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Qi Y, Yan Y, Tang D, Han J, Zhu X, Cui M, Wu H, Tao Y, Fan F. Inflammatory and Immune Mechanisms in COPD: Current Status and Therapeutic Prospects. J Inflamm Res 2024; 17:6603-6618. [PMID: 39318994 PMCID: PMC11421452 DOI: 10.2147/jir.s478568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 09/12/2024] [Indexed: 09/26/2024] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) currently ranks among the top three causes of mortality worldwide, presenting as a prevalent and complex respiratory ailment. Ongoing research has underscored the pivotal role of immune function in the onset and progression of COPD. The immune response in COPD patients exhibits abnormalities, characterized by diminished anti-infection capacity due to immune senescence, heightened activation of neutrophils and macrophages, T cell infiltration, and aberrant B cell activity, collectively contributing to airway inflammation and lung injury in COPD. Objective This review aimed to explore the pivotal role of the immune system in COPD and its therapeutic potential. Methods We conducted a review of immunity and COPD published within the past decade in the Web of Science and PubMed databases, sorting through and summarizing relevant literature. Results This article examines the pivotal roles of the immune system in COPD. Understanding the specific functions and interactions of these immune cells could facilitate the development of novel therapeutic strategies and interventions aimed at controlling inflammation, enhancing immune function, and mitigating the impact of respiratory infections in COPD patients.
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Affiliation(s)
- Yanan Qi
- School of Pharmacy, Bengbu Medical University, Bengbu, People’s Republic of China
- Anhui Engineering Technology Research Center of Biochemical Pharmaceutical, Bengbu, People’s Republic of China
| | - Yuanyuan Yan
- School of Pharmacy, Bengbu Medical University, Bengbu, People’s Republic of China
- Anhui Engineering Technology Research Center of Biochemical Pharmaceutical, Bengbu, People’s Republic of China
| | - Dawei Tang
- School of Pharmacy, Bengbu Medical University, Bengbu, People’s Republic of China
- Anhui Engineering Technology Research Center of Biochemical Pharmaceutical, Bengbu, People’s Republic of China
| | - Jingjing Han
- School of Pharmacy, Bengbu Medical University, Bengbu, People’s Republic of China
- Anhui Engineering Technology Research Center of Biochemical Pharmaceutical, Bengbu, People’s Republic of China
| | - Xinyi Zhu
- School of Pharmacy, Bengbu Medical University, Bengbu, People’s Republic of China
- Anhui Engineering Technology Research Center of Biochemical Pharmaceutical, Bengbu, People’s Republic of China
| | - Mengting Cui
- School of Pharmacy, Bengbu Medical University, Bengbu, People’s Republic of China
- Anhui Engineering Technology Research Center of Biochemical Pharmaceutical, Bengbu, People’s Republic of China
| | - Hongyan Wu
- Institute of Biomedical Technology, Jiangsu Vocational College of Medicine, Yancheng, Jiangsu, 224005, People’s Republic of China
| | - Yu Tao
- School of Pharmacy, Bengbu Medical University, Bengbu, People’s Republic of China
- Anhui Engineering Technology Research Center of Biochemical Pharmaceutical, Bengbu, People’s Republic of China
| | - Fangtian Fan
- School of Pharmacy, Bengbu Medical University, Bengbu, People’s Republic of China
- Anhui Engineering Technology Research Center of Biochemical Pharmaceutical, Bengbu, People’s Republic of China
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2
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Alupo P, Baluku J, Bongomin F, Siddharthan T, Katagira W, Ddungu A, Hurst JR, van Boven JFM, Worodria W, Kirenga BJ. Overcoming challenges of managing chronic obstructive pulmonary disease in low- and middle-income countries. Expert Rev Respir Med 2024:1-10. [PMID: 39268898 DOI: 10.1080/17476348.2024.2398639] [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: 04/08/2024] [Revised: 07/24/2024] [Accepted: 08/27/2024] [Indexed: 09/15/2024]
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) ranks among the top three global causes of death, with 90% of fatalities concentrated in low- and middle-income countries (LMICs). The projected rise in COPD burden, especially in LMICs, emphasizes the need to address the challenges for effective control and reversal of this trend. We aimed to provide an overview, and propose potential solutions to these challenges. AREAS COVERED We highlight the challenges faced in managing COPD in LMICs and put forward the potential approaches to mitigate the same. EXPERT OPINION In LMICs, the effective management of COPD encounters numerous barriers. These include limited access to critical diagnostic services, inadequately trained healthcare personnel, shortages of inhaler medications, oxygen therapy, insufficient access to vaccines, and pulmonary rehabilitation programs. Compounding the above challenges is the late presentation due to misdiagnosis by health workers, and limited access to vital diagnostics. Moreover, the pharmacological armamentarium for optimal COPD therapy, notably inhaled therapies, face constraints in both access and affordability. We propose multi-level and multifaceted interventions to address the urgent need for enhanced respiratory care, human resource capacity building, relevant diagnostic approaches, increased access to medications, government, regional and global efforts to achieve optimal COPD management in LMICs.
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Affiliation(s)
- Patricia Alupo
- Lung Institute, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Clinical Pharmacy & Pharmacology, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, Groningen, Netherlands
| | - Joseph Baluku
- Lung Institute, Makerere University College of Health Sciences, Kampala, Uganda
- Division of Pulmonology, Kirruddu National Referral Hospital, Kampala, Uganda
| | - Felix Bongomin
- Department of medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
- Department of Internal Medicine, Gulu Regional referral Hospital, Gulu, Uganda
| | - Trishul Siddharthan
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Miami, Miami, FL, USA
| | - Winceslaus Katagira
- Lung Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ahmed Ddungu
- Lung Institute, Makerere University College of Health Sciences, Kampala, Uganda
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - John R Hurst
- UCL Respiratory, University College London, London, UK
| | - Job F M van Boven
- Department of Clinical Pharmacy & Pharmacology, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, Groningen, Netherlands
| | - William Worodria
- Mulago National Referral Hospital, Ministry of Health, Kampala, Uganda
| | - Bruce J Kirenga
- Lung Institute, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
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3
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Ali KJ, Ehsan S, Tran A, Haugstetter M, Singh H. Diagnostic Excellence in the Context of Climate Change: A Review. Am J Med 2024:S0002-9343(24)00403-0. [PMID: 38925497 DOI: 10.1016/j.amjmed.2024.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
Climate change is leading to a rise in heat-related illnesses, vector-borne diseases, and numerous negative impacts on patients' physical and mental health outcomes. Concurrently, healthcare contributes about 4.6% of global greenhouse gas emissions. Low-value care, such as overtesting and overdiagnosis, contributes to unnecessary emissions. In this review, we describe diagnostic excellence in the context of climate change and focus on two topics. First, climate change is affecting health, leading to the emergence of certain diseases, some of which are new, while others are increasing in prevalence and/or becoming more widespread. These conditions will require timely and accurate diagnosis by clinicians who may not be used to diagnosing them. Second, diagnostic quality issues, such as overtesting and overdiagnosis, contribute to climate change through unnecessary emissions and waste and should be targeted for interventions. We also highlight implications for clinical practice, research, and policy. Our findings call for efforts to engage healthcare professionals and policymakers in understanding the urgent implications for diagnosis in the context of climate change and reducing global greenhouse gas emissions to enhance both patient and planetary outcomes.
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Affiliation(s)
- Kisha J Ali
- MedStar Institute for Quality and Safety, MedStar Health Research Institute, Columbia, MD
| | - Sara Ehsan
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX
| | - Alberta Tran
- MedStar Institute for Quality and Safety, MedStar Health Research Institute, Columbia, MD
| | - Monika Haugstetter
- Center for Quality Improvement and Patient Safety, Agency for Healthcare Research and Quality, Rockville, MD
| | - Hardeep Singh
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX.
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4
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Tran HM, Lai CH, Chen WL, Wang CC, Liang CW, Chien CY, Pan CH, Chuang KJ, Chuang HC. Effects of occupational exposure to metal fume PM 2.5 on lung function and biomarkers among shipyard workers: a 3-year prospective cohort study. Int Arch Occup Environ Health 2024; 97:401-412. [PMID: 38480609 PMCID: PMC10999385 DOI: 10.1007/s00420-024-02055-1] [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: 12/08/2023] [Accepted: 02/05/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE This study investigates the associations of α1-antitrypsin, inter-α-trypsin inhibitor heavy chain (ITIH4), and 8-isoprostane with lung function in shipyard workers exposed to occupational metal fume fine particulate matter (PM2.5), which is known to be associated with adverse respiratory outcomes. METHODS A 3-year follow-up study was conducted on 180 shipyard workers with 262 measurements. Personal exposure to welding fume PM2.5 was collected for an 8-h working day. Pre-exposure, post-exposure, and delta (∆) levels of α1-antitrypsin, ITIH4, and 8-isoprostane were determined in urine using enzyme-linked immunosorbent assays. Post-exposure urinary metals were sampled at the beginning of the next working day and analyzed by inductively coupled plasma-mass spectrometry. Lung function measurements were also conducted the next working day for post-exposure. RESULTS An IQR increase in PM2.5 was associated with decreases of 2.157% in FEV1, 2.806% in PEF, 4.328% in FEF25%, 5.047% in FEF50%, and 7.205% in FEF75%. An IQR increase in PM2.5 led to increases of 42.155 µg/g in ∆α1-antitrypsin and 16.273 µg/g in ∆ITIH4. Notably, IQR increases in various urinary metals were associated with increases in specific biomarkers, such as post-urinary α1-antitrypsin and ITIH4. Moreover, increases in ∆ α1-antitrypsin and ∆ITIH4 were associated with decreases in FEV1/FVC by 0.008% and 0.020%, respectively, and an increase in ∆8-isoprostane resulted in a 1.538% decline in FVC. CONCLUSION Our study suggests that urinary α1-antitrypsin and ITIH4 could indicate early lung function decline in shipyard workers exposed to metal fume PM2.5, underscoring the need for better safety and health monitoring to reduce respiratory risks.
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Affiliation(s)
- Huan Minh Tran
- Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Faculty of Public Health, Da Nang University of Medical Technology and Pharmacy, Da Nang, Vietnam
| | - Ching-Huang Lai
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chung Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Che-Wei Liang
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Yu Chien
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Hong Pan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Institute of Labor, Occupational Safety and Health, Ministry of Labor, New Taipei City, Taiwan
| | - Kai-Jen Chuang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Chi Chuang
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
- Inhalation Toxicology Research Lab (ITRL), School of Respiratory Therapy, College of Medicine, Taipei Medical University, 250 Wuxing Street, Taipei, 11031, Taiwan.
- Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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5
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Hagedorn R, Tullis B, Nguyen C, Stockard R, Mace JC, Ramakrishnan VR, Beswick DM, Soler ZM, Smith TL, Alt JA, Gill AS. Does air pollutant exposure impact disease severity or outcomes in chronic rhinosinusitis? Int Forum Allergy Rhinol 2024; 14:755-764. [PMID: 37555485 DOI: 10.1002/alr.23250] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/26/2023] [Accepted: 08/04/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Poor air quality increases the risk of developing chronic rhinosinusitis (CRS) and other airway diseases. However, there are limited data on air pollutants and CRS-specific disease severity. We assessed the impact of air pollutants on sinonasal-specific and general quality-of-life (QOL) measures in a multi-institutional cohort of patients with CRS. METHODS Participants with CRS were prospectively enrolled in a cross-sectional study and self-selected continued appropriate medical therapy or endoscopic sinus surgery (ESS). The 22-item SinoNasal Outcome Test (SNOT-22) and Medical Outcomes Study Questionnaire Short-Form 6-D (SF-6D) health utility value scores were recorded. Patient exposure to air pollutants was determined using residence zip codes. Unadjusted group differences were compared, and correlation coefficients were evaluated to identify the magnitude of bivariate association. RESULTS A total of 486 patients were enrolled and followed for a mean of 6.9 (standard deviation [SD] ± 2.3) months. Pollutant exposure did not significantly correlate with baseline SNOT-22 or SF-6D scores. Revision ESS was associated with higher median fine particulate matter (PM2.5; Δ = 0.12, [95% confidence interval {CI}: 0.003, 0.234]; p = 0.006) compared with primary surgery. PM2.5, PM10, and nitrogen dioxide concentrations (μg/m3) did not correlate with change in total SNOT-22 or SF-6D scores after treatment. Nevertheless, sulfur dioxide (SNOT-22: ρ = -0.121 [95% CI: -0.210, -0.030]; p = 0.007; SF-6D: ρ = 0.095 [95% CI: 0.002, 0.186]; p = 0.04) and carbon monoxide (SNOT-22: ρ = -0.141 [95% CI: -0.230, 0.050]; p = 0.002) exposure did correlate with these outcome measures. CONCLUSION Air pollutants may contribute, at least in part, to disease severity in CRS; future investigation is needed to further elucidate the nature of this relationship.
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Affiliation(s)
- Robert Hagedorn
- Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Benton Tullis
- Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Cassidy Nguyen
- Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Ryan Stockard
- Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Jess C Mace
- Division of Rhinology and Sinus Surgery/Oregon Sinus Center, Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University (OHSU), Portland, Oregon, USA
| | - Vijay R Ramakrishnan
- Department of Otolaryngology - Head and Neck Surgery, University of Indiana, Indianapolis, Indiana, USA
| | - Daniel M Beswick
- Department of Otolaryngology - Head and Neck Surgery, University of California, Los Angeles, California, USA
| | - Zachary M Soler
- Department of Otolaryngology -Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Timothy L Smith
- Division of Rhinology and Sinus Surgery/Oregon Sinus Center, Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University (OHSU), Portland, Oregon, USA
| | - Jeremiah A Alt
- Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Amarbir S Gill
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
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Owusu Agyare B, Eder P, Shenai S, Chendi BH, Carlson C, Iradukunda A, Mukoka M, Ogony J, Manigart O, Ogbaini-Emovon E, Seida AA, Prado EO, Ghadrshenas A, Carmona S, Tucker JD. Potential implications of the climate crisis on diagnostics. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002935. [PMID: 38457445 PMCID: PMC10923424 DOI: 10.1371/journal.pgph.0002935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Affiliation(s)
- Bernard Owusu Agyare
- Center for Global Health Science and Security, Georgetown University, Washington, DC, United States of America
| | - Paul Eder
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | | | - Bih H. Chendi
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- SAMRC Centre for Tuberculosis Research, Division of Immunology, Department of Biomedical Sciences, Stellenbosch University, Cape Town, South Africa
| | - Colin Carlson
- Center for Global Health Science and Security, Georgetown University, Washington, DC, United States of America
| | | | - Marithe Mukoka
- Rodolphe Meriuex Laboratory INRB- Goma, Goma, Democratic Republic of Congo
| | - Jack Ogony
- College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Olivier Manigart
- GFA Consulting Group, Bobo-Dioulasso, Burkina Faso
- PROALAB, West African Health Organization, Bobo-Dioulasso, Burkina Faso
| | | | - Ahmed A. Seida
- Immunology and Microbiology Department, Faculty of Veterinary Medicine, Cairo University, Cairo, Egypt
| | | | | | | | - Joseph D. Tucker
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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7
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Tran HM, Lin YC, Tsai FJ, Lee KY, Chang JH, Chung CL, Chung KF, Chuang KJ, Chuang HC. Short-term mediating effects of PM 2.5 on climate-associated COPD severity. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 903:166523. [PMID: 37625725 DOI: 10.1016/j.scitotenv.2023.166523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 08/27/2023]
Abstract
The impact of short-term exposure to environmental factors such as temperature, relative humidity (RH), and fine particulate matter (PM2.5) on chronic obstructive pulmonary disease (COPD) remains unclear. The objective of this study is to investigate PM2.5 as a mediator in the relationship between short-term variations in RH and temperature and COPD severity. A cross-sectional study was conducted on 930 COPD patients in Taiwan from 2017 to 2022. Lung function, COPD Assessment Test (CAT) score, and modified Medical Research Council (mMRC) dyspnea scale were assessed. The mean and differences in 1-day, 7-day, and 30-day individual-level exposure to ambient RH, temperature, and PM2.5 were estimated. The associations between these factors and clinical outcomes were analyzed using linear regression models and generalized additive mixed models, adjusting for age, sex, smoking, and body mass index. In the total season, increases in RH difference were associated with increases in forced expiratory volume in 1 s (FEV1) / forced vital capacity (FVC), while increases in temperature difference were associated with decreases in FEV1 and FEV1/FVC. Increases in PM2.5 mean were associated with declines in FEV1. In the cold season, increases in temperature mean were associated with decreases in CAT and mMRC scores, while increases in PM2.5 mean were associated with declines in FEV1, FVC, and FEV1/FVC. In the warm season, increases in temperature difference were associated with decreases in FEV1 and FEV1/FVC, while increases in RH difference and PM2.5 mean were associated with decreases in CAT score. PM2.5 fully mediated the associations of temperature mean with FEV1/FVC in the cold season. In conclusion, PM2.5 mediates the effects of temperature and RH on clinical outcomes. Monitoring patients during low RH, extreme temperature, and high PM2.5 levels is crucial. Capsule of findings The significance of this study is that an increase in ambient RH and temperature, as well as PM2.5 exposure, were significantly associated with changes in lung function, and clinical symptoms in these patients. The novelty of this study is that PM2.5 plays a mediating role in the association of RH and temperature with COPD clinical outcomes in the short term.
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Affiliation(s)
- Huan Minh Tran
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan; Faculty of Public Health, Da Nang University of Medical Technology and Pharmacy, Da Nang, Viet Nam.
| | - Yuan-Chien Lin
- Department of Civil Engineering, National Central University, Taoyuan City, Taiwan.
| | - Feng-Jen Tsai
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan.
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Jer-Hwa Chang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Chi-Li Chung
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Kian Fan Chung
- National Heart & Lung Institute, Imperial College London, UK.
| | - Kai-Jen Chuang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Hsiao-Chi Chuang
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; National Heart & Lung Institute, Imperial College London, UK; Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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8
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Tran HM, Tsai FJ, Lee YL, Chang JH, Chang LT, Chang TY, Chung KF, Kuo HP, Lee KY, Chuang KJ, Chuang HC. The impact of air pollution on respiratory diseases in an era of climate change: A review of the current evidence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 898:166340. [PMID: 37591374 DOI: 10.1016/j.scitotenv.2023.166340] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/27/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
The impacts of climate change and air pollution on respiratory diseases present significant global health challenges. This review aims to investigate the effects of the interactions between these challenges focusing on respiratory diseases. Climate change is predicted to increase the frequency and intensity of extreme weather events amplifying air pollution levels and exacerbating respiratory diseases. Air pollution levels are projected to rise due to ongoing economic growth and population expansion in many areas worldwide, resulting in a greater burden of respiratory diseases. This is especially true among vulnerable populations like children, older adults, and those with pre-existing respiratory disorders. These challenges induce inflammation, create oxidative stress, and impair the immune system function of the lungs. Consequently, public health measures are required to mitigate the effects of climate change and air pollution on respiratory health. The review proposes that reducing greenhouse gas emissions contribute to slowing down climate change and lessening the severity of extreme weather events. Enhancing air quality through regulatory and technological innovations also helps reduce the morbidity of respiratory diseases. Moreover, policies and interventions aimed at improving healthcare access and social support can assist in decreasing the vulnerability of populations to the adverse health effects of air pollution and climate change. In conclusion, there is an urgent need for continuous research, establishment of policies, and public health efforts to tackle the complex and multi-dimensional challenges of climate change, air pollution, and respiratory health. Practical and comprehensive interventions can protect respiratory health and enhance public health outcomes for all.
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Affiliation(s)
- Huan Minh Tran
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan; Faculty of Public Health, Da Nang University of Medical Technology and Pharmacy, Viet Nam
| | - Feng-Jen Tsai
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Yueh-Lun Lee
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jer-Hwa Chang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Li-Te Chang
- Department of Environmental Engineering and Science, Feng Chia University, Taichung, Taiwan
| | - Ta-Yuan Chang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Han-Pin Kuo
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Kai-Jen Chuang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; National Heart and Lung Institute, Imperial College London, London, UK; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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9
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Quoc TT, Bácskay I, Fehér P, Pallér Á, Papp B, Bíró K, Ujhelyi Z. Personalized Nasal Protective Devices: Importance and Perspectives. Life (Basel) 2023; 13:2116. [PMID: 38004256 PMCID: PMC10672262 DOI: 10.3390/life13112116] [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: 08/28/2023] [Revised: 10/16/2023] [Accepted: 10/22/2023] [Indexed: 11/26/2023] Open
Abstract
Nowadays, in addition to diseases caused by environmental pollution, the importance of personalized protection against various infectious agents has become of paramount importance. Besides medicine, several technical and technological studies have been carried out to develop suitable devices. One such revolutionary solution is the use of personalized nasal filters, which allow our body to defend itself more effectively against external environmental damage and pathogens. These filters are small devices that are placed in the nose and specifically filter the inhaled environmental contaminants, allergens, and microorganisms according to individual needs. These devices not only play a key role in maintaining our health but also contribute to environmental protection, reducing the inhalation of pollutants and their harmful impact on the natural environment. Another advantage of personalized filters is that they also provide an opportunity to strengthen our individual immune systems. The use of personalized filters allows medicine to provide optimized protection for everyone, focusing on individual genetic and immunological conditions. The momentum behind the development and research of personalized nasal filters has reached astonishing proportions today. Nowadays, many research groups and medical institutions are working to create new materials, nanotechnologies, and bioinformatics solutions in order to create even more effective personalized nasal filters that can also be shaped easily and safely. Considering the needs of the users is at least as important during development as the efficiency of the device. These two properties together determine the success of the product. Industry research focuses not only on improving the efficiency of devices, but also on making them more responsive to user needs, comfort, and portability. Based on all this, it can be concluded that personalized nasal filters can be a promising and innovative solution for protection against environmental pollutants and pathogens. Through a commitment to the research and development of technology, the long-term impact of such devices on our health and the environment can be significant, contributing to improving people's quality of life and creating a sustainable future. With unique solutions and continuous research, we give hope that in the future, despite the environmental challenges, we can enjoy the protection of our health with even more efficient and sophisticated devices.
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Affiliation(s)
- Thinh To Quoc
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei Sqr 98, 4032 Debrecen, Hungary; (T.T.Q.); (I.B.); (P.F.); (Á.P.); (B.P.)
- Doctoral School of Pharmaceutical Sciences, University of Debrecen, Nagyerdei Sqr 98, 4032 Debrecen, Hungary;
| | - Ildikó Bácskay
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei Sqr 98, 4032 Debrecen, Hungary; (T.T.Q.); (I.B.); (P.F.); (Á.P.); (B.P.)
- Doctoral School of Pharmaceutical Sciences, University of Debrecen, Nagyerdei Sqr 98, 4032 Debrecen, Hungary;
- Institute of Healthcare Industry, University of Debrecen, Nagyerdei Sqr 98, 4032 Debrecen, Hungary
| | - Pálma Fehér
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei Sqr 98, 4032 Debrecen, Hungary; (T.T.Q.); (I.B.); (P.F.); (Á.P.); (B.P.)
- Doctoral School of Pharmaceutical Sciences, University of Debrecen, Nagyerdei Sqr 98, 4032 Debrecen, Hungary;
| | - Ádám Pallér
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei Sqr 98, 4032 Debrecen, Hungary; (T.T.Q.); (I.B.); (P.F.); (Á.P.); (B.P.)
| | - Boglárka Papp
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei Sqr 98, 4032 Debrecen, Hungary; (T.T.Q.); (I.B.); (P.F.); (Á.P.); (B.P.)
- Doctoral School of Pharmaceutical Sciences, University of Debrecen, Nagyerdei Sqr 98, 4032 Debrecen, Hungary;
| | - Krisztina Bíró
- Doctoral School of Pharmaceutical Sciences, University of Debrecen, Nagyerdei Sqr 98, 4032 Debrecen, Hungary;
- Hospital Pharmacy at the University of Debrecen, University of Debrecen, Nagyerdei Sqr 98, 4032 Debrecen, Hungary
| | - Zoltán Ujhelyi
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei Sqr 98, 4032 Debrecen, Hungary; (T.T.Q.); (I.B.); (P.F.); (Á.P.); (B.P.)
- Doctoral School of Pharmaceutical Sciences, University of Debrecen, Nagyerdei Sqr 98, 4032 Debrecen, Hungary;
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10
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Squires E. Effects of climate change on patients with respiratory and cardiovascular conditions. Nurs Stand 2023; 38:57-61. [PMID: 37259785 DOI: 10.7748/ns.2023.e12087] [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] [Accepted: 01/23/2023] [Indexed: 06/02/2023]
Abstract
Climate change is one of the most significant global challenges and is already having detrimental effects on people's health. Pollution levels and ambient temperatures continue to increase, resulting in higher levels of humidity and pollen production. These environmental threats can affect many vulnerable patients, particularly those with respiratory and cardiovascular conditions, and nurses have a crucial role in raising awareness of the health implications of climate change. This article explores the pathophysiological effects of climate change on patients with asthma, chronic obstructive pulmonary disease and cardiovascular disease, and aims to enhance nurses' understanding of the health challenges of climate change.
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Affiliation(s)
- Eleanor Squires
- School of Health and Social Work, University of Hertfordshire, Hatfield, England
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11
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Cheng C, Han C, Fang Q, Liu Y, Chi X, Li X. Associations between air pollutants and hospital admissions for chronic obstructive pulmonary disease in Jinan: potential benefits from air quality improvements. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:46435-46445. [PMID: 36717420 PMCID: PMC9887246 DOI: 10.1007/s11356-023-25567-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/19/2023] [Indexed: 06/01/2023]
Abstract
Evidence between air pollution and chronic obstructive pulmonary disease (COPD) is inconsistent and limited in China. In this study, we aim to examine the associations between air pollutants and hospital admissions for COPD, hoping to provide practical advice for prevention and control of COPD. Hospital admissions for COPD were collected from a Grade-A tertiary hospital in Jinan from 2014 to 2020. A generalized additive model (GAM) was used to examine the associations between air pollutants and hospital admissions for COPD. Stratified analysis was also conducted for gender, age (20-74 and ≥75 years), and season (warm and cold). The avoidable number of COPD hospital admissions was calculated when air pollutants were controlled under national and WHO standards. Over the study period, a total of 4,012 hospital admissions for COPD were recorded. The daily hospital admissions of COPD increased by 2.36% (95%CI: 0.13-4.65%) and 2.39% (95%CI: 0.19-4.65%) for per 10 μg/m3 increase of NO2 and SO2 concentrations at lag2, respectively. There was no statistically significant difference in health effects caused by increased concentrations of PM2.5, PM10, CO, and O3. The health effects of increased SO2 concentration were stronger in women, the ≥75 years old people and the cold season. About 2 (95%CI: 0-3), 64 (95%CI: 4-132) and 86 (95%CI: 6-177) COPD admissions would be avoided when the SO2 concentration was controlled below the NAAQS-II (150 μg/m3), NAAQS-I (50 μg/m3), and WHO's AQG2021 standard (40 μg/m3), respectively. These findings suggest that short-term exposure to NO2 and SO2 was associated with increased risks of daily COPD admissions, especially for females and the elderly. The control of SO2 and NO2 under the national and WHO standards could avoid more COPD admissions and obtain greater health benefits.
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Affiliation(s)
- Chuanlong Cheng
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Chuang Han
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Qidi Fang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Ying Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Xiangyu Chi
- Department of Geriatric Respiratory Disease, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xiujun Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China.
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12
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Wang Q, Liu S. The Effects and Pathogenesis of PM2.5 and Its Components on Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2023; 18:493-506. [PMID: 37056681 PMCID: PMC10086390 DOI: 10.2147/copd.s402122] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/27/2023] [Indexed: 04/15/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD), a heterogeneous disease, is the leading cause of death worldwide. In recent years, air pollution, especially particulate matter (PM), has been widely studied as a contributing factor to COPD. As an essential component of PM, PM2.5 is associated with COPD prevalence, morbidity, and acute exacerbations. However, the specific pathogenic mechanisms were still unclear and deserve further research. The diversity and complexity of PM2.5 components make it challenging to get its accurate effects and mechanisms for COPD. It has been determined that the most toxic PM2.5 components are metals, polycyclic aromatic hydrocarbons (PAHs), carbonaceous particles (CPs), and other organic compounds. PM2.5-induced cytokine release and oxidative stress are the main mechanisms reported leading to COPD. Nonnegligibly, the microorganism in PM 2.5 may directly cause mononuclear inflammation or break the microorganism balance contributing to the development and exacerbation of COPD. This review focuses on the pathophysiology and consequences of PM2.5 and its components on COPD.
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Affiliation(s)
- Qi Wang
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, People’s Republic of China
| | - Sha Liu
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, People’s Republic of China
- Correspondence: Sha Liu, Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital, Hengyang Medical School, University of South China, 35 Jiefang Avenue, Zhengxiang District, Hengyang, Hunan, 421001, People’s Republic of China, Email
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