResearch Centre, Telethon Kids Institute, Perth, WA, Australia
- School of Population Health, Curtin University, Bentley, WA, Australia
- Centre for Cell Therapy and Regenerative Medicine, School of Medicine, The University of Western Australia, Nedlands, WA, Australia
| | - Patricia Agudelo-Romero
- Wal-yan RespiratoryResearch Centre, Telethon Kids Institute, Perth, WA, Australia
- European Virus Bioinformatics Centre, Jena, Germany
| | | | | | - Desiree Silva
- School of Medicine, The University of Western Australia, Nedlands, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
- Department of Paediatrics and Neonatology, Joondalup Health Campus, Joondalup, WA, Australia
- School of Medicine and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | | | - Peter N. Le Souef
- Wal-yan RespiratoryResearch Centre, Telethon Kids Institute, Perth, WA, Australia
- Department of Respiratory and Sleep Medicine, Perth Children’s Hospital, Nedlands, WA, Australia
| | - Anthony Bosco
- School of Population Health, Curtin University, Bentley, WA, Australia
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, United States
- Department of Immunobiology, The University of Arizona College of Medicine, Tucson, AZ, United States
| | - David J. Martino
- Wal-yan RespiratoryResearch Centre, Telethon Kids Institute, Perth, WA, Australia
| | - Anthony Kicic
- Wal-yan RespiratoryResearch Centre, Telethon Kids Institute, Perth, WA, Australia
- School of Population Health, Curtin University, Bentley, WA, Australia
- Centre for Cell Therapy and Regenerative Medicine, School of Medicine, The University of Western Australia, Nedlands, WA, Australia
| | - Susan L. Prescott
- School of Medicine, The University of Western Australia, Nedlands, WA, Australia
- European Virus Bioinformatics Centre, Jena, Germany
| | - Stephen M. Stick
- Wal-yan RespiratoryResearch Centre, Telethon Kids Institute, Perth, WA, Australia
- Department of Respiratory and Sleep Medicine, Perth Children’s Hospital, Nedlands, WA, Australia
- Centre for Cell Therapy and Regenerative Medicine, School of Medicine, The University of Western Australia, Nedlands, WA, Australia
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7
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Ai S, Liu L, Xue Y, Cheng X, Li M, Deng Q. Prenatal Exposure to Air Pollutants Associated with Allergic Diseases in Children: Which Pollutant, When Exposure, and What Disease? A Systematic Review and Meta-analysis. Clin Rev Allergy Immunol 2024; 66:149-163. [PMID: 38639856 DOI: 10.1007/s12016-024-08987-3] [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] [Accepted: 03/14/2024] [Indexed: 04/20/2024]
Abstract
This systematic review aims to identify the association between prenatal exposure to air pollutants and allergic diseases in children, focusing on specific pollutants, timing of exposure, and associated diseases. We searched PubMed, Scopus, and Web of Science for English articles until May 1, 2023, examining maternal exposure to outdoor air pollutants (PM1, PM2.5, PM10, NO, NO2, SO2, CO, and O3) during pregnancy and child allergic diseases (atopic dermatitis (AD), food allergy (FA), asthma (AT) and allergic rhinitis (AR)/hay fever (HF)). The final 38 eligible studies were included in the meta-analysis. Exposure to PM2.5 and NO2 during pregnancy was associated with the risk of childhood AD, with pooled ORs of 1.34 (95% confidence interval (CI), 1.10-1.63) and 1.10 (95%CI, 1.05-1.15) per 10 µg/m3 increase, respectively. Maternal exposure to PM1, PM2.5, and NO2 with a 10 µg/m3 increase posed a risk for AT, with pooled ORs of 1.34 (95%CI, 1.17-1.54), 1.11 (95%CI, 1.05-1.18), and 1.07 (95%CI, 1.02-1.12), respectively. An increased risk of HF was observed for PM2.5 and NO2 with a 10 µg/m3 increase, with ORs of 1.36 (95%CI, 1.17-1.58) and 1.26 (95%CI, 1.08-1.48), respectively. Traffic-related air pollutants (TRAP), particularly PM2.5 and NO2, throughout pregnancy, pose a pervasive risk for childhood allergies. Different pollutants may induce diverse allergic diseases in children across varying perinatal periods. AT is more likely to be induced by outdoor air pollutants as a health outcome. More research is needed to explore links between air pollution and airway-derived food allergies.
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Affiliation(s)
- Surui Ai
- School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Le Liu
- School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Yuan Xue
- School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Xiaoou Cheng
- School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Meng Li
- School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China.
| | - Qihong Deng
- School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China.
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8
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Schrott R, Feinberg JI, Newschaffer CJ, Hertz-Picciotto I, Croen LA, Fallin MD, Volk HE, Ladd-Acosta C, Feinberg AP. Exposure to air pollution is associated with DNA methylation changes in sperm. ENVIRONMENTAL EPIGENETICS 2024; 10:dvae003. [PMID: 38559770 PMCID: PMC10980975 DOI: 10.1093/eep/dvae003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/10/2024] [Accepted: 02/02/2024] [Indexed: 04/04/2024]
Abstract
Exposure to air pollutants has been associated with adverse health outcomes in adults and children who were prenatally exposed. In addition to reducing exposure to air pollutants, it is important to identify their biologic targets in order to mitigate the health consequences of exposure. One molecular change associated with prenatal exposure to air pollutants is DNA methylation (DNAm), which has been associated with changes in placenta and cord blood tissues at birth. However, little is known about how air pollution exposure impacts the sperm epigenome, which could provide important insights into the mechanism of transmission to offspring. In the present study, we explored whether exposure to particulate matter less than 2.5 microns in diameter, particulate matter less than 10 microns in diameter, nitrogen dioxide (NO2), or ozone (O3) was associated with DNAm in sperm contributed by participants in the Early Autism Risk Longitudinal Investigation prospective pregnancy cohort. Air pollution exposure measurements were calculated as the average exposure for each pollutant measured within 4 weeks prior to the date of sample collection. Using array-based genome-scale methylation analyses, we identified 80, 96, 35, and 67 differentially methylated regions (DMRs) significantly associated with particulate matter less than 2.5 microns in diameter, particulate matter less than 10 microns in diameter, NO2, and O3, respectively. While no DMRs were associated with exposure to all four pollutants, we found that genes overlapping exposure-related DMRs had a shared enrichment for gene ontology biological processes related to neurodevelopment. Together, these data provide compelling support for the hypothesis that paternal exposure to air pollution impacts DNAm in sperm, particularly in regions implicated in neurodevelopment.
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Affiliation(s)
- Rose Schrott
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Jason I Feinberg
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Craig J Newschaffer
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, State College, PA 16802, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, University of California, Davis, CA 95616, USA
| | - Lisa A Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
| | - M Daniele Fallin
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Heather E Volk
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Christine Ladd-Acosta
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Andrew P Feinberg
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Center for Epigenetics, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
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9
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Aguilera J, Konvinse K, Lee A, Maecker H, Prunicki M, Mahalingaiah S, Sampath V, Utz PJ, Yang E, Nadeau KC. Air pollution and pregnancy. Semin Perinatol 2023; 47:151838. [PMID: 37858459 PMCID: PMC10843016 DOI: 10.1016/j.semperi.2023.151838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
Increased fossil fuel usage and extreme climate change events have led to global increases in greenhouse gases and particulate matter with 99% of the world's population now breathing polluted air that exceeds the World Health Organization's recommended limits. Pregnant women and neonates with exposure to high levels of air pollutants are at increased risk of adverse health outcomes such as maternal hypertensive disorders, postpartum depression, placental abruption, low birth weight, preterm birth, infant mortality, and adverse lung and respiratory effects. While the exact mechanism by which air pollution exerts adverse health effects is unknown, oxidative stress as well as epigenetic and immune mechanisms are thought to play roles. Comprehensive, global efforts are urgently required to tackle the health challenges posed by air pollution through policies and action for reducing air pollution as well as finding ways to protect the health of vulnerable populations in the face of increasing air pollution.
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Affiliation(s)
- Juan Aguilera
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health, El Paso, Texas
| | | | - Alexandra Lee
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, Palo Alto, CA
| | - Holden Maecker
- Institute for Immunity, Transplantation, and Infection, School of Medicine, Stanford University, Stanford, CA
| | - Mary Prunicki
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA
| | - Shruthi Mahalingaiah
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA; Division of Reproductive Endocrinology and Infertility, Department of OB/GYN, Massachusetts General Hospital, Boston, MA
| | - Vanitha Sampath
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA
| | - Paul J Utz
- Department of Medicine, Stanford University, Palo Alto, CA
| | - Emily Yang
- Department of Medicine, Stanford University, Palo Alto, CA
| | - Kari C Nadeau
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA.
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Yadav A, Pacheco SE. Prebirth effects of climate change on children's respiratory health. Curr Opin Pediatr 2023; 35:344-349. [PMID: 36974440 DOI: 10.1097/mop.0000000000001241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
PURPOSE OF REVIEW To date, there is no evidence that humanity will implement appropriate mitigation measures to avoid the catastrophic impact of climate change on the planet and human health. Vulnerable populations such as pregnant women and children will be the most affected. This review highlights epidemiologic data on climate change-related prenatal environmental exposures affecting the fetus and children's respiratory health. RECENT FINDINGS Research on outcomes of prenatal exposure to climate change-related environmental changes and pediatric pulmonary health is limited. In addition to adverse pregnancy outcomes known to affect lung development, changes in lung function, increased prevalence of wheezing, atopy, and respiratory infections have been associated with prenatal exposure to increased temperatures, air pollution, and maternal stress. The mechanisms behind these changes are ill-defined, although oxidative stress, impaired placental functioning, and epigenetic modifications have been observed. However, the long-term impact of these changes remains unknown. SUMMARY The detrimental impact of the climate crisis on pediatric respiratory health begins before birth, highlighting the inherent vulnerability of pregnant women and children. Research and advocacy, along with mitigation and adaptation measures, must be implemented to protect pregnant women and children, the most affected but the least responsible for the climate crisis.
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Affiliation(s)
- Aravind Yadav
- Division of Pulmonary Medicine, Department of Pediatrics, The University of Texas Health Science Center, McGovern Medical School, Houston, Texas, USA
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Kicic-Starcevich E, Hancock DG, Iosifidis T, Agudelo-Romero P, Caparros-Martin JA, Silva D, Turkovic L, Le Souef PN, Bosco A, Martino DJ, Kicic A, Prescott SL, Stick SM. Airway Epithelium Respiratory Illnesses and Allergy (AERIAL) birth cohort: study protocol. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.29.23289314. [PMID: 37205501 PMCID: PMC10187351 DOI: 10.1101/2023.04.29.23289314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Introduction Recurrent wheezing disorders including asthma are complex and heterogeneous diseases that affect up to 30% of all children, contributing to a major burden on children, their families, and global healthcare systems. It is now recognized that a dysfunctional airway epithelium plays a central role in the pathogenesis of recurrent wheeze, although the underlying mechanisms are still not fully understood. This prospective birth cohort aims to bridge this knowledge gap by investigating the influence of intrinsic epithelial dysfunction on the risk for developing respiratory disorders and the modulation of this risk by maternal morbidities, in utero exposures, and respiratory exposures in the first year of life. Methods and Analysis The Airway Epithelium Respiratory Illnesses and Allergy (AERIAL) study is nested within the ORIGINS Project and will monitor 400 infants from birth to five years. The primary outcome of the AERIAL study will be the identification of epithelial endotypes and exposure variables that influence the development of recurrent wheezing, asthma, and allergic sensitisation. Nasal respiratory epithelium at birth to six weeks, one, three, and five years will be analysed by bulk RNA-seq and DNA methylation sequencing. Maternal morbidities and in utero exposures will be identified on maternal history and their effects measured through transcriptomic and epigenetic analyses of the amnion and newborn epithelium. Exposures within the first year of life will be identified based on infant medical history as well as on background and symptomatic nasal sampling for viral PCR and microbiome analysis. Daily temperatures and symptoms recorded in a study-specific Smartphone App will be used to identify symptomatic respiratory illnesses. Ethics and Dissemination Ethical approval has been obtained from Ramsey Health Care HREC WA-SA (#1908). Results will be disseminated through open-access peer-reviewed manuscripts, conference presentations, and through different media channels to consumers, ORIGINS families, and the wider community.
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Abstract
PURPOSE OF REVIEW The increasing global prevalence of food allergy indicates that environmental exposures are likely contributing to food allergy development. This review summarizes recent studies on how specific factors within the external exposome may impact the development of food allergy. RECENT FINDINGS There is strong evidence that nonoral exposure to food allergens within the living environment is a risk factor for food sensitization and food allergy. The role of air pollution in food allergy development remains unclear, as cohort studies have not found consistent relationships between air pollutant exposure and food sensitization. Early-life microbial exposures linked to a rural lifestyle are likely protective against food allergy development, possibly through alteration of the infant microbiome. In contrast, factors associated with urbanization and decreased exposure to microbes may contribute to food allergy development. Recent studies on the role of residential greenness in food allergy development suggest either no relationship or a possible increased risk for food allergy. SUMMARY The external exposome comprises a number of exposures that can modify food allergy risk. Improved understanding of how complex environmental exposures interact with genetic factors will be necessary for developing effective interventions aimed at preventing food allergy development in children.
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Affiliation(s)
- Timothy P. Moran
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC, USA
- Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA
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