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Yang L, Wang M, Xuan C, Yu C, Zhu Y, Luo H, Meng X, Shi S, Wang Y, Chu H, Chen R, Yan J. Long-term exposure to particulate matter pollution and incidence of ischemic and hemorrhagic stroke: A prospective cohort study in Eastern China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 358:124446. [PMID: 38945192 DOI: 10.1016/j.envpol.2024.124446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 06/18/2024] [Accepted: 06/24/2024] [Indexed: 07/02/2024]
Abstract
Although epidemiological studies have demonstrated significant associations of long-term exposure to particulate matter (PM) air pollution with stroke, evidence on the long-term effects of PM exposure on cause-specific stroke incidence is scarce and inconsistent. We incorporated 33,282 and 33,868 individuals aged 35-75 years without a history of ischemic or hemorrhagic stroke at the baseline in 2014, who were followed up till 2021. Residential exposures to particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) and particulate matter with an aerodynamic diameter less than 10 μm (PM10) for each participant were predicted using a satellite-based model with a spatial resolution of 1 × 1 km. We employed time-varying Cox proportional hazards models to assess the long-term effect of PM pollution on incident stroke. We identified 926 cases of ischemic stroke and 211 of hemorrhagic stroke. Long-term PM exposure was significantly associated with increased incidence of both ischemic and hemorrhagic stroke, with almost 2 times higher risk on hemorrhagic stroke. Specifically, a 10 μg/m³ increase in 3-year average concentrations of PM2.5 was linked to a hazard ratio (HR) of 1.35 (95% confidence interval (CI): 1.18-1.54) for incident ischemic stroke and 1.79 (95% CI: 1.36-2.34) for incident hemorrhagic stroke. The HR related to PM10, though smaller, remained statistically significant, with a HR of 1.25 for ischemic stroke and a HR of 1.51 for hemorrhagic stroke. The excess risks are larger among rural residents and individuals with lower educational attainment. The present cohort study contributed to the mounting evidence on the increased risk of incident stroke associated with long-term PM exposures. Our results further provide valuable evidence on the heightened sensitivity of hemorrhagic stroke to air pollution exposures compared with ischemic stroke.
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Affiliation(s)
- Li Yang
- Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Menghao Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Cheng Xuan
- Chronic Disease Control Department, Zhuji Second People's Hospital, Zhuji, Zhejiang, China
| | - Caiyan Yu
- Chronic Disease Control Department, Zhuji Second People's Hospital, Zhuji, Zhejiang, China
| | - Yixiang Zhu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Huihuan Luo
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Su Shi
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yali Wang
- Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Hongjie Chu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Jing Yan
- Zhejiang Hospital, Hangzhou, Zhejiang, China.
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Tian Y, Ma Y, Wu J, Wu Y, Wu T, Hu Y, Wei J. Ambient PM 2.5 Chemical Composition and Cardiovascular Disease Hospitalizations in China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:16327-16335. [PMID: 39137068 DOI: 10.1021/acs.est.4c05718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
Little is known about the impacts of specific chemical components on cardiovascular hospitalizations. We examined the relationships of PM2.5 chemical composition and daily hospitalizations for cardiovascular disease in 184 Chinese cities. Acute PM2.5 chemical composition exposures were linked to higher cardiovascular disease hospitalizations on the same day and the percentage change of cardiovascular admission was the highest at 1.76% (95% CI, 1.36-2.16%) per interquartile range increase in BC, followed by 1.07% (0.72-1.43%) for SO42-, 1.04% (0.63-1.46%) for NH4+, 0.99% (0.55-1.43%) for NO3-, 0.83% (0.50-1.17%) for OM, and 0.80% (0.34%-1.26%) for Cl-. Similar findings were observed for all cause-specific major cardiovascular diseases, except for heart rhythm disturbances. Short-term exposures to PM2.5 chemical composition were related to higher admissions and showed diverse impacts on major cardiovascular diseases.
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Affiliation(s)
- Yaohua Tian
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, 430030 Wuhan, China
| | - Yudiyang Ma
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, 430030 Wuhan, China
| | - Junhui Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
- Medical Informatics Center, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, Maryland 20742, United States
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Kuntic M, Hahad O, Al-Kindi S, Oelze M, Lelieveld J, Daiber A, Münzel T. Pathomechanistic Synergy Between Particulate Matter and Traffic Noise-Induced Cardiovascular Damage and the Classical Risk Factor Hypertension. Antioxid Redox Signal 2024. [PMID: 38874533 DOI: 10.1089/ars.2024.0659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Affiliation(s)
- Marin Kuntic
- Department of Cardiology 1, Medical Center of the Johannes Gutenberg University, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Mainz, Germany
| | - Omar Hahad
- Department of Cardiology 1, Medical Center of the Johannes Gutenberg University, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Mainz, Germany
| | - Sadeer Al-Kindi
- Cardiovascular Prevention & Wellness and Center for CV Computational & Precision Health, Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA
| | - Matthias Oelze
- Department of Cardiology 1, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Jos Lelieveld
- Max Planck Institute for Chemistry, Atmospheric Chemistry, Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology 1, Medical Center of the Johannes Gutenberg University, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology 1, Medical Center of the Johannes Gutenberg University, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Mainz, Germany
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Andrews JPM, Joshi SS, Tzolos E, Syed MB, Cuthbert H, Crica LE, Lozano N, Okwelogu E, Raftis JB, Bruce L, Poland CA, Duffin R, Fokkens PHB, Boere AJF, Leseman DLAC, Megson IL, Whitfield PD, Ziegler K, Tammireddy S, Hadjidemetriou M, Bussy C, Cassee FR, Newby DE, Kostarelos K, Miller MR. First-in-human controlled inhalation of thin graphene oxide nanosheets to study acute cardiorespiratory responses. NATURE NANOTECHNOLOGY 2024; 19:705-714. [PMID: 38366225 PMCID: PMC11106005 DOI: 10.1038/s41565-023-01572-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 11/09/2023] [Indexed: 02/18/2024]
Abstract
Graphene oxide nanomaterials are being developed for wide-ranging applications but are associated with potential safety concerns for human health. We conducted a double-blind randomized controlled study to determine how the inhalation of graphene oxide nanosheets affects acute pulmonary and cardiovascular function. Small and ultrasmall graphene oxide nanosheets at a concentration of 200 μg m-3 or filtered air were inhaled for 2 h by 14 young healthy volunteers in repeated visits. Overall, graphene oxide nanosheet exposure was well tolerated with no adverse effects. Heart rate, blood pressure, lung function and inflammatory markers were unaffected irrespective of graphene oxide particle size. Highly enriched blood proteomics analysis revealed very few differential plasma proteins and thrombus formation was mildly increased in an ex vivo model of arterial injury. Overall, acute inhalation of highly purified and thin nanometre-sized graphene oxide nanosheets was not associated with overt detrimental effects in healthy humans. These findings demonstrate the feasibility of carefully controlled human exposures at a clinical setting for risk assessment of graphene oxide, and lay the foundations for investigating the effects of other two-dimensional nanomaterials in humans. Clinicaltrials.gov ref: NCT03659864.
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Affiliation(s)
- Jack P M Andrews
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- The Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Shruti S Joshi
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Evangelos Tzolos
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Maaz B Syed
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | | | - Livia E Crica
- Nanomedicine Lab, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
- National Graphene Institute, The University of Manchester, Manchester, UK
| | - Neus Lozano
- Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC and BIST, Campus UAB, Barcelona, Spain
| | - Emmanuel Okwelogu
- Nanomedicine Lab, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
| | - Jennifer B Raftis
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Lorraine Bruce
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Craig A Poland
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK
| | - Rodger Duffin
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK
| | - Paul H B Fokkens
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - A John F Boere
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Daan L A C Leseman
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Ian L Megson
- Division of Biomedical Sciences, University of the Highlands and Islands, Inverness, UK
| | - Phil D Whitfield
- Division of Biomedical Sciences, University of the Highlands and Islands, Inverness, UK
| | - Kerstin Ziegler
- Division of Biomedical Sciences, University of the Highlands and Islands, Inverness, UK
| | - Seshu Tammireddy
- Division of Biomedical Sciences, University of the Highlands and Islands, Inverness, UK
| | - Marilena Hadjidemetriou
- Nanomedicine Lab, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
| | - Cyrill Bussy
- Nanomedicine Lab, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
- National Graphene Institute, The University of Manchester, Manchester, UK
- Lydia Becker Institute of Immunology and Inflammation, The University of Manchester, Manchester, UK
- Thomas Ashton Institute for Risk and Regulatory Research, The University of Manchester, Manchester, UK
| | - Flemming R Cassee
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - David E Newby
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Kostas Kostarelos
- Nanomedicine Lab, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK.
- National Graphene Institute, The University of Manchester, Manchester, UK.
- Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC and BIST, Campus UAB, Barcelona, Spain.
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Pg. Lluís Companys 23, Barcelona, Spain.
| | - Mark R Miller
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
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Hameed S, Karim N, Wasay M, Venketasubramanian N. Emerging Stroke Risk Factors: A Focus on Infectious and Environmental Determinants. J Cardiovasc Dev Dis 2024; 11:19. [PMID: 38248889 PMCID: PMC10816862 DOI: 10.3390/jcdd11010019] [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: 11/22/2023] [Revised: 12/28/2023] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
This review focuses on emerging risk factors for stroke, including air pollution and climate change, gut microbiota, high altitude, and systemic infection. Up to 14% of all stroke-associated mortality is attributed to air pollution and is more pronounced in developing countries. Fine particulate matter and other air pollutants contribute to an increased stroke risk, and this risk appears to increase with higher levels and duration of exposure. Short term air pollution exposure has also been reported to increase the stroke risk. The gut microbiota is a complex ecosystem of bacteria and other microorganisms that reside in the digestive system and affect multiple body systems. Disruptions in the gut microbiota may contribute to stroke development, possibly by promoting inflammation and atherosclerosis. High altitudes have been associated with erythrocytosis and cerebrovascular sinus thrombosis, but several studies have reported an increased risk of thrombosis and ischemic stroke at high altitudes, typically above 3000 m. Systemic infection, particularly infections caused by viruses and bacteria, can also increase the risk of stroke. The risk seems to be greatest in the days to weeks following the infection, and the pathophysiology is complex. All these emerging risk factors are modifiable, and interventions to address them could potentially reduce stroke incidence.
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Affiliation(s)
- Sajid Hameed
- Department of Neurology, University of Virginia, Charlottesville, VA 22903, USA;
| | - Nurose Karim
- Department of Neurology, East Carolina University, Greenville, NC 27834, USA;
| | - Mohammad Wasay
- Department of Neurology, Aga Khan University, Karachi 74800, Pakistan;
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Henning RJ. Particulate Matter Air Pollution is a Significant Risk Factor for Cardiovascular Disease. Curr Probl Cardiol 2024; 49:102094. [PMID: 37734693 DOI: 10.1016/j.cpcardiol.2023.102094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 09/23/2023]
Abstract
Air pollution is responsible worldwide for 9-12 million deaths annually. The major contributor to air pollution is particulate matter ≤2.5 µg per cubic meter of air (PM2.5) from vehicles, industrial emissions, and wildfire smoke. United States ambient air standards recommend annual average PM2.5 concentrations of ≤12 μg/m³ while European standards allow an average annual PM2.5 concentration of ≤20 μg/m3. However, significant PM2.5 cardiovascular and pulmonary health risks exist below these concentrations. Chronic PM2.5 exposure significantly increases major cardiovascular and pulmonary event risks in Americans by 8 to more than 20% for each 10-μg/m3 increase in PM2.5. PM2.5-induced increases in lipid peroxidation, induction of vascular inflammation and endothelial cell injury initiate and propagate respiratory diseases, coronary and carotid atherosclerosis. PM2.5 can cause atherosclerotic vascular plaque rupture and myocardial infarction and stroke by activating metalloproteinases. This article discusses PM2.5 effects on the cardiovascular and pulmonary systems, specific PM2.5 pathophysiologic mechanisms contributing to cardiopulmonary disease, and preventive measures to limit the cardiovascular and pulmonary effects of PM2.5.
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Qian Y, Cai R, Su X, Li Q, Jin S, Shi W, Chen R, Wang C, He J. Residential Nitrogen Dioxide Exposure and Cause-Specific Cerebrovascular Mortality: An Individual-Level, Case-Crossover Study. TOXICS 2023; 12:10. [PMID: 38250966 PMCID: PMC10818787 DOI: 10.3390/toxics12010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Existing studies have already shown a connection between nitrogen dioxide (NO2) exposure and cerebrovascular mortality. However, the differential effects of NO2 on cerebrovascular disease and its subtypes remain unclear and require further exploration. METHODS Daily stroke mortality data between 2013 and 2021 in Shanghai, China were collected. Residential daily air pollution data for each decedent were predicted from a satellite model. An individual-level, time-stratified, case-crossover design was applied to examine the relationship between NO2 exposure and cerebrovascular mortality. A combination of conditional logistic regression and distributed lag models with a maximum lag of 7 days was used for data analysis. RESULTS A total of 219,147 cases of cerebrovascular mortality were recorded. Among them, the proportion of sequelae of cerebrovascular disease, hemorrhagic stroke and ischemic stroke was 50.7%, 17.1% and 27.5%, respectively. The monotonic increases in mortality risks of cerebrovascular diseases, sequelae of cerebrovascular disease and ischemic stroke were observed, without any discernible thresholds. Each 10 μg/m3 increase in NO2 concentration was associated with increments of 3.62% [95% confidence interval (CI): 2.56%, 4.69%] for total cerebrovascular mortality, 4.29% (95% CI: 2.81%, 5.80%) for sequelae of cerebrovascular disease mortality and 4.30% (95% CI: 2.30%, 6.33%) for ischemic stroke mortality. No positive associations between NO2 exposure and hemorrhagic stroke mortality were observed. A greater risk of NO2 was observed in the warm season, in patients with less than 9 years of education and in those with single marital status. The effects of NO2 were robust to mutual adjustment of co-pollutants. CONCLUSIONS Short-term exposures to NO2 may increase the risk of cerebrovascular mortality, specifically for ischemic stroke and sequelae of cerebrovascular disease.
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Affiliation(s)
- Yifeng Qian
- Department of Health Statistics, Naval Medical University, Shanghai 200433, China
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
| | - Renzhi Cai
- Division of Vital Statistics, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Xiaozhen Su
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Qi Li
- Division of Vital Statistics, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Shan Jin
- Division of Vital Statistics, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Wentao Shi
- Clinical Research Unit, School of Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200011, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Chunfang Wang
- Division of Vital Statistics, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Jia He
- Department of Health Statistics, Naval Medical University, Shanghai 200433, China
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Friberg M, Behndig AF, Bosson JA, Muala A, Barath S, Dove R, Glencross D, Kelly FJ, Blomberg A, Mudway IS, Sandström T, Pourazar J. Human exposure to diesel exhaust induces CYP1A1 expression and AhR activation without a coordinated antioxidant response. Part Fibre Toxicol 2023; 20:47. [PMID: 38062420 PMCID: PMC10704793 DOI: 10.1186/s12989-023-00559-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Diesel exhaust (DE) induces neutrophilia and lymphocytosis in experimentally exposed humans. These responses occur in parallel to nuclear migration of NF-κB and c-Jun, activation of mitogen activated protein kinases and increased production of inflammatory mediators. There remains uncertainty regarding the impact of DE on endogenous antioxidant and xenobiotic defences, mediated by nuclear factor erythroid 2-related factor 2 (Nrf2) and the aryl hydrocarbon receptor (AhR) respectively, and the extent to which cellular antioxidant adaptations protect against the adverse effects of DE. METHODS Using immunohistochemistry we investigated the nuclear localization of Nrf2 and AhR in the epithelium of endobronchial mucosal biopsies from healthy subjects six-hours post exposure to DE (PM10, 300 µg/m3) versus post-filtered air in a randomized double blind study, as a marker of activation. Cytoplasmic expression of cytochrome P450s, family 1, subfamily A, polypeptide 1 (CYP1A1) and subfamily B, Polypeptide 1 (CYP1B1) were examined to confirm AhR activation; with the expression of aldo-keto reductases (AKR1A1, AKR1C1 and AKR1C3), epoxide hydrolase and NAD(P)H dehydrogenase quinone 1 (NQO1) also quantified. Inflammatory and oxidative stress markers were examined to contextualize the responses observed. RESULTS DE exposure caused an influx of neutrophils to the bronchial airway surface (p = 0.013), as well as increased bronchial submucosal neutrophil (p < 0.001), lymphocyte (p = 0.007) and mast cell (p = 0.002) numbers. In addition, DE exposure enhanced the nuclear translocation of the AhR and increased the CYP1A1 expression in the bronchial epithelium (p = 0.001 and p = 0.028, respectively). Nuclear translocation of AhR was also increased in the submucosal leukocytes (p < 0.001). Epithelial nuclear AhR expression was negatively associated with bronchial submucosal CD3 numbers post DE (r = -0.706, p = 0.002). In contrast, DE did not increase nuclear translocation of Nrf2 and was associated with decreased NQO1 in bronchial epithelial cells (p = 0.02), without affecting CYP1B1, aldo-keto reductases, or epoxide hydrolase protein expression. CONCLUSION These in vivo human data confirm earlier cell and animal-based observations of the induction of the AhR and CYP1A1 by diesel exhaust. The induction of phase I xenobiotic response occurred in the absence of the induction of antioxidant or phase II xenobiotic defences at the investigated time point 6 h post-exposures. This suggests DE-associated compounds, such as polycyclic aromatic hydrocarbons (PAHs), may induce acute inflammation and alter detoxification enzymes without concomitant protective cellular adaptations in human airways.
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Affiliation(s)
- M Friberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - A F Behndig
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - J A Bosson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Ala Muala
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - S Barath
- Department of Respiratory Medicine and Allergy, Lund University Hospital, Lund, Sweden
| | - R Dove
- Wolfson Institute for Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - D Glencross
- MRC Centre for Environment and Health, Imperial College London, London, UK
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, UK
| | - F J Kelly
- MRC Centre for Environment and Health, Imperial College London, London, UK
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, UK
| | - A Blomberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - I S Mudway
- MRC Centre for Environment and Health, Imperial College London, London, UK
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, UK
| | - T Sandström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - J Pourazar
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
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Lv X, Shi W, Yuan K, Zhang Y, Cao W, Li C, Xu L, Wu L, Sun S, Hong F. Hourly Air Pollution Exposure and Emergency Hospital Admissions for Stroke: A Multicenter Case-Crossover Study. Stroke 2023; 54:3038-3045. [PMID: 37901948 DOI: 10.1161/strokeaha.123.044191] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/26/2023] [Indexed: 10/31/2023]
Abstract
BACKGROUND Daily exposure to ambient air pollution is associated with stroke morbidity and mortality; however, the association between hourly exposure to air pollutants and risk of emergency hospital admissions for stroke and its subtypes remains relatively unexplored. METHODS We obtained hourly concentrations of fine particulate matter (PM2.5), respirable particulate matter (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO) from the China National Environmental Monitoring Center. We conducted a time-stratified case-crossover study among 86 635 emergency hospital admissions for stroke across 10 hospitals in 3 cities (Jinhua, Hangzhou, and Zhoushan) in Zhejiang province, China, between January 1, 2016 and December 31, 2021. Using a conditional logistic regression combined with a distributed lag linear model, we estimated the association between hourly exposure to multiple air pollutants and risk of emergency hospital admissions for total stroke, ischemic stroke, hemorrhagic stroke, and undetermined type. RESULTS Hourly exposure to PM2.5, PM10, NO2, and SO2 was associated with an increased risk of hospital admissions for total stroke and ischemic stroke. The associations were most pronounced during the concurrent hour of exposure and lasted for ≈2 hours. We found that the risk was more pronounced among male patients or those aged <65 years old. CONCLUSIONS Our findings suggest that exposure to PM2.5, PM10, NO2, and SO2, but not CO and O3, is associated with emergency hospital admissions for total stroke or ischemic stroke shortly after exposure. Implementing targeted pollution emission reduction measures may have significant public health implications in controlling and reducing the burden of stroke.
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Affiliation(s)
- Xin Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China (X.L., W.S., K.Y., Y.Z., S.S.)
| | - Wanying Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China (X.L., W.S., K.Y., Y.Z., S.S.)
| | - Kun Yuan
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China (X.L., W.S., K.Y., Y.Z., S.S.)
| | - Yangchang Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China (X.L., W.S., K.Y., Y.Z., S.S.)
| | - Wangnan Cao
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China (W.C.)
| | - Chunrong Li
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China (C.L.)
| | - Lufei Xu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Human Resources, Peking University Cancer Hospital and Institute, China (L.X.)
| | - Lizhi Wu
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China (L.W.)
| | - Shengzhi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China (X.L., W.S., K.Y., Y.Z., S.S.)
- The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China (S.S., F.H.)
| | - Feng Hong
- The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China (S.S., F.H.)
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10
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Marchini T. Redox and inflammatory mechanisms linking air pollution particulate matter with cardiometabolic derangements. Free Radic Biol Med 2023; 209:320-341. [PMID: 37852544 DOI: 10.1016/j.freeradbiomed.2023.10.396] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/27/2023] [Accepted: 10/15/2023] [Indexed: 10/20/2023]
Abstract
Air pollution is the largest environmental risk factor for disease and premature death. Among the different components that are present in polluted air, fine particulate matter below 2.5 μm in diameter (PM2.5) has been identified as the main hazardous constituent. PM2.5 mainly arises from fossil fuel combustion during power generation, industrial processes, and transportation. Exposure to PM2.5 correlates with enhanced mortality risk from cardiovascular diseases (CVD), such as myocardial infarction and stroke. Over the last decade, it has been increasingly suggested that PM2.5 affects CVD already at the stage of risk factor development. Among the multiple biological mechanisms that have been described, the interplay between oxidative stress and inflammation has been consistently highlighted as one of the main drivers of pulmonary, systemic, and cardiovascular effects of PM2.5 exposure. In this context, PM2.5 uptake by tissue-resident immune cells in the lung promotes oxidative and inflammatory mediators release that alter tissue homeostasis at remote locations. This pathway is central for PM2.5 pathogenesis and might account for the accelerated development of risk factors for CVD, including obesity and diabetes. However, transmission and end-organ mechanisms that explain PM2.5-induced impaired function in metabolic active organs are not completely understood. In this review, the main features of PM2.5 physicochemical characteristics related to PM2.5 ability to induce oxidative stress and inflammation will be presented. Hallmark and recent epidemiological and interventional studies will be summarized and discussed in the context of current air quality guidelines and legislation, knowledge gaps, and inequities. Lastly, mechanistic studies at the intersection between redox metabolism, inflammation, and function will be discussed, with focus on heart and adipose tissue alterations. By offering an integrated analysis of PM2.5-induced effects on cardiometabolic derangements, this review aims to contribute to a better understanding of the pathogenesis and potential interventions of air pollution-related CVD.
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Affiliation(s)
- Timoteo Marchini
- Vascular Immunology Laboratory, Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany; Universidad de Buenos Aires, CONICET, Instituto de Bioquímica y Medicina Molecular Prof. Alberto Boveris (IBIMOL), Facultad de Farmacia y Bioquímica, C1113AAD, Buenos Aires, Argentina.
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11
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Mallah MA, Soomro T, Ali M, Noreen S, Khatoon N, Kafle A, Feng F, Wang W, Naveed M, Zhang Q. Cigarette smoking and air pollution exposure and their effects on cardiovascular diseases. Front Public Health 2023; 11:967047. [PMID: 38045957 PMCID: PMC10691265 DOI: 10.3389/fpubh.2023.967047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 06/26/2023] [Indexed: 12/05/2023] Open
Abstract
Cardiovascular disease (CVD) has no socioeconomic, topographical, or sex limitations as reported by the World Health Organization (WHO). The significant drivers of CVD are cardio-metabolic, behavioral, environmental, and social risk factors. However, some significant risk factors for CVD (e.g., a pitiable diet, tobacco smoking, and a lack of physical activities), have also been linked to an elevated risk of cardiovascular disease. Lifestyles and environmental factors are known key variables in cardiovascular disease. The familiarity with smoke goes along with the contact with the environment: air pollution is considered a source of toxins that contribute to the CVD burden. The incidence of myocardial infarction increases in males and females and may lead to fatal coronary artery disease, as confirmed by epidemiological studies. Lipid modification, inflammation, and vasomotor dysfunction are integral components of atherosclerosis development and advancement. These aspects are essential for the identification of atherosclerosis in clinical investigations. This article aims to show the findings on the influence of CVD on the health of individuals and human populations, as well as possible pathology and their involvement in smoking-related cardiovascular diseases. This review also explains lifestyle and environmental factors that are known to contribute to CVD, with indications suggesting an affiliation between cigarette smoking, air pollution, and CVD.
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Affiliation(s)
| | - Tahmina Soomro
- Department of Sociology, Shah Abdul Latif University, Khairpur, Pakistan
| | - Mukhtiar Ali
- Department of Chemical Engineering, Quaid-e-Awam University of Engineering, Science and Technology, Nawabshah, Sindh, Pakistan
| | - Sobia Noreen
- Department of Pharmaceutics Technology, Institute of Pharmacy, University of Innsbruck, Insbruck, Austria
| | - Nafeesa Khatoon
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Akriti Kafle
- School of Nursing, Zhengzhou University, Zhengzhou, China
| | - Feifei Feng
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wei Wang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Muhammad Naveed
- Department of Physiology and Pharmacology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
| | - Qiao Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, China
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12
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Toubasi A, Al-Sayegh TN. Short-term Exposure to Air Pollution and Ischemic Stroke: A Systematic Review and Meta-analysis. Neurology 2023; 101:e1922-e1932. [PMID: 37758483 PMCID: PMC10662999 DOI: 10.1212/wnl.0000000000207856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/28/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Approximately 5 million fatalities occur annually due to stroke, along with its substantial effects on patient well-being and functional impairment. Research has established a connection between extended exposure to air pollutants and ischemic stroke. However, the link between short-term exposure to air pollutants and stroke remains less definitive. METHODS A comprehensive search was conducted on MEDLINE, Scopus, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Sciences databases up until February 2023, without any language restrictions. The inclusion criteria encompassed observational or interventional studies that examined the correlation between short-term exposure to air pollutants (carbon monoxide [CO], sulfur dioxide [SO2], nitrogen dioxide [NO2], ozone [O3]) and particulate matter with diameters of less than 1 µm, less than 2.5 µm, or less than 10 µm (PM1, PM2.5, and PM10), with the incidence and mortality of ischemic stroke. Short-term exposure was defined as exposure occurring within 5 days of the onset of stroke. RESULTS A total of 18,035,408 cases of ischemic stroke were included in the analysis, derived from 110 observational studies. Asia accounted for most included studies, representing 58.8% of the total. By contrast, Europe and the Americas contributed 24.6% and 16.7% of the studies, respectively. Notably, none of the included studies were conducted in Africa. Stroke incidence was significantly associated with an increase in the concentration of NO2 (RR = 1.28; 95% CI 1.21-1.36), O3 (RR = 1.05; 95% CI 1.03-1.07), CO (RR = 1.26; 95% CI 1.21-1.32), SO2 (RR = 1.15; 95% CI 1.11-1.19), PM1 (RR = 1.09; 95% CI 1.06-1.12), PM2.5 (RR = 1.15; 95% CI 1.13-1.17), and PM10 (RR = 1.14; 95% CI 1.12-1.16). Moreover, an increase in the concentration of NO2 (RR = 1.33; 95% CI 1.07-1.65), SO2 (RR = 1.60; 95% CI 1.05-2.44), PM2.5 (RR = 1.09; 95% CI 1.04-1.15), and PM10 (RR = 1.02; 95% CI 1.00-1.04) was associated with an increase in stroke mortality. DISCUSSION There is a strong and significant correlation between gaseous and particulate air pollutants and the occurrence and mortality rates of stroke. This close temporal association underscores the importance of implementing global initiatives to develop policies aimed at reducing air pollution. By doing so, alleviate the burden of ischemic stroke and its consequences.
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Affiliation(s)
- Ahmad Toubasi
- From the Faculty of Medicine, the University of Jordan, Amman.
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13
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Lamorie-Foote K, Ge B, Shkirkova K, Liu Q, Mack W. Effect of Air Pollution Particulate Matter on Ischemic and Hemorrhagic Stroke: A Scoping Review. Cureus 2023; 15:e46694. [PMID: 37942398 PMCID: PMC10629995 DOI: 10.7759/cureus.46694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 11/10/2023] Open
Abstract
Air pollution particulate matter (PM) exposure has been established as a risk factor for stroke. However, few studies have investigated the effects of PM exposure on stroke subtypes (ischemic and hemorrhagic stroke). Ischemic (IS) and hemorrhagic strokes (HS) involve distinctive pathophysiological pathways and may be differentially influenced by PM exposure. This review aims to characterize the effects of PM exposure on ischemic and hemorrhagic strokes. It also identifies subpopulations that may be uniquely vulnerable to PM toxicity. Pubmed was queried from 2000 to 2023 to identify clinical and epidemiological studies examining the association between PM exposure and stroke subtypes (ischemic and hemorrhagic stroke). Inclusion criteria were: 1) articles written in English 2) clinical and epidemiological studies 3) studies with a clear definition of stroke, IS, HS, and air pollution 4) studies reporting the effects of PM and 5) studies that included distinct analyses per stroke subtype. Two independent reviewers screened the literature for applicable studies. A total of 50 articles were included in this review. Overall, PM exposure increases ischemic stroke risk in both lightly and heavily polluted countries. The association between PM exposure and hemorrhagic stroke is variable and may be influenced by a country's ambient air pollution levels. A stronger association between PM exposure and stroke is demonstrated in older individuals and those with pre-existing diabetes. There is no clear effect of sex or hypertension on PM-associated stroke risk. Current literature suggests PM exposure increases ischemic stroke risk, with an unclear effect on hemorrhagic stroke risk. Older patients and those with pre-existing diabetes may be the most vulnerable to PM toxicity. Future investigations are needed to characterize the influence of sex and hypertension on PM-associated stroke risk.
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Affiliation(s)
| | - Brandon Ge
- Neurological Surgery, Keck School of Medicine of University of Southern California, Los Angeles, USA
| | - Kristina Shkirkova
- Neurological Surgery, Keck School of Medicine of University of Southern California, Los Angeles, USA
| | - Qinghai Liu
- Neurological Surgery, University of Southern California, Los Angeles, USA
| | - William Mack
- Neurological Surgery, University of Southern California, Los Angeles, USA
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14
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Reeves F, Potter BJ. Toward a Cardio-Environmental Risk Model: Environmental Determinants of Cardiovascular Disease. Can J Cardiol 2023; 39:1166-1181. [PMID: 37380103 DOI: 10.1016/j.cjca.2023.06.419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023] Open
Abstract
It is increasingly recognized that strong geographic variations in cardiovascular risk cannot be explained using traditional cardiovascular risk factors alone. Indeed, it is highly unlikely that heredity and classic risk factors such as hypertension, diabetes, dyslipidemia, and tobacco use can explain the tenfold variation observed in cardiovascular mortality among men in Russia and those in Switzerland. Since the advent of industrialization and resultant changes to our climate, it is now clear that environmental stressors also influence cardiovascular health and our thinking around cardiovascular risk prediction is in need of a paradigm shift. Herein, we review the basis for this shift in our understanding of the interplay of environmental factors with cardiovascular health. We illustrate how air pollution, hyperprocessed foods, the amount of green space, and population activity levels are now considered the 4 major environmental determinants of cardiovascular health and provide a framework for how these considerations might be incorporated into clinical risk assessment. We also outline the clinical and socioeconomic effects of the environment on cardiovascular health and review key recommendations from major medical societies.
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Affiliation(s)
- François Reeves
- CHUM Cardiovascular Center, Department of Medicine, Centre hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; University of Montréal School of Public Health (ESPUM), Montréal, Quebec, Canada.
| | - Brian J Potter
- CHUM Cardiovascular Center, Department of Medicine, Centre hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Health Innovation and Evaluation Hub, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
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15
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Bo Y, Zhu Y, Zhang X, Chang H, Zhang J, Lao XQ, Yu Z. Spatiotemporal Trends of Stroke Burden Attributable to Ambient PM 2.5 in 204 Countries and Territories, 1990-2019: A Global Analysis. Neurology 2023; 101:e764-e776. [PMID: 37380431 PMCID: PMC10437020 DOI: 10.1212/wnl.0000000000207503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/21/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Previous studies suggested that long-term exposure to ambient fine particulate matter (PM2.5) is associated with increased risk of stroke. However, limited studies evaluated the stroke burden attributable to ambient PM2.5 globally, especially comprising across different regions, countries, and social-economic levels. We thus conducted this study to estimate the spatial and temporal trends of ambient PM2.5-related stroke burden by sex, age, and subtypes from 1990 to 2019 at global, regional, and national levels. METHODS Information on the ambient PM2.5-related stroke burden from 1990 to 2019 was obtained from the Global Burden of Disease study 2019. The burdens of stroke attributable to ambient PM2.5 (i.e., age-standardized mortality rate [ASMR] and age-standardized disability-adjusted life-year rate [ASDR]) were estimated by sex, age, and subtypes from 1990 to 2019 at global, regional, and national levels. The estimated annual percentage change (EAPC) was used to evaluate the changing trends of ASDR and ASMR attributable to ambient PM2.5 from 1990 to 2019. The Spearman correlation coefficient was used to examine the correlation between sociodemographic index (SDI) and EAPC of ASMR and ASDR at the national level. RESULTS In 2019, the global ambient PM2.5-related stroke mortality and disability-adjusted life years were 1.14 million and 28.74 million, respectively, with the corresponding ASDR and ASMR of 348.1 and 14.3 per 100,000 population, respectively. The ASDR and ASMR increased with age and were highest among male patients, in the middle SDI regions, and for intracerebral hemorrhage (ICH). From 1990 to 2019, the absolute death number of stroke attributable to ambient PM2.5 and the corresponding ASMR and ASDR were both in an increasing trend. The corresponding EAPCs in ASMR and ASDR were 0.09 (95% CI -0.05 to 0.24) and 0.31 (95% CI 0.18-0.44), respectively. The significant increases of ASMR and ASDR were observed in the low, low-middle, and middle SDI regions, and for ICH. However, a decreasing trend was observed in high and middle-high SDI regions, and for subarachnoid hemorrhage. DISCUSSION The global burden of stroke attributable to ambient PM2.5 showed an increasing trend over the past 30 years, especially in male patients, low-income countries, and for ICH. Continued efforts on reducing the level of ambient PM2.5 are necessary to reduce the burden of stroke.
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Affiliation(s)
- Yacong Bo
- From the School of Public Health (Y.B., Z.Y.), Zhengzhou University; Department of Cardiology (Y.Z.), The First Affiliated Hospital of Zhengzhou University; The Third Affiliated Hospital of Zhengzhou University (X.Z., H.C.); NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention (J.Z.), Zhengzhou, China; and Department of Biomedical Sciences (X.Q.L.), City University of Hong Kong, Kowloon Tong
| | - Yongjian Zhu
- From the School of Public Health (Y.B., Z.Y.), Zhengzhou University; Department of Cardiology (Y.Z.), The First Affiliated Hospital of Zhengzhou University; The Third Affiliated Hospital of Zhengzhou University (X.Z., H.C.); NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention (J.Z.), Zhengzhou, China; and Department of Biomedical Sciences (X.Q.L.), City University of Hong Kong, Kowloon Tong
| | - Xiaoan Zhang
- From the School of Public Health (Y.B., Z.Y.), Zhengzhou University; Department of Cardiology (Y.Z.), The First Affiliated Hospital of Zhengzhou University; The Third Affiliated Hospital of Zhengzhou University (X.Z., H.C.); NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention (J.Z.), Zhengzhou, China; and Department of Biomedical Sciences (X.Q.L.), City University of Hong Kong, Kowloon Tong
| | - Hui Chang
- From the School of Public Health (Y.B., Z.Y.), Zhengzhou University; Department of Cardiology (Y.Z.), The First Affiliated Hospital of Zhengzhou University; The Third Affiliated Hospital of Zhengzhou University (X.Z., H.C.); NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention (J.Z.), Zhengzhou, China; and Department of Biomedical Sciences (X.Q.L.), City University of Hong Kong, Kowloon Tong
| | - Junxi Zhang
- From the School of Public Health (Y.B., Z.Y.), Zhengzhou University; Department of Cardiology (Y.Z.), The First Affiliated Hospital of Zhengzhou University; The Third Affiliated Hospital of Zhengzhou University (X.Z., H.C.); NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention (J.Z.), Zhengzhou, China; and Department of Biomedical Sciences (X.Q.L.), City University of Hong Kong, Kowloon Tong
| | - Xiang Qian Lao
- From the School of Public Health (Y.B., Z.Y.), Zhengzhou University; Department of Cardiology (Y.Z.), The First Affiliated Hospital of Zhengzhou University; The Third Affiliated Hospital of Zhengzhou University (X.Z., H.C.); NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention (J.Z.), Zhengzhou, China; and Department of Biomedical Sciences (X.Q.L.), City University of Hong Kong, Kowloon Tong
| | - Zengli Yu
- From the School of Public Health (Y.B., Z.Y.), Zhengzhou University; Department of Cardiology (Y.Z.), The First Affiliated Hospital of Zhengzhou University; The Third Affiliated Hospital of Zhengzhou University (X.Z., H.C.); NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention (J.Z.), Zhengzhou, China; and Department of Biomedical Sciences (X.Q.L.), City University of Hong Kong, Kowloon Tong.
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16
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Rahman M, Upadhyay S, Ganguly K, Introna M, Ji J, Boman C, Muala A, Blomberg A, Sandström T, Palmberg L. Comparable Response Following Exposure to Biodiesel and Diesel Exhaust Particles in Advanced Multicellular Human Lung Models. TOXICS 2023; 11:532. [PMID: 37368632 DOI: 10.3390/toxics11060532] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/31/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023]
Abstract
Biodiesel is considered to be a sustainable alternative for fossil fuels such as petroleum-based diesel. However, we still lack knowledge about the impact of biodiesel emissions on humans, as airways and lungs are the primary target organs of inhaled toxicants. This study investigated the effect of exhaust particles from well-characterized rapeseed methyl ester (RME) biodiesel exhaust particles (BDEP) and petro-diesel exhaust particles (DEP) on primary bronchial epithelial cells (PBEC) and macrophages (MQ). The advanced multicellular physiologically relevant bronchial mucosa models were developed using human primary bronchial epithelial cells (PBEC) cultured at air-liquid interface (ALI) in the presence or absence of THP-1 cell-derived macrophages (MQ). The experimental set-up used for BDEP and DEP exposures (18 µg/cm2 and 36 µg/cm2) as well as the corresponding control exposures were PBEC-ALI, MQ-ALI, and PBEC co-cultured with MQ (PBEC-ALI/MQ). Following exposure to both BDEP and DEP, reactive oxygen species as well as the stress protein heat shock protein 60 were upregulated in PBEC-ALI and MQ-ALI. Expression of both pro-inflammatory (M1: CD86) and repair (M2: CD206) macrophage polarization markers was increased in MQ-ALI after both BDEP and DEP exposures. Phagocytosis activity of MQ and the phagocytosis receptors CD35 and CD64 were downregulated, whereas CD36 was upregulated in MQ-ALI. Increased transcript and secreted protein levels of CXCL8, as well as IL-6 and TNF-α, were detected following both BDEP and DEP exposure at both doses in PBEC-ALI. Furthermore, the cyclooxygenase-2 (COX-2) pathway, COX-2-mediated histone phosphorylation and DNA damage were all increased in PBEC-ALI following exposure to both doses of BDEP and DEP. Valdecoxib, a COX-2 inhibitor, reduced the level of prostaglandin E2, histone phosphorylation, and DNA damage in PBEC-ALI following exposure to both concentrations of BDEP and DEP. Using physiologically relevant multicellular human lung mucosa models with human primary bronchial epithelial cells and macrophages, we found BDEP and DEP to induce comparable levels of oxidative stress, inflammatory response, and impairment of phagocytosis. The use of a renewable carbon-neutral biodiesel fuel does not appear to be more favorable than conventional petroleum-based alternative, as regards of its potential for adverse health effects.
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Affiliation(s)
- Mizanur Rahman
- Unit of Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Swapna Upadhyay
- Unit of Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Koustav Ganguly
- Unit of Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Micol Introna
- Unit of Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Jie Ji
- Unit of Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Christoffer Boman
- Thermochemical Energy Conversion Laboratory, Department of Applied Physics and Electronics, Umeå University, 901 87 Umeå, Sweden
| | - Ala Muala
- Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden
| | - Anders Blomberg
- Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden
| | - Thomas Sandström
- Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden
| | - Lena Palmberg
- Unit of Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
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17
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Tzolos E, Bing R, Andrews J, MacAskill MG, Tavares AAS, Macnaught G, Clark T, Mills NL, Fujisawa T, Nash J, Dey D, Slomka PJ, Koglin N, Stephens AW, Deutsch MA, van Beek EJR, Williams MC, Hermann S, Hugenberg V, Dweck MR, Newby DE. Noninvasive In Vivo Coronary Artery Thrombus Imaging. JACC Cardiovasc Imaging 2023; 16:820-832. [PMID: 36526577 DOI: 10.1016/j.jcmg.2022.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/16/2022] [Accepted: 10/06/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND The diagnosis and management of myocardial infarction are increasingly complex, and establishing the presence of intracoronary thrombosis has major implications for both the classification and treatment of myocardial infarction. OBJECTIVES The aim of this study was to investigate whether positron emission tomographic (PET) and computed tomographic (CT) imaging could noninvasively detect in vivo thrombus formation in human coronary arteries using a novel glycoprotein IIb/IIIa receptor antagonist-based radiotracer, 18F-GP1. METHODS In a single-center observational case-control study, patients with or without acute myocardial infarction underwent coronary 18F-GP1 PET/CT angiography. Coronary artery 18F-GP1 uptake was assessed visually and quantified using maximum target-to-background ratios. RESULTS 18F-GP1 PET/CT angiography was performed in 49 patients with and 50 patients without acute myocardial infarction (mean age: 61 ± 9 years, 75% men). Coronary 18F-GP1 uptake was apparent in 39 of the 49 culprit lesions (80%) in patients with acute myocardial infarction. False negative results appeared to relate to time delays to scan performance and low thrombus burden in small-caliber distal arteries. On multivariable regression analysis, culprit vessel status was the only independent variable associated with higher 18F-GP1 uptake. Extracoronary cardiac 18F-GP1 findings included a high frequency of infarct-related intramyocardial uptake (35%) as well as left ventricular (8%) or left atrial (2%) thrombus. CONCLUSIONS Coronary 18F-GP1 PET/CT angiography is the first noninvasive selective technique to identify in vivo coronary thrombosis in patients with acute myocardial infarction. This novel approach can further define the role and location of thrombosis within the heart and has the potential to inform the diagnosis, management, and treatment of patients with acute myocardial infarction. (In-Vivo Thrombus Imaging With 18F-GP1, a Novel Platelet PET Radiotracer [iThrombus]; NCT03943966).
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Affiliation(s)
- Evangelos Tzolos
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom.
| | - Rong Bing
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Jack Andrews
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Mark G MacAskill
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Imaging, Queen's Medical Research Institute, Edinburgh, United Kingdom
| | - Adriana A S Tavares
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Imaging, Queen's Medical Research Institute, Edinburgh, United Kingdom
| | - Gillian Macnaught
- Edinburgh Imaging, Queen's Medical Research Institute, Edinburgh, United Kingdom
| | - Tim Clark
- Edinburgh Imaging, Queen's Medical Research Institute, Edinburgh, United Kingdom
| | - Nicholas L Mills
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom; Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Takeshi Fujisawa
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Jennifer Nash
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Damini Dey
- Departments of Medicine (Division of Artificial Intelligence in Medicine) and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Piotr J Slomka
- Departments of Medicine (Division of Artificial Intelligence in Medicine) and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | | | | | - Marcus-Andre Deutsch
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, University Hospital Ruhr-University Bochum, Bad Oeynhausen, Germany
| | - Edwin J R van Beek
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Imaging, Queen's Medical Research Institute, Edinburgh, United Kingdom
| | - Michelle C Williams
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Imaging, Queen's Medical Research Institute, Edinburgh, United Kingdom
| | - Sven Hermann
- European Institute for Molecular Imaging, University of Münster, Münster, Germany
| | - Verena Hugenberg
- Institute of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine-Westphalia Bochum, University Hospital of the Ruhr University, Bad Oeynhausen, Germany
| | - Marc R Dweck
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Imaging, Queen's Medical Research Institute, Edinburgh, United Kingdom
| | - David E Newby
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Imaging, Queen's Medical Research Institute, Edinburgh, United Kingdom
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18
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Benito-Lozano M, López-Ayala P, Rodríguez S, Llorens P, Domínguez-Rodríguez A, Aguirre A, Alquézar A, Jacob J, Gil V, Martín-Sánchez FJ, Mir M, Andueza JA, Burillo-Putze G, Miró Ò. Analysis of the relationship between ambient air pollution and the severity of heart failure decompensations in two Spanish metropolises (Barcelona and Madrid). Med Clin (Barc) 2023:S0025-7753(23)00143-4. [PMID: 37055253 DOI: 10.1016/j.medcli.2023.02.016] [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: 12/19/2022] [Revised: 02/23/2023] [Accepted: 02/26/2023] [Indexed: 04/15/2023]
Abstract
OBJECTIVES To analyze whether the high levels of air pollutants are related to a greater severity of decompensated heart failure (HF). METHOD Patients diagnosed with decompensated HF in the emergency department of 4 hospitals in Barcelona and 3 in Madrid were included. Clinical data (age, sex, comorbidities, baseline functional status), atmospheric (temperature, atmospheric pressure) and pollutant data (SO2, NO2, CO, O3, PM10, PM2.5) were collected in the city on the day of emergency care. The severity of decompensation was estimated using 7-day mortality (primary indicator) and the need for hospitalization, in-hospital mortality, and prolonged hospitalization (secondary indicators). The association adjusted for clinical, atmospheric and city data between pollutant concentration and severity was investigated using linear regression (linearity assumption) and restricted cubic spline curves (no linearity assumption). RESULTS A total of 5292 decompensations were included, with a median age of 83 years (IQR=76-88) and 56% women. The medians (IQR) of the daily pollutant averages were: SO2=2.5μg/m3 (1.4-7.0), NO2=43μg/m3 (34-57), CO=0.48mg/m3 (0.35-0.63), O3=35μg/m3 (25-48), PM10=22μg/m3 (15-31) and PM2.5=12μg/m3 (8-17). Mortality at 7 days was 3.9%, and hospitalization, in-hospital mortality, and prolonged hospitalization were 78.9, 6.9, and 47.5%, respectively. SO2 was the only pollutant that showed a linear association with the severity of decompensation, since each unit of increase implied an OR for the need for hospitalization of 1.04 (95% CI 1.01-1.08). The restricted cubic spline curves study also did not show clear associations between pollutants and severity, except for SO2 and hospitalization, with OR of 1.55 (95% CI 1.01-2.36) and 2.71 (95% CI 1.13-6.49) for concentrations of 15 and 24μg/m3, respectively, in relation to a reference concentration of 5μg/m3. CONCLUSION Exposure to ambient air pollutants, in a medium to low concentration range, is generally not related to the severity of HF decompensations, and only NO2 may be associated with an increased need for hospitalization.
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Affiliation(s)
| | - Pedro López-Ayala
- Cardiovascular Research Institute Basel (CRIB) and Cardiology Department, University Hospital Basel, University of Basel, Basel, Suiza
| | - Sergio Rodríguez
- Instituto de Productos Naturales y Agrobiología (IPNA), CSIC, La Laguna, Santa Cruz de Tenerife, España
| | - Pere Llorens
- Servicio de Urgencias, Corta Estancia y Hospitalización a Domicilio, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, España
| | | | - Alfons Aguirre
- Servicio de Urgencias, Hospital del Mar, Barcelona, España
| | - Aitor Alquézar
- Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - Javier Jacob
- Servicio de Urgencias, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - Víctor Gil
- Área de Urgencias, Hospital Clínic, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, España
| | | | - María Mir
- Servicio de Urgencias, Hospital Universitario Infanta Leonor, Madrid, España
| | - Juan Antonio Andueza
- Servicio de Urgencias, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Guillermo Burillo-Putze
- Facultad de Ciencias de la Salud, Universidad Europea de Canarias, La Orotava, Tenerife, España.
| | - Òscar Miró
- Área de Urgencias, Hospital Clínic, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, España
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19
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Impact of air pollution on ischemic heart disease: Evidence, mechanisms, clinical perspectives. Atherosclerosis 2023; 366:22-31. [PMID: 36696748 DOI: 10.1016/j.atherosclerosis.2023.01.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/23/2022] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
Ambient air pollution, and especially particulate matter (PM) air pollution <2.5 μm in diameter (PM2.5), has clearly emerged as an important yet often overlooked risk factor for atherosclerosis and ischemic heart disease (IHD). In this review, we examine the available evidence demonstrating how acute and chronic PM2.5 exposure clinically translates into a heightened coronary atherosclerotic burden and an increased risk of acute ischemic coronary events. Moreover, we provide insights into the pathophysiologic mechanisms underlying PM2.5-mediated atherosclerosis, focusing on the specific biological mechanism through which PM2.5 exerts its detrimental effects. Further, we discuss about the possible mechanisms that explain the recent findings reporting a strong association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, increased PM2.5 exposure, and morbidity and mortality from IHD. We also address the possible mitigation strategies that should be implemented to reduce the impact of PM2.5 on cardiovascular morbidity and mortality, and underscoring the strong need of clinical trials demonstrating the efficacy of specific interventions (including both PM2.5 reduction and/or specific drugs) in reducing the incidence of IHD. Finally, we introduce the emerging concept of the exposome, highlighting the close relationship between PM2.5 and other environmental exposures (i.e.: traffic noise and climate change) in terms of common underlying pathophysiologic mechanisms and possible mitigation strategies.
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20
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Mohammadian-Khoshnoud M, Habibi H, Manafi B, Safarpour G, Soltanian AR. Effects of Air Pollutant Exposure on Acute Myocardial Infarction. Heart Lung Circ 2023; 32:79-89. [PMID: 36428180 DOI: 10.1016/j.hlc.2022.10.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Air pollution is a consequence of industrial development that is exacerbated as a result of population growth, and urbanisation. AIM The goal of the study is to investigate the effects of air pollution on the number of cases of acute myocardial infarction (AMI) according to gender using the Zero-inflated Poisson Regression model in Hamadan, Iran. METHODS The study used an ecological design, and data collected from March 2016 to September 2020 in Hamadan were included. The intended response was the number of cases of AMI recorded in the investigated period. The time lag of the pollutants was used to investigate the effect of air pollution on the number of AMIs. RESULTS The number of AMI recorded for men and women was 1,195 and 553, respectively. The average age (±SD) for men and women was 64.60 (±12.27) and 70.98 (±11.79) years, respectively. According to the air quality index in Hamadan, the values of particulate matter < 2.5 μm (PM2.5), SO2, O3, and CO were below moderate levels. Also, according to NO2 and particulate matter between 25 μm-10 μm (PM10), the air quality index of Hamadan was in the very unhealthy mode just for 2 and 3 days, respectively. The O3 and NO2 are significant positive effects on AMI among men. But, PM2.5, PM10, and SO2 are negative impacts on hospitalisation in men due to AMI. For women, PM2.5 and O3 had positive effects on AMI. But, NO2 and PM10 had a significant negative impact on hospitalisation in women during different time lags. CONCLUSIONS The results of the study showed that if the analyses are based on gender, the responses to pollutants are different and hence the stratified analysis is important.
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Affiliation(s)
| | - Hossein Habibi
- Department of Environment, College of Basic Sciences, Hamedan Branch, Islamic Azad University, Hamedan, Iran
| | - Babak Manafi
- Department of Heart Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Gholamreza Safarpour
- Department of Heart Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Reza Soltanian
- Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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21
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Kshirsagar AV, Zeitler EM, Weaver A, Franceschini N, Engel LS. Environmental Exposures and Kidney Disease. KIDNEY360 2022; 3:2174-2182. [PMID: 36591345 PMCID: PMC9802544 DOI: 10.34067/kid.0007962021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/04/2022] [Indexed: 12/31/2022]
Abstract
Accumulating evidence underscores the large role played by the environment in the health of communities and individuals. We review the currently known contribution of environmental exposures and pollutants on kidney disease and its associated morbidity. We review air pollutants, such as particulate matter; water pollutants, such as trace elements, per- and polyfluoroalkyl substances, and pesticides; and extreme weather events and natural disasters. We also discuss gaps in the evidence that presently relies heavily on observational studies and animal models, and propose using recently developed analytic methods to help bridge the gaps. With the expected increase in the intensity and frequency of many environmental exposures in the decades to come, an improved understanding of their potential effect on kidney disease is crucial to mitigate potential morbidity and mortality.
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Affiliation(s)
- Abhijit V. Kshirsagar
- UNC Kidney Center and Division of Nephrology and Hypertension, University of North Carolina, Chapel Hill, North Carolina
| | - Evan M. Zeitler
- UNC Kidney Center and Division of Nephrology and Hypertension, University of North Carolina, Chapel Hill, North Carolina
| | - Anne Weaver
- Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Chapel Hill, North Carolina
| | - Nora Franceschini
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Lawrence S. Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
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22
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Wang K, Wang W, Lei L, Lan Y, Liu Q, Ren L, Wu S. Association between short-term exposure to ambient air pollution and biomarkers of coagulation: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2022; 215:114210. [PMID: 36030918 DOI: 10.1016/j.envres.2022.114210] [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: 05/23/2022] [Revised: 08/17/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
Ambient air pollution is one of the major global risk factors for cardiovascular health, and coagulation changes have been proposed to mediate this risk. Plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor (vWF), soluble P-selectin (sP-selectin) and tissue plasminogen activator (t-PA) are major coagulation biomarkers. However, there has been no systematic meta-analysis to summarize associations of ambient air pollution with these coagulation biomarkers. To assess the overall associations between ambient particulate matter (PM2.5, PM10), ozone (O3), nitrogen dioxide (NO2), carbon monoxide (CO) and major coagulation biomarkers including PAI-1, vWF, sP-selectin and t-PA based on the existing epidemiological research. We performed a systematic literature search of publications reporting the associations of ambient air pollutants (PM2.5, PM10, O3, NO2, and CO) with coagulation biomarkers (PAI-1, vWF, sP-selectin and t-PA) in PubMed, Web of Science, EMBASE, and Scopus databases as of April 5, 2022. Then, we performed a random-effect meta-analysis, which included 27 articles, and then identified the potential sources of heterogeneity. The pooled percent changes of coagulation biomarkers per 10 μg/m3 increase in short-term exposure to ambient PM2.5 were 2.43% (95% CI: 0.59%, 4.29%) in PAI-1, 1.08% (95% CI: 0.21%, 1.96%) in vWF and 1.14% (95% CI: 0.59%, 1.68%) in sP-selectin, respectively. We also found significant associations of short-term exposure to ambient O3 with PAI-1 (1.62%, 95% CI: 0.01%, 3.25%), sP-selectin (9.59%, 95% CI:2.78%, 16.86%) and t-PA (0.45%, 95% CI: 0.02%, 0.88%), respectively. Short-term exposures to ambient PM10, NO2 and CO were not significantly associated with changes in coagulation biomarkers. In conclusion, short-term exposures to PM2.5 and O3 are associated with significant increases in coagulation biomarkers, suggesting an activated coagulation state upon air pollution exposure.
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Affiliation(s)
- Kai Wang
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China
| | - Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Lei Lei
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China
| | - Yang Lan
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China
| | - Qisijing Liu
- Research Institute of Public Health, School of Medicine, Nankai University, Tianjin, China
| | - Lihua Ren
- School of Nursing, Peking University, Beijing, China
| | - Shaowei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China.
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23
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Song J, An Z, Zhu J, Li J, Qu R, Tian G, Wang G, Zhang Y, Li H, Jiang J, Wu H, Wang Y, Wu W. Subclinical cardiovascular outcomes of acute exposure to fine particulate matter and its constituents: A glutathione S-transferase polymorphism-based longitudinal study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 846:157469. [PMID: 35868381 DOI: 10.1016/j.scitotenv.2022.157469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 07/03/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
To explore the acute subclinical cardiovascular effects of fine particulate matter (PM2.5) and its constituents, a longitudinal study with 61 healthy young volunteers was conducted in Xinxiang, China. Linear mixed-effect models were used to analyze the association of PM2.5 and its constituents with cardiovascular outcomes, respectively, including blood pressure (BP), heart rate (HR), serum levels of high-sensitivity C-reactive protein (hs-CRP), 8-hydroxy-2'-deoxyguanosine (8-OHdG), tissue-type plasminogen activator (t-PA), and platelet-monocyte aggregation (PMA). Additionally, the modifying effects of glutathione S-transferase mu 1 (GSTM1) and glutathione S-transferase theta 1 (GSTT1) polymorphisms were examined. A 10 μg/m3 increase in PM2.5 was associated with -1.04 (95 % CI: -1.86 to -0.22) mmHg and -0.90 (95 % CI: -1.69 to -0.11) mmHg decreases in diastolic BP (DBP) and mean arterial BP (MABP) along with 1.83 % (95 % CI: 0.59-3.08 %), 5.93 % (95 % CI: 0.70-11.16 %) increases in 8-OHdG and hs-CRP, respectively. Ni content was positively associated with the 8-OHdG levels whereas several other metals presented negative association with 8-OHdG and HR. Intriguingly, GSTT1+/GSTTM1+ subjects showed higher susceptibility to PM2.5-induced alterations of DBP and PMA, and GSTT1-/GSTM1+ subjects showed higher alteration on t-PA. Taken together, our findings indicated that short-term PM2.5 exposure induced oxidative stress, systemic inflammation, autonomic alterations, and fibrinolysis in healthy young subjects. Among multiple examined metal components Ni appeared to positively associated with systematic oxidative stress. In addition, GST-sufficient subjects might be more prone to PM2.5-induced autonomic alterations.
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Affiliation(s)
- Jie Song
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Zhen An
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Jingfang Zhu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Juan Li
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Rongrong Qu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Ge Tian
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Gui Wang
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Yange Zhang
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Huijun Li
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Jing Jiang
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Hui Wu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Yinbiao Wang
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Weidong Wu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China.
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24
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Hasegawa K, Tsukahara T, Nomiyama T. Short-term associations of ambient air pollution with hospital admissions for ischemic stroke in 97 Japanese cities. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:78821-78831. [PMID: 35701697 DOI: 10.1007/s11356-022-21206-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/27/2022] [Indexed: 06/15/2023]
Abstract
The short-term association between ambient air pollution and hospital admissions for ischemic stroke is not fully understood. We examined the association between four regularly measured major ambient air pollutants, i.e., sulfur dioxide (SO2), nitrogen dioxide (NO2), photochemical oxidants (Ox), and particulate matter with aerodynamic diameters ≤ 2.5 μm (PM2.5), and hospital admissions for ischemic stroke by analyzing 3 years of nationwide claims data from 97 cities in Japan. We first estimated city-specific results by using generalized additive models with a quasi-Poisson regression, and we obtained the national average by combining city-specific results with the use of random-effect models. We identified a total of 335,248 hospital admissions for ischemic stroke during the 3-year period. Our analysis results demonstrated that interquartile range increases in the following four ambient air pollutants were significantly associated with hospital admissions for ischemic stroke on the same day: SO2 (1.05 ppb), 1.05% (95% CI: 0.59-1.50%); NO2 (6.40 ppb), 1.10% (95% CI: 0.61-1.59%); Ox (18.32 ppb), 1.43% (95% CI: 0.81-2.06%); and PM2.5 (7.86 μg/m3), 0.90% (95% CI: 0.35-1.45%). When the data were stratified by the hospital admittees' medication use, we observed stronger associations with SO2, NO2, and PM2.5 among the patients who were taking antihypertensive drugs and weaker associations with SO2, NO2, and Ox among those taking antiplatelet drugs. Short-term exposure to ambient air pollution was associated with increased hospital admissions for ischemic stroke, and medication use and season may modify the association.
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Affiliation(s)
- Kohei Hasegawa
- Department of Preventive Medicine and Public Health, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
| | - Teruomi Tsukahara
- Department of Preventive Medicine and Public Health, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
- Department of Occupational Medicine, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Tetsuo Nomiyama
- Department of Preventive Medicine and Public Health, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
- Department of Occupational Medicine, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
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25
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Abstract
Air pollutants are a complex mixture of gaseous substances and particulate matter (PM). Each component potentially has specific harmful effects on human health, but several experimental and clinical studies have shown a strong impact of fine particles on major adverse cardiovascular events. Most of the available evidence concerns the effects of exposure to PM with a diameter of <2.5 µm (PM2.5) and the risk of developing coronary heart disease through inflammation and oxidative stress. While prolonged exposure to PM2.5 has been shown to be associated with the development of atherosclerosis and cardio-metabolic risk factors, short-term exposure has instead proved to be a trigger for acute coronary events, and especially in subjects with pre-existing coronary artery disease. As such, environmental PM2.5 is a major risk element for global public health. This underlines on the one hand not only the need to adopt and encourage preventive measures especially for individuals with a higher risk profile but also to practice environmental policies that are effective in promoting the reduction of exposure to pollutants.
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26
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Wang T, Chen X, Li H, Chen W, Xu Y, Yao Y, Zhang H, Han Y, Zhang L, Que C, Gong J, Qiu X, Zhu T. Pro-thrombotic changes associated with exposure to ambient ultrafine particles in patients with chronic obstructive pulmonary disease: roles of lipid peroxidation and systemic inflammation. Part Fibre Toxicol 2022; 19:65. [PMID: 36280873 PMCID: PMC9590143 DOI: 10.1186/s12989-022-00503-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 09/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exposure to particulate matter air pollution is associated with an increased risk of cardiovascular mortality in patients with chronic obstructive pulmonary disease (COPD), but the underlying mechanisms are not yet understood. Enhanced platelet and pro-thrombotic activity in COPD patients may explain their increased cardiovascular risk. We aim to explore whether short-term exposure to ambient particulate matter is associated with pro-thrombotic changes in adults with and without COPD, and investigate the underlying biological mechanisms in a longitudinal panel study. Serum concentration of thromboxane (Tx)B2 was measured to reflect platelet and pro-thrombotic activity. Lipoxygenase-mediated lipid peroxidation products (hydroxyeicosatetraenoic acids [HETEs]) and inflammatory biomarkers (interleukins [ILs], monocyte chemoattractant protein-1 [MCP-1], tumour necrosis factor alpha [TNF-α], and macrophage inflammatory proteins [MIPs]) were measured as potential mediating determinants of particle-associated pro-thrombotic changes. RESULTS 53 COPD and 82 non-COPD individuals were followed-up on a maximum of four visits conducted from August 2016 to September 2017 in Beijing, China. Compared to non-COPD individuals, the association between exposure to ambient ultrafine particles (UFPs) during the 3-8 days preceding clinical visits and the TxB2 serum concentration was significantly stronger in COPD patients. For example, a 103/cm3 increase in the 6-day average UFP level was associated with a 25.4% increase in the TxB2 level in the COPD group but only an 11.2% increase in the non-COPD group. The association in the COPD group remained robust after adjustment for the levels of fine particulate matter and gaseous pollutants. Compared to the non-COPD group, the COPD group also showed greater increases in the serum concentrations of 12-HETE (16.6% vs. 6.5%) and 15-HETE (9.3% vs. 4.5%) per 103/cm3 increase in the 6-day UFP average. The two lipid peroxidation products mediated 35% and 33% of the UFP-associated increase in the TxB2 level of COPD patients. UFP exposure was also associated with the increased levels of IL-8, MCP-1, MIP-1α, MIP-1β, TNF-α, and IL-1β in COPD patients, but these inflammatory biomarkers did not mediate the TxB2 increase. CONCLUSIONS Short-term exposure to ambient UFPs was associated with a greater pro-thrombotic change among patients with COPD, at least partially driven by lipoxygenase-mediated pathways following exposure. Trial registration ChiCTR1900023692 . Date of registration June 7, 2019, i.e. retrospectively registered.
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Affiliation(s)
- Teng Wang
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Xi Chen
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, China.,Hebei Technology Innovation Center of Human Settlement in Green Building (TCHS), Shenzhen Institute of Building Research Co., Ltd., Xiongan, China
| | - Haonan Li
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Wu Chen
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Yifan Xu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Yuan Yao
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Hanxiyue Zhang
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Yiqun Han
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, China.,Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK
| | - Lina Zhang
- Shi Cha Hai Community Health Service Center, Beijing, China
| | - Chengli Que
- Peking University First Hospital, Peking University, Beijing, China
| | - Jicheng Gong
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Xinghua Qiu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Tong Zhu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, China.
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27
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Gwon JG, Park JH, Kim JS, Seo HM. Exposure to Long-Term Air Pollution and Incidence of Peripheral Arterial Disease in the General Population: A Korean National Population-Based Retrospective Cohort Study. Angiology 2022:33197221121010. [DOI: 10.1177/00033197221121010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to evaluate the causal relationship between long-term outdoor air pollutants and incidence of peripheral arterial disease (PAD) using the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC) database. We included 292,091 subjects from the general population who had previously not been diagnosed with PAD by the NHIS-NSC between 2008 and 2014. Hourly air pollutant data (particulate and gaseous) and climate data were collected. Correlation analysis of the collected data confirmed the relationship between air pollution and PAD incidence. For 1,836,965.4 person-years, incident cases of PAD were observed in 5243 subjects (285.4/100,000 person-years). In the Cox proportional hazard analysis, exposure to long-term average concentration of sulfur dioxide (SO2) [hazard ratio (HR), 1.686; (95% confidence interval (CI), 1.108–2.565) for .01ppm] and nitrogen dioxide (NO2) [HR, 1.200; (95% CI, 1.077–1.336) for .01 ppm] significantly increased the risk of PAD occurrence after the adjustment for several variables. This study demonstrated that SO2 and NO2 exposure are independent predictors of PAD.
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Affiliation(s)
- Jun Gyo Gwon
- Division of Vascular Surgery, Department of Surgery, Ulsan University College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Ji Hun Park
- Department of Dermatology, College of Medicine, Hanyang University, Hanyang University Guri Hospital, Guri-si, Republic of Korea
| | - Joung Soo Kim
- Department of Dermatology, College of Medicine, Hanyang University, Hanyang University Guri Hospital, Guri-si, Republic of Korea
| | - Hyun-Min Seo
- Department of Dermatology, College of Medicine, Hanyang University, Hanyang University Guri Hospital, Guri-si, Republic of Korea
- Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Republic of Korea
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Caldeira D, Franco F, Bravo Baptista S, Cabral S, Cachulo MDC, Dores H, Peixeiro A, Rodrigues R, Santos M, Timóteo AT, Vasconcelos J, Gonçalves L. Air pollution and cardiovascular diseases: A position paper. Rev Port Cardiol 2022; 41:709-717. [DOI: 10.1016/j.repc.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 05/17/2022] [Indexed: 10/17/2022] Open
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Joshi SS, Miller MR, Newby DE. Air pollution and cardiovascular disease: the Paul Wood Lecture, British Cardiovascular Society 2021. Heart 2022; 108:1267-1273. [PMID: 35074847 DOI: 10.1136/heartjnl-2021-319844] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/22/2021] [Indexed: 11/04/2022] Open
Abstract
Air pollution is associated with up to 8.8 million excess deaths worldwide each year and is a major contributor to the global burden of disease. Cardiovascular conditions are the predominant cause for air pollution-related deaths and there is an urgent need to address the silent pandemic of air pollution on cardiovascular health. Air pollution exposure is associated with acute events like acute coronary syndrome and stroke, and with chronic conditions, such as atherosclerosis and heart failure. Several potential mechanisms have been proposed that link particle inhalation to cardiovascular disease including oxidative stress and inflammation, changes in autonomic balance and neuroendocrine regulation and the particle translocation into the circulation itself. This, in turn, can cause endothelial, vasomotor and fibrinolytic dysfunction and increased thrombogenicity and blood pressure which are implicated in the mediation of adverse cardiovascular events. Certain interventions can help mitigate these adverse effects. At an individual level, this includes the use of a facemask and indoor air purification systems. At an environmental level, interventions reducing the generation or release of combustion-derived pollutants are key and include public health policies to facilitate active transport, cleaner sources of energy and reductions in vehicular and fossil fuel emissions. In this review, we summarise the key pathways and mechanisms that draw together how air pollution can lead to adverse cardiovascular effects, as well as explore potential interventions to reduce the burden of air pollution-induced cardiovascular morbidity and mortality.
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Affiliation(s)
- Shruti S Joshi
- BHF Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - Mark R Miller
- BHF Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - David E Newby
- BHF Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
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Levesque T, Koning R, Gillibert A, Hohweyer J, Bonnet P, Lesault PF, Motreff P, Eltchaninoff H, Rangé G, Durand E. Impact of the Lubrizol factory fire in Rouen on coronary events: A retrospective study from the France PCI registry. Arch Cardiovasc Dis 2022; 115:467-475. [PMID: 35872078 DOI: 10.1016/j.acvd.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/12/2022] [Accepted: 05/17/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND On 26 September 2019, an industrial fire occurred in the Lubrizol factory in Rouen (France), exposing the population to the inhalation of many volatile toxic agents secondary to combustion. AIM To assess the impact of the Lubrizol factory fire on the incidence of coronary artery events. METHODS All coronary angiograms performed in Rouen (exposed) and Le Havre (unexposed) from May 2019 to December 2019 were extracted from the prospective France Percutaneous Coronary Intervention (France PCI) registry. To study the impact of the fire on coronary events, an interrupted time series analysis was performed in Rouen, with adjustment on Le Havre in an autoregressive moving average (ARMA)(1,1) model with the precision of 1 week. The primary outcome was the incidence of acute coronary syndrome, and the secondary outcome was the incidence of ST-segment elevation myocardial infarction. RESULTS The mean number of acute coronary syndromes per week in the exposed zone (Rouen) increased non-significantly from 37.5±9.4 before the fire to 43.2±6.2 after the fire, for an estimated effect of +5.5 (95% confidence interval -0.7 to 11.8; P=0.09) events per week. In municipalities exposed to the plume of smoke (subgroup of Rouen), the mean number of acute coronary syndromes increased non-significantly from 7.3±2.8 before the fire to 8.7±3.6 after the fire, for an estimated effect of +1.0 (95% confidence interval -2.0 to 4.0; P=0.51) events per week. The results were similar when taking into account only ST-segment elevation myocardial infarctions or all coronary events. CONCLUSIONS Our study did not find a significant effect of the Lubrizol factory fire on the incidence of acute coronary syndrome. Further studies are needed to investigate the impact of industrial accidents on air pollution and coronary events.
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Affiliation(s)
- Thomas Levesque
- U1096, Department of Cardiology, FHU CARNAVAL, CHU de Rouen, Normandie University UNIROUEN, 76000 Rouen, France
| | - René Koning
- Department of Cardiology, Clinique Saint-Hilaire, 76031 Rouen, France
| | - André Gillibert
- U1096, Department of Biostatistics, FHU CARNAVAL, CHU de Rouen, Normandie University UNIROUEN, 76000 Rouen, France
| | - Jeanne Hohweyer
- Department of Cardiology, Clinique Saint-Hilaire, 76031 Rouen, France
| | - Philippe Bonnet
- Department of Cardiology, Groupe Hospitalier du Havre, 76600 Le Havre, France
| | | | - Pascal Motreff
- Department of Cardiology, Clermont-Ferrand University Hospital, 63000 Clermont-Ferrand, France
| | - Hélène Eltchaninoff
- U1096, Department of Cardiology, FHU CARNAVAL, CHU de Rouen, Normandie University UNIROUEN, 76000 Rouen, France
| | - Gregoire Rangé
- Department of Cardiology, Les Hôpitaux de Chartres, 28630 Le Coudray, France
| | - Eric Durand
- U1096, Department of Cardiology, FHU CARNAVAL, CHU de Rouen, Normandie University UNIROUEN, 76000 Rouen, France.
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Li L, Huang S, Tian Y, Ji J, Zhang Y, Hu J, Lv Z, Liu N, Wang P, Yin P, Yu S. Short-term exposure to nitrogen dioxide and ischemic stroke incidence in Shenzhen, China: Modification effects by season and temperature. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 239:113644. [PMID: 35588618 DOI: 10.1016/j.ecoenv.2022.113644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVES China has experienced a serious public health burden because of the increased incidence of ischemic stroke. Evidence describing the association between short-term exposure to nitrogen dioxide (NO2) and ischemic stroke morbidity is limited, and few studies have focused on the effects of season and temperature. This study aimed to evaluate the acute effects of NO2 on ischemic stroke incidence in Shenzhen, a southeastern city of China, considering the modified effects of season and temperature. METHODS A time-stratified case-crossover study was conducted between 2003 and 2014 among 98,482 ischemic stroke hospitalizations. Conditional quasi-Poisson regression was used to estimate the percentage changes in ischemic stroke admissions in relation to each 10 μg/m3 increment in NO2. RESULTS NO2 was positively associated with ischemic stroke onset over the full year, as well as in the cold season (November through April) and on cold days (ambient temperature≤median temperature), with significant single-day effects within 3 days after the exposure, and significant cumulative effects within the delayed five days. The maximum percentage changes were obtained at lag0-5, with 1.81% (95% confidence interval (CI) was 0.86-2.76%) over the full year, 2.75% (1.48-4.03%) in the cold season, and 3.04% (1.74-4.35%) on cold days. Additionally, the effects of exposure were found to be greater in males and people with higher education, and were lasting longer in subgroups of older individuals. CONCLUSIONS Our findings provide evidence that reductions in NO2 levels might decrease ischemic stroke morbidity, and enhance the understanding of ischemic stroke occurrence associated with NO2 modified by season and temperature.
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Affiliation(s)
- Lei Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China
| | - Suli Huang
- Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, Guangdong, China
| | - Yuchen Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China
| | - Jiajia Ji
- Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, Guangdong, China
| | - Yu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China
| | - Jing Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China
| | - Ziquan Lv
- Department of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, Guangdong, China
| | - Ning Liu
- Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, Guangdong, China
| | - Peng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China.
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China.
| | - Shuyuan Yu
- Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, Guangdong, China.
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An Update on Advancements and Challenges in Inhalational Drug Delivery for Pulmonary Arterial Hypertension. Molecules 2022; 27:molecules27113490. [PMID: 35684428 PMCID: PMC9182169 DOI: 10.3390/molecules27113490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/14/2022] [Accepted: 05/17/2022] [Indexed: 12/17/2022] Open
Abstract
A lethal condition at the arterial–alveolar juncture caused the exhaustive remodeling of pulmonary arterioles and persistent vasoconstriction, followed by a cumulative augmentation of resistance at the pulmonary vascular and, consequently, right-heart collapse. The selective dilation of the pulmonary endothelium and remodeled vasculature can be achieved by using targeted drug delivery in PAH. Although 12 therapeutics were approved by the FDA for PAH, because of traditional non-specific targeting, they suffered from inconsistent drug release. Despite available inhalation delivery platforms, drug particle deposition into the microenvironment of the pulmonary vasculature and the consequent efficacy of molecules are influenced by pathophysiological conditions, the characteristics of aerosolized mist, and formulations. Uncertainty exists in peripheral hemodynamics outside the pulmonary vasculature and extra-pulmonary side effects, which may be further exacerbated by underlying disease states. The speedy improvement of arterial pressure is possible via the inhalation route because it has direct access to pulmonary arterioles. Additionally, closed particle deposition and accumulation in diseased tissues benefit the restoration of remolded arterioles by reducing fallacious drug deposition in other organs. This review is designed to decipher the pathological changes that should be taken into account when targeting the underlying pulmonary endothelial vasculature, especially with regard to inhaled particle deposition in the alveolar vasculature and characteristic formulations.
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Long E, Schwartz C, Carlsten C. Controlled human exposure to diesel exhaust: a method for understanding health effects of traffic-related air pollution. Part Fibre Toxicol 2022; 19:15. [PMID: 35216599 PMCID: PMC8876178 DOI: 10.1186/s12989-022-00454-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 02/03/2022] [Indexed: 12/17/2022] Open
Abstract
Diesel exhaust (DE) is a major component of air pollution in urban centers. Controlled human exposure (CHE) experiments are commonly used to investigate the acute effects of DE inhalation specifically and also as a paradigm for investigating responses to traffic-related air pollution (TRAP) more generally. Given the critical role this model plays in our understanding of TRAP's health effects mechanistically and in support of associated policy and regulation, we review the methodology of CHE to DE (CHE-DE) in detail to distill critical elements so that the results of these studies can be understood in context. From 104 eligible publications, we identified 79 CHE-DE studies and extracted information on DE generation, exposure session characteristics, pollutant and particulate composition of exposures, and participant demographics. Virtually all studies had a crossover design, and most studies involved a single DE exposure per participant. Exposure sessions were typically 1 or 2 h in duration, with participants alternating between exercise and rest. Most CHE-DE targeted a PM concentration of 300 μg/m3. There was a wide range in commonly measured co-pollutants including nitrogen oxides, carbon monoxide, and total organic compounds. Reporting of detailed parameters of aerosol composition, including particle diameter, was inconsistent between studies, and older studies from a given lab were often cited in lieu of repeating measurements for new experiments. There was a male predominance in participants, and over half of studies involved healthy participants only. Other populations studied include those with asthma, atopy, or metabolic syndrome. Standardization in reporting exposure conditions, potentially using current versions of engines with modern emissions control technology, will allow for more valid comparisons between studies of CHE-DE, while recognizing that diesel engines in much of the world remain old and heterogeneous. Inclusion of female participants as well as populations more susceptible to TRAP will broaden the applicability of results from CHE-DE studies.
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Affiliation(s)
- Erin Long
- Faculty of Medicine, University of British Columbia, 317 - 2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Carley Schwartz
- Department of Medicine, Division of Respiratory Medicine, University of British Columbia, 2775 Laurel Street 7th Floor, Vancouver, BC, V5Z 1M9, Canada
| | - Christopher Carlsten
- Department of Medicine, Division of Respiratory Medicine, University of British Columbia, 2775 Laurel Street 7th Floor, Vancouver, BC, V5Z 1M9, Canada.
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Long E, Carlsten C. Controlled human exposure to diesel exhaust: results illuminate health effects of traffic-related air pollution and inform future directions. Part Fibre Toxicol 2022; 19:11. [PMID: 35139881 PMCID: PMC8827176 DOI: 10.1186/s12989-022-00450-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/31/2022] [Indexed: 12/03/2022] Open
Abstract
Air pollution is an issue of increasing interest due to its globally relevant impacts on morbidity and mortality. Controlled human exposure (CHE) studies are often employed to investigate the impacts of pollution on human health, with diesel exhaust (DE) commonly used as a surrogate of traffic related air pollution (TRAP). This paper will review the results derived from 104 publications of CHE to DE (CHE-DE) with respect to health outcomes. CHE-DE studies have provided mechanistic evidence supporting TRAP’s detrimental effects on related to the cardiovascular system (e.g., vasomotor dysfunction, inhibition of fibrinolysis, and impaired cardiac function) and respiratory system (e.g., airway inflammation, increased airway responsiveness, and clinical symptoms of asthma). Oxidative stress is thought to be the primary mechanism of TRAP-induced effects and has been supported by several CHE-DE studies. A historical limitation of some air pollution research is consideration of TRAP (or its components) in isolation, limiting insight into the interactions between TRAP and other environmental factors often encountered in tandem. CHE-DE studies can help to shed light on complex conditions, and several have included co-exposure to common elements such as allergens, ozone, and activity level. The ability of filters to mitigate the adverse effects of DE, by limiting exposure to the particulate fraction of polluted aerosols, has also been examined. While various biomarkers of DE exposure have been evaluated in CHE-DE studies, a definitive such endpoint has yet to be identified. In spite of the above advantages, this paradigm for TRAP is constrained to acute exposures and can only be indirectly applied to chronic exposures, despite the critical real-world impact of living long-term with TRAP. Those with significant medical conditions are often excluded from CHE-DE studies and so results derived from healthy individuals may not apply to more susceptible populations whose further study is needed to avoid potentially misleading conclusions. In spite of limitations, the contributions of CHE-DE studies have greatly advanced current understanding of the health impacts associated with TRAP exposure, especially regarding mechanisms therein, with important implications for regulation and policy.
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Affiliation(s)
- Erin Long
- Faculty of Medicine, University of British Columbia, 317 - 2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Christopher Carlsten
- Division of Respiratory Medicine, Department of Medicine, University of British Columbia, 2775 Laurel Street 7th Floor, Vancouver, BC, V5Z 1M9, Canada.
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Alarabi AB, Lozano PA, Khasawneh FT, Alshbool FZ. The effect of emerging tobacco related products and their toxic constituents on thrombosis. Life Sci 2022; 290:120255. [PMID: 34953893 PMCID: PMC9118784 DOI: 10.1016/j.lfs.2021.120255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 02/03/2023]
Abstract
Although conventional cigarette smoking is declining, emerging tobacco related products (ETRPs) are currently gaining ground, especially among the youth. These products include electronic cigarettes, waterpipes/hookah, cigars/cigarillo, smokeless tobacco, and heat-not-burn cigarettes. The observed increase in the use of ETRPs is multifactorial and complex but appears to be mainly driven by efforts from the major tobacco companies to reinvent themselves, and present more appealing and allegedly safe(r) tobacco products. However, it is becoming apparent that these products produce substantial amounts of toxic chemicals, many of which have been shown to exert negative health effects, including in the context of the cardiovascular system. Thus, there has been research efforts, albeit limited in general, to characterize the health impact of these products on occlusive/thrombotic cardiovascular diseases (CVD). In this review, we will discuss the potential impact of ETRPs on thrombosis-based CVD. Specifically, we will review how these products and the major chemicals they produce and/or emit can trigger key players in the process of thrombosis, namely inflammation, oxidative stress, platelets, coagulation, and the vascular endothelium, and the relationship between these effects.
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Affiliation(s)
- Ahmed B Alarabi
- Department of Pharmacy Practice, Irma Lerma Rangel College of Pharmacy Texas A&M University, Kingsville, TX, USA
| | - Patricia A Lozano
- Department of Pharmacy Practice, Irma Lerma Rangel College of Pharmacy Texas A&M University, Kingsville, TX, USA
| | - Fadi T Khasawneh
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy Texas A&M University, Kingsville, TX, USA.
| | - Fatima Z Alshbool
- Department of Pharmacy Practice, Irma Lerma Rangel College of Pharmacy Texas A&M University, Kingsville, TX, USA.
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Nemmar A, Beegam S, Zaaba NE, Alblooshi S, Alseiari S, Ali BH. The Salutary Effects of Catalpol on Diesel Exhaust Particles-Induced Thrombogenic Changes and Cardiac Oxidative Stress, Inflammation and Apoptosis. Biomedicines 2022; 10:99. [PMID: 35052780 PMCID: PMC8773344 DOI: 10.3390/biomedicines10010099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/10/2021] [Accepted: 11/16/2021] [Indexed: 12/13/2022] Open
Abstract
Inhaled particulate air pollution exerts pulmonary inflammation and cardiovascular toxicity through secondary systemic effects due to oxidative stress and inflammation. Catalpol, an iridiod glucoside, extracted from the roots of Rehmannia glutinosa Libosch, has been reported to possess anti-inflammatory and antioxidant properties. Yet, the potential ameliorative effects of catalpol on particulate air pollution-induced cardiovascular toxicity, has not been studied so far. Hence, we evaluated the possible mitigating mechanism of catalpol (5 mg/kg) which was administered to mice by intraperitoneal injection one hour before the intratracheal (i.t.) administration of a relevant type of pollutant particle, viz. diesel exhaust particles (DEPs, 30 µg/mouse). Twenty-four hours after the lung deposition of DEPs, several cardiovascular endpoints were evaluated. DEPs caused a significant shortening of the thrombotic occlusion time in pial microvessels in vivo, induced platelet aggregation in vitro, and reduced the prothrombin time and the activated partial thromboplastin time. All these actions were effectively mitigated by catalpol pretreatment. Likewise, catalpol inhibited the increase of the plasma concentration of C-reactive proteins, fibrinogen, plasminogen activator inhibitor-1 and P- and E-selectins, induced by DEPs. Moreover, in heart tissue, catalpol inhibited the increase of markers of oxidative (lipid peroxidation and superoxide dismutase) and nitrosative (nitric oxide) stress, and inflammation (tumor necrosis factor α, interleukin (IL)-6 and IL-1β) triggered by lung exposure to DEPs. Exposure to DEPs also caused heart DNA damage and increased the levels of cytochrome C and cleaved caspase, and these effects were significantly diminished by the catalpol pretreatment. Moreover, catalpol significantly reduced the DEPs-induced increase of the nuclear factor κB (NFκB) in the heart. In conclusion, catalpol significantly ameliorated DEPs-induced procoagulant events and heart oxidative and nitrosative stress, inflammation, DNA damage and apoptosis, at least partly, through the inhibition of NFκB activation.
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Affiliation(s)
- Abderrahim Nemmar
- Department of Physiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (S.B.); (N.E.Z.); (S.A.); (S.A.)
| | - Sumaya Beegam
- Department of Physiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (S.B.); (N.E.Z.); (S.A.); (S.A.)
| | - Nur Elena Zaaba
- Department of Physiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (S.B.); (N.E.Z.); (S.A.); (S.A.)
| | - Salem Alblooshi
- Department of Physiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (S.B.); (N.E.Z.); (S.A.); (S.A.)
| | - Saleh Alseiari
- Department of Physiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (S.B.); (N.E.Z.); (S.A.); (S.A.)
| | - Badreldin H. Ali
- Department of Pharmacology and Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, P.O. Box 35, Muscat 123, Oman;
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Zhang H, Yi M, Wang Y, Zhang Y, Xiao K, Si J, Shi N, Sun L, Miao Z, Zhao T, Sun X, Liu Z, Gao J, Li J. Air pollution and recurrence of cardiovascular events after ST-segment elevation myocardial infarction. Atherosclerosis 2021; 342:1-8. [PMID: 34974197 DOI: 10.1016/j.atherosclerosis.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 12/12/2021] [Accepted: 12/17/2021] [Indexed: 11/02/2022]
Abstract
BACKGROUND AND AIMS The effects of air pollution on discharged patients after ST-segment elevation myocardial infarction (STEMI) still remain uncertain. We examined the association between air pollutants and recurrent cardiovascular events in STEMI survivors. METHODS A retrospective cohort of 1641 discharged patients after STEMI was established in 2013 and followed until the end of 2019. Concentrations of air pollutants including fine particles <2.5 μm aerodynamic diameter (PM2.5), inhalable particles <10 μm aerodynamic diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) and ozone (O3) measured by fixed ambient air monitoring stations were collected for exposure assessment. Multivariate-adjusted Cox proportional hazards models were used to estimate the increased risks of recurrent cardiovascular events. RESULTS Compared with the first exposure quartile, for short-term exposure, hazard ratios (HRs) of recurrent cardiovascular events associated with the fourth exposure quartiles of PM2.5, PM10, NO2, SO2, CO, and O3 were 4.06 (95% CI: 2.62-6.30), 3.79 (95% CI: 2.57-5.58), 2.22 (95% CI: 1.67-2.94), 4.47 (95% CI: 3.08-6.48), 3.73 (95% CI: 2.54-5.48), and 5.35 (95% CI: 3.12-9.20), respectively. For long-term exposure, HRs associated with the fourth exposure quartiles of PM2.5, PM10, NO2, SO2, CO, and O3 were 6.43 (95% CI: 3.60-11.47), 4.77 (95% CI: 2.85-7.99), 3.22 (95% CI: 2.00-5.19), 3.20 (95% CI: 2.05-5.01), 4.44 (95% CI: 2.65-7.45), and 1.07 (95% CI: 0.80-1.42), respectively. The risks of recurrent cardiovascular events brought by air pollutants mostly increased nonlinearly. CONCLUSIONS Short- and long-term exposure to air pollutants except ozone increases the risks of recurrent cardiovascular events in STEMI survivors. Better environmental policies and secondary prevention strategies should be developed to protect STEMI survivors as a susceptible population.
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Affiliation(s)
- Haoyu Zhang
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Ming Yi
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China
| | - Yang Wang
- Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Yinghua Zhang
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Keling Xiao
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Jin Si
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Ning Shi
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Lijie Sun
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Zupei Miao
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Ting Zhao
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Xipeng Sun
- Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Zhi Liu
- Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Jing Gao
- Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Jing Li
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
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Liu WY, Yi JP, Tung TH, Yan JB. Association Between the Ambient Fine Particulate Pollution and the Daily Internal Medicine Outpatient Visits in Zhoushan, China: A Time-Series Study. Front Public Health 2021; 9:749191. [PMID: 34765582 PMCID: PMC8575696 DOI: 10.3389/fpubh.2021.749191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/24/2021] [Indexed: 11/13/2022] Open
Abstract
Background: There has been a recent worsening of air pollution in China, which poses a huge threat to public health by inducing and promoting circulatory and respiratory diseases. This study aimed to explore the association between the concentration of air pollution and daily internal medicine outpatient visits registered for the treatment of circulatory and respiratory symptoms in Zhoushan, China using a time-series method. Methods: We validated and acquired the daily internal medicine outpatient visits records between January 1, 2014, and December 31, 2019, from the Zhoushan Center for Disease Control and Prevention in Zhejiang, China. Further, we collected the daily average records of the ambient air pollutants from the Zhoushan Environmental Monitoring Centre within the same duration. A generalized additive model with the natural splines was constructed to explore the association between the ambient air pollutants and daily internal medicine outpatient visits. Further, we conducted a lag analysis by using the distributed lag non-linear model to estimate the time-delayed effects of the air pollutants on the daily internal medicine outpatient visits. Results: A total of 2,190,258 daily internal medicine outpatient visits with a mean of 202.4 visits per day were recorded. The non-linear relationships were found among particulate matter2.5 (PM2.5), sulfur dioxide (SO2), and the daily internal medicine outpatient visits. Overall, PM2.5 was positively correlated with the daily internal medicine outpatient visits. Both ozone (O3) and SO2 had significant delayed effects on the daily internal medical outpatient numbers; however, PM2.5 only showed a short-term risk. Conclusion: Short-term exposure to PM2.5 was associated with an increase in the daily internal medicine outpatient visits for circulatory and respiratory diseases/symptoms in Zhoushan, China. SO2 and O3 were shown to induce significant effects after a concentration-dependent time lag.
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Affiliation(s)
- Wen-Yi Liu
- Department of Health Policy Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.,Shanghai Bluecross Medical Science Institute, Shanghai, China.,Institute for Hospital Management, Tsing Hua University, Beijing, China
| | - Jing-Ping Yi
- Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, China
| | - Tao-Hsin Tung
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Jian-Bo Yan
- Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, China
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Weng L, Li N, Feng T, Zhu R, Zheng ZJ. Short-Term Association of Air Pollutant Levels and Hospital Admissions for Stroke and Effect Modification by Apparent Temperature: Evidence From Shanghai, China. Front Public Health 2021; 9:716153. [PMID: 34646803 PMCID: PMC8503471 DOI: 10.3389/fpubh.2021.716153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/23/2021] [Indexed: 11/19/2022] Open
Abstract
The epidemiological evidence on relationships between air pollution, temperature, and stroke remains inconclusive. Limited evidence is available for the effect modification by apparent temperature, an indicator reflecting reactions to the thermal environment, on short-term associations between air pollution and hospital admissions for stroke. We used a generalized additive model with Poisson regression to estimate the relative risk (RR) of stroke admissions in Shanghai, China, between 2014 and 2016 associated with air pollutants, with subgroup analyses by age, sex, apparent temperature, and season. During the study period, changes in the daily number of stroke admissions per 10 μg/m3 increase in nitrogen dioxide (at lags 0, 1, 0–1, and 0–2) ranged from 1.05 (95% CI: 0.82%, 2.88%) to 2.24% (95% CI: 0.84%, 3.65%). For each 10 μg/m3 increase in sulfur dioxide concentrations at lags 1, 2, 0–1, and 0–2, the RR of daily stroke admissions increased by 3.34 (95% CI: 0.955%, 5.79%), 0.32 (95% CI: −1.97%, 2.67%), 3.33 (95% CI: 0.38%, 6.37%), and 2.86% (95% CI: −0.45%, 6.28%), respectively. The associations of same-day exposure to nitrogen dioxide with stroke admissions remained significant after adjustment for ozone levels. These associations were not modified by sex, age, apparent temperature, or season. More research is warranted to determine whether apparent temperature modifies the associations between air pollution and stroke admissions.
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Affiliation(s)
- Lvkan Weng
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Chest Hospital, Shanghai, China
| | - Na Li
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Tienan Feng
- Clinic Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rongjia Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University, Shanghai, China.,Clinic Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
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40
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The cardiovascular effects of air pollution: Prevention and reversal by pharmacological agents. Pharmacol Ther 2021; 232:107996. [PMID: 34571110 PMCID: PMC8941724 DOI: 10.1016/j.pharmthera.2021.107996] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/11/2021] [Indexed: 12/15/2022]
Abstract
Air pollution is associated with staggering levels of cardiovascular morbidity and mortality. Airborne particulate matter (PM), in particular, has been associated with a wide range of detrimental cardiovascular effects, including impaired vascular function, raised blood pressure, alterations in cardiac rhythm, blood clotting disorders, coronary artery disease, and stroke. Considerable headway has been made in elucidating the biological processes underlying these associations, revealing a labyrinth of multiple interacting mechanistic pathways. Several studies have used pharmacological agents to prevent or reverse the cardiovascular effects of PM; an approach that not only has the advantages of elucidating mechanisms, but also potentially revealing therapeutic agents that could benefit individuals that are especially susceptible to the effects of air pollution. This review gathers investigations with pharmacological agents, offering insight into the biology of how PM, and other air pollutants, may cause cardiovascular morbidity.
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Wolhuter K, Arora M, Kovacic JC. Air pollution and cardiovascular disease: Can the Australian bushfires and global COVID-19 pandemic of 2020 convince us to change our ways? Bioessays 2021; 43:e2100046. [PMID: 34106476 PMCID: PMC8209912 DOI: 10.1002/bies.202100046] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/10/2021] [Accepted: 05/25/2021] [Indexed: 12/13/2022]
Abstract
Air pollution is a major global challenge for a multitude of reasons. As a specific concern, there is now compelling evidence demonstrating a causal relationship between exposure to airborne pollutants and the onset of cardiovascular disease (CVD). As such, reducing air pollution as a means to decrease cardiovascular morbidity and mortality should be a global health priority. This review provides an overview of the cardiovascular effects of air pollution and uses two major events of 2020-the Australian bushfires and COVID-19 pandemic lockdown-to illustrate the relationship between air pollution and CVD. The bushfires highlight the substantial human and economic costs associated with elevations in air pollution. Conversely, the COVID-19-related lockdowns demonstrated that stringent measures are effective at reducing airborne pollutants, which in turn resulted in a potential reduction in cardiovascular events. Perhaps one positive to come out of 2020 will be the recognition that tough measures are effective at reducing air pollution and that these measures have the potential to stop thousands of deaths from CVD.
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Affiliation(s)
| | - Manish Arora
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Jason C. Kovacic
- Victor Chang Cardiac Research InstituteSydneyAustralia
- St Vincent's Clinical SchoolUniversity of New South WalesSydneyAustralia
- Zena and Michael A. Wiener Cardiovascular InstituteIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
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Lozano-Sabido ED, Berrios-Barcenas EA, Cazares-Diazleal AC, Viveros-Renterìa E, Àlvarez-Mosquera JB, Portos-Silva JM, Kiamco-Castillo CR. "ST-elevation myocardial infarction associated with air pollution levels in Mexico City". IJC HEART & VASCULATURE 2021; 35:100846. [PMID: 34386574 PMCID: PMC8342967 DOI: 10.1016/j.ijcha.2021.100846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 07/15/2021] [Accepted: 07/17/2021] [Indexed: 11/29/2022]
Abstract
Background Coronary heart disease has multiple risk factors, including air pollution. Numerous pathophysiological mechanisms have been identified with increasing levels of air pollution, mainly with ozone (O3), nitrogen dioxide (NO2), sulphur dioxide (SO2), particulate matter (PM10), fine particulate matter (PM2.5) and carbon monoxide (CO). In Mexico, the pollution level is reported using an air quality index called IMECA. Methods All patients with STEMI admitted at Hospital Español were collected between 2012 and 2019 (N = 348). We conducted a retrospective analysis using the air pollution exposure at the time of each event (lag0), the previous 24 h (lag1), 48 h (lag2), 72 h (lag3) and 5-day cumulative lag. The level of air pollution was analyzed independently using IMECA and particle concentrations. The data was divided in two groups: days with one of more STEMI’s (MI group) and days free of events (Control group), using ANCOVA to evaluate the difference between means of both groups taking into account confounders. Results: For days with one or more cardiovascular event, a significant increase in SO2 was observed at lag1; similar increase was found in CO, PM2.5, SO2 at lag2. For the 5-day cumulative lag, SO2 and PM2.5 showed a significant increase. No differences were found using the IMECA levels in both groups. Conclusions: The elevated concentrations levels of CO, SO2 and PM2.5 showed significant association with STEMI at different time points before the event. Ozone, PM10 and NO2 showed no difference between groups. IMECA levels showed no association with STEMI in our study.
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Affiliation(s)
- E D Lozano-Sabido
- Department of Cardiology, Hospital Español, Ciudad de México. Ejército Nacional 613, Miguel Hidalgo, Mexico City, Mexicos
| | - E A Berrios-Barcenas
- Department of Cardiology, Division of Cardiac imaging, Hospital Español, Ciudad de México. Ejército Nacional 613, Miguel Hidalgo, Mexico City, Mexico
| | - A C Cazares-Diazleal
- Department of Interventional Cardiology, Hospital Español, Ciudad de México. Ejército Nacional 613, Miguel Hidalgo, Mexico City, Mexico
| | - E Viveros-Renterìa
- Department of Cardiology, Hospital Español, Ciudad de México. Ejército Nacional 613, Miguel Hidalgo, Mexico City, Mexico
| | - J B Àlvarez-Mosquera
- Chief of Cardiology Department, Hospital Español, Ciudad de México. Ejército Nacional 613, Miguel Hidalgo, Mexico City, Mexico
| | - J M Portos-Silva
- Department of Cardiology, Hospital Español, Ciudad de México. Ejército Nacional 613, Miguel Hidalgo, Mexico City, Mexico
| | - C R Kiamco-Castillo
- Department of Interventional Cardiology. Hospital Español, Ciudad de México. Ejército Nacional 613, Miguel Hidalgo, Mexico City, Mexico
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Lai A, Chang ML, O'Donnell RP, Zhou C, Sumner JA, Hsiai TK. Association of COVID-19 transmission with high levels of ambient pollutants: Initiation and impact of the inflammatory response on cardiopulmonary disease. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 779:146464. [PMID: 33961545 PMCID: PMC7960028 DOI: 10.1016/j.scitotenv.2021.146464] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 05/14/2023]
Abstract
Ambient air pollution contributes to 7 million premature deaths annually. Concurrently, the ongoing coronavirus disease 2019 (COVID-19) pandemic, complicated with S-protein mutations and other variants, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in over 2.5 million deaths globally. Chronic air pollution-mediated cardiopulmonary diseases have been associated with an increased incidence of hospitalization and mechanical ventilation following COVID-19 transmission. While the underlying mechanisms responsible for this association remain elusive, air pollutant-induced vascular oxidative stress and inflammatory responses have been implicated in amplifying COVID-19-mediated cytokine release and vascular thrombosis. In addition, prolonged exposure to certain types of particulate matter (PM2.5, d < 2.5 μm) has also been correlated with increased lung epithelial and vascular endothelial expression of the angiotensin-converting enzyme-2 (ACE2) receptors to which the SARS-CoV-2 spike glycoproteins (S) bind for fusion and internalization into host cells. Emerging literature has linked high rates of SARS-CoV-2 infection to regions with elevated levels of PM2.5, suggesting that COVID-19 lockdowns have been implicated in regional reductions in air pollutant-mediated cardiopulmonary effects. Taken together, an increased incidence of SARS-CoV-2-mediated cardiopulmonary diseases seems to overlap with highly polluted regions. To this end, we will review the redox-active components of air pollutants, the pathophysiology of SARS-CoV-2 transmission, and the key oxidative mechanisms and ACE2 overexpression underlying air pollution-exacerbated SARS-CoV-2 transmission.
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Affiliation(s)
- Angela Lai
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, United States of America
| | - Megan L Chang
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, United States of America
| | - Ryan P O'Donnell
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, United States of America
| | - Changcheng Zhou
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, CA, United States of America
| | - Jennifer A Sumner
- Department of Psychology, College of Life Sciences, University of California, Los Angeles, United States of America
| | - Tzung K Hsiai
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, United States of America; Department of Medicine, Greater Los Angeles VA Healthcare System, Los Angeles, CA, United States of America; Department of Bioengineering, Henry Samueli School of Engineering & Applied Science, University of California, Los Angeles, CA, United States of America.
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Hu D, Jia X, Cui L, Liu J, Chen J, Wang Y, Niu W, Xu J, Miller MR, Loh M, Deng F, Guo X. Exposure to fine particulate matter promotes platelet activation and thrombosis via obesity-related inflammation. JOURNAL OF HAZARDOUS MATERIALS 2021; 413:125341. [PMID: 33596527 DOI: 10.1016/j.jhazmat.2021.125341] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/21/2021] [Accepted: 02/02/2021] [Indexed: 06/12/2023]
Abstract
Short-term exposure to fine particulate matter (PM2.5) increases thrombotic risk particularly in obese individuals, but the underlying mechanisms remain unclear. This study aims to compare the effects of PM2.5 on inflammation and platelet activation in obese versus normal-weight adults, and investigate potential causal pathways. We conducted a panel study measuring blood markers in 44 obese and 53 normal-weight adults on 3 separate occasions in 2017-2018. Associations between PM2.5/black carbon (BC) and biomarkers were estimated using mixed-effect models. An interaction analysis compared PM2.5/BC-related effects between subgroups. Biomarker combinations and mediation analysis were performed to elucidate the biological pathways. There was a significant "low-high-low" trend of PM2.5 levels across the 3 study periods. Increases in pro-inflammatory cytokines and changes of platelet activation and aggregation markers were associated with PM2.5/BC in obese subgroup only. Among obese subjects, the combination of pro-inflammatory cytokines and that of platelet markers increased 26.8% (95% CI: 16.0%, 37.9%) and 14.7% (95% CI: 1.9%, 27.0%) per IQR increase in PM2.5 over 5-day and 7-day averages. Inflammation mediated 24.5% of the pathways through which PM2.5 promoted platelet activation. This study suggested obese people are susceptible to pro-thrombotic impacts of PM2.5 exposures. PM2.5 may aggravate thrombosis through obesity-related inflammation.
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Affiliation(s)
- Dayu Hu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xu Jia
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Liyan Cui
- Department of Laboratory Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Junxiu Liu
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing 100191, China
| | - Jiahui Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Yazheng Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Wei Niu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Junhui Xu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Mark R Miller
- University/BHF Centre for Cardiovascular Science, Queens Medical Research Institute, The University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Research Avenue North Riccarton, Edinburgh EH14 4AP, UK
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
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Unosson J, Kabéle M, Boman C, Nyström R, Sadiktsis I, Westerholm R, Mudway IS, Purdie E, Raftis J, Miller MR, Mills NL, Newby DE, Blomberg A, Sandström T, Bosson JA. Acute cardiovascular effects of controlled exposure to dilute Petrodiesel and biodiesel exhaust in healthy volunteers: a crossover study. Part Fibre Toxicol 2021; 18:22. [PMID: 34127003 PMCID: PMC8204543 DOI: 10.1186/s12989-021-00412-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 05/04/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Air pollution derived from combustion is associated with considerable cardiorespiratory morbidity and mortality in addition to environmental effects. Replacing petrodiesel with biodiesel may have ecological benefits, but impacts on human health remain unquantified. The objective was to compare acute cardiovascular effects of blended and pure biodiesel exhaust exposure against known adverse effects of petrodiesel exhaust (PDE) exposure in human subjects. In two randomized controlled double-blind crossover studies, healthy volunteers were exposed to PDE or biodiesel exhaust for one hour. In study one, 16 subjects were exposed, on separate occasions, to PDE and 30% rapeseed methyl ester biodiesel blend (RME30) exhaust, aiming at PM10 300 μg/m3. In study two, 19 male subjects were separately exposed to PDE and exhaust from a 100% RME fuel (RME100) using similar engine load and exhaust dilution. Generated exhaust was analyzed for physicochemical composition and oxidative potential. Following exposure, vascular endothelial function was assessed using forearm venous occlusion plethysmography and ex vivo thrombus formation was assessed using a Badimon chamber model of acute arterial injury. Biomarkers of inflammation, platelet activation and fibrinolysis were measured in the blood. RESULTS In study 1, PDE and RME30 exposures were at comparable PM levels (314 ± 27 μg/m3; (PM10 ± SD) and 309 ± 30 μg/m3 respectively), whereas in study 2, the PDE exposure concentrations remained similar (310 ± 34 μg/m3), but RME100 levels were lower in PM (165 ± 16 μg/m3) and PAHs, but higher in particle number concentration. Compared to PDE, PM from RME had less oxidative potential. Forearm infusion of the vasodilators acetylcholine, bradykinin, sodium nitroprusside and verapamil resulted in dose-dependent increases in blood flow after all exposures. Vasodilatation and ex vivo thrombus formation were similar following exposure to exhaust from petrodiesel and the two biodiesel formulations (RME30 and RME100). There were no significant differences in blood biomarkers or exhaled nitric oxide levels between exposures. CONCLUSIONS Despite differences in PM composition and particle reactivity, controlled exposure to biodiesel exhaust was associated with similar cardiovascular effects to PDE. We suggest that the potential adverse health effects of biodiesel fuel emissions should be taken into account when evaluating future fuel policies. TRIAL REGISTRATION ClinicalTrials.gov, NCT01337882 /NCT01883466. Date of first enrollment March 11, 2011, registered April 19, 2011, i.e. retrospectively registered.
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Affiliation(s)
- Jon Unosson
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Mikael Kabéle
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
| | - Christoffer Boman
- Thermochemical Energy Conversion Laboratory, Umeå University, Umeå, Sweden
| | - Robin Nyström
- Thermochemical Energy Conversion Laboratory, Umeå University, Umeå, Sweden
| | - Ioannis Sadiktsis
- Department of Materials and Environmental Chemistry, Stockholm University, Stockholm, Sweden
| | - Roger Westerholm
- Department of Materials and Environmental Chemistry, Stockholm University, Stockholm, Sweden
| | - Ian S. Mudway
- MRC-PHE Centre for Environment and Health, NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, UK
| | - Esme Purdie
- MRC-PHE Centre for Environment and Health, NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, UK
| | - Jennifer Raftis
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK
| | - Mark R. Miller
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Nicholas L. Mills
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - David E. Newby
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Anders Blomberg
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
| | - Thomas Sandström
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
- Dept. of Medicine, Division of Respiratory Med, University Hospital, 90185 Umeå, Sweden
| | - Jenny A. Bosson
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
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Yan Y, Chen X, Guo Y, Wu C, Zhao Y, Yang N, Dai J, Gong J, Xiang H. Ambient air pollution and cerebrovascular disease mortality: an ecological time-series study based on 7-year death records in central China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:27299-27307. [PMID: 33511535 DOI: 10.1007/s11356-021-12474-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/11/2021] [Indexed: 06/12/2023]
Abstract
Most studies of short-term exposure to ambient air pollution and cerebrovascular diseases focused on specific stroke-related outcomes, and results were inconsistent due to data unavailability and limited sample size. It is unclear yet how ambient air pollution contributes to the total cardiovascular mortality in central China. Daily deaths from cerebrovascular diseases were obtained from the Disease Surveillance Point System (DSPs) of Wuhan Center for Disease Control and Prevention during the period from 2013 to 2019. Air pollution data were obtained from Wuhan Ecology and Environment Institute from 10 national air quality monitoring stations, including average daily PM2.5, PM10, SO2, NO2, and O3. Average daily temperature and relative humidity were obtained from Wuhan Meteorological Bureau. We performed a Poisson regression in generalized additive models (GAM) to examine the association between ambient air pollution and cerebrovascular disease mortality. We observed a total of 84,811 deaths from cerebrovascular diseases from 1 January 2013 to 31 December 2019 in Wuhan. Short-term exposure to PM2.5, PM10, SO2, and NO2 was positively associated with daily deaths from cerebrovascular diseases, and no significant association was found for O3. The largest effect on cerebrovascular disease mortality was found at lag0 for PM2.5 (ERR: 0.927, 95% CI: 0.749-1.105 per 10 μg/m3) and lag1 for PM10 (ERR: 0.627, 95% CI: 0.493-0.761 per 10 μg/m3), SO2 (ERR: 2.518, 95% CI: 1.914, 3.122 per 10 μg/m3), and NO2 (ERR: 1.090, 95% CI: 0.822-1.358 per 10 μg/m3). The trends across lags were statistically significant. The stratified analysis demonstrated that females were more susceptible to SO2 and NO2, while elder individuals aged above 65 years old, compared with younger people, suffered more from air pollution, especially from SO2. Short-term exposure to PM2.5, PM10, SO2, and NO2 were significantly associated with a higher risk of cerebrovascular disease mortality, and elder females seemed to suffer more from air pollution. Further research is required to reveal the underlying mechanisms.
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Affiliation(s)
- Yaqiong Yan
- Wuhan Centers for Disease Control and Prevention, No.288 Machang Road, Wuhan, China
| | - Xi Chen
- Wuhan Centers for Disease Control and Prevention, No.288 Machang Road, Wuhan, China
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Yan Guo
- Wuhan Centers for Disease Control and Prevention, No.288 Machang Road, Wuhan, China
| | - Chuangxin Wu
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Yuanyuan Zhao
- Wuhan Centers for Disease Control and Prevention, No.288 Machang Road, Wuhan, China
| | - Niannian Yang
- Wuhan Centers for Disease Control and Prevention, No.288 Machang Road, Wuhan, China
| | - Juan Dai
- Wuhan Centers for Disease Control and Prevention, No.288 Machang Road, Wuhan, China
| | - Jie Gong
- Wuhan Centers for Disease Control and Prevention, No.288 Machang Road, Wuhan, China.
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China.
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Rankin GD, Kabéle M, Brown R, Macefield VG, Sandström T, Bosson JA. Acute Exposure to Diesel Exhaust Increases Muscle Sympathetic Nerve Activity in Humans. J Am Heart Assoc 2021; 10:e018448. [PMID: 33942621 PMCID: PMC8200707 DOI: 10.1161/jaha.120.018448] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Diesel exhaust (DE) emissions are a major contributor to ambient air pollution and are strongly associated with cardiovascular morbidity and mortality. Exposure to traffic‐related particulate matter is linked with acute adverse cardiovascular events; however, the mechanisms are not fully understood. We examined the role of the autonomic nervous system during exposure to DE that has previously only been indirectly investigated. Methods and Results Using microneurography, we measured muscle sympathetic nerve activity (MSNA) directly in the peroneal nerve of 16 healthy individuals. MSNA, heart rate, and respiration were recorded while subjects rested breathing filtered air, filtered air with an exposure mask, and standardized diluted DE (300 µg/m3) through the exposure mask. Heart rate variability was assessed from an ECG. DE inhalation rapidly causes an increase in number of MSNA bursts as well as the size of bursts within 10 minutes, peaking by 30 minutes (P<0.001), compared with baseline filtered air with an exposure mask. No significant changes occurred in heart rate variability indices during DE exposure; however, MSNA frequency correlated negatively with total power (r2=0.294, P=0.03) and low frequency (r2=0.258, P=0.045). Heart rate correlated positively with MSNA frequency (r2=0.268, P=0.04) and the change in percentage of larger bursts (burst amplitude, height >50% of the maximum burst) from filtered air with an exposure mask (r2=0.368, P=0.013). Conclusions Our study provides direct evidence for the rapid modulation of the autonomic nervous system after exposure to DE, with an increase in MSNA. The quick increase in sympathetic outflow may explain the strong epidemiological data associating traffic‐related particulate matter to acute adverse cardiovascular events such as myocardial infarction. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02892279.
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Affiliation(s)
- Gregory D Rankin
- Department of Public Health and Clinical Medicine Section of Medicine/Respiratory Umeå University Umeå Sweden
| | - Mikael Kabéle
- Department of Public Health and Clinical Medicine Section of Medicine/Respiratory Umeå University Umeå Sweden
| | - Rachael Brown
- School of Medicine Western Sydney University Sydney NSW Australia
| | - Vaughan G Macefield
- Human Autonomic Neurophysiology Laboratory School of Medicine Baker Heart and Diabetes Institute Melbourne Vic. Australia.,Department of Physiology School of Biomedical Sciences The University of Melbourne Melbourne Vic. Australia
| | - Thomas Sandström
- Department of Public Health and Clinical Medicine Section of Medicine/Respiratory Umeå University Umeå Sweden
| | - Jenny A Bosson
- Department of Public Health and Clinical Medicine Section of Medicine/Respiratory Umeå University Umeå Sweden
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Orach J, Rider CF, Carlsten C. Concentration-dependent health effects of air pollution in controlled human exposures. ENVIRONMENT INTERNATIONAL 2021; 150:106424. [PMID: 33596522 DOI: 10.1016/j.envint.2021.106424] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/21/2021] [Accepted: 01/26/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Air pollution is a leading contributor to premature mortality worldwide and is often represented by particulate matter (PM), a key contributor to its harmful health effects. Concentration-response relationships are useful for quantifying the effects of air pollution in relevant populations and in considering potential effect thresholds. Controlled human exposures can provide data on acute effects and concentration-response relationships that complement epidemiological studies. OBJECTIVES We examined PM concentration-responses after controlled human air pollution exposures to examine exposure-response markers, assess effect modifiers, and identify potential effect thresholds. METHODS We reviewed primary research from published controlled human exposure studies where responses were reported at multiple target PM concentrations or summarized per unit change in PM to identify concentration-dependent effects. RESULTS Of the 191 publications identified through PubMed and supplementary searches, 31 were eligible. Eligible studies collectively represented four pollutant models: concentrated ambient particles, engineered carbon nanoparticles, diesel exhaust, and woodsmoke. We identified concentration-dependent effects on oxidative stress markers, inflammation, and cardiovascular function that overlapped across different pollutants. Metabolic syndrome and glutathione s-transferase mu 1 genotype were identified as potential effect modifiers. DISCUSSION Improved understanding of concentration-response relationships is integral to biomonitoring and mitigation of health effects through impact assessment and policy. Although we identified potential concentration-response markers, thresholds, and modifiers, our conclusions on these relationships were limited by a dearth of eligible publications, considerable variability in methodology, and inconsistent reporting standards between studies. More research is required to validate these observations. We recommend that future studies harmonize estimate reporting to facilitate the identification of robust response markers across research and applied settings.
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Affiliation(s)
- Juma Orach
- Air Pollution Exposure Laboratory, Division of Respiratory Medicine, Department of Medicine, Vancouver Coastal Health Research Institute, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Christopher F Rider
- Air Pollution Exposure Laboratory, Division of Respiratory Medicine, Department of Medicine, Vancouver Coastal Health Research Institute, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Christopher Carlsten
- Air Pollution Exposure Laboratory, Division of Respiratory Medicine, Department of Medicine, Vancouver Coastal Health Research Institute, The University of British Columbia, Vancouver, British Columbia, Canada.
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Wu J, Ning Y, Gao Y, Shan R, Wang B, Lv J, Li L. Association between Ambient Air Pollution and MRI-Defined Brain Infarcts in Health Examinations in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084325. [PMID: 33921763 PMCID: PMC8072670 DOI: 10.3390/ijerph18084325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 11/16/2022]
Abstract
The study aimed to evaluate the relationships between air pollutants and risk of magnetic resonance imaging (MRI)-defined brain infarcts (BI). We used data from routine health examinations of 1,400,503 participants aged ≥18 years who underwent brain MRI scans in 174 cities in 30 provinces in China in 2018. We assessed exposures to particulate matter (PM)2.5, PM10, nitrogen dioxide (NO2), and carbon monoxide (CO) from 2015 to 2017. MRI-defined BI was defined as lesions ≥3 mm in diameter. Air pollutants were associated with a higher risk of MRI-defined BI. The odds ratio (OR) (95% CI) for MRI-defined BI comparing the highest with the lowest tertiles of air pollutant concentrations was 2.00 (1.96–2.03) for PM2.5, 1.68 (1.65–1.71) for PM10, 1.58 (1.55–1.61) for NO2, and 1.57 (1.54–1.60) for CO. Each SD increase in air pollutants was associated with 16–42% increases in the risk of MRI-defined BI. The associations were stronger in the elderly subgroup. This is the largest survey to evaluate the association between air pollution and MRI-defined BI. Our findings indicate that ambient air pollution was significantly associated with a higher risk of MRI-defined BI.
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Affiliation(s)
- Jing Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (J.W.); (R.S.); (J.L.)
| | - Yi Ning
- Meinian Public Health Institute, Peking University Health Science Center, Beijing 100191, China;
- Meinian Institute of Health, Beijing 100191, China;
- Correspondence: (Y.N.); (L.L.); Tel.: +86-0089-3791 (Y.N.); +86-10-828-01528 (ext. 321) (L.L.)
| | | | - Ruiqi Shan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (J.W.); (R.S.); (J.L.)
| | - Bo Wang
- Meinian Public Health Institute, Peking University Health Science Center, Beijing 100191, China;
- Meinian Institute of Health, Beijing 100191, China;
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (J.W.); (R.S.); (J.L.)
- Meinian Public Health Institute, Peking University Health Science Center, Beijing 100191, China;
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (J.W.); (R.S.); (J.L.)
- Meinian Public Health Institute, Peking University Health Science Center, Beijing 100191, China;
- Correspondence: (Y.N.); (L.L.); Tel.: +86-0089-3791 (Y.N.); +86-10-828-01528 (ext. 321) (L.L.)
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Abstract
Climate change is one of the biggest challenges humanity is facing in the 21st century. Two recognized sequelae of climate change are global warming and air pollution. The gradual increase in ambient temperature, coupled with elevated pollution levels have a devastating effect on our health, potentially contributing to the increased rate and severity of numerous neurological disorders. The main aim of this review paper is to shed some light on the association between the phenomena of global warming and air pollution, and two of the most common and debilitating neurological conditions: stroke and neurodegenerative disorders. Extreme ambient temperatures induce neurological impairment and increase stroke incidence and mortality. Global warming does not participate in the etiology of neurodegenerative disorders, but it exacerbates symptoms of dementia, Alzheimer's disease (AD) and Parkinson's Disease (PD). A very close link exists between accumulated levels of air pollutants (principally particulate matter), and the incidence of ischemic rather than hemorrhagic strokes. People exposed to air pollutants have a higher risk of developing dementia and AD, but not PD. Oxidative stress, changes in cardiovascular and cerebrovascular haemodynamics, excitotoxicity, microglial activation, and cellular apoptosis, all play a central role in the overlap of the effect of climate change on neurological disorders. The complex interactions between global warming and air pollution, and their intricate effect on the nervous system, imply that future policies aimed to mitigate climate change must address these two challenges in unison.
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Affiliation(s)
- Christian Zammit
- Anatomy Department, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
| | - Natalia Torzhenskaya
- Anatomy Department, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
| | | | - Jean Calleja Agius
- Anatomy Department, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
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