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Upadhyay S, Rahman M, Rinaldi S, Koelmel J, Lin EZ, Mahesh PA, Beckers J, Johanson G, Pollitt KJG, Palmberg L, Irmler M, Ganguly K. Assessment of wood smoke induced pulmonary toxicity in normal- and chronic bronchitis-like bronchial and alveolar lung mucosa models at air-liquid interface. Respir Res 2024; 25:49. [PMID: 38245732 PMCID: PMC10799428 DOI: 10.1186/s12931-024-02686-5] [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: 08/30/2023] [Accepted: 01/08/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) has the highest increased risk due to household air pollution arising from biomass fuel burning. However, knowledge on COPD patho-mechanisms is mainly limited to tobacco smoke exposure. In this study, a repeated direct wood smoke (WS) exposure was performed using normal- (bro-ALI) and chronic bronchitis-like bronchial (bro-ALI-CB), and alveolar (alv-ALI) lung mucosa models at air-liquid interface (ALI) to assess broad toxicological end points. METHODS The bro-ALI and bro-ALI-CB models were developed using human primary bronchial epithelial cells and the alv-ALI model was developed using a representative type-II pneumocyte cell line. The lung models were exposed to WS (10 min/exposure; 5-exposures over 3-days; n = 6-7 independent experiments). Sham exposed samples served as control. WS composition was analyzed following passive sampling. Cytotoxicity, total cellular reactive oxygen species (ROS) and stress responsive NFkB were assessed by flow cytometry. WS exposure induced changes in gene expression were evaluated by RNA-seq (p ≤ 0.01) followed by pathway enrichment analysis. Secreted levels of proinflammatory cytokines were assessed in the basal media. Non-parametric statistical analysis was performed. RESULTS 147 unique compounds were annotated in WS of which 42 compounds have inhalation toxicity (9 very high). WS exposure resulted in significantly increased ROS in bro-ALI (11.2%) and bro-ALI-CB (25.7%) along with correspondingly increased NFkB levels (bro-ALI: 35.6%; bro-ALI-CB: 18.1%). A total of 1262 (817-up and 445-down), 329 (141-up and 188-down), and 102 (33-up and 69-down) genes were differentially regulated in the WS-exposed bro-ALI, bro-ALI-CB, and alv-ALI models respectively. The enriched pathways included the terms acute phase response, mitochondrial dysfunction, inflammation, oxidative stress, NFkB, ROS, xenobiotic metabolism of AHR, and chronic respiratory disorder. The enrichment of the 'cilium' related genes was predominant in the WS-exposed bro-ALI (180-up and 7-down). The pathways primary ciliary dyskinesia, ciliopathy, and ciliary movement were enriched in both WS-exposed bro-ALI and bro-ALI-CB. Interleukin-6 and tumor necrosis factor-α were reduced (p < 0.05) in WS-exposed bro-ALI and bro-ALI-CB. CONCLUSION Findings of this study indicate differential response to WS-exposure in different lung regions and in chronic bronchitis, a condition commonly associated with COPD. Further, the data suggests ciliopathy as a candidate pathway in relation to WS-exposure.
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Affiliation(s)
- Swapna Upadhyay
- Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Mizanur Rahman
- Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Selina Rinaldi
- Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Jeremy Koelmel
- Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Elizabeth Z Lin
- Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Padukudru Anand Mahesh
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, 570015, India
| | - Johannes Beckers
- Institute of Experimental Genetics, Helmholtz Zentrum München, Deutsches Forschungszentrum Für Gesundheit Und Umwelt (GmbH), 85764, Neuherberg, Germany
- German Center for Diabetes Research (DZD E.V.), 85764, Neuherberg, Germany
- Chair of Experimental Genetics, Technical University of Munich, 85354, Freising, Germany
| | - Gunnar Johanson
- Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Krystal J Godri Pollitt
- Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Lena Palmberg
- Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Martin Irmler
- Institute of Experimental Genetics, Helmholtz Zentrum München, Deutsches Forschungszentrum Für Gesundheit Und Umwelt (GmbH), 85764, Neuherberg, Germany
| | - Koustav Ganguly
- Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, 171 77, Stockholm, Sweden.
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Giraldo-Montoya ÁM, Torres-Duque CA, Giraldo-Cadavid LF, Laucho-Contreras ME, González-Flórez A, Santos AM, Tuta-Quintero EA, Celli BR, González-García M. Sputum Biomarkers in Wood and Tobacco Smoke Etiotypes of Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2023; 19:1-10. [PMID: 38179428 PMCID: PMC10763680 DOI: 10.2147/copd.s439064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/19/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction There is a need to better understand the etiotypes of chronic obstructive pulmonary disease (COPD) beyond the tobacco-smoke (TS-COPD). Wood smoke COPD (WS-COPD) is characterized by greater airway compromise, milder emphysema, and slower rate of lung function decline than TS-COPD. However, it is unclear if these two etiotypes of COPD have differences in sputum biomarker concentrations. Objective was to compare sputum levels of selected sputum biomarkers between WS-COPD and TS-COPD, and healthy controls. Methods Eighty-eight women (69±12 years) were recruited and classified into: WS-COPD (n=31), TS-COPD (n=29) and controls (n=28). Using ELISA, we determined induced sputum levels of metalloproteinase 9 (MMP-9), chemokine ligand 5 (CCL5), interleukin-8 (IL-8), chemokine ligand 16 (CCL16/HCC-4) and vascular endothelial growth factor (VEGF-1). Differences were analyzed by Kruskal-Wallis and Mann-Whitney-U tests and correlation between airflow limitation and biomarkers by Spearman's test. Results At similar degree of airflow obstruction, anthropometrics and medications use, the level of sputum CCL5 was higher in TS-COPD than WS-COPD (p=0.03) without differences in MMP-9, IL-8, CCL16/HCC-4, and VEGF-1. Women with WS-COPD and TS-COPD showed significantly higher sputum levels of MMP-9, IL-8 and CCL5 compared with controls (p<0.001). FEV1% predicted correlated negatively with levels of MMP-9 (rho:-0.26; P=0.016), CCL5 (rho:-0.37; P=0.001), IL-8 (rho:-0.42; P<0.001) and VEGF (rho:-0.22; P=0.04). Conclusion While sputum concentrations of MMP-9, IL-8, and CCL5 were higher in COPD women compared with controls, women with TS-COPD had higher levels of CCL5 compared with those with WS-COPD. Whether this finding relates to differences in pathobiological pathways remains to be determined.
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Affiliation(s)
- Ángela María Giraldo-Montoya
- CINEUMO, Research Center, Fundación Neumológica Colombiana, Bogotá, Colombia
- School of Medicine, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Carlos A Torres-Duque
- CINEUMO, Research Center, Fundación Neumológica Colombiana, Bogotá, Colombia
- Biosciences Doctoral, Universidad de La Sabana, Chía, Colombia
| | - Luis F Giraldo-Cadavid
- Medical Department, Fundación Neumológica Colombiana, Bogotá, Colombia
- Epidemiology and Biostatistics Department, Universidad de La Sabana, Chía, Colombia
| | | | | | | | - Eduardo A Tuta-Quintero
- CINEUMO, Research Center, Fundación Neumológica Colombiana, Bogotá, Colombia
- Epidemiology and Biostatistics Department, Universidad de La Sabana, Chía, Colombia
| | | | - Mauricio González-García
- CINEUMO, Research Center, Fundación Neumológica Colombiana, Bogotá, Colombia
- School of Medicine, Universidad de La Sabana, Chía, Colombia
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Zhang X, Zhu X, Wang X, Wang L, Sun H, Yuan P, Ji Y. Association of Exposure to Biomass Fuels with Occurrence of Chronic Obstructive Pulmonary Disease in Rural Western China: A Real-World Nested Case-Control Study. Int J Chron Obstruct Pulmon Dis 2023; 18:2207-2224. [PMID: 37841748 PMCID: PMC10572384 DOI: 10.2147/copd.s417600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/17/2023] [Indexed: 10/17/2023] Open
Abstract
Background This study investigated the potential contribution of biomass fuels exposure to the occurrence of chronic obstructive pulmonary disease (COPD) in rural areas of western China. Methods We analyzed data collected between October 2017 and October 2018 from a nested case-control study of individuals at least 40 years old in the general population in Mianyang City, Sichuan Province, China. Demographic information was collected using a custom-designed questionnaire, and lung function was measured using spirometry. We used multivariate logistic regression to explore the possible relationship between biomass fuels exposure and COPD, as well as between other potential risk factors and COPD. Bayes' theorem was used to estimate weights for different COPD risk factors. Results COPD was newly diagnosed in 500 of the 11398 adults surveyed, corresponding to an incidence of 4.39%. Individuals who were exposed to biomass fuels were at a significantly greater risk of developing COPD than those not exposed (OR 2.58, 95% CI 2.23-3.05). In subgroup analysis, exposure to biomass fuels increased the risk of COPD in men by 1.71 times (95% CI 1.09-2.68) and in women by 2.88 times (95% CI 2.01-3.48), in never-smokers by 2.18 times. Bayesian weights for COPD risk factors were highest for poor kitchen ventilation (W=31.13%) and biomass fuels exposure (W=18.08%). Conclusion Our data indicate that rural Chinese who are exposed to biomass fuels during cooking or heating are at greater risk of developing COPD. Efforts should be made to strengthen the construction of clean energy infrastructure, so as to reduce the use of biomass fuels and thereby help prevent COPD.
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Affiliation(s)
- Xuan Zhang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People’s Republic of China
| | - Xia Zhu
- Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People’s Republic of China
| | - Xiaoli Wang
- Department of Infectious disease Prevention and Control, Center for Disease Control and Prevention of Fucheng, Mianyang, Sichuan Province, 621000, People’s Republic of China
| | - Liping Wang
- Department of Disease Control, Health Bureau of Jiangyou, Jiangyou, Sichuan Province, 621700, People’s Republic of China
| | - Hongying Sun
- Department of Tuberculosis Prevention and Control, Center for Disease Control and Prevention of Mianyang, Mianyang, Sichuan Province, 621000, People’s Republic of China
| | - Ping Yuan
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan Province, 610041, People’s Republic of China
| | - Yulin Ji
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People’s Republic of China
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Huang X, Li J, Cao W, Lyu J, Guo Y, Pei P, Xia Q, Du H, Chen Y, Ling Y, Kerosi R, Stevens R, Yang X, Chen J, Yu C, Chen Z, Li L. Association between fresh fruit consumption and the risk of chronic obstructive pulmonary disease-related hospitalization and death in Chinese adults: A prospective cohort study. Chin Med J (Engl) 2023; 136:2316-2323. [PMID: 37537725 PMCID: PMC10538915 DOI: 10.1097/cm9.0000000000002591] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Existing evidence suggests that fruit consumption is a significant influencing factor for chronic obstructive pulmonary disease (COPD), but this is unclear in the Chinese population. We examined the association of fresh fruit consumption with the risk of COPD-related hospitalization and death in a nationwide, population-based prospective cohort from China. METHODS Between 2004 and 2008, the China Kadoorie Biobank recruited >0.5 million adults aged 30 to 79 years from ten diverse regions across China. After excluding individuals diagnosed with major chronic diseases and prevalent COPD, the prospective analysis included 421,428 participants. Cox regression was used to calculate the hazard ratios (HRs) for the association between fresh fruit consumption and risk of COPD-related hospitalization and death, with adjustment for established and potential confounders. RESULTS During a mean follow-up of 10.9 years, 11,292 COPD hospitalization events and deaths were documented, with an overall incidence rate of 2.47/1000 person-years. Participants who consumed fresh fruit daily had a 22% lower risk of COPD-related hospitalization and death compared with non-consumers (HR = 0.78, 95% confidence interval [CI]: 0.71-0.87). The inverse association between fresh fruit consumption and COPD-related hospitalization and death was stronger among non-current smokers and participants with normal body mass index (BMI) (18.5 kg/m 2 ≤ BMI < 24.0 kg/m 2 ); the corresponding HRs for daily fresh fruit consumption were 0.78 (95% CI: 0.68-0.89) and 0.69 (95% CI: 0.59-0.79) compared with their counterparts, respectively. CONCLUSIONS High-frequency fruit consumption was associated with a lower risk of COPD in Chinese adults. Increasing fruit consumption, together with cigarette cessation and weight control, should be considered in the prevention and management of COPD.
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Affiliation(s)
- Xin Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Jiachen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Weihua Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Jun Lyu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing 100191, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing 100191, China
| | - Yu Guo
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Beijing 100037, China
| | - Pei Pei
- National Coordinate Center, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Qingmei Xia
- National Coordinate Center, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Huaidong Du
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford OX3 7LF, UK
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford OX3 7LF, UK
| | - Yiping Chen
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford OX3 7LF, UK
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford OX3 7LF, UK
| | - Yang Ling
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford OX3 7LF, UK
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford OX3 7LF, UK
| | - Rene Kerosi
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford OX3 7LF, UK
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford OX3 7LF, UK
| | - Rebecca Stevens
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford OX3 7LF, UK
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford OX3 7LF, UK
| | - Xujun Yang
- Maiji Center for Disease Control and Prevention, Tianshui, Gansu 741020, China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing 100022, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing 100191, China
| | - Zhengming Chen
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford OX3 7LF, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing 100191, China
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Salahuddin M, Khan DA, Ayub S, Shahzad T, Irfan M. Biomass Smoke–Associated Lung Diseases. CURRENT PULMONOLOGY REPORTS 2023; 12:151-161. [DOI: 10.1007/s13665-023-00318-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2023] [Indexed: 09/01/2023]
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Njoku CM, Hurst JR, Kinsman L, Balogun S, Obamiro K. COPD in Africa: risk factors, hospitalisation, readmission and associated outcomes-a systematic review and meta-analysis. Thorax 2023; 78:596-605. [PMID: 36635039 DOI: 10.1136/thorax-2022-218675] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 11/30/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND This review aims to synthesise available evidence on the prevalence of chronic obstructive pulmonary disease (COPD), associated risk factors, hospitalisations and COPD readmissions in Africa. METHOD Using the Met-Analyses and Systematic Reviews of Observational Studies guideline, electronic databases were searched from inception to 1 October 2021. The quality of studies was assessed using the Newcastle-Ottawa Scale. Evidence from retrieved articles was synthesised, and a random-effect model meta-analysis was conducted. The protocol was registered on PROSPERO. RESULTS Thirty-nine studies met the inclusion criteria, with 13 included in the meta-analysis. The prevalence of COPD varied between the Global Initiative for Chronic Obstructive Lung Disease (2%-24%), American Thoracic Society/European Respiratory Society (1%-17%) and Medical Research Council chronic bronchitis (2%-11%) criteria, respectively. Increasing age, wheezing and asthma were consistent risk factors for COPD from studies included in the narrative synthesis. Our meta-analysis indicated that prior tuberculosis ((OR 5.98, 95% CI 4.18 to 8.56), smoking (OR 2.80, 95% CI: 2.19 to 3.59) and use of biomass fuel (OR 1.52, 95% CI: 1.39 to 1.67)) were significant risk factors for COPD. Long-term oxygen therapy (HR 4.97, 95% CI (1.04 to 23.74)) and frequent hospitalisation (≥3 per year) (HR 11.48, 95% CI (1.31 to 100.79)) were risk factors associated with 30-day COPD readmission. CONCLUSION This study not only highlights specific risk factors for COPD risk in Africa but also demonstrates the paucity and absence of research in several countries in a continent with substantial COPD-related mortality. Our findings contribute towards the development of evidence-based clinical guidelines for COPD in Africa.PROSPERO registration numberCRD42020210581.
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Affiliation(s)
- Chidiamara Maria Njoku
- College of Health Sciences, Sport and Exercise Science, James Cook University Division of Tropical Health and Medicine, Townsville, Queensland, Australia
| | - John R Hurst
- Academic Unit of Respiratory Medicine, UCL Medical School, London, UK
| | - Leigh Kinsman
- School of Nursing and Midwifery, The University of Newcastle School of Nursing and Midwifery, Callaghan, New South Wales, Australia
| | - Saliu Balogun
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Kehinde Obamiro
- Centre for Rural Health, University of Tasmania School of Health Sciences, Launceston, Tasmania, Australia
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Yan R, Duong M, Tse LA, Yin L, Rangarajan S, Yusuf S, Hou Y, Xu Z, Li J, Li W. Regional differences in the contribution of smoking, dietary and cooking behaviours to airflow obstruction in China: A population-based case-control study. Respirology 2023; 28:37-46. [PMID: 35999170 DOI: 10.1111/resp.14347] [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: 03/23/2022] [Accepted: 08/08/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND OBJECTIVE The major contributing risk factors to airflow obstruction (AO) in China remain largely unknown. We examined the environmental and lifestyle risk factors of unrecognized AO in the baseline of a population-based cohort drawn from 115 urban and rural communities across 12 provinces in China. METHODS Amongst 46,285 adults recruited from 2005 to 2009, 3686 were identified with AO on spirometry (defined by the ratio of forced expiratory volume in the first second to forced vital capacity <0.7) and without known chronic lung disease. These cases were age- and sex-matched to 11,129 controls with normal spirometry and no chronic lung disease from the same community. Conditional multivariable adjusted OR and population attributable fraction (PAF) were calculated for each identified risk factor and their combined effect. RESULTS Compared to controls, smoking initiation age <20 years (OR 1.22 [95% CI 1.01-1.48]), smoking duration ≥40 years (OR 1.82 [1.50-2.22]), low vegetables (OR 1.86 [1.67-2.07]) and fruits (OR 1.14 [1.02-1.29]) intake, cooking with biomass fuels (OR 2.54 [2.32-2.78]) and poor kitchen ventilation (OR 1.37 [1.19-1.58]) were significantly associated with elevated risks of unrecognized AO. The combined effect of these lifestyle factors significantly elevated the odds by 25 fold (18.6-34.3). The addition of prior tuberculosis and low socioeconomic status further increased the odds to 40.1 (28.2-57.0) and the PAF to 66.7% (51.1-78.1). CONCLUSION Smoking, unhealthy diet, biomass cooking fuels and low socioeconomic status are strongly associated with AO. Addressing these risk factors could substantially reduce the burden of AO in China.
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Affiliation(s)
- Ruohua Yan
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - MyLinh Duong
- Population Health Research Institute, Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Lap Ah Tse
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Lu Yin
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sumathy Rangarajan
- Population Health Research Institute, Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Salim Yusuf
- Population Health Research Institute, Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Yan Hou
- Balingqiao Community Health Service, Taiyuan, China
| | - Zhengting Xu
- Bayannaoer Center for Disease Control and Prevention, Bayannaoer, China
| | - Jinyuan Li
- Jiangxi Nanchang Ninth Hospital, Nanchang, China
| | - Wei Li
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Early Features of Chronic Obstructive Pulmonary Disease in Patients with Asthma: Is there ACO before ACO? Immunol Allergy Clin North Am 2022; 42:549-558. [PMID: 35965044 DOI: 10.1016/j.iac.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The diagnosis of asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) is considered when a patient presents features of both asthma and COPD, usually including a component of irreversible airway obstruction (IRAO). However, some patients with asthma, particularly smokers, may have various features typical of COPD in the absence of such component of IRAO. Features of early COPD can be found at a young age in such patients even with normal spirometry. More longitudinal studies should be conducted to determine steps needed to improve clinical outcomes of these patients including the early recognition of these changes and the application of preventative/therapeutic interventions.
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Zaigham S, Tanash H, Nilsson PM, Muhammad IF. Triglyceride-Glucose Index is a Risk Marker of Incident COPD Events in Women. Int J Chron Obstruct Pulmon Dis 2022; 17:1393-1401. [PMID: 35746923 PMCID: PMC9212790 DOI: 10.2147/copd.s360793] [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: 02/04/2022] [Accepted: 04/30/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose The triglyceride-glucose index (TyG index) is a marker of insulin resistance and metabolic dysfunction and has the advantage of being universally available. Although recent evidence suggests the TyG index has relevance to respiratory health, there have been no prospective studies assessing its value as a biomarker for chronic lung diseases. We aim to assess the TyG index as a potential risk marker for future incident COPD events in the general population. Patients and Methods Baseline TyG index was assessed in 28,282 middle-aged men and women without previous history of chronic obstructive pulmonary disease (COPD) from the Malmö Preventive Project (men between 1974 and 1982 and women between 1982 and 1992). All subjects were followed up prospectively, and Cox proportional hazards regression was used to assess incident COPD events according to quartiles of TyG index. Results After an average of 31 years of follow-up, TyG index was a strong predictor of future COPD events even after adjusting for potential confounders (Q4 (highest TyG index) HR (95% CI): 1.21 (1.09–1.35) vs Q1 (reference), p-trend <0.001). After stratifying by sex, the results remained statistically significant in women only (Q4 vs Q1 HR 1.72 (1.41–2.09)). Additionally, the risk remained significant in a cohort of life-long never smokers (Q4 vs Q1 HR 1.47 (1.08–2.01)). Conclusion A raised TyG index is a novel risk marker of future incident COPD events in women. Insulin resistance as reflected by the TyG index can precede the development of obstructive lung disease and as such may be an easily measurable and useful predictor of COPD in women.
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Affiliation(s)
- Suneela Zaigham
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Hanan Tanash
- Department of Respiratory Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Peter M Nilsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Iram F Muhammad
- Department of Clinical Sciences, Lund University, Malmö, Sweden
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Mitra P, Chakraborty D, Mondal NK. Assessment of household air pollution exposure of tribal women. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 817:152869. [PMID: 34995613 DOI: 10.1016/j.scitotenv.2021.152869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/29/2021] [Accepted: 12/29/2021] [Indexed: 06/14/2023]
Abstract
There is a growing evidence that the burning of unprocessed biomass fuels is associated with adverse health impacts. This study estimated the gaseous pollutants (CO, CO2, O3, SO2, and NO2) and particulate matters (PM2.5 and PM10) during the burning of biomass and liquefied petroleum gas (LPG) fuels and their impacts on the health of tribal women. The results revealed that the tribal women mainly used six types of unprocessed biomass fuels (dry leaves, cow dung cake, dry woods, twigs, rice straw, and agricultural residues) along with five types of traditional earthen stoves. The concentration of gaseous and PM was recorded as in the order of CO2 > SO2 > CO > O3 and total suspended particulate matter (TSPM) > PM10 > PM2.5, respectively. The pollutant concentration inside the kitchen room for biomass users was significantly (p < 0.001) higher than LPG users. The biomass using tribal women might be suffering from higher cardiovascular risk than LPG users. The lung function study results also indicated that the mean values of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC were lower among biomass users than LPG users. The correlation study shows that tribal women who were exposed to biomass smoke were in a more vulnerable position than those who used LPG. Moreover, the toxicological risk among tribal biomass users was observed high (3.52) compared to LPG users (0.39). On the other hand, the Monte Carlo probabilistic simulation model for uncertainty analysis revealed that the mean value of Hazard Quotient (HQ) for PM2.5 in kitchen room was observed as 4.31E-00 and 9.40E-01 for biomass and LPG users, respectively. Modelling study also revealed that exposure of duration and cooking time are extremely important for toxicological risk assessment. However, further long-term comprehensive studies are extremely important.
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Affiliation(s)
- Pradip Mitra
- Environmental Chemistry Laboratory, Department of Environmental Science, The University of Burdwan, West Bengal, India
| | - Deep Chakraborty
- Environmental Chemistry Laboratory, Department of Environmental Science, The University of Burdwan, West Bengal, India
| | - Naba Kumar Mondal
- Environmental Chemistry Laboratory, Department of Environmental Science, The University of Burdwan, West Bengal, India.
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Kattimani S, Thimmegowda U, Nagarathna C. Knowledge, Attitude and Behavior Regarding the Hazards of Tobacco Use and Cigarette and Other Tobacco Products Act among Parents Visiting Pediatric Dental Clinic: A Cross- sectional Questionnaire Survey. Int J Clin Pediatr Dent 2022; 15:47-53. [PMID: 35528501 PMCID: PMC9016916 DOI: 10.5005/jp-journals-10005-2174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aim “Today's adolescents are tomorrow's citizens.” Tobacco use in children and adolescents is reaching pandemic levels as they are the most vulnerable population to initiate tobacco use. It is well established that most of the adult users of tobacco, start the use of tobacco either in their childhood or adolescence. Parents are the best route to reach a child and can help lead to bring better outcomes for children. Hence, the aim of this study is to assess the knowledge, attitude, and behavior regarding the hazards of tobacco use and Cigarette and Other Tobacco Products Act (COTPA) among the parents visiting pediatric dental clinic. Materials and methods A cross-sectional survey was conducted using a self-administered questionnaire regarding knowledge, attitude, and behavior regarding the hazards of tobacco use and COTPA law. Samples size of 400 parents of adolescents aged between 10 and 16 years visiting to the department of Pediatrics and Preventive Dentistry were included in the study, data thus obtained was subjected to statistical analysis. Results Smoking tobacco product known to the parent population in the present study is cigarette (88.8%) and smokeless tobacco product is pan masala (65.2%). The tobacco health hazard known is cancer by 70.5 and 85.3% parent populations were aware of mandatory display of pictorial health warnings in COTPA law. Strict implementation of COTPA law was opted by 61.8%. Conclusion Knowledge, attitude, and behavior of parents is required to educate and motivate adolescents. Parents have given their positive attitude regarding the strict implementation of COTPA law in India and realize the role of tobacco as a causative factor for health hazards both in children and adults. COTPA law should be made aware for both young and old to educate and motivate and to prevent the use of tobacco in India. How to cite this article Kattimani S, Thimmegowda U, Nagarathna C. Knowledge, Attitude and Behavior Regarding the Hazards of Tobacco Use and Cigarette and Other Tobacco Products Act among Parents Visiting Pediatric Dental Clinic: A Cross-sectional Questionnaire Survey. Int J Clin Pediatr Dent 2022;15(1):47-53.
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Affiliation(s)
- Susan Kattimani
- Pediatric and Preventive Dentistry, Rajarajeswari Dental College, Bengaluru, Karnataka, India
| | - Umapathy Thimmegowda
- Pediatric and Preventive Dentistry, Rajarajeswari Dental College, Bengaluru, Karnataka, India
- Umapathy Thimmegowda, Pediatric and Preventive Dentistry, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India, Phone: +91 9986478744, e-mail:
| | - C Nagarathna
- Pediatric and Preventive Dentistry, Rajarajeswari Dental College, Bengaluru, Karnataka, India
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12
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Golpe R, Blanco-Cid N, Dacal-Rivas D, Martín-Robles I, Veiga I, Guzmán-Peralta I, Castro-Añón O, Pérez-de-Llano L. Incidence and profile of severe exacerbations of chronic obstructive pulmonary disease due to biomass smoke or tobacco. Ann Thorac Med 2022; 17:193-198. [PMID: 36387759 PMCID: PMC9662078 DOI: 10.4103/atm.atm_155_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/23/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES: Stable chronic obstructive pulmonary disease (COPD) caused by biomass smoke (B-COPD) has some differences from tobacco-induced-COPD (T-COPD), but acute exacerbations (AECOPD) have not been well characterized in B-COPD. OBJECTIVE: To compare the incidence, characteristics and outcomes of AECOPD in B-COPD with those of T-COPD. METHODS: A retrospective observational study that included consecutive patients seen at a specialized COPD clinic (2008–2021). The incidence of severe AECOPD that required hospital admission was studied. For the first AECOPD, the following variables were recorded: fever, coexistence of pneumonia, purulent sputum, eosinophil count, neutrophil to lymphocyte ratio, hypercapnia, and respiratory acidosis. Outcome variables were intensive care unit (ICU) admission, length of hospital stay, and mortality within 1 month of hospital admission. RESULTS: Of 1060 subjects, 195 (18.4%) belonged to the B-COPD group and 865 (81.6%) to the T-COPD group. During a follow-up of 67.9 (37.8–98.8) months, 75 (38.4%) patients in the B-COPD group and 319 (36.8%) in the T-COPD group suffered at least one severe AECOPD. The only difference between groups was in a higher risk of ICU admission for the T-COPD group. The incidence, characteristics, and the rest of the outcomes of AECOPD were similar for both groups. CONCLUSION: AECOPD are similar events for B-COPD and T-COPD and should be managed similarly.
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Abstract
Purpose for Review Since the coronavirus SARS-CoV-2 outbreak in China in late 2019 turned into a global pandemic, numerous studies have reported associations between environmental factors, such as weather conditions and a range of air pollutants (particulate matter, nitrogen dioxide, ozone, etc.) and the first wave of COVID-19 cases. This review aims to offer a critical assessment of the role of environmental exposure risk factors on SARS-CoV-2 infections and COVID-19 disease severity. Recent Findings In this review, we provide a critical assessment of COVID-19 risk factors, identify gaps in our knowledge (e.g., indoor air pollution), and discuss methodological challenges of association and causation and the impact lockdowns had on air quality. In addition, we will draw attention to ethnic and socioeconomic factors driving viral transmission related to COVID-19. The complex role angiotensin-converting enzyme 2 (ACE2) plays in COVID-19 and future promising avenues of research are discussed. Summary To demonstrate causality, we stress the need for future epidemiologic studies integrating personal air pollution exposures, detailed clinical COVID-19 data, and a range of socioeconomic factors, as well as in vitro and in vivo mechanistic studies.
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Duan JX, Cheng W, Zeng YQ, Chen Y, Cai S, Li X, Zhu YQ, Chen M, Zhou ML, Ma LB, Liu QM, Chen P. Characteristics of Patients with Chronic Obstructive Pulmonary Disease Exposed to Different Environmental Risk Factors: A Large Cross-Sectional Study. Int J Chron Obstruct Pulmon Dis 2020; 15:2857-2867. [PMID: 33192059 PMCID: PMC7654530 DOI: 10.2147/copd.s267114] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 10/14/2020] [Indexed: 12/17/2022] Open
Abstract
Purpose Tobacco smoking, biomass smoke, and occupational exposure are the main risk factors for chronic obstructive pulmonary disease (COPD). The present study analyzes data on exposure to these factors in a cohort of patients with COPD and assesses their differences in demographic and clinical characteristics. Patients and Methods The cross-sectional observational study was conducted from November 2016 to December 2019. Inclusion criteria were patients aged over 40 years old with post-bronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) <0.7. At baseline, demographic features and exposure history were recorded. Moreover, respiratory symptoms were assessed by the COPD Assessment Test (CAT) and modified Medical Research Council scale (mMRC). A generalized linear mixed model was used to adjust for potential confounders. Results A total of 5183 patients with COPD were included in the final analysis. The results demonstrate that exposure to tobacco combined with other risk factors resulted in significantly higher CAT scores (16.0 ± 6.7 vs 15.3 ± 6.3, P = 0.003) and more severe dyspnea (patients with mMRC ≥ 2, 71.5% vs 61.6%, P < 0.001) than exposure to tobacco alone. In addition, COPD patients with biomass smoke exposure alone had higher CAT scores than patients with only tobacco or occupational exposure (17.5 ± 6.3 vs 15.3 ± 6.3, and 15.2 ± 6.3, respectively, P < 0.05 for each comparison) and were more likely to be female and older. In addition, COPD patients who suffered from occupational exposure developed more severe dyspnea than those exposed to tobacco alone (70.8% vs 61.6%, P < 0.05), as did those exposed to biomass smoke alone (74.2% vs 61.6%, P < 0.05). This difference remained strong even after adjustment for potential confounders. Conclusion There are significant demographic and clinical differences among COPD patients with tobacco smoking, biomass smoke, and occupational exposures.
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Affiliation(s)
- Jia-Xi Duan
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, People's Republic of China
| | - Wei Cheng
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, People's Republic of China
| | - Yu-Qin Zeng
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, People's Republic of China
| | - Yan Chen
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, People's Republic of China
| | - Shan Cai
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, People's Republic of China
| | - Xin Li
- Division 4 of Occupational Diseases, Hunan Prevention and Treatment Institute for Occupational Diseases, Changsha, Hunan 410000, People's Republic of China
| | - Ying-Qun Zhu
- Department of Respiratory Medicine, The Third Hospital of Changsha, Changsha, Hunan 410011, People's Republic of China
| | - Ming Chen
- Department of Respiratory Medicine, The No.1 Traditional Chinese Medicine Hospital in Changde, Changde, Hunan 415000, People's Republic of China
| | - Mei-Ling Zhou
- Department of Respiratory Medicine, The First People's Hospital of Huaihua, Huaihua, Hunan 418000, People's Republic of China
| | - Li-Bing Ma
- Department of Respiratory Medicine, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi 541000, People's Republic of China
| | - Qi-Mi Liu
- Department of Respiratory and Critical Care Medicine, The Second People's Hospital of Guilin, Guilin, Guangxi 541000, People's Republic of China
| | - Ping Chen
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, Hunan 410011, People's Republic of China
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15
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Finicelli M, Squillaro T, Galderisi U, Peluso G. Micro-RNAs: Crossroads between the Exposure to Environmental Particulate Pollution and the Obstructive Pulmonary Disease. Int J Mol Sci 2020; 21:E7221. [PMID: 33007849 PMCID: PMC7582315 DOI: 10.3390/ijms21197221] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 12/18/2022] Open
Abstract
Environmental pollution has reached a global echo and represents a serious problem for human health. Air pollution encompasses a set of hazardous substances, such as particulate matter and heavy metals (e.g., cadmium, lead, and arsenic), and has a strong impact on the environment by affecting groundwater, soil, and air. An adaptive response to environmental cues is essential for human survival, which is associated with the induction of adaptive phenotypes. The epigenetic mechanisms regulating the expression patterns of several genes are promising candidates to provide mechanistic and prognostic insights into this. Micro-RNAs (miRNAs) fulfil these features given their ability to respond to environmental factors and their critical role in determining phenotypes. These molecules are present in extracellular fluids, and their expression patterns are organ-, tissue-, or cell-specific. Moreover, the experimental settings for their quantitative and qualitative analysis are robust, standardized, and inexpensive. In this review, we provide an update on the role of miRNAs as suitable tools for understanding the mechanisms behind the physiopathological response to toxicants and the prognostic value of their expression pattern associable with specific exposures. We look at the mechanistic evidence associable to the role of miRNAs in the processes leading to environmental-induced pulmonary disease (i.e., chronic obstructive pulmonary disease).
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Affiliation(s)
- Mauro Finicelli
- Research Institute on Terrestrial Ecosystems (IRET), National Research Council of Italy (CNR), via Pietro Castellino 111, 80131 Naples, Italy
| | - Tiziana Squillaro
- Department of Experimental Medicine, Division of Molecular Biology, Biotechnology and Histology, University of Campania “Luigi Vanvitelli”, via Santa Maria di Costantinopoli 16, 80138 Naples, Italy; (T.S.); (U.G.)
| | - Umberto Galderisi
- Department of Experimental Medicine, Division of Molecular Biology, Biotechnology and Histology, University of Campania “Luigi Vanvitelli”, via Santa Maria di Costantinopoli 16, 80138 Naples, Italy; (T.S.); (U.G.)
| | - Gianfranco Peluso
- Research Institute on Terrestrial Ecosystems (IRET), National Research Council of Italy (CNR), via Pietro Castellino 111, 80131 Naples, Italy
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16
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Clinical, Epidemiological and Experimental Approaches to Assess Adverse Health Outcomes of Indoor Biomass Smoke Exposure: Conclusions from An Indo-Swedish Workshop in Mysuru, January 2020. TOXICS 2020; 8:toxics8030068. [PMID: 32899560 PMCID: PMC7560295 DOI: 10.3390/toxics8030068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/31/2020] [Accepted: 09/03/2020] [Indexed: 12/14/2022]
Abstract
This report summarizes the outcome of a workshop held in Mysuru, India in January 2020 addressing the adverse health effects of exposure to biomass smoke (BMS). The aim of the workshop was to identify uncertainties and gaps in knowledge and possible methods to address them in the Mysuru study on Determinants of Health in Rural Adults (MUDHRA) cohort. Specific aims were to discuss the possibility to improve and introduce new screening methods for exposure and effect, logistic limitations and other potential obstacles, and plausible strategies to overcome these in future studies. Field visits were included in the workshop prior to discussing these issues. The workshop concluded that multi-disciplinary approaches to perform: (a) indoor and personalized exposure assessment; (b) clinical and epidemiological field studies among children, adolescents, and adults; (c) controlled exposure experiments using physiologically relevant in vitro and in vivo models to understand molecular patho-mechanisms are warranted to dissect BMS-induced adverse health effects. It was perceived that assessment of dietary exposure (like phytochemical index) may serve as an important indicator for understanding potential protective mechanisms. Well trained field teams and close collaboration with the participating hospital were identified as the key requirements to successfully carry out the study objectives.
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17
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Accordini S, Calciano L, Marcon A, Pesce G, Antó JM, Beckmeyer-Borowko AB, Carsin AE, Corsico AG, Imboden M, Janson C, Keidel D, Locatelli F, Svanes C, Burney PGJ, Jarvis D, Probst-Hensch NM, Minelli C. Incidence trends of airflow obstruction among European adults without asthma: a 20-year cohort study. Sci Rep 2020; 10:3452. [PMID: 32103063 PMCID: PMC7044325 DOI: 10.1038/s41598-020-60478-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 02/13/2020] [Indexed: 11/08/2022] Open
Abstract
Investigating COPD trends may help healthcare providers to forecast future disease burden. We estimated sex- and smoking-specific incidence trends of pre-bronchodilator airflow obstruction (AO) among adults without asthma from 11 European countries within a 20-year follow-up (ECRHS and SAPALDIA cohorts). We also quantified the extent of misclassification in the definition based on pre-bronchodilator spirometry (using post-bronchodilator measurements from a subsample of subjects) and we used this information to estimate the incidence of post-bronchodilator AO (AOpost-BD), which is the primary characteristic of COPD. AO incidence was 4.4 (95% CI: 3.5-5.3) male and 3.8 (3.1-4.6) female cases/1,000/year. Among ever smokers (median pack-years: 20, males; 12, females), AO incidence significantly increased with ageing in men only [incidence rate ratio (IRR), 1-year increase: 1.05 (1.03-1.07)]. A strong exposure-response relationship with smoking was found both in males [IRR, 1-pack-year increase: 1.03 (1.02-1.04)] and females [1.03 (1.02-1.05)]. The positive predictive value of AO for AOpost-BD was 59.1% (52.0-66.2%) in men and 42.6% (35.1-50.1%) in women. AOpost-BD incidence was 2.6 (1.7-3.4) male and 1.6 (1.0-2.2) female cases/1,000/year. AO incidence was considerable in Europe and the sex-specific ageing-related increase among ever smokers was strongly related to cumulative tobacco exposure. AOpost-BD incidence is expected to be half of AO incidence.
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Affiliation(s)
- Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
| | - Lucia Calciano
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giancarlo Pesce
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
- Sorbonne Universités, INSERM UMR-S 1136, IPLESP, Team EPAR, F75012, Paris, France
| | - Josep M Antó
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Anna B Beckmeyer-Borowko
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Anne-Elie Carsin
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Angelo G Corsico
- Division of Respiratory Diseases, IRCCS 'San Matteo' Hospital Foundation-University of Pavia, Pavia, Italy
| | - Medea Imboden
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Dirk Keidel
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Francesca Locatelli
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Cecilie Svanes
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Peter G J Burney
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK
- MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - Deborah Jarvis
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK
- MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - Nicole M Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Cosetta Minelli
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK
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Lee AG, Kaali S, Quinn A, Delimini R, Burkart K, Opoku-Mensah J, Wylie BJ, Yawson AK, Kinney PL, Ae-Ngibise KA, Chillrud S, Jack D, Asante KP. Prenatal Household Air Pollution Is Associated with Impaired Infant Lung Function with Sex-Specific Effects. Evidence from GRAPHS, a Cluster Randomized Cookstove Intervention Trial. Am J Respir Crit Care Med 2020; 199:738-746. [PMID: 30256656 DOI: 10.1164/rccm.201804-0694oc] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
RATIONALE Approximately 2.8 billion people are exposed daily to household air pollution from polluting cookstoves. The effects of prenatal household air pollution on lung development are unknown. OBJECTIVES To prospectively examine associations between prenatal household air pollution and infant lung function and pneumonia in rural Ghana. METHODS Prenatal household air pollution exposure was indexed by serial maternal carbon monoxide personal exposure measurements. Using linear regression, we examined associations between average prenatal carbon monoxide and infant lung function at age 30 days, first in the entire cohort (n = 384) and then stratified by sex. Quasi-Poisson generalized additive models explored associations between infant lung function and pneumonia. MEASUREMENTS AND MAIN RESULTS Multivariable linear regression models showed that average prenatal carbon monoxide exposure was associated with reduced time to peak tidal expiratory flow to expiratory time (β = -0.004; P = 0.01), increased respiratory rate (β = 0.28; P = 0.01), and increased minute ventilation (β = 7.21; P = 0.05), considered separately, per 1 ppm increase in average prenatal carbon monoxide. Sex-stratified analyses suggested that girls were particularly vulnerable (time to peak tidal expiratory flow to expiratory time: β = -0.003, P = 0.05; respiratory rate: β = 0.36, P = 0.01; minute ventilation: β = 11.25, P = 0.01; passive respiratory compliance normalized for body weight: β = 0.005, P = 0.01). Increased respiratory rate at age 30 days was associated with increased risk for physician-assessed pneumonia (relative risk, 1.02; 95% confidence interval, 1.00-1.04) and severe pneumonia (relative risk, 1.04; 95% confidence interval, 1.00-1.08) in the first year of life. CONCLUSIONS Increased prenatal household air pollution exposure is associated with impaired infant lung function. Altered infant lung function may increase risk for pneumonia in the first year of life. These findings have implications for future respiratory health. Clinical trial registered with www.clinicaltrials.gov (NCT 01335490).
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Affiliation(s)
- Alison G Lee
- 1 Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Seyram Kaali
- 2 Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Ashlinn Quinn
- 3 Fogarty International Center, National Institutes of Health, Bethesda, Maryland
| | - Rupert Delimini
- 4 Department of Biomedical Sciences, University of Health and Allied Services, Volta Region, Ghana
| | - Katrin Burkart
- 5 Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York
| | - Jones Opoku-Mensah
- 2 Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Blair J Wylie
- 6 Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massacusetts
| | - Abena Konadu Yawson
- 2 Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Patrick L Kinney
- 7 Department of Health, Boston University School of Public Health, Boston, Massachusetts; and
| | - Kenneth A Ae-Ngibise
- 2 Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Steven Chillrud
- 8 Lamont-Doherty Earth Observatory at Columbia University, Palisades, New York
| | - Darby Jack
- 5 Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York
| | - Kwaku Poku Asante
- 2 Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
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Hosgood HD, Klugman M, Matsuo K, White AJ, Sadakane A, Shu XO, Lopez-Ridaura R, Shin A, Tsuji I, Malekzadeh R, Noisel N, Bhatti P, Yang G, Saito E, Rahman S, Hu W, Bassig B, Downward G, Vermeulen R, Xue X, Rohan T, Abe SK, Broët P, Grant EJ, Dummer TJB, Rothman N, Inoue M, Lajous M, Yoo KY, Ito H, Sandler DP, Ashan H, Zheng W, Boffetta P, Lan Q. The establishment of the Household Air Pollution Consortium (HAPCO). ATMOSPHERE 2019; 10:10.3390/atmos10070422. [PMID: 32064123 PMCID: PMC7021252 DOI: 10.3390/atmos10070422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Household air pollution (HAP) is of public health concern with ~3 billion people worldwide (including >15 million in the US) exposed. HAP from coal use is a human lung carcinogen, yet the epidemiological evidence on carcinogenicity of HAP from biomass use, primarily wood, is not conclusive. To robustly assess biomass's carcinogenic potential, prospective studies of individuals experiencing a variety of HAP exposures are needed. We have built a global consortium of 13 prospective cohorts (HAPCO: Household Air Pollution Consortium) that have site- and disease-specific mortality and solid fuel use data, for a combined sample size of 587,257 participants and 57,483 deaths. HAPCO provides a novel opportunity to assess the association of HAP with lung cancer death while controlling for important confounders such as tobacco and outdoor air pollution exposures. HAPCO is also uniquely positioned to determine the risks associated with cancers other than lung as well as non-malignant respiratory and cardiometabolic outcomes, for which prospective epidemiologic research is limited. HAPCO will facilitate research to address public health concerns associated with HAP-attributed exposures by enabling investigators to evaluate sex-specific and smoking status-specific effects under various exposure scenarios.
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Affiliation(s)
- H. Dean Hosgood
- Department of Epidemiology and Population Health, Albert
Einstein College of Medicine, Bronx, NY, 10461, United States
| | - Madelyn Klugman
- Department of Epidemiology and Population Health, Albert
Einstein College of Medicine, Bronx, NY, 10461, United States
| | - Keitaro Matsuo
- Division of Epidemiology and Prevention, Aichi Cancer
Center Research Institute; Nagoya, 464-8681, Japan
| | - Alexandra J. White
- Epidemiology Branch, National Institute of Environmental
Health Science, Research Triangle Park, NC 27709, United States
| | - Atsuko Sadakane
- Department of Epidemiology, Radiation Effects Research
Foundation, Hiroshima 732-0815, Japan
| | - Xiao-Ou Shu
- Vanderbilt Institute for Global Health, Vanderbilt
University School of Medicine, Nashville, TN 37203-1738, United States
| | - Ruy Lopez-Ridaura
- National Institute of Public Health, Cuernavaca, Morelos,
62100, Mexico
| | - Aesun Shin
- Department of Preventative Medicine, Seoul National
University College of Medicine, Seoul 03080, Korea
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics
and Public Health, Tohoku University Graduate School of Medicine, Miyagi 980-8575,
Japan
| | - Reza Malekzadeh
- Digestive Diseases Research Institute, Tehran University of
Medical Sciences, Tehran, 14117, Iran
| | - Nolwenn Noisel
- CARTaGENE, Centre de Recherche du CHU Sainte-Justine,
Montreal, Quebec, H3T 1C5, Canada
| | | | - Gong Yang
- Center for Health Services, Vanderbilt University School
of Medicine, Nashville, TN, 37203-1738, United States
| | - Eiko Saito
- Division of Cancer Statistics and Integration, Center for
Cancer Control and Information Services, National Cancer Center, Tokyo, 104-0045,
Japan
| | - Shafiur Rahman
- Department of Global Health Policy, Graduate School of
Medicine, University of Tokyo, Tokyo, 113-8654, Japan
| | - Wei Hu
- Occupational and Environmental Epidemiology Branch,
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda MD
20892-7240
| | - Bryan Bassig
- Occupational and Environmental Epidemiology Branch,
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda MD
20892-7240
| | - George Downward
- Institute for Risk Assessment Services, Utrecht
University, Utrecht, 3508, The Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Services, Utrecht
University, Utrecht, 3508, The Netherlands
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert
Einstein College of Medicine, Bronx, NY, 10461, United States
| | - Thomas Rohan
- Department of Epidemiology and Population Health, Albert
Einstein College of Medicine, Bronx, NY, 10461, United States
| | - Sarah K Abe
- Epidemiology and Prevention Group, Center for Public
Health Sciences, National Cancer Center, Tokyo, 104-0045, Japan
| | - Philippe Broët
- CARTaGENE, Centre de Recherche du CHU Sainte-Justine,
Montreal, Quebec, H3T 1C5, Canada
| | - Eric J. Grant
- Department of Epidemiology, Radiation Effects Research
Foundation, Hiroshima 732-0815, Japan
| | - Trevor J. B. Dummer
- School of Population and Public Health, University of
British Columbia, Vancouver, BC, V6T 1Z3, Canada
| | - Nat Rothman
- Occupational and Environmental Epidemiology Branch,
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda MD
20892-7240
| | - Manami Inoue
- Epidemiology and Prevention Group, Center for Public
Health Sciences, National Cancer Center, Tokyo, 104-0045, Japan
| | - Martin Lajous
- National Institute of Public Health, Cuernavaca, Morelos,
62100, Mexico
- Department of Global Health and Population, Harvard T.H.
Chan School of Public Health, Boston, MA
| | - Keun-Young Yoo
- Department of Preventative Medicine, Seoul National
University College of Medicine, Seoul 03080, Korea
| | - Hidemi Ito
- Division of Epidemiology and Prevention, Aichi Cancer
Center Research Institute; Nagoya, 464-8681, Japan
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental
Health Science, Research Triangle Park, NC 27709, United States
| | - Habib Ashan
- Department of Health Sciences, The University of Chicago,
Chicago, IL, 60637, United States
| | - Wei Zheng
- Center for Health Services, Vanderbilt University School
of Medicine, Nashville, TN, 37203-1738, United States
| | - Paolo Boffetta
- The Tisch Cancer Institute, Mount Sinai School of
Medicine, New York, NY 10029-6574, United States
- Department of Medical and Surgical Sciences, University
of Bologna, Bologna, 40126, Italy
| | - Qing Lan
- Occupational and Environmental Epidemiology Branch,
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda MD
20892-7240
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20
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Duarte-de-Araújo A, Teixeira P, Hespanhol V, Correia-de-Sousa J. Characterisation of morbidity in a COPD hospital cohort. Pulmonology 2019; 25:200-207. [PMID: 31155471 DOI: 10.1016/j.pulmoe.2019.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/14/2019] [Accepted: 02/18/2019] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES To characterise the morbidity of COPD out-patients based on symptoms, acute exacerbations, FEV1 and comorbidities, and to explore the association between different patients' characteristics such as social, demographic, clinical history or exposure. METHODS Stable COPD outpatients over 40 years old diagnosed according to GOLD criteria were included consecutively; the exclusion criteria were only refusal to participate and inability to understand clinical questionnaires. A survey of demographic and clinical data was conducted. Symptoms were evaluated using the CAT and mMRC questionnaires. The number of COPD acute exacerbations reported in the previous year was assessed, and spirometry performed on all participants according to ATS/ERS recommendations. Different variables were collected and then related to each other. RESULTS We studied 303 COPD outpatients, all Caucasians, 79.5% males and mostly elderly. 65.7% of participants reported having low monthly income and 87.8% a low education level. Tobacco smoking was the most common exposure identified but a substantial proportion of COPD patients were non-smokers (26%). Frequent acute exacerbations were reported by 38.0% of patients. The mean post-bronchodilator FEV1 was 53.2%. The distribution of patients according to GOLD 2017 stage and classification was respectively 9.9%, 41.9%, 35.0% and 13.2% from 1 to 4 and 23.1%, 39.6%, 2.3% and 35.0% from GOLD A to D. Only 29 patients (9.5%) presented no comorbid conditions, and the most common were hypertension, heart diseases and dyslipidaemia. CONCLUSIONS Our data confirms COPD as a complex and heterogeneous disorder, with a significant morbidity due to the nature of symptoms, frequent comorbidities and exacerbations. A substantial proportion of COPD patients were never-smokers, mainly women, calling attention to the need for COPD recognition in these cases. COPD in women, in never-smokers and in patients with a previous diagnosis of asthma presented some specific characteristics. Some patient characteristics are associated with frequent acute exacerbations. FEV1 was strongly related both to symptoms and exacerbations.
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Affiliation(s)
- A Duarte-de-Araújo
- Respiratory Department, H. Sª Oliveira, Guimarães, Portugal; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.
| | - P Teixeira
- Respiratory Department, H. Sª Oliveira, Guimarães, Portugal; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - V Hespanhol
- Department of Pneumology, Centro Hospitalar de S. João, Faculty of Medicine (FMUP), University of Porto, Portugal
| | - J Correia-de-Sousa
- Respiratory Department, H. Sª Oliveira, Guimarães, Portugal; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; Horizonte Family Health Unit, Matosinhos, Portugal
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21
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Gautam SS, Kc R, Leong KW, Mac Aogáin M, O'Toole RF. A step-by-step beginner's protocol for whole genome sequencing of human bacterial pathogens. J Biol Methods 2019; 6:e110. [PMID: 31453259 PMCID: PMC6706130 DOI: 10.14440/jbm.2019.276] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/13/2019] [Accepted: 01/28/2019] [Indexed: 02/06/2023] Open
Abstract
Bacterial whole genome sequencing (WGS) is becoming a widely-used technique in research, clinical diagnostic, and public health laboratories. It enables high resolution characterization of bacterial pathogens in terms of properties that include antibiotic resistance, molecular epidemiology, and virulence. The introduction of next-generation sequencing instrumentation has made WGS attainable in terms of costs. However, the lack of a beginner’s protocol for WGS still represents a barrier to its adoption in some settings. Here, we present detailed step-by-step methods for obtaining WGS data from a range of different bacteria (Gram-positive, Gram-negative, and acid-fast) using the Illumina platform. Modifications have been performed with respect to DNA extraction and library normalization to maximize the output from the laboratory consumables invested. The protocol represents a simplified and reproducible method for producing high quality sequencing data. The key advantages of this protocol include: simplicity of the protocol for users with no prior genome sequencing experience and reproducibility of the protocol across a wide range of bacteria.
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Affiliation(s)
- Sanjay S Gautam
- School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, TAS 7001, Australia
| | - Rajendra Kc
- School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, TAS 7001, Australia
| | - Kelvin Wc Leong
- School of Molecular Sciences, College of Science, Health and Engineering, La Trobe University, Victoria 3690, Australia
| | - Micheál Mac Aogáin
- Department of Clinical Microbiology, School of Medicine, Trinity College Dublin, Dublin D08 W9RT, Ireland
| | - Ronan F O'Toole
- School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, TAS 7001, Australia.,Department of Clinical Microbiology, School of Medicine, Trinity College Dublin, Dublin D08 W9RT, Ireland.,School of Molecular Sciences, College of Science, Health and Engineering, La Trobe University, Victoria 3690, Australia
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22
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Brakema EA, van Gemert FA, van der Kleij RMJJ, Salvi S, Puhan M, Chavannes NH. COPD's early origins in low-and-middle income countries: what are the implications of a false start? NPJ Prim Care Respir Med 2019; 29:6. [PMID: 30837469 PMCID: PMC6401185 DOI: 10.1038/s41533-019-0117-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 01/28/2019] [Indexed: 01/16/2023] Open
Affiliation(s)
- E A Brakema
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden University, Leiden, The Netherlands.
| | - F A van Gemert
- Department of General Practice Groningen, Institute for Asthma and COPD, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - R M J J van der Kleij
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden University, Leiden, The Netherlands
| | - S Salvi
- Chest Research Foundation, Pune, India
| | - M Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - N H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden University, Leiden, The Netherlands
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23
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Huang X, Zhu Z, Guo X, Kong X. The roles of microRNAs in the pathogenesis of chronic obstructive pulmonary disease. Int Immunopharmacol 2018; 67:335-347. [PMID: 30578969 DOI: 10.1016/j.intimp.2018.12.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/16/2018] [Accepted: 12/05/2018] [Indexed: 02/07/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is characterized by a progressive and irreversible airflow obstruction, with an abnormal lung function. The etiology of COPD correlates with complex interactions between environmental and genetic determinants. However, the exact pathogenesis of COPD is obscure although it involves multiple aspects including oxidative stress, imbalance between proteolytic and anti-proteolytic activity, immunity and inflammation, apoptosis, and repair and destruction in both airways and lungs. Many genes have been demonstrated to be involved in those pathogenic processes of this disease in patients exposed to harmful environmental factors. Previous reports have investigated promising microRNAs (miRNAs) to disclose the molecular mechanisms for COPD development induced by different environmental exposure and genetic predisposition encounter, and find some potential miRNA biomarkers for early diagnosis and treatment targets of COPD. In this review, we summarized the expression profiles of the reported miRNAs from studies of COPD associated with environmental risk factors including cigarette smoking and air pollution exposures, and provided an overview of roles of those miRNAs in the pathogenesis of the disease. We also highlighted the potential utility and limitations of miRNAs serving as diagnostic biomarkers and therapeutic targets for COPD.
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Affiliation(s)
- Xinwei Huang
- Medical School, Kunming University of Science and Technology, Kunming, Yunnan Province 650500, China
| | - Zongxin Zhu
- Medical School, Kunming University of Science and Technology, Kunming, Yunnan Province 650500, China
| | - Xiaoran Guo
- Medical School, Kunming University of Science and Technology, Kunming, Yunnan Province 650500, China
| | - Xiangyang Kong
- Medical School, Kunming University of Science and Technology, Kunming, Yunnan Province 650500, China.
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24
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Vishweswaraiah S, Thimraj TA, George L, Krishnarao CS, Lokesh KS, Siddaiah JB, Larsson K, Upadhyay S, Palmberg L, Anand MP, Ganguly K. Putative Systemic Biomarkers of Biomass Smoke-Induced Chronic Obstructive Pulmonary Disease among Women in a Rural South Indian Population. DISEASE MARKERS 2018; 2018:4949175. [PMID: 30595762 PMCID: PMC6282129 DOI: 10.1155/2018/4949175] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/25/2018] [Accepted: 09/27/2018] [Indexed: 12/28/2022]
Abstract
RATIONALE Exposure to biomass smoke (BMS) has been implicated in chronic obstructive pulmonary disease (COPD). About 3 billion people worldwide use biomass fuel for cooking and heating. Women in rural communities of low- and lower-middle-income countries are disproportionately exposed to massive amounts of BMS during active cooking hours (4-6 h/day). Therefore, BMS exposure is considered as a risk factor for COPD in the same order of magnitude as tobacco smoke. In rural India, due to cultural reasons, women are the primary cook of the family and are mostly nonsmokers. Thus, BMS-induced COPD is predominant among rural Indian women. However, BMS-COPD remains a relatively unexplored health problem globally. Therefore, we investigated the serum chemokine and cytokine signatures of BMS-COPD and tobacco smoke-induced COPD (TS-COPD) patients compared to their control in a rural South Indian population for this field study. METHODS Concentrations of 40 serum chemokines and cytokines were measured using a multiplexed immunoassay. The study cohort consisted of BMS-COPD (female; n = 29) and BMS-exposed subjects without COPD (BMS-CONTROL; female; n = 24). For comparison, data from TS-COPD patients (male, n = 23) and tobacco smokers without COPD (TS-CONTROL; male, n = 22) were investigated. Subjects were matched for age, sex, and biomass exposure. Tobacco consumption was slightly higher in TS-COPD subjects compared to TS-CONTROL. BMS-exposed and TS-exposed subjects (currently exposed) were from the same locality with similar dwelling habits and socioeconomic status. A validated structured questionnaire-based survey and spirometry was performed. An additional control group with no tobacco and BMS exposure (TS-BMS-CONTROL; n = 15) was included. Statistical significance was set at p ≤ 0.01. RESULTS Serum median concentrations (pg/ml) of CCL15 [8799.35; 5977.22], CCL27 [1409.14; 1024.99], and CXCL13 [37.14; 26.03] were significantly higher in BMS-CONTROL compared to BMS-COPD subjects. Nine analytes exhibited higher concentrations in TS-CONTROL compared to TS-COPD subjects. Comparison of chemokine and cytokine concentrations among BMS-COPD versus TS-COPD and BMS-CONTROL versus TS-CONTROL subjects also revealed distinct molecular signatures. CONCLUSION Our data identifies CCL27 and CXCL13 as putative, plausibly homeostatic/protective biomarkers for BMS-COPD within the investigated population that warrants validation in larger and multiple cohorts. The findings further indicate exposure-specific systemic response of chemokines and cytokines.
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Affiliation(s)
- Sangeetha Vishweswaraiah
- SRM Research Institute, SRM Institute of Science and Technology (Formerly SRM University), Chennai 603203, India
| | - Tania Ahalya Thimraj
- SRM Research Institute, SRM Institute of Science and Technology (Formerly SRM University), Chennai 603203, India
| | - Leema George
- SRM Research Institute, SRM Institute of Science and Technology (Formerly SRM University), Chennai 603203, India
| | - Chaya Sindaghatta Krishnarao
- Department of Pulmonary Medicine, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, India
| | - Komarla Sundararaja Lokesh
- Department of Pulmonary Medicine, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, India
| | - Jayaraj Biligere Siddaiah
- Department of Pulmonary Medicine, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, India
| | - Kjell Larsson
- Work Environment Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Box 287, SE-171 77 Stockholm, Sweden
| | - Swapna Upadhyay
- Work Environment Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Box 287, SE-171 77 Stockholm, Sweden
| | - Lena Palmberg
- Work Environment Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Box 287, SE-171 77 Stockholm, Sweden
| | - Mahesh Padukudru Anand
- Department of Pulmonary Medicine, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, India
| | - Koustav Ganguly
- SRM Research Institute, SRM Institute of Science and Technology (Formerly SRM University), Chennai 603203, India
- Work Environment Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Box 287, SE-171 77 Stockholm, Sweden
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25
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Katoto PDMC, Murhula A, Kayembe-Kitenge T, Lawin H, Bisimwa BC, Cirhambiza JP, Musafiri E, Birembano F, Kashongwe Z, Kirenga B, Mfinanga S, Mortimer K, De Boever P, Nawrot TS, Nachega JB, Nemery B. Household Air Pollution Is Associated with Chronic Cough but Not Hemoptysis after Completion of Pulmonary Tuberculosis Treatment in Adults, Rural Eastern Democratic Republic of Congo. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2563. [PMID: 30445808 PMCID: PMC6265859 DOI: 10.3390/ijerph15112563] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/10/2018] [Accepted: 11/12/2018] [Indexed: 11/25/2022]
Abstract
Little is known about the respiratory health damage related to household air pollution (HAP) in survivors of pulmonary tuberculosis (PTB). In a population-based cross-sectional study, we determined the prevalence and associated predictors of chronic cough and hemoptysis in 441 randomly selected PTB survivors living in 13 remote health zones with high TB burden in the South Kivu province of the Democratic Republic of Congo (DRC). Trained community and health-care workers administered a validated questionnaire. In a multivariate logistic regression, chronic cough was independently associated with HAP (adjusted odds ratios (aOR) 2.10, 95% CI: 1.10⁻4.00) and PTB treatment >6 months (aOR 3.80, 95% CI: 1.62⁻8.96). Among women, chronic cough was associated with cooking ≥3 h daily (aOR 2.74, 95% CI: 1.25⁻6.07) and with HAP (aOR 3.93, 95% CI: 1.15⁻13.43). Independent predictors of hemoptysis were PTB retreatment (aOR 3.04, 95% CI: 1.04⁻5.09) and ignorance of treatment outcome (aOR 2.24, 95% CI: 1.09⁻4.58) but not HAP (aOR 1.86, 95% CI: 0.61⁻5.62). Exposure to HAP proved a major risk factor for chronic cough in PTB survivors, especially in women. This factor is amenable to intervention.
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Affiliation(s)
- Patrick D M C Katoto
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, 300 Leuven, Belgium.
- Department of Internal Medicine and Prof Lurhuma Biomedical Research Laboratory, Mycobacterium Unit, Faculty of Medicine, Catholic University of Bukavu, 02BP, Bukavu, Congo.
| | - Aime Murhula
- Department of Internal Medicine and Prof Lurhuma Biomedical Research Laboratory, Mycobacterium Unit, Faculty of Medicine, Catholic University of Bukavu, 02BP, Bukavu, Congo.
| | - Tony Kayembe-Kitenge
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, 300 Leuven, Belgium.
- Unit of Toxicology and Environment, University hospital of Lubumbashi, School of Public Health Faculty of Medicine, Lubumbashi 1825BP, Congo.
| | - Herve Lawin
- Unit of Teaching and Research in Occupational and Environmental Health, Faculty of Health Sciences, University of Abomey-Calavi (UAC), Cotonou 03BP0490, Benin.
| | - Bertin C Bisimwa
- Department of Internal Medicine and Prof Lurhuma Biomedical Research Laboratory, Mycobacterium Unit, Faculty of Medicine, Catholic University of Bukavu, 02BP, Bukavu, Congo.
- Département de Biologie médicale, Institut Supérieur des Techniques Médicales (ISTM) Bukavu, BP 3036, Bukavu, Congo.
| | - Jean Paul Cirhambiza
- National TB Program, Provincial and national Anti-Leprosy and TB Coordination, BP. 1899, Bukavu, Dem. Congo.
| | - Eric Musafiri
- National TB Program, Provincial and national Anti-Leprosy and TB Coordination, BP. 1899, Bukavu, Dem. Congo.
| | - Freddy Birembano
- National TB Program, Provincial and national Anti-Leprosy and TB Coordination, BP. 1899, Bukavu, Dem. Congo.
| | - Zacharie Kashongwe
- National TB Program, Provincial and national Anti-Leprosy and TB Coordination, BP. 1899, Bukavu, Dem. Congo.
| | - Bruce Kirenga
- Department of Pulmonary Medicine and Lung Institute, Makerere University, PB 7072, Kampala, Uganda.
| | - Sayoki Mfinanga
- National Institute for Medical Research Muhimbili Medical Research Centre, PB 65001, Dar es Salaam, Tanzania.
| | - Kevin Mortimer
- Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK.
| | - Patrick De Boever
- Centre for Environmental Sciences, Hasselt University, Agoralaan, building D, 3590, Diepenbeek, Belgium.
- Health Unit, Flemish Institute for Technological Research (VITO), Vlasmeer7, 2400 Mol, Belgium.
| | - Tim S Nawrot
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, 300 Leuven, Belgium.
- Centre for Environmental Sciences, Hasselt University, Agoralaan, building D, 3590, Diepenbeek, Belgium.
| | - Jean B Nachega
- Department of Medicine and Center for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, 8000, Francie Van Zijl Drive, PB 241, Cape Town, South Africa.
- Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, 21205, MD, USA.
- Departments of Epidemiology, Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, 15210, PA, USA.
| | - Benoit Nemery
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, 300 Leuven, Belgium.
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26
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Rajendra KC, Zosky GR, Shukla SD, O’Toole RF. A cost-effective technique for generating preservable biomass smoke extract and measuring its effect on cell receptor expression in human bronchial epithelial cells. Biol Methods Protoc 2018; 3:bpy010. [PMID: 32161803 PMCID: PMC6994070 DOI: 10.1093/biomethods/bpy010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/02/2018] [Accepted: 08/10/2018] [Indexed: 12/13/2022] Open
Abstract
Nearly half of the world’s population uses biomass fuel for the purposes of cooking and heating. Smoke derived from biomass increases the risk of the development of lung diseases, including pneumonia, chronic obstructive pulmonary disease, airway tract infections, and lung cancer. Despite the evidence linking biomass smoke exposure to pulmonary disease, only a small number of experimental studies have been conducted on the impact of biomass smoke on airway epithelial cells. This is in part due to the lack of a standard and easily accessible procedure for the preparation of biomass smoke. Here, we describe a cost-effective and reproducible method for the generation of different smoke extracts, in particular, cow dung smoke extract (CDSE) and wood smoke extract (WSE) for use in a range of biological applications. We examined the effect of the biomass smoke extracts on human bronchial epithelial cell expression of a known responder to cigarette smoke exposure (CSE), the platelet-activating factor receptor (PAFR). Similar to the treatment with CSE, we observed a dose-dependent increase in PAFR expression on human airway epithelial cells that were exposed to CDSE and WSE. This method provides biomass smoke in a re-usable form for cell and molecular bioscience studies on the pathogenesis of chronic lung disease.
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Affiliation(s)
- K C Rajendra
- College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Graeme R Zosky
- College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Shakti D Shukla
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia
| | - Ronan F O’Toole
- College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Correspondence address: School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia. Tel: +61-3-62266974; E-mail:
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27
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Chen HC, Wu CF, Chong IW, Wu MT. Exposure to cooking oil fumes and chronic bronchitis in nonsmoking women aged 40 years and over: a health-care based study. BMC Public Health 2018; 18:246. [PMID: 29439699 PMCID: PMC5812191 DOI: 10.1186/s12889-018-5146-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 02/01/2018] [Indexed: 11/10/2022] Open
Abstract
Background Little is known about the effect of exposure to cooking oil fumes (COFs) on the development of non-malignant respiratory diseases in nonsmoking women. This study investigated the relationship between exposure to COFs and chronic bronchitis in female Taiwanese non-smokers. Methods Searching the 1999 claims and registration records maintained by Taiwan’s National Health Insurance Program, we identified 1846 women aged 40 years or older diagnosed as having chronic bronchitis (ICD-9 code: 491) at least twice in 1999 as potential study cases and 4624 women who had no diagnosis of chronic bronchitis the same year as potential study controls. We visited randomly selected women from each group in their homes, interviewed to collect related data including cooking habits and kitchen characteristics, and them a spirometry to collect FEV1 and FVC data between 2000 and 2009. Results After the exclusion of thirty smokers, the women were classified those with chronic bronchitis (n = 53), probable chronic bronchitis (n = 285), and no pulmonary disease (n = 306) based on physician diagnosis and American Thoracic Society criteria. Women who had cooked ≥ 21 times per week between the ages of 20 and 40 years old had a 4.73-fold higher risk of chronic bronchitis than those cooking < 14 times per week (95% CI = 1.65–13.53). Perceived kitchen smokiness was significantly associated with decreased FEV1 (− 137 ml, p = 0.021) and FEV1/FVC ratio (− 7.67%, p = 0.008). Conclusions Exposure to COF may exacerbate the progression of chronic bronchitis in nonsmoking women. Electronic supplementary material The online version of this article (10.1186/s12889-018-5146-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Huang-Chi Chen
- Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Fang Wu
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Inn-Wen Chong
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ming-Tsang Wu
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan. .,Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. .,Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Gibbs-Flournoy EA, Gilmour MI, Higuchi M, Jetter J, George I, Copeland L, Harrison R, Moser VC, Dye JA. Differential exposure and acute health impacts of inhaled solid-fuel emissions from rudimentary and advanced cookstoves in female CD-1 mice. ENVIRONMENTAL RESEARCH 2018; 161:35-48. [PMID: 29100208 PMCID: PMC6143295 DOI: 10.1016/j.envres.2017.10.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/25/2017] [Accepted: 10/24/2017] [Indexed: 05/04/2023]
Abstract
BACKGROUND There is an urgent need to provide access to cleaner end user energy technologies for the nearly 40% of the world's population who currently depend on rudimentary cooking and heating systems. Advanced cookstoves (CS) are designed to cut emissions and solid-fuel consumption, thus reducing adverse human health and environmental impacts. STUDY PREMISE We hypothesized that, compared to a traditional (Tier 0) three-stone (3-S) fire, acute inhalation of solid-fuel emissions from advanced natural-draft (ND; Tier 2) or forced-draft (FD; Tier 3) stoves would reduce exposure biomarkers and lessen pulmonary and innate immune system health effects in exposed mice. RESULTS Across two simulated cooking cycles (duration ~ 3h), emitted particulate mass concentrations were reduced 80% and 62% by FD and ND stoves, respectively, compared to the 3-S fire; with corresponding decreases in particles visible within murine alveolar macrophages. Emitted carbon monoxide was reduced ~ 90% and ~ 60%, respectively. Only 3-S-fire-exposed mice had increased carboxyhemoglobin levels. Emitted volatile organic compounds were FD ≪ 3-S-fire ≤ ND stove; increased expression of genes involved in xenobiotic metabolism (COX-2, NQO1, CYP1a1) was detected only in ND- and 3-S-fire-exposed mice. Diminished macrophage phagocytosis was observed in the ND group. Lung glutathione was significantly depleted across all CS groups, however the FD group had the most severe, ongoing oxidative stress. CONCLUSIONS These results are consistent with reports associating exposure to solid fuel stove emissions with modulation of the innate immune system and increased susceptibility to infection. Lower respiratory infections continue to be a leading cause of death in low-income economies. Notably, 3-S-fire-exposed mice were the only group to develop acute lung injury, possibly because they inhaled the highest concentrations of hazardous air toxicants (e.g., 1,3-butadiene, toluene, benzene, acrolein) in association with the greatest number of particles, and particles with the highest % organic carbon. However, no Tier 0-3 ranked CS group was without some untoward health effect indicating that access to still cleaner, ideally renewable, energy technologies for cooking and heating is warranted.
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Affiliation(s)
| | - M Ian Gilmour
- National Health and Environmental Research Laboratory (NHEERL), Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Mark Higuchi
- National Health and Environmental Research Laboratory (NHEERL), Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - James Jetter
- National Risk Management Research Laboratory (NRMRL), Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Ingrid George
- National Risk Management Research Laboratory (NRMRL), Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Lisa Copeland
- National Health and Environmental Research Laboratory (NHEERL), Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Randy Harrison
- National Health and Environmental Research Laboratory (NHEERL), Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Virginia C Moser
- National Health and Environmental Research Laboratory (NHEERL), Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Janice A Dye
- National Health and Environmental Research Laboratory (NHEERL), Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
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Yang Y, Mao J, Ye Z, Li J, Zhao H, Liu Y. Risk factors of chronic obstructive pulmonary disease among adults in Chinese mainland: A systematic review and meta-analysis. Respir Med 2017; 131:158-165. [DOI: 10.1016/j.rmed.2017.08.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 08/16/2017] [Accepted: 08/17/2017] [Indexed: 12/12/2022]
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von Seidlein L, Ikonomidis K, Mshamu S, Nkya TE, Mukaka M, Pell C, Lindsay SW, Deen JL, Kisinza WN, Knudsen JB. Affordable house designs to improve health in rural Africa: a field study from northeastern Tanzania. Lancet Planet Health 2017; 1:e188-e199. [PMID: 29851640 DOI: 10.1016/s2542-5196(17)30078-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 07/05/2017] [Accepted: 07/11/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND The population of sub-Saharan Africa is currently estimated to be 1245 million and is expected to quadruple by the end of the century, necessitating the building of millions of homes. Malaria remains a substantial problem in this region and efforts to minimise transmission should be considered in future house planning. We studied how building elements, which have been successfully employed in southeast Asia to prevent mosquitos from entering and cooling the house, could be integrated in a more sustainable house design in rural northeastern Tanzania, Africa, to decrease mosquito density and regulate indoor climate. METHODS In this field study, six prototype houses of southeast Asian design were built in in the village of Magoda in Muheza District, Tanga Region, Tanzania, and compared with modified and unmodified, traditional, sub-Saharan African houses. Prototype houses were built with walls made of lightweight permeable materials (bamboo, shade net, or timber) with bedrooms elevated from the ground and with screened windows. Modified and unmodified traditional African houses, wattle-daub or mud-block constructions, built on the ground with poor ventilation served as controls. In the modified houses, major structural problems such as leaking roofs were repaired, windows screened, open eaves blocked with bricks and mortar, cement floors repaired or constructed, and rain gutters and a tank for water storage added. Prototype houses were randomly allocated to village households through a free, fair, and transparent lottery. The lottery tickets were deposited in a bucket made of transparent plastic. Each participant could draw one ticket. Hourly measurements of indoor temperature and humidity were recorded in all study houses with data loggers and mosquitoes were collected indoors and outdoors using Furvela tent traps and were identified with standard taxonomic keys. Mosquitoes of the Anopheles gambiae complex were identified to species using PCR. Attitudes towards the new house design were assessed 6-9 months after the residents moved into their new or modified homes through 15 in-depth interviews with household heads of the new houses and five focus group discussions including neighbours of each group of prototype housing. FINDINGS Between July, 2014, and July, 2015, six prototype houses were constructed; one single and one double storey building with each of the following claddings: bamboo, shade net, and timber. The overall reduction of all mosquitoes caught was highest in the double-storey buildings (96%; 95% CI 92-98) followed closely by the reduction found in single-storey buildings (77%; 72-82) and lowest in the modified reference houses (43%; 36-50) and unmodified reference houses (23%; 18-29). The indoor temperature in the new design houses was 2·3°C (95% CI 2·2-2·4) cooler than in the reference houses. While both single and two-storey buildings provided a cooler indoor climate than did traditional housing, two-story buildings provided the biggest reduction in mosquito densities (96%, 95% CI 89-100). Seven people who moved into the prototype houses and seven of their neighbours (three of whom had their houses modified) participated in in-depth interviews. After living in their new prototype houses for 6-9 months, residents expressed satisfaction with the new design, especially the second-storey sleeping area because of the privacy and security of upstairs bedrooms. INTERPRETATION The new design houses had fewer mosquitoes and were cooler than modified and unmodified traditional homes. New house designs are an underused intervention and hold promise to reduce malaria transmission in sub-Saharan Africa and keep areas malaria-free after elimination. FUNDING Ruth W Jensens Foundation, Copenhagen and Hanako Foundation, Singapore.
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Affiliation(s)
- Lorenz von Seidlein
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | | | | | - Theresia E Nkya
- The National Institute for Medical Research, Amani Medical Research Centre, Muheza, Tanzania
| | - Mavuto Mukaka
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Christopher Pell
- Centre for Social Science and Global Health, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands
| | - Steven W Lindsay
- School of Biological and Biomedical Sciences, Durham University, Durham, UK
| | - Jacqueline L Deen
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines, Manila, Philippines
| | - William N Kisinza
- The National Institute for Medical Research, Amani Medical Research Centre, Muheza, Tanzania
| | - Jakob B Knudsen
- Ingvartsen Arkitekter, København K, Denmark; Det Kongelige Danske Kunstakademis Skoler for Arkitektur, Design og Konservering-Arkitektskolen, Copenhagen, Denmark
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31
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Ghio AJ, Hilborn ED. Indices of iron homeostasis correlate with airway obstruction in an NHANES III cohort. Int J Chron Obstruct Pulmon Dis 2017; 12:2075-2084. [PMID: 28790810 PMCID: PMC5529299 DOI: 10.2147/copd.s138457] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Cigarette smoking results in the accumulation of iron both systemically and locally, in the lung thereby causing imbalance in iron homeostasis. This disruption in iron homeostasis can be associated with oxidative stress and consequent tissue injury. Therefore, in this study, we tested the association between iron homeostasis and airway obstruction by examining a large cohort of smokers and non-smokers for relationships between 1) serum ferritin and iron concentrations and transferrin saturation and 2) forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and their ratio (FEV1/FVC). Data from the National Health and Examination Survey III were analyzed. The study population included persons aged 20 years and above with their following data recorded: race, gender, serum ferritin and iron concentrations, and transferrin saturation; the final sample number was 7,251. In the total population, Pearson correlation coefficients between 1) serum ferritin and iron concentrations and transferrin saturation and 2) FVC and FEV1 were significantly positive; whereas those between 1) serum ferritin concentrations and transferrin saturation and 2) FEV1/FVC were significantly negative. With separate analyses, serum ferritin concentrations demonstrated positive associations with FVC and FEV1 but an inverse relationship with FEV1/FVC in smokers and non-smokers. Serum ferritin levels increased with worsening airway obstruction among smokers, and its highest concentrations were found among those with the lowest values of FEV1/FVC ratio (<60%). Comparable to cigarette smokers, serum ferritin concentrations among non-smokers were greatest in those with the lowest FEV1/FVC ratio. Furthermore, elevated levels of serum iron and saturation of transferrin also corresponded with decreased FEV1/FVC ratio among non-smokers. Thus, we conclude that indices of iron homeostasis are associated with airway obstruction in both smokers and non-smokers.
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Affiliation(s)
- Andrew J Ghio
- Environmental Public Health Division, National Health and Environmental Effects Research Laboratory, Chapel Hill, NC, USA
| | - Elizabeth D Hilborn
- Environmental Public Health Division, National Health and Environmental Effects Research Laboratory, Chapel Hill, NC, USA
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Seguel JM, Merrill R, Seguel D, Campagna AC. Indoor Air Quality. Am J Lifestyle Med 2017; 11:284-295. [PMID: 30202344 PMCID: PMC6125109 DOI: 10.1177/1559827616653343] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 05/09/2016] [Accepted: 05/11/2016] [Indexed: 01/09/2023] Open
Abstract
Many health care providers are concerned with the role environmental exposures play in the development of respiratory disease. While most individuals understand that outdoor air quality is important to their health status, many are unaware of the detrimental effects indoor air pollution can potentially have on them. The Environmental Protection Agency (EPA) regulates both outdoor and indoor air quality. According to the EPA, indoor levels of pollutants may be up to 100 times higher than outdoor pollutant levels and have been ranked among the top 5 environmental risks to the public. There has been a strong correlation between air quality and health, which is why it is crucial to obtain a complete environmental exposure history from a patient. This article focuses on the effects indoor air quality has on the respiratory system. Specifically, this article will address secondhand smoke, radon, carbon monoxide, nitrogen dioxide, formaldehyde, house cleaning agents, indoor mold, animal dander, and dust mites. These are common agents that may lead to hazardous exposures among individuals living in the United States. It is important for health care providers to be educated on the potential risks of indoor air pollution and the effects it may have on patient outcomes. Health problems resulting from poor indoor air quality are not easily recognized and may affect a patient's health years after the onset of exposure.
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Affiliation(s)
- Joseph M. Seguel
- Joseph M. Seguel, MD, St. Peter’s Hospital, 315 South Manning Boulevard, Albany, NY 12208; e-mail:
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33
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Quansah R, Semple S, Ochieng CA, Juvekar S, Armah FA, Luginaah I, Emina J. Effectiveness of interventions to reduce household air pollution and/or improve health in homes using solid fuel in low-and-middle income countries: A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2017; 103:73-90. [PMID: 28341576 DOI: 10.1016/j.envint.2017.03.010] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 03/12/2017] [Accepted: 03/14/2017] [Indexed: 05/21/2023]
Abstract
BACKGROUND Cookstove intervention programs have been increasing over the past two (2) decades in Low and Middle Income Countries (LMICs) across the globe. However, there remains uncertainty regarding the effects of these interventions on household air pollution concentrations, personal exposure concentrations and health outcomes. OBJECTIVES The primary objective was to determine if household air pollution (HAP) interventions were associated with improved indoor air quality (IAQ) in households in LMICs. Given the potential impact of HAP interventions on health, a secondary objective was to evaluate the effectiveness of HAP interventions to improve health in populations receiving these interventions. DATA SOURCES OVID Medline, Ovid Embase, SCOPUS and PubMED were searched from their inception until December 2015 with no restrictions on study design. The WHO Global database of household air pollution measurements and Members' archives were also reviewed together with the reference lists of identified reviews and relevant articles. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTION We considered randomized controlled trials, or non-randomized control trials, or before-and-after studies; original studies; studies conducted in a LMIC (based on the United Nations Human Development Report released in March 2013 (World Bank, 2013); interventions that were explicitly aimed at improving IAQ and/or health from solid fuel use; studies published in a peer-reviewed journal or student theses or reports; studies that reported on outcomes which was indicative of IAQ or/and health. There was no restriction on the type of comparator (e.g. household receiving plancha vs. household using traditional cookstove) used in the intervention study. STUDY APPRAISAL AND SYNTHESIS METHODS Five review authors independently used pre-designed data collection forms to extract information from the original studies and assessed risk of bias using the Effective Public Health Practice Project (EPHPP). We computed standardized weighted mean difference (SMD) using random-effects models. Heterogeneity was computed using the Q and I2-statistics. We examined the influence of various characteristics on the study-specific effect estimates by stratifying the analysis by population type, study design, intervention type, and duration of exposure monitoring. The trim and fill method was used to assess the potential impact of missing studies. RESULTS Fifty-five studies met our a priori inclusion criteria and were included in the systematic review. Fifteen studies provided 43 effect estimates for our meta-analysis. The largest improvement in HAP was observed for average particulate matter (PM) (SMD=1.57) concentrations in household kitchens (1.03), followed by daily personal average concentrations of PM (1.18), and carbon monoxide (CO) concentrations in kitchens. With respect to personal PM, significant improvement was observed in studies of children (1.26) and studies monitoring PM for ≥24h (1.32). This observation was also noted in terms of studies of kitchen concentrations of CO. A significant improvement was also observed for kitchen levels of PM in both adult populations (1.56) and in RCT/cohort designs (1.59) involving replacing cookstoves without chimneys. Our findings on health outcomes were inconclusive. LIMITATIONS, CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS We observed high statistical between study variability in the study-specific estimate. Thus, care should be taken in concluding that HAP interventions - as currently designed and implemented - support reductions in the average kitchen and personal levels of PM and CO. Further, there is limited evidence that current stand-alone HAP interventions yield any health benefits. Post-intervention levels of pollutants were generally still greatly in excess of the relevant WHO guideline and thus a need to promote cleaner fuels in LMICs to reduce HAP levels below the WHO guidelines. SYSTEMATIC REVIEW REGISTRATION NUMBER The review has been registered with PROSPERO (registration number CRD42014009768).
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Affiliation(s)
- Reginald Quansah
- Biological, Environmental & Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana; Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
| | - Sean Semple
- Respiratory Intervention Group, Institute of Applied Health Science, University of Aberdeen, Aberdeen, Scotland
| | | | - Sanjar Juvekar
- KEM Hospital Research Centre, Pune, India; INDEPTH Network, Accra, Ghana
| | | | - Isaac Luginaah
- Department of Geography, Western University, Ontario, Canada
| | - Jacques Emina
- INDEPTH Network, Accra, Ghana; Department of Population and Development Studies, University of Kinshasa, Kinshasa, People's Republic of Congo
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Weitz CA, Olszowy KM, Dancause KN, Sun C, Pomer A, Silverman H, Lee G, Tarivonda L, Chan CW, Kaneko A, Lum JK, Garruto RM. Rolling Tobacco in Banana Leaves, Newspaper, or Copybook Paper Associated With Significant Reduction in Lung Function in Vanuatu. Asia Pac J Public Health 2017; 29:180-188. [DOI: 10.1177/1010539517696552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In addition to the widespread availability of packaged cigarettes, the inhabitants of island nations of the Southwest Pacific frequently smoke commercially available loose tobacco using manufactured rolling papers, as well as locally grown tobacco rolled in manufactured rolling paper or wrapped in leaves, copybook paper, and newspaper. In this study, Vanuatu men who smoked local tobacco rolled in leaves, copybook paper, or newspaper showed significantly lower forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC ratios than men who smoked packaged cigarettes, store-bought tobacco rolled in manufactured rolling paper, or who smoked locally grown tobacco rolled in manufactured rolling papers. The addition of toxins from these unusual tobacco-wrapping media produces lung function deficits similar to the pattern noted among tobacco smokers who also inhale smoke from burning biomass. Thus, public health initiatives should consider including strategies addressing the use of wrapping media among smokers in South Pacific island societies.
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Affiliation(s)
| | - Kathryn M. Olszowy
- Cleveland State University, Cleveland, OH, USA
- SUNY Binghamton, Binghamton, NY, USA
| | | | - Cheng Sun
- SUNY Binghamton, Binghamton, NY, USA
| | | | | | - G. Lee
- SUNY Binghamton, Binghamton, NY, USA
| | - Len Tarivonda
- Ministry of Health, PMB 042, Port Vila, Republic of Vanuatu
| | | | - Akira Kaneko
- Karolinska Institutet, Stockholm, Sweden
- Osaka City University Graduate School of Medicine, Abeno Ward, Osaka, Japan
- Nagasaki University, Nagasaki, Japan
| | - J. K. Lum
- SUNY Binghamton, Binghamton, NY, USA
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Tsuchiya K, Toyoshima M, Kamiya Y, Nakamura Y, Baba S, Suda T. Non-smoking Chronic Obstructive Pulmonary Disease Attributed to Occupational Exposure to Silica Dust. Intern Med 2017; 56:1701-1704. [PMID: 28674361 PMCID: PMC5519474 DOI: 10.2169/internalmedicine.56.7577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
An 85-year-old, never-smoking man presented with exertional dyspnea. He had been exposed to silica dust in the work place. Chest computed tomography revealed bronchial wall thickening without emphysema. A pulmonary function test showed airflow obstruction without impaired gas transfer. Airway hyperresponsiveness and reversibility were not evident. A transbronchial lung biopsy showed findings suggestive of mineral dust exposure, such as fibrosis and slight pigmentation of bronchioles. He was diagnosed with non-smoking chronic obstructive pulmonary disease (COPD) due to occupational exposure to silica dust. His symptoms were improved using an inhaled long-acting bronchodilator. The clinical characteristics of non-smoking COPD are discussed in this report.
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Affiliation(s)
- Kazuo Tsuchiya
- Department of Respiratory Medicine, Hamamatsu Rosai Hospital, Japan
| | - Mikio Toyoshima
- Department of Respiratory Medicine, Hamamatsu Rosai Hospital, Japan
| | - Yosuke Kamiya
- Second Department of Internal Medicine, Hamamatsu University School of Medicine, Japan
| | - Yutaro Nakamura
- Second Department of Internal Medicine, Hamamatsu University School of Medicine, Japan
| | - Satoshi Baba
- Department of Diagnostic Pathology, Hamamatsu University School of Medicine, Japan
| | - Takafumi Suda
- Second Department of Internal Medicine, Hamamatsu University School of Medicine, Japan
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Araújo A. COPD: From the stethoscope to the spirometer. REVISTA PORTUGUESA DE PNEUMOLOGIA 2017; 23:52-53. [PMID: 27080084 DOI: 10.1016/j.rppnen.2016.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 02/25/2016] [Accepted: 02/26/2016] [Indexed: 10/22/2022] Open
Affiliation(s)
- A Araújo
- Respiratory Department, H. Sª Oliveira, Guimarães, Portugal.
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37
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McCarthy CE, Duffney PF, Gelein R, Thatcher TH, Elder A, Phipps RP, Sime PJ. Dung biomass smoke activates inflammatory signaling pathways in human small airway epithelial cells. Am J Physiol Lung Cell Mol Physiol 2016; 311:L1222-L1233. [PMID: 27836898 DOI: 10.1152/ajplung.00183.2016] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 11/03/2016] [Indexed: 11/22/2022] Open
Abstract
Animal dung is a biomass fuel burned by vulnerable populations who cannot afford cleaner sources of energy, such as wood and gas, for cooking and heating their homes. Exposure to biomass smoke is the leading environmental risk for mortality, with over 4,000,000 deaths each year worldwide attributed to indoor air pollution from biomass smoke. Biomass smoke inhalation is epidemiologically associated with pulmonary diseases, including chronic obstructive pulmonary disease (COPD), lung cancer, and respiratory infections, especially in low and middle-income countries. Yet, few studies have examined the mechanisms of dung biomass smoke-induced inflammatory responses in human lung cells. Here, we tested the hypothesis that dung biomass smoke causes inflammatory responses in human lung cells through signaling pathways involved in acute and chronic lung inflammation. Primary human small airway epithelial cells (SAECs) were exposed to dung smoke at the air-liquid interface using a newly developed, automated, and reproducible dung biomass smoke generation system. The examination of inflammatory signaling showed that dung biomass smoke increased the production of several proinflammatory cytokines and enzymes in SAECs through activation of the activator protein (AP)-1 and arylhydrocarbon receptor (AhR) but not nuclear factor-κB (NF-κB) pathways. We propose that the inflammatory responses of lung cells exposed to dung biomass smoke contribute to the development of respiratory diseases.
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Affiliation(s)
- Claire E McCarthy
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York.,Lung Biology and Disease Program, University of Rochester, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Parker F Duffney
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York.,Lung Biology and Disease Program, University of Rochester, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Robert Gelein
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Thomas H Thatcher
- Division of Pulmonary and Critical Care Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York; and.,Lung Biology and Disease Program, University of Rochester, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Alison Elder
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York.,Lung Biology and Disease Program, University of Rochester, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Richard P Phipps
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York.,Division of Pulmonary and Critical Care Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York; and.,Lung Biology and Disease Program, University of Rochester, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Patricia J Sime
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York; .,Division of Pulmonary and Critical Care Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York; and.,Lung Biology and Disease Program, University of Rochester, University of Rochester School of Medicine and Dentistry, Rochester, New York
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van Gemert F, Chavannes N, Kirenga B, Jones R, Williams S, Tsiligianni I, Vonk J, Kocks J, de Jong C, van der Molen T. Socio-economic factors, gender and smoking as determinants of COPD in a low-income country of sub-Saharan Africa: FRESH AIR Uganda. NPJ Prim Care Respir Med 2016; 26:16050. [PMID: 27597659 PMCID: PMC5011937 DOI: 10.1038/npjpcrm.2016.50] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 06/06/2016] [Accepted: 06/17/2016] [Indexed: 01/29/2023] Open
Abstract
In Uganda, biomass smoke seems to be the largest risk factor for the development of COPD, but socio-economic factors and gender may have a role. Therefore, more in-depth research is needed to understand the risk factors. The aim of this study was to investigate the impact of socio-economic factors and gender differences on the COPD prevalence in Uganda. The population comprised 588 randomly selected participants (>30 years) who previously completed the FRESH AIR Uganda study. In this post hoc analysis, the impact of several socio-economic characteristics, gender and smoking on the prevalence of COPD was assessed using a logistic regression model. The main risk factors associated with COPD were non-Bantu ethnicity (odds ratio (OR) 1.73, 95% confidence interval (CI) 1.06–2.82, P=0.030), biomass fuel use for heating (OR 1.76, 95% CI 1.03–3.00, P=0.038), former smoker (OR 1.87, 95% CI 0.97–3.60, P=0.063) and being unmarried (OR 0.087, 95% CI 0.93–2.95, P=0.087). A substantial difference in the prevalence of COPD was seen between the two ethnic groups: non-Bantu 20% and Bantu 12.9%. Additional analysis between these two groups showed significant differences in socio-economic circumstances: non-Bantu people smoked more (57.7% vs 10.7%), lived in tobacco-growing areas (72% vs 14.8%) and were less educated (28.5% vs 12.9% had no education). With regard to gender, men with COPD were unmarried (OR 3.09, 95% CI 1.25–7.61, P=0.015) and used more biomass fuel for heating (OR 2.15, 95% CI 1.02–4.54, P=0.045), and women with COPD were former smokers (OR 3.35, 95% CI 1.22–9.22, P=0.019). Only a few socio-economic factors (i.e., smoking, biomass fuel use for heating, marital status and non-Bantu ethnicity) have been found to be associated with COPD. This applied for gender differences as well (i.e., for men, marital status and biomass fuel for heating, and for women being a former smoker). More research is needed to clarify the complexity of the different risk factors.
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Affiliation(s)
- Frederik van Gemert
- Department of General Practice, Groningen Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Niels Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Bruce Kirenga
- Division of Pulmonary Medicine, Makerere University Lung Institute, Mulago Hospital, Makerere University, Kampala, Uganda
| | - Rupert Jones
- Centre for Clinical Trials and Population Studies, Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, UK
| | - Sian Williams
- Executive Office, International Primary Care Respiratory Group, London, UK
| | - Ioanna Tsiligianni
- Department of General Practice, Groningen Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Judith Vonk
- Department of Epidemiology, Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Janwillem Kocks
- Department of General Practice, Groningen Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Corina de Jong
- Department of General Practice, Groningen Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Thys van der Molen
- Department of General Practice, Groningen Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Barnes PJ. Sex Differences in Chronic Obstructive Pulmonary Disease Mechanisms. Am J Respir Crit Care Med 2016; 193:813-4. [PMID: 27082528 DOI: 10.1164/rccm.201512-2379ed] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Peter J Barnes
- 1 National Heart and Lung Institute Imperial College London London, United Kingdom
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Is Chronic Obstructive Pulmonary Disease Caused by Wood Smoke a Different Phenotype or a Different Entity? ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.arbr.2016.06.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Torres-Duque CA, García-Rodriguez MC, González-García M. Is Chronic Obstructive Pulmonary Disease Caused by Wood Smoke a Different Phenotype or a Different Entity? Arch Bronconeumol 2016; 52:425-31. [PMID: 27207325 DOI: 10.1016/j.arbres.2016.04.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 04/03/2016] [Accepted: 04/04/2016] [Indexed: 01/29/2023]
Abstract
Around 40% of the world's population continue using solid fuel, including wood, for cooking or heating their homes. Chronic exposure to wood smoke is a risk factor for developing chronic obstructive pulmonary disease (COPD). In some regions of the world, this can be a more important cause of COPD than exposure to tobacco smoke from cigarettes. Significant differences between COPD associated with wood smoke (W-COPD) and that caused by smoking (S-COPD) have led some authors to suggest that W-COPD should be considered a new COPD phenotype. We present a review of the differences between W-COPD and S-COPD. On the premise that wood smoke and tobacco smoke are not the same and the physiopathological mechanisms they induce may differ, we have analyzed whether W-COPD can be considered as another COPD phenotype or a distinct nosological entity.
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Antuni JD, Barnes PJ. Evaluation of Individuals at Risk for COPD: Beyond the Scope of the Global Initiative for Chronic Obstructive Lung Disease. CHRONIC OBSTRUCTIVE PULMONARY DISEASES-JOURNAL OF THE COPD FOUNDATION 2016; 3:653-667. [PMID: 28848890 DOI: 10.15326/jcopdf.3.3.2016.0129] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Global initiative for chronic Obstructive Lung Disease (GOLD) Strategy is a valuable tool for clinicians in the diagnosis and management of patients with established chronic obstructive pulmonary disease (COPD). However, there are no recommendations for the evaluation of individuals, exposed to risk factors, who are most likely to develop COPD. Consequently, it is necessary to consider all of the factors that may play a role in the pathogenesis of COPD: genetic factors, gender, socioeconomic status, disadvantageous factors in childhood, lung diseases and exposure to risk factors such as smoking, biomass fuel smoke, occupational hazards and air pollution. Along with the clinical assessment, periodic spirometry should be performed to evaluate lung function and make possible early detection of individuals who will develop the disease through the rate of forced expiratory volume in 1 second (FEV1) decline. The first spirometry, periodicity, and clinically significant decline in FEV1 will encompass the cornerstones of clinical follow up. This approach allows the implementation of important interventions in order to help individuals to cease contact with risk factors and prevent progressive respiratory impairment with the consequent deterioration of quality of life and increased morbidity and mortality.
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Affiliation(s)
- Julio D Antuni
- Corporación Médica de General San Martín, Buenos Aires, Argentina
| | - Peter J Barnes
- National Heart and Lung Institute, Royal Brompton Hospital, London, United Kingdom
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Lopez-Campos JL, Marquez-Martin E, Soriano JB. The role of air pollution in COPD and implications for therapy. Expert Rev Respir Med 2016; 10:849-59. [DOI: 10.1080/17476348.2016.1191356] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Lalloo UG, Pillay S, Mngqibisa R, Abdool-Gaffar S, Ambaram A. HIV and COPD: a conspiracy of risk factors. Respirology 2016; 21:1166-72. [PMID: 27237114 DOI: 10.1111/resp.12806] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 02/07/2016] [Accepted: 03/15/2016] [Indexed: 11/27/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is an under recognized complication of HIV infection. It is estimated that up to 25% of HIV infected people may have COPD. HIV is associated with COPD as a result of a complex interplay of multiple factors such as pulmonary inflammation, recurrent pulmonary infections especially tuberculosis (TB), increased cigarette smoking, socio-economic status, childhood respiratory illnesses and industrial and environmental exposures; each of which are risk factors for COPD in their own right. COPD presents at an earlier age in people with HIV infection. There are over 35 million people living with HIV, and most people infected with HIV live in developing regions of the world where they are faced with multiple risk factors for COPD and suboptimal access to health care. TB is the commonest infectious complication of HIV, and HIV infected persons often experience multiple episodes of TB. Cigarette smoking is increasing in developing countries where the greatest burden of TB and HIV is experienced. Cigarette smoking is associated with increased risk of TB and may be associated with acquisition of HIV infection and progression. It is not clear whether non-infectious pulmonary inflammation persists in the lung when immune reconstitution occurs. Prevention and control of HIV infection must be part of the multiple interventions to reduce the global burden of COPD. A multidisciplinary approach, including behavioural science is required to address this challenge. It presents research opportunities that should be driven by the pulmonology community.
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Affiliation(s)
| | - Sandy Pillay
- Durban University of Technology, Durban, South Africa
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KalagoudaMahishale V, Angadi N, Metgudmath V, Lolly M, Eti A, Khan S. The Prevalence of Chronic Obstructive Pulmonary Disease and the Determinants of Underdiagnosis in Women Exposed to Biomass Fuel in India- a Cross Section Study. Chonnam Med J 2016; 52:117-22. [PMID: 27231676 PMCID: PMC4880576 DOI: 10.4068/cmj.2016.52.2.117] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 04/05/2016] [Accepted: 04/12/2016] [Indexed: 11/26/2022] Open
Abstract
Background and Objectives Tobacco smoking has been established as a major risk factor for chronic obstructive pulmonary disease (COPD) in women of developing countries, but emerging evidence suggests that biomass fuel is an important risk factor as well. The primary objective of the study was to find the true prevalence of COPD in Indian women exposed to biomass fuel using spirometry. We also aimed to find the determinants of underdiagnosis of COPD in these participants. Methods Women with a history of exposure to biomass fuel for >10 years were screened for COPD using spirometry following all standard protocols as per GOLD/ATS/ERS definitions. Results Of the 2868 women screened, a total of 529 (18.4%) women were confirmed to have COPD in which 123 (4.2%) were "Women with known COPD" and 406 (14.2%) "Women with new COPD". The mean age at the time of Diagnosis was 61±5.2 and 47±3.6 respectively. The duration of exposure to biomass fuel had a great impact on the risk of COPD with OR 1.2, 95% CI (1.1-1.9) for patients with 10-15 years exposure and OR 2.9, 95% CI (2.5-3.1) for exposure >25 years, p<0.001. Conclusion The prevalence of COPD among women exposed to biomass fuel is very high. A strong correlation was found between the risk of COPD and the duration of exposure along with the age at which the exposure to biomass fuel begins. Underdiagnosis of COPD was frequent in women due to the lack of the availability of spirometry, lack knowledge of hazards of biomass fuel, a low level of education and the ignorance of the health care provider being the important determinants of underdiagnosis.
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Affiliation(s)
- Vinay KalagoudaMahishale
- Department of Pulmonary Medicine, KLE University's J. N. Medical College, Belagavi, Karnataka, India
| | - Naveen Angadi
- Department of Pulmonary Medicine, KLE University's J. N. Medical College, Belagavi, Karnataka, India
| | - Vjayanand Metgudmath
- Department of Pulmonary Medicine, KLE University's J. N. Medical College, Belagavi, Karnataka, India
| | - Mitchelle Lolly
- Department of Pulmonary Medicine, KLE University's J. N. Medical College, Belagavi, Karnataka, India
| | - Ajith Eti
- Department of Pulmonary Medicine, KLE University's J. N. Medical College, Belagavi, Karnataka, India
| | - Sujeer Khan
- Department of Pulmonary Medicine, KLE University's J. N. Medical College, Belagavi, Karnataka, India
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[COPD: Gender equality now!]. Rev Mal Respir 2016; 33:203-5. [PMID: 26782993 DOI: 10.1016/j.rmr.2015.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 11/17/2015] [Indexed: 10/22/2022]
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