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Vuillermoz A, Lefranc M, Prouvez N, Brault C, Zerbib Y, Schmitt M, Forel JM, Le Tutour M, Lesimple A, Mercat A, Richard JC, Beloncle FM. Modes of administration of nitric oxide devices and ventilators flow-by impact the delivery of pre-determined concentrations. Ann Intensive Care 2024; 14:130. [PMID: 39167232 PMCID: PMC11339004 DOI: 10.1186/s13613-024-01351-w] [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: 02/12/2024] [Accepted: 07/11/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Nitric oxide (NO) is a strong vasodilator, selectively directed on pulmonary circulation through inhaled administration. In adult intensive care units (ICU), it is mainly used for refractory hypoxemia in mechanically ventilated patients. Several medical delivery devices have been developed to deliver inhaled nitric oxide (iNO). The main purpose of those devices is to guarantee an accurate inspiratory NO concentration, whatever the ventilator used, with NO2 concentrations lower than 0.3 ppm. We hypothesized that the performances of the different available iNO delivery systems could depend on their working principle and could be influenced by the ventilator settings. The objective of this study was to assess the accuracy of seven different iNO-devices combined with different ICU ventilators' flow-by to reach inspiratory NO concentration targets and to evaluate their potential risk of toxicity. METHODS We tested seven iNO-devices on a test-lung connected to distinct ICU ventilators offering four different levels of flow-by. We measured the flow in the inspiratory limb of the patient circuit and the airway pressure. The nitric oxide/nitrogen (NO/N2) flow was measured on the administration line of the iNO-devices. NO and NO2 concentrations were measured in the test-lung using an electrochemical analyzer. RESULTS We identified three iNO-device generations based on the way they deliver NO flow: "Continuous", "Sequential to inspiratory phase" (I-Sequential) and "Proportional to inspiratory and expiratory ventilator flow" (Proportional). Median accuracy of iNO concentration measured in the test lung was 2% (interquartile range, IQR -19; 36), -23% (IQR -29; -17) and 0% (IQR -2; 0) with Continuous, I-Sequential and Proportional devices, respectively. Increased ventilator flow-by resulted in decreased iNO concentration in the test-lung with Continuous and I-Sequential devices, but not with Proportional ones. NO2 formation measured to assess potential risks of toxicity never exceeded the predefined safety target of 0.5 ppm. However, NO2 concentrations higher than or equal to 0.3 ppm, a concentration that can cause bronchoconstriction, were observed in 19% of the different configurations. CONCLUSION We identified three different generations of iNO-devices, based on their gas administration modalities, that were associated with highly variable iNO concentrations' accuracy. Ventilator's flow by significantly impacted iNO concentration. Only the Proportional devices permitted to accurately deliver iNO whatever the conditions and the ventilators tested.
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Affiliation(s)
- Alice Vuillermoz
- Vent'Lab, Medical Intensive Care Unit, University Hospital of Angers, Angers, France
- University of Angers, Angers, France
| | - Mathilde Lefranc
- Vent'Lab, Medical Intensive Care Unit, University Hospital of Angers, Angers, France
- University of Angers, Angers, France
- Med2Lab, Air Liquide Medical Systems, Antony, France
| | | | - Clément Brault
- Medical Intensive Care Unit, Amiens University Hospital, Amiens, France
| | - Yoann Zerbib
- Medical Intensive Care Unit, Amiens University Hospital, Amiens, France
| | - Mary Schmitt
- Air Liquide Santé International, Bagneux, France
| | - Jean-Marie Forel
- Medical Intensive Care Unit, APHM Hôpital Nord, Marseille, France
| | - Mathieu Le Tutour
- Vent'Lab, Medical Intensive Care Unit, University Hospital of Angers, Angers, France
| | - Arnaud Lesimple
- Vent'Lab, Medical Intensive Care Unit, University Hospital of Angers, Angers, France
- Med2Lab, Air Liquide Medical Systems, Antony, France
| | - Alain Mercat
- Vent'Lab, Medical Intensive Care Unit, University Hospital of Angers, Angers, France
- University of Angers, Angers, France
| | - Jean-Christophe Richard
- Vent'Lab, Medical Intensive Care Unit, University Hospital of Angers, Angers, France
- Med2Lab, Air Liquide Medical Systems, Antony, France
| | - François M Beloncle
- Vent'Lab, Medical Intensive Care Unit, University Hospital of Angers, Angers, France.
- University of Angers, Angers, France.
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Palacio LC, Pachajoa DC, Echeverri-Londoño CA, Saiz J, Tobón C. Air Pollution and Cardiac Diseases: A Review of Experimental Studies. Dose Response 2023; 21:15593258231212793. [PMID: 37933269 PMCID: PMC10625734 DOI: 10.1177/15593258231212793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/20/2023] [Indexed: 11/08/2023] Open
Abstract
Air pollution is associated with around 6.5 million premature deaths annually, which are directly related to cardiovascular diseases, and the most dangerous atmospheric pollutants to health are as follows: NO2, SO2, CO, and PM. The mechanisms underlying the observed effects have not yet been clearly defined. This work aims to conduct a narrative review of experimental studies to provide a more comprehensive and multiperspective assessment of how the effect of atmospheric pollutants on cardiac activity can result in the development of cardiac diseases. For this purpose, a review was carried out in databases of experimental studies, excluding clinical trials, and epidemiological and simulation studies. After analyzing the available information, the existence of pathophysiological effects of the different pollutants on cardiac activity from exposure during both short-term and long-term is evident. This narrative review based on experimental studies is a basis for the development of recommendations for public health.
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Affiliation(s)
| | | | | | - Javier Saiz
- Universitat Politècnica de València, Valencia, Spain
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Hu F, Ye Z, Dong K, Zhang W, Fang D, Cao J. Divergent structures and functions of the Cupin proteins in plants. Int J Biol Macromol 2023; 242:124791. [PMID: 37164139 DOI: 10.1016/j.ijbiomac.2023.124791] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 05/12/2023]
Abstract
Cupin superfamily proteins have extensive functions. Their members are not only involved in the development of plants but also responded to various stresses. Whereas, the research on the Cupin members has not attracted enough attention. In this article, we summarized the research progress on these family genes in recent years and explored their evolution, structural characteristics, and biological functions. The significance of members of the Cupin family in the development of plant cell walls, roots, leaves, flowers, fruits, and seeds and their role in stress response are highlighted. Simultaneously, the prospective application of Cupin protein in crop enhancement was introduced. Some members can enhance plant growth, development, and resistance to adversity, thereby increasing crop yield. It will be as a foundation for future effective crop research and breeding.
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Affiliation(s)
- Fei Hu
- School of Life Sciences, Jiangsu University, Zhenjiang 212013, Jiangsu, China
| | - Ziyi Ye
- School of Life Sciences, Jiangsu University, Zhenjiang 212013, Jiangsu, China
| | - Kui Dong
- School of Life Sciences, Jiangsu University, Zhenjiang 212013, Jiangsu, China
| | - Weimeng Zhang
- School of Life Sciences, Jiangsu University, Zhenjiang 212013, Jiangsu, China
| | - Da Fang
- School of Life Sciences, Jiangsu University, Zhenjiang 212013, Jiangsu, China
| | - Jun Cao
- School of Life Sciences, Jiangsu University, Zhenjiang 212013, Jiangsu, China.
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Chen YC, Chin WS, Pan SC, Wu CD, Guo YLL. Long-Term Exposure to Air Pollution and the Occurrence of Metabolic Syndrome and Its Components in Taiwan. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:17001. [PMID: 36598238 PMCID: PMC9811992 DOI: 10.1289/ehp10611] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 11/19/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Metabolic syndrome (MetS), a major contributor to cardiovascular and metabolic diseases, has been linked with exposure to air pollution. However, the relationship between air pollutants and the five components of MetS [abdominal obesity, elevated triglyceride, decreased high-density lipoprotein cholesterol (HDL-C), elevated blood pressure, and elevated fasting blood glucose levels], has not been clearly described. OBJECTIVE We examined the association between long-term exposure to air pollutants and the occurrence of MetS and its components by using a longitudinal cohort in Taiwan. METHODS The MJ Health Research Foundation is a medical institute that conducts regular physical examinations. The development of MetS, based on a health examination and the medical history of an MJ cohort of 93,771 participants who were enrolled between 2006 and 2016 and had two or more examinations, was compared with estimated exposure to air pollutants in the year prior to health examination. The exposure levels to fine particulate matter [PM with an aerodynamic diameter of ≤2.5μm (PM2.5)] and nitrogen dioxide (NO2) in the participants' residential areas were estimated using a hybrid Kriging/land-use regression (LUR) model executed using the XGBoost algorithm and a hybrid Kriging/LUR model, respectively. Cox regression with time-dependent covariates was conducted to estimate the effects of annual air pollutant exposure on the risk of MetS and its components. RESULTS During the average follow-up period of 3.4 y, the incidence of MetS was 38.1/1,000 person-years. After mutual adjustment and adjustments for potential covariates, the results indicated that every 10-μg/m3 increase in annual PM2.5 concentration was associated with an increased risk of abdominal obesity [adjusted hazard ratio (aHR)=1.07; 95% confidence interval (CI): 1.01, 1.14], hypertriglyceridemia (aHR=1.17; 95% CI: 1.11, 1.23), low HDL-C (aHR=1.09; 95% CI: 1.02, 1.17), hypertension (aHR=1.15; 95% CI: 1.09, 1.21), and elevated fasting blood glucose (aHR=1.15; 95% CI: 1.10, 1.20). Furthermore, PM2.5 and NO2 may increase the risk of developing MetS among people who already "have" some components of MetS. DISCUSSION Our findings suggest that in apparently healthy adults undergoing physical examination, exposure to PM2.5 and NO2 might be associated with the occurrence of MetS and its components. https://doi.org/10.1289/EHP10611.
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Affiliation(s)
- Yi-Chuan Chen
- National Institute of Environmental Health Sciences, National Health Research Institute, Miaoli, Taiwan
| | - Wei-Shan Chin
- School of Nursing, College of Medicine, National Taiwan University (NTU), Taipei, Taiwan
- Department of Nursing, NTU Hospital, Taipei, Taiwan
| | - Shih-Chun Pan
- National Institute of Environmental Health Sciences, National Health Research Institute, Miaoli, Taiwan
| | - Chih-Da Wu
- National Institute of Environmental Health Sciences, National Health Research Institute, Miaoli, Taiwan
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan
| | - Yue-Liang Leon Guo
- National Institute of Environmental Health Sciences, National Health Research Institute, Miaoli, Taiwan
- Environmental and Occupational Medicine, College of Medicine, NTU and NTU Hospital, Taipei, Taiwan
- Graduate Institute of Environmental and Occupational Health Science, College of Public Health, NTU, Taipei, Taiwan
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Fu Y, Zhang W, Li Y, Li H, Deng F, Ma Q. Association and interaction of O 3 and NO 2 with emergency room visits for respiratory diseases in Beijing, China: a time-series study. BMC Public Health 2022; 22:2265. [PMID: 36464692 PMCID: PMC9721066 DOI: 10.1186/s12889-022-14473-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 10/26/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Ozone (O3) and nitrogen dioxide (NO2) are the two main gaseous pollutants in the atmosphere that act as oxidants. Their short-term effects and interaction on emergency room visits (ERVs) for respiratory diseases remain unclear. METHODS We conducted a time-series study based on 144,326 ERVs for respiratory diseases of Peking University Third Hospital from 2014 to 2019 in Beijing, China. Generalized additive models with quasi-Poisson regression were performed to analyze the association of O3, NO2 and their composite indicators (Ox and Oxwt) with ERVs for respiratory diseases. An interaction model was further performed to evaluate the interaction between O3 and NO2. RESULTS Exposure to O3, NO2, Ox and Oxwt was positively associated with ERVs for total respiratory diseases and acute upper respiratory infection (AURI). For instance, a 10 μg/m3 increase in O3 and NO2 were associated with 0.93% (95%CI: 0.05%, 1.81%) and 5.87% (95%CI: 3.92%, 7.85%) increase in AURI at lag0-5 days, respectively. Significant linear exposure-response relationships were observed in Ox and Oxwt over the entire concentration range. In stratification analysis, stronger associations were observed in the group aged < 18 years for both O3 and NO2, in the warm season for O3, but in the cold season for NO2. In interaction analysis, the effect of O3 on total respiratory emergency room visits and AURI visits was the strongest at high levels (> 75% quantile) of NO2 in the < 18 years group. CONCLUSIONS Short-term exposure to O3 and NO2 was positively associated with ERVs for respiratory diseases, particularly in younger people (< 18 years). This study for the first time demonstrated the synergistic effect of O3 and NO2 on respiratory ERVs, and Ox and Oxwt may be potential proxies.
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Affiliation(s)
- Yuanwei Fu
- grid.411642.40000 0004 0605 3760Emergency Department, Peking University Third Hospital, Beijing, 100191 China
| | - Wenlou Zhang
- grid.11135.370000 0001 2256 9319Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191 China
| | - Yan Li
- grid.411642.40000 0004 0605 3760Emergency Department, Peking University Third Hospital, Beijing, 100191 China
| | - Hongyu Li
- grid.11135.370000 0001 2256 9319Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191 China
| | - Furong Deng
- grid.11135.370000 0001 2256 9319Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191 China
| | - Qingbian Ma
- grid.411642.40000 0004 0605 3760Emergency Department, Peking University Third Hospital, Beijing, 100191 China
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Álvaro-Meca A, Sepúlveda-Crespo D, Resino R, Ryan P, Martínez I, Resino S. Neighborhood environmental factors linked to hospitalizations of older people for viral lower respiratory tract infections in Spain: a case-crossover study. Environ Health 2022; 21:107. [PMID: 36348411 PMCID: PMC9640778 DOI: 10.1186/s12940-022-00928-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Lower respiratory tract viral infection (LRTI) is a significant cause of morbidity-mortality in older people worldwide. We analyzed the association between short-term exposure to environmental factors (climatic factors and outdoor air pollution) and hospital admissions with a viral LRTI diagnosis in older adults. METHODS We conducted a bidirectional case-crossover study in 6367 patients over 65 years of age with viral LRTI and residential zip code in the Spanish Minimum Basic Data Set. Spain's State Meteorological Agency was the source of environmental data. Associations were assessed using conditional logistic regression. P-values were corrected for false discovery rate (q-values). RESULTS Almost all were hospital emergency admissions (98.13%), 18.64% were admitted to the intensive care unit (ICU), and 7.44% died. The most frequent clinical discharge diagnosis was influenza (90.25%). LRTI hospital admissions were more frequent when there were lower values of temperature and O3 and higher values of relative humidity and NO2. The regression analysis adjusted by temperatures and relative humidity showed higher concentrations at the hospital admission for NO2 [compared to the lag time of 1-week (q-value< 0.001) and 2-weeks (q-value< 0.001)] and O3 [compared to the lag time of 3-days (q-value< 0.001), 1-week (q-value< 0.001), and 2-weeks (q-value< 0.001)] were related to a higher odds of hospital admissions due to viral LRTI. Moreover, higher concentrations of PM10 at the lag time of 1-week (q-value = 0.023) and 2-weeks (q-value = 0.002), and CO at the lag time of 3-days (q-value = 0.023), 1-week (q-value< 0.001) and 2-weeks (q-value< 0.001)], compared to the day of hospitalization, were related to a higher chances of hospital admissions with viral LRTI. CONCLUSION Unfavorable environmental factors (low temperatures, high relative humidity, and high concentrations of NO2, O3, PM10, and CO) increased the odds of hospital admissions with viral LRTI among older people, indicating they are potentially vulnerable to these environmental factors.
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Affiliation(s)
- Alejandro Álvaro-Meca
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Daniel Sepúlveda-Crespo
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Rosa Resino
- Departamento de Geografía, Facultad de Geografía e Historia, Universidad Complutense de Madrid, Madrid, Spain
| | - Pablo Ryan
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Infanta Leonor, Madrid, Spain
- Universidad Complutense de Madrid (UCM), Madrid, Spain
- Instituto de Investigaciones Sanitarias Gregorio Marañón (IiSGM), Madrid, Spain
| | - Isidoro Martínez
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Salvador Resino
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
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Opoku‐Damoah Y, Zhang R, Ta HT, Xu ZP. Therapeutic gas-releasing nanomedicines with controlled release: Advances and perspectives. EXPLORATION (BEIJING, CHINA) 2022; 2:20210181. [PMID: 37325503 PMCID: PMC10190986 DOI: 10.1002/exp.20210181] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/15/2022] [Indexed: 06/16/2023]
Abstract
Nanoparticle-based drug delivery has become one of the most popular approaches for maximising drug therapeutic potentials. With the notable improvements, a greater challenge hinges on the formulation of gasotransmitters with unique challenges that are not met in liquid and solid active ingredients. Gas molecules upon release from formulations for therapeutic purposes have not really been discussed extensively. Herein, we take a critical look at four key gasotransmitters, that is, carbon monoxide (CO), nitric oxide (NO), hydrogen sulphide (H2S) and sulphur dioxide (SO2), their possible modification into prodrugs known as gas-releasing molecules (GRMs), and their release from GRMs. Different nanosystems and their mediatory roles for efficient shuttling, targeting and release of these therapeutic gases are also reviewed extensively. This review thoroughly looks at the diverse ways in which these GRM prodrugs in delivery nanosystems are designed to respond to intrinsic and extrinsic stimuli for sustained release. In this review, we seek to provide a succinct summary for the development of therapeutic gases into potent prodrugs that can be adapted in nanomedicine for potential clinical use.
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Affiliation(s)
- Yaw Opoku‐Damoah
- Australian Institute for Bioengineering and NanotechnologyThe University of QueenslandBrisbaneQueenslandAustralia
| | - Run Zhang
- Australian Institute for Bioengineering and NanotechnologyThe University of QueenslandBrisbaneQueenslandAustralia
| | - Hang T. Ta
- Australian Institute for Bioengineering and NanotechnologyThe University of QueenslandBrisbaneQueenslandAustralia
- School of Environment and ScienceGriffith UniversityBrisbaneQueenslandAustralia
- Queensland Micro and Nanotechnology CentreGriffith UniversityBrisbaneQueenslandAustralia
| | - Zhi Ping Xu
- Australian Institute for Bioengineering and NanotechnologyThe University of QueenslandBrisbaneQueenslandAustralia
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Li M, Gu H, Lam SS, Sonne C, Peng W. Deposition-mediated phytoremediation of nitrogen oxide emissions. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 308:119706. [PMID: 35798191 DOI: 10.1016/j.envpol.2022.119706] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/06/2022] [Accepted: 06/29/2022] [Indexed: 06/15/2023]
Abstract
The growing global population and use of natural resources lead to significant air pollution. Nitrogen oxide emissions is a potential killer threatening human health requiring focus and remediation using vegetation being efficient and cheap. Here we review the mechanisms of removing nitrogen oxides by dry deposition of plants, discussing the principle of leaf absorption of pollutants and factors affecting the removal of nitrogen oxides providing a theoretical basis for the selection of urban greening vegetation.
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Affiliation(s)
- Mengzhen Li
- Henan Province International Collaboration Lab of Forest Resources Utilization, School of Forestry, Henan Agricultural University, Zhengzhou 450002, China
| | - Haping Gu
- Henan Province International Collaboration Lab of Forest Resources Utilization, School of Forestry, Henan Agricultural University, Zhengzhou 450002, China
| | - Su Shiung Lam
- Universiti Malaysia Terengganu, Higher Institution Centre of Excellence (HICoE), Institute of Tropical Aquaculture and Fisheries; 21030 Kuala Nerus, Terengganu, Malaysia
| | - Christian Sonne
- Aarhus University, Department of Bioscience, Arctic Research Centre (ARC), Frederiksborgvej 399, PO Box 358, DK-4000 Roskilde, Denmark
| | - Wanxi Peng
- Henan Province International Collaboration Lab of Forest Resources Utilization, School of Forestry, Henan Agricultural University, Zhengzhou 450002, China.
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Chin WS, Pan SC, Huang CC, Chen PJ, Guo YL. Exposure to Air Pollution and Survival in Follow-Up after Hepatocellular Carcinoma. Liver Cancer 2022; 11:474-482. [PMID: 36158593 PMCID: PMC9485987 DOI: 10.1159/000525346] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 05/09/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction Air pollutants are classified as carcinogens by the International Agency for Research on Cancer. Long-term exposure to ambient particulate matter with an aerodiameter of 2.5 μm or lower (PM2.5) has been reported to be linked with increased mortality due to hepatocellular carcinoma (HCC). However, the effects of air pollutants other than PM2.5 on HCC-related mortality have not been fully investigated. Accordingly, we conducted this study to assess the effect of long-term exposure to air pollutants (PM2.5 and nitrogen dioxide [NO2]) on HCC-related mortality. Method In 2005, the Taiwan Liver Cancer Network (TLCN) was established by the National Research Program for Genomic Medicine to recruit liver cancer patients from 5 major medical centers in northern, central, and southern Taiwan. The TLCN had successfully recruited 9,344 patients by the end of 2018. In this study, we included 1,000 patients randomly sampled from the TLCN to assess the effect of exposure to air pollutants on HCC mortality after HCC diagnosis. Daily averages of PM2.5 and NO2 concentrations were retrieved from 77 air quality-monitoring stations and interpolated to the townships of patients' residences by using the Kriging method. The effect of air pollutants on HCC survival was assessed using a Cox proportional hazards model. Results A total of 940 patients were included in the analysis. After adjusting for potential confounders and mutually adjusting for co-pollutants, we observed that the hazards ratio (95% confidence interval) for HCC-related mortality for every 1-μg/m3 increase in PM2.5 concentration was 1.11 (1.08-1.14) and that for every 1-ppb increase in NO2 concentration was 1.08 (1.03-1.13). Conclusion Our study suggests that long-term exposure to PM2.5 and NO2 was associated with decreased survival time in patients with HCC in Taiwan.
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Affiliation(s)
- Wei-Shan Chin
- School of Nursing, College of Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
| | - Shin-Chun Pan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Ching-Chun Huang
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan
| | - Pei-Jer Chen
- Graduate Institute of Microbiology, NTU College of Medicine, Taipei, Taiwan
- Department of Gastroenterology, NTU Hospital, Taipei, Taiwan
| | - Yue Leon Guo
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan
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Nikolaidis A, Kramer R, Ostojic S. Nitric Oxide: The Missing Factor in COVID-19 Severity? Med Sci (Basel) 2021; 10:3. [PMID: 35076566 PMCID: PMC8788438 DOI: 10.3390/medsci10010003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 11/17/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a contagious respiratory and vascular disease that continues to spread among people around the world, mutating into new strains with increased transmission rates, such as the delta variant. The scientific community is struggling to discover the link between negative COVID-19 outcomes in patients with preexisting conditions, as well as identify the cause of the negative clinical patient outcomes (patients who need medical attention, including hospitalization) in what seems like a widespread range of COVID-19 symptoms that manifest atypically to any preexisting respiratory tract infectious diseases known so far. Having successfully developed a nutritional formulation intervention based on nitrate, a nitric oxide precursor, the authors hypothesis is that both the comorbidities associated with negative clinical patient outcomes and symptoms associated with COVID-19 sickness are linked to the depletion of a simple molecule: nitric oxide.
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Affiliation(s)
| | - Ron Kramer
- ThermoLife International, Phoenix, AZ 85048, USA;
| | - Sergej Ostojic
- Applied Bioenergetics Lab, Faculty of Sport and PE, University of Novi Sad, 21102 Novi Sad, Serbia;
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Poyraz BM, Engin ED, Engin AB, Engin A. The effect of environmental diesel exhaust pollution on SARS-CoV-2 infection: The mechanism of pulmonary ground glass opacity. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2021; 86:103657. [PMID: 33838330 PMCID: PMC8025547 DOI: 10.1016/j.etap.2021.103657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/30/2021] [Accepted: 04/02/2021] [Indexed: 05/19/2023]
Abstract
Diesel exhaust particles (DEP) are the major components of atmospheric particulate matter (PM) and chronic exposure is recognized to enhance respiratory system complications. Although the spread of SARS-CoV-2 was found to be associated with the PMs, the mechanism by which exposure to DEP increases the risk of SARS-CoV-2 infection is still under discussion. However, diesel fine PM (dPM) elevate the probability of SARS-CoV-2 infection, as it coincides with the increase in the number of ACE2 receptors. Expression of ACE2 and its colocalized activator, transmembrane protease serine 2 (TMPRSS2) facilitate the entry of SARS-CoV-2 into the alveolar epithelial cells exposed to dPM. Thus, the coexistence of PM and SARS-CoV-2 in the environment augments inflammation and exacerbates lung damage. Increased TGF-β1 expression due to DEP accompanies the proliferation of the extracellular matrix. In this case, "multifocal ground-glass opacity" (GGO) in a CT scan is an indication of a cytokine storm and severe pneumonia in COVID-19.
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Affiliation(s)
| | - Evren Doruk Engin
- Ankara University, Biotechnology Institute, Gumusdere Campus, Kecioren, Ankara, Turkey
| | - Ayse Basak Engin
- Gazi University, Faculty of Pharmacy, Department of Toxicology, Ankara, Turkey.
| | - Atilla Engin
- Gazi University, Faculty of Medicine, Department of General Surgery, Ankara, Turkey
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Suhaimi NF, Jalaludin J, Abu Bakar S. The Influence of Traffic-Related Air Pollution (TRAP) in Primary Schools and Residential Proximity to Traffic Sources on Histone H3 Level in Selected Malaysian Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157995. [PMID: 34360284 PMCID: PMC8345469 DOI: 10.3390/ijerph18157995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/12/2021] [Accepted: 07/21/2021] [Indexed: 02/07/2023]
Abstract
This study aimed to investigate the association between traffic-related air pollution (TRAP) exposure and histone H3 modification among school children in high-traffic (HT) and low-traffic (LT) areas in Malaysia. Respondents' background information and personal exposure to traffic sources were obtained from questionnaires distributed to randomly selected school children. Real-time monitoring instruments were used for 6-h measurements of PM10, PM2.5, PM1, NO2, SO2, O3, CO, and total volatile organic compounds (TVOC). Meanwhile, 24-h measurements of PM2.5-bound black carbon (BC) were performed using air sampling pumps. The salivary histone H3 level was captured using an enzyme-linked immunosorbent assay (ELISA). HT schools had significantly higher PM10, PM2.5, PM1, BC, NO2, SO2, O3, CO, and TVOC than LT schools, all at p < 0.001. Children in the HT area were more likely to get higher histone H3 levels (z = -5.13). There were positive weak correlations between histone H3 level and concentrations of NO2 (r = 0.37), CO (r = 0.36), PM1 (r = 0.35), PM2.5 (r = 0.34), SO2 (r = 0.34), PM10 (r = 0.33), O3 (r = 0.33), TVOC (r = 0.25), and BC (r = 0.19). Overall, this study proposes the possible role of histone H3 modification in interpreting the effects of TRAP exposure via non-genotoxic mechanisms.
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Affiliation(s)
- Nur Faseeha Suhaimi
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia;
| | - Juliana Jalaludin
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia;
- Department of Occupational Health and Safety, Faculty of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia
- Correspondence: ; Tel.: +603-97692401
| | - Suhaili Abu Bakar
- Department of Biomedical Science, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia;
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Dąbrowiecki P, Adamkiewicz Ł, Mucha D, Czechowski PO, Soliński M, Chciałowski A, Badyda A. Impact of Air Pollution on Lung Function among Preadolescent Children in Two Cities in Poland. J Clin Med 2021; 10:jcm10112375. [PMID: 34071258 PMCID: PMC8198305 DOI: 10.3390/jcm10112375] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/21/2021] [Accepted: 05/23/2021] [Indexed: 12/13/2022] Open
Abstract
Ambient air pollution impairs lung development in children, particularly in industrialized areas. The air quality in Zabrze, a city located in the Upper Silesian Industrial Region of Poland, is among the worst in Europe. We compared lung function and the frequency of respiratory or allergic symptoms between children living in Zabrze and those living in Gdynia, a city on the Baltic coast, which has the best long-term air quality in Poland. We enrolled children aged 9–15 years from both cities who were able to perform a spirometry. The following spirometry variables were measured for all participants: forced vital capacity (FVC), forced expiratory volume during the first second of expiration (FEV1), FEV1/FVC index, and peak expiratory flow (PEF). The frequencies of respiratory or allergic symptoms were taken from a survey completed by the participants’ parents. In total, 258 children from Gdynia and 512 children from Zabrze were examined. The mean values of FVC, FEV1, and PEF were significantly greater among children in Gdynia than those reported in Zabrze (p ≤ 0.032), and the frequencies of seasonal rhinorrhea (p = 0.015) or coughing episodes (p = 0.022) were significantly higher in Zabrze than in Gdynia. In conclusion, lung function was significantly impaired in children living in Zabrze, an area which is associated with poor air quality. Strategies to improve air quality in the Silesia region are urgently needed.
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Affiliation(s)
- Piotr Dąbrowiecki
- Department of Allergology and Infectious Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland;
- Polish Federation of Asthma, Allergy and COPD Patients Associations, 01-604 Warsaw, Poland;
- Correspondence:
| | - Łukasz Adamkiewicz
- Cracow Smog Alert, 31-104 Krakow, Poland; (Ł.A.); (D.M.)
- European Clean Air Center, 31-104 Krakow, Poland
| | - Dominika Mucha
- Cracow Smog Alert, 31-104 Krakow, Poland; (Ł.A.); (D.M.)
- Faculty of Building Services, Hydro- and Environmental Engineering, Warsaw University of Technology, 00-653 Warsaw, Poland
| | - Piotr Oskar Czechowski
- Department of Quantitative Methods and Environmental Management, Faculty of Management and Quality Science, Gdynia Maritime University, 83 Morska Street, 81-225 Gdynia, Poland;
| | - Mateusz Soliński
- Faculty of Physics, Warsaw University of Technology, 00-662 Warsaw, Poland;
| | - Andrzej Chciałowski
- Department of Allergology and Infectious Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland;
| | - Artur Badyda
- Polish Federation of Asthma, Allergy and COPD Patients Associations, 01-604 Warsaw, Poland;
- Faculty of Building Services, Hydro- and Environmental Engineering, Warsaw University of Technology, 00-653 Warsaw, Poland
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14
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Kramer A, Mortensen CS, Schultz JG, Lyhne MD, Andersen A, Nielsen-Kudsk JE. Inhaled nitric oxide has pulmonary vasodilator efficacy both in the immediate and prolonged phase of acute pulmonary embolism. EUROPEAN HEART JOURNAL. ACUTE CARDIOVASCULAR CARE 2021; 10:265–272. [PMID: 32662283 DOI: 10.1177/2048872620918713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 03/24/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Inhaled nitric oxide (iNO) effectively reduces right ventricular afterload when administered in the immediate phase of acute pulmonary embolism (PE) in preclinical animal models. In a porcine model of intermediate-risk PE, we aimed to investigate whether iNO has pulmonary vasodilator efficacy both in the immediate and prolonged phase of acute PE. METHODS Anesthetized pigs (n = 18) were randomized into three subgroups. An acute PE iNO-group (n = 6) received iNO at 40 ppm at one, three, six, nine and 12 hours after onset of PE. Vehicle animals (n = 6) received PE, but no active treatment. A third group of sham animals (n = 6) received neither PE nor treatment. Animals were evaluated using intravascular pressures, respiratory parameters, biochemistry and intracardiac pressure-volume measurements. RESULTS The administration of PE increased mean pulmonary artery pressure (mPAP) (vehicle vs sham; 33.3 vs 17.7 mmHg, p < 0.0001), pulmonary vascular resistance (vehicle vs sham; 847.5 vs 82.0 dynes, p < 0.0001) and right ventricular arterial elastance (vehicle vs sham; 1.2 vs 0.2 mmHg/ml, p < 0.0001). Significant mPAP reduction by iNO was preserved at 12 hours after the onset of acute PE (vehicle vs iNO; 0.5 vs -3.5 mmHg, p < 0.0001). However, this response was attenuated over time (p = 0.0313). iNO did not affect the systemic circulation. CONCLUSIONS iNO is a safe and effective pulmonary vasodilator both in the immediate and prolonged phase of acute PE in an in-vivo porcine model of intermediate-risk PE.
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Affiliation(s)
- Anders Kramer
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Christian Schmidt Mortensen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Jacob Gammelgaard Schultz
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Mads Dam Lyhne
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Asger Andersen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Jens Erik Nielsen-Kudsk
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
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15
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Harrison MF, Villar D, Yarrarapu SNS, Guru P, Mallea J, Torp K, Bechtle P, Lee A, Franco PM, Sanghavi DK. Oxygen therapy via a noninvasive helmet: A COVID-19 novelty with potential post-pandemic uses. Respir Med Case Rep 2021; 32:101369. [PMID: 33643838 PMCID: PMC7899918 DOI: 10.1016/j.rmcr.2021.101369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/03/2021] [Accepted: 02/15/2021] [Indexed: 01/08/2023] Open
Abstract
COVID-19 has placed a significant strain upon healthcare resources at a global level and refractory hypoxemia is the leading cause of death among COVID-19 patients. The management of limited resources such as mechanical ventilators has remained a contentious issue both at an individual and institutional level since the beginning of the pandemic. As a result, the COVID-19 pandemic has presented challenges to critical care practitioners to find innovative ways to provide supplemental oxygen therapy to their patients. We present a single-center experience: a case series of five COVID-19 infected patients managed with a novel approach to provide supplemental oxygen and positive end-expiration pressure (PEEP) via the helmet. Three of the five patients responded to therapy, did not require intubation, and survived to discharge. The other two patients continued to deteriorate clinically, required endotracheal intubation, and subsequently expired during their hospitalization. We extrapolated our accumulated experience with non-invasive oxygen support by helmet in COVID-19 patients to a non-COVID-19 postoperative patient who underwent sinus surgery and developed hypoxemic respiratory failure also resulting in avoidance of endotracheal intubation. We conclude that oxygen therapy via a helmet is a safe, cost-effective technique to prevent intubation in carefully selected patients with infectious and non-infectious causes of hypoxic respiratory failure. Our positive experience with the system warrants further large-scale study and possible technique refinement.
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Affiliation(s)
- Michael F Harrison
- Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA.,Department of Emergency Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Dolores Villar
- Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA
| | | | - Pramod Guru
- Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Jorge Mallea
- Department of Anesthesia and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, USA.,Division of Pulmonary, Allergy and Sleep Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Klaus Torp
- Department of Anesthesia and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Perry Bechtle
- Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA.,Department of Anesthesia and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Augustine Lee
- Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA.,Division of Pulmonary, Allergy and Sleep Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Pablo Moreno Franco
- Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA.,Department of Transplantation, Mayo Clinic, Jacksonville, FL, USA
| | - Devang K Sanghavi
- Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA
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16
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Michaelsen VS, Ribeiro RV, Ali A, Wang A, Gazzalle A, Keshavjee S, Cypel M. Safety of continuous 12-hour delivery of antimicrobial doses of inhaled nitric oxide during ex vivo lung perfusion. J Thorac Cardiovasc Surg 2020; 163:841-849.e1. [DOI: 10.1016/j.jtcvs.2020.11.150] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/20/2020] [Accepted: 11/27/2020] [Indexed: 11/25/2022]
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17
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Ali N, Islam F. The Effects of Air Pollution on COVID-19 Infection and Mortality-A Review on Recent Evidence. Front Public Health 2020; 8:580057. [PMID: 33324598 PMCID: PMC7725793 DOI: 10.3389/fpubh.2020.580057] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 10/23/2020] [Indexed: 11/24/2022] Open
Abstract
The outbreak of COVID-19 has created a serious public health concern worldwide. Although, most of the regions around the globe have been affected by COVID-19 infections; some regions are more badly affected in terms of infections and fatality rates than others. The exact reasons for such variations are not clear yet. This review discussed the possible effects of air pollution on COVID-19 infections and mortality based on some recent evidence. The findings of most studies reviewed here demonstrate that both short-term and long-term exposure to air pollution especially PM2.5 and nitrogen dioxide (NO2) may contribute significantly to higher rates of COVID-19 infections and mortalities with a lesser extent also PM10. A significant correlation has been found between air pollution and COVID-19 infections and mortality in some countries in the world. The available data also indicate that exposure to air pollution may influence COVID-19 transmission. Moreover, exposure to air pollution may increase vulnerability and have harmful effects on the prognosis of patients affected by COVID-19 infections. Further research should be conducted considering some potential confounders such as age and pre-existing medical conditions along with exposure to NO2, PM2.5 and other air pollutants to confirm their detrimental effects on mortalities from COVID-19.
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Affiliation(s)
- Nurshad Ali
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
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18
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Short-Term Associations of Nitrogen Dioxide (NO2) on Mortality in 18 French Cities, 2010–2014. ATMOSPHERE 2020. [DOI: 10.3390/atmos11111198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We present an analysis of short-term associations between ambient NO2 and mortality according to cause, age-group, and period (cold and warm) in 18 areas in metropolitan France for the 2010–2014 period. Associations were estimated in each area using a generalized additive Poisson regression model, and effects were summarized in a meta-analysis. The percentage increase in mortality rate was estimated for a 10 µg m−3 increase in the NO2 level in each area for each complete calendar year and for cold (November to April) and warm periods (May to October) in each year. We found that the NO2 increase (lag of 0–1 days) was associated with a 0.75% increase of non-accidental mortality for all age-groups (95% confidence interval (CI): (0.4; 1.10)). During the warm period, this NO2 increase was associated with a 3.07% increase in non-accidental mortality in the ≥75 years old group (95% CI: 1.97; 4.18). This study supports the short-term effects of NO2 as a proxy of urban traffic pollution on mortality, even for concentrations below the maximum guideline of 40 µg m−3 set down by the European Air Quality Standards and the World Health Organization (WHO).
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19
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Seposo X, Ueda K, Sugata S, Yoshino A, Takami A. Short-term effects of air pollution on daily single- and co-morbidity cardiorespiratory outpatient visits. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 729:138934. [PMID: 32371210 DOI: 10.1016/j.scitotenv.2020.138934] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 04/14/2023]
Abstract
Several studies have noted that the existence of comorbidities lead to an increase in the risk of premature mortality and morbidity. Most of the studies examining the effects of air pollution on comorbidity visits were from Northern American countries, with scarce literature from Asia. This study contributes to existing, yet limited understanding of air pollution-comorbidity by examining the effects of daily air pollutants on outpatient single morbidity and comorbid cardiorespiratory visits in Japan. A total of 1,452,505 outpatient cardiorespiratory visits were recorded among the 21 Japanese cities from 2013 to 2016. Daily outpatient cardiorespiratory visit data were obtained from a health insurance claims database managed by the Japan Medical Data Center Co., Ltd. (JMDC). A time-stratified case crossover analysis coupled with Generalized Additive Mixed Model was used to analyze the association of daily air pollutants (particulate matter 2.5 μm or less in diameter, ozone and nitrogen dioxide) on daily single (respiratory and cardiovascular) and comorbidity health outcomes. We further examined single and cumulative effects for 0-3 and 0-14 lag periods. Ozone, NO2, and PM2.5 were positively associated with cardiorespiratory visits in either shorter or longer lags, with more apparent comorbidity associations with NO2 exposure. A 10-unit increase in NO2, after adjusting for ozone, was associated with a 2.24% (95% CI: 1.34-3.15) and 6.49% (95% CI: 5.00-8.01) increase in comorbidity visit at Lag 0 (of Lag 0-3) and cumulative lag 0-3, respectively. Our results contribute to existing evidence suggesting that short-term and extended exposure to air pollution elicit health risks on cardiovascular, respiratory and comorbid clinic visits. Exposure to NO2, in particular, was associated with increase in the risk of single and comorbidity cardiorespiratory visits. Results can be potentially utilized for both individual health (e.g. risk population health management) and health facility management (e.g. health visit influx determination).
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Affiliation(s)
- Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Japan.
| | - Kayo Ueda
- Environmental Health Division, Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Japan; Environmental Health Sciences, Department of Global Ecology, Graduate School of Global Environmental Studies, Kyoto University, Japan
| | - Seiji Sugata
- Center for Regional Environmental Research, National Institute for Environmental Studies, Japan
| | - Ayako Yoshino
- Center for Regional Environmental Research, National Institute for Environmental Studies, Japan
| | - Akinori Takami
- Center for Regional Environmental Research, National Institute for Environmental Studies, Japan
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20
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Dales R, Blanco-Vidal C, Cakmak S. The Association Between Air Pollution and Hospitalization of Patients With Idiopathic Pulmonary Fibrosis in Chile: A Daily Time Series Analysis. Chest 2020; 158:630-636. [PMID: 32092324 DOI: 10.1016/j.chest.2020.02.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 02/03/2020] [Accepted: 02/06/2020] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) causes progressive dyspnea, hypoxemia, and death within a few years. Little is known about the effect of air pollution on disease exacerbations. RESEARCH QUESTION Are acute increases in air pollution a risk factor for hospitalization of patients with a primary diagnosis of IPF. STUDY DESIGN AND METHODS Hospital admissions for IPF are coded J84.1 by the International Classification of Disease, 10th Revision. Using ambient air pollution and climate data from seven air monitoring stations distributed in the seven urban centers in Santiago, Chile, along with daily patient hospitalization data from 2001 to 2012, a linear association between daily ambient air pollution and daily J84.1 hospital admissions was tested using generalized linear models. RESULTS Average pollutant levels for all regions were as follows: carbon monoxide was 0.96 ppm, ozone was 64 ppb, nitrogen dioxide (NO2) was 43 ppb, sulfur dioxide was 9 ppb, particulate matter < 2.5 μm in diameter was 29 μg/m3 and particulate matter < 10 μm in diameter (PM10) was 67 μg/m3. For the combined Santiago area, relative risk estimates of J84.1 hospitalizations for all pollutants (except ozone), adjusted for age, sex, and weather were statistically significant. In the two-pollutant models, the significance of NO2 and PM10 persisted despite adjustments for each of the other measured pollutants. INTERPRETATION Our findings suggest that acute increases in air pollution are a risk factor for hospitalization of patients with a primary diagnosis of IPF.
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Affiliation(s)
- Robert Dales
- Population Studies Division, Environmental Health Science & Research Bureau, Health Canada, Canada
| | | | - Sabit Cakmak
- Population Studies Division, Environmental Health Science & Research Bureau, Health Canada, Canada.
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21
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Spina S, Lei C, Pinciroli R, Berra L. Hemolysis and Kidney Injury in Cardiac Surgery: The Protective Role of Nitric Oxide Therapy. Semin Nephrol 2019; 39:484-495. [DOI: 10.1016/j.semnephrol.2019.06.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Gaudard P, Barbanti C, Rozec B, Mauriat P, M'rini M, Cambonie G, Liet JM, Girard C, Leger PL, Assaf Z, Damas P, Loron G, Lecourt L, Amour J, Pouard P. New Modalities for the Administration of Inhaled Nitric Oxide in Intensive Care Units After Cardiac Surgery or for Neonatal Indications: A Prospective Observational Study. Anesth Analg 2019; 126:1234-1240. [PMID: 29341967 DOI: 10.1213/ane.0000000000002813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Nitric oxide (NO) has a well-known efficacy in pulmonary hypertension (PH), with wide use for 20 years in many countries. The objective of this study was to describe the current use of NO in real life and the gap with the guidelines. METHODS This is a multicenter, prospective, observational study on inhaled NO administered through an integrated delivery and monitoring device and indicated for PH according to the market authorizations. The characteristics of NO therapy and ventilation modes were observed. Concomitant pulmonary vasodilator treatments, safety data, and outcome were also collected. Quantitative data are expressed as median (25th, 75th percentile). RESULTS Over 1 year, 236 patients were included from 14 equipped and trained centers: 117 adults and 81 children with PH associated with cardiac surgery and 38 neonates with persistent PH of the newborn. Inhaled NO was initiated before intensive care unit (ICU) admission in 57%, 12.7%, and 38.9% with an initial dose of 10 (10, 15) ppm, 20 (18, 20) ppm, and 17 (11, 20) ppm, and a median duration of administration of 3.9 (1.9, 6.1) days, 3.8 (1.8, 6.8) days, and 3.1 (1.0, 5.7) days, respectively, for the adult population, pediatric cardiac group, and newborns. The treatment was performed using administration synchronized to the mechanical ventilation. The dose was gradually decreased before withdrawal in 86% of the cases according to the usual procedure of each center. Adverse events included rebound effect for 3.4% (95% confidence interval [CI], 0.9%-8.5%) of adults, 1.2% (95% CI, 0.0%-6.7%) of children, and 2.6% (95% CI, 0.1%-13.8%) of neonates and methemoglobinemia exceeded 2.5% for 5 of 62 monitored patients. Other pulmonary vasodilators were associated with NO in 23% of adults, 95% of children, and 23.7% of neonates. ICU stay was respectively 10 (6, 22) days, 7.5 (5.5, 15) days, and 9 (8, 15) days and ICU mortality was 22.2%, 6.2%, and 7.9% for adults, children, and neonates, respectively. CONCLUSIONS This study confirms the safety of NO therapy in the 3 populations with a low rate of rebound effect. Gradual withdrawal of NO combined with pulmonary vasodilators are current practices in this population. The use of last-generation NO devices allowed good compliance with recommendations.
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Affiliation(s)
- Philippe Gaudard
- From the Cardiothoracic Intensive Care Unit, Centre Hospitalier Universitaire de Montpellier, and PhyMedExp, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Claudio Barbanti
- Pediatric Cardiac Intensive Care, Anesthesia and Perfusion Unit, Reference Centre for Complex Congenital Cardiac Disease, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Bertrand Rozec
- Department of Anesthesia and Intensive Care, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Philippe Mauriat
- Congenital Cardiac Surgery Unit, Department of Anesthesia and Intensive Care II, Maison du Haut Lévêque - Groupe Hospitalier Sud, Pessac, France
| | | | - Gilles Cambonie
- Neonatal and pediatric Intensive Care Unit, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Jean Michel Liet
- Pediatric Intensive Care Unit, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Claude Girard
- Cardiovascular Intensive Care Unit, Centre Hospitalier Universitaire Bocage Central, Dijon, France
| | | | - Ziad Assaf
- Pediatric Cardiac Intensive Care, Anesthesia and Perfusion Unit, Reference Centre for Complex Congenital Cardiac Disease, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Pierre Damas
- Intensive Care Unit, Centre Hospitalier Universitaire de Liège, Liège, Belgique
| | - Gauthier Loron
- Neonatal Intensive Care Unit, Centre Hospitalier Universitaire de Reims, Reims, France
| | | | - Julien Amour
- Sorbonne Universités, UPMC Univ Paris 06, UMR INSERM 1166, IHU ICAN, and Department of Anesthesiology and Critical Care Medicine, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Philippe Pouard
- Pediatric Cardiac Intensive Care, Anesthesia and Perfusion Unit, Reference Centre for Complex Congenital Cardiac Disease, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
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23
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Bentur L, Gur M, Ashkenazi M, Livnat-Levanon G, Mizrahi M, Tal A, Ghaffari A, Geffen Y, Aviram M, Efrati O. Pilot study to test inhaled nitric oxide in cystic fibrosis patients with refractory Mycobacterium abscessus lung infection. J Cyst Fibros 2019; 19:225-231. [PMID: 31129068 DOI: 10.1016/j.jcf.2019.05.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 04/30/2019] [Accepted: 05/02/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Airways of Cystic Fibrosis (CF) patients are Nitric Oxide (NO) deficient which may contribute to impaired lung function and infection clearance. Mycobacterium abscessus (M. abscessus) infection prevalence is increasing in CF patients and is associated with increased morbidity and mortality. Here, we assess the safety and efficacy of intermittent inhaled NO (iNO) as adjuvant therapy in CF patients with refractory M. abscessus lung infection. METHODS A prospective, open-label pilot study of iNO (160 ppm) administered five times/day during hospitalization (14 days), and three times/day during ambulatory treatment (7 days) was conducted. The primary outcome was safety measured by NO-related adverse events (AEs). Secondary outcomes were six-minute walk distance (6MWD), forced expiratory volume in 1 s (FEV1), and M. abscessus burden in airways. RESULTS Nine subjects were recruited. INO at 160 ppm was well-tolerated and no iNO-related SAEs were observed during the study. Mean FEV1 and 6WMD were increased relative to baseline during NO treatment. M. abscessus culture conversion was not achieved, but 3/9 patients experienced at least one negative culture during the study. Mean time to positivity in M. abscessus culture, and qPCR analysis showed reductions in sputum bacterial load. The study was not powered to achieve statistical significance in FEV1, 6WMD, and bacterial load. CONCLUSIONS Intermittent iNO at 160 ppm is well tolerated and safe and led to increases in mean 6MWD and FEV1. INO exhibited potential antibacterial activity against M. abscessus. Further evaluation of secondary endpoints in a larger cohort of CF patients is warranted to demonstrate statistical significance.
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Affiliation(s)
- Lea Bentur
- Pediatric Pulmonary Institute and CF Center, Ruth Children's Hospital, Rambam Health Care Campus, POB 9602, Haifa, Israel; Technion-Israel Institute of Technology, Haifa, Israel.
| | - Michal Gur
- Pediatric Pulmonary Institute and CF Center, Ruth Children's Hospital, Rambam Health Care Campus, POB 9602, Haifa, Israel; Technion-Israel Institute of Technology, Haifa, Israel
| | - Moshe Ashkenazi
- Pediatric Pulmonary Institute and National CF Center, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer 52621, Ramat-Gan, Israel; Pediatric Pulmonary Unit, Soroka University Medical Center POB 151, Beer-Sheva, Israel
| | - Galit Livnat-Levanon
- Pediatric Pulmonology Unit and CF Center, Lady Davis Carmel Medical Center, Haifa, Israel
| | | | - Asher Tal
- AIT Therapeutics Inc, Garden City, NY 11530, USA
| | | | - Yuval Geffen
- Microbiology Laboratory, Rambam Health Care Campus, POB 9602, Haifa, Israel
| | - Micha Aviram
- Pediatric Pulmonary Unit, Soroka University Medical Center POB 151, Beer-Sheva, Israel
| | - Ori Efrati
- Pediatric Pulmonary Institute and National CF Center, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer 52621, Ramat-Gan, Israel; Sackler Faculty of Medicine, Tel-Aviv University, POB 39040, Tel-Aviv, Israel
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Lucht S, Hennig F, Moebus S, Führer-Sakel D, Herder C, Jöckel KH, Hoffmann B. Air pollution and diabetes-related biomarkers in non-diabetic adults: A pathway to impaired glucose metabolism? ENVIRONMENT INTERNATIONAL 2019; 124:370-392. [PMID: 30660850 DOI: 10.1016/j.envint.2019.01.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 12/14/2018] [Accepted: 01/03/2019] [Indexed: 05/05/2023]
Abstract
BACKGROUND While prior studies have linked air pollution (AP) to diabetes prevalence and incidence, few have investigated whether AP exposure is also associated with alterations in diabetes-related biomarkers in metabolically healthy adults. OBJECTIVE To evaluate the associations between short-, medium-, and long-term AP and diabetes-related biomarkers (adiponectin, interleukin-1 receptor antagonist [IL-1RA], high sensitivity C-reactive protein [hsCRP], fibrinogen) in persons without diabetes. METHODS Adiponectin, IL-1RA, hsCRP, and fibrinogen were measured in blood samples collected at the baseline (t0; 2000-2003) and first follow-up (t1; 2006-2008) examinations of the prospective Heinz Nixdorf Recall (HNR) cohort study in Germany. Participants' residential mean exposures to PM10, PM2.5, NO2, and accumulation mode particle number concentration (PNAM) were estimated for several time windows (1- to 365-day) prior to examination using a dispersion and chemistry transport model. We fitted covariate-adjusted linear mixed effects models using a random participant intercept and investigated effect modification by obesity status. RESULTS We analyzed 6727 observations (nt0 = 3626, nt1 = 3101) from 4052 participants of the HNR study (52% women; ages 45-76 years at t0). For all air pollutants, medium-term exposures (60- to 120-day) were negatively associated with adiponectin (e.g., 91-day PNAM: -2.51% change [-3.40%, -1.53%] per interquartile [IQR] increase). Several short-, medium-, and long-term AP exposures were positively associated with IL-1RA (e.g., 365-day PM10: 2.64% change [1.25%, 4.22%] per IQR increase). Long-term exposures were positively associated with hsCRP level while no consistent patterns were observed for fibrinogen. Stronger associations for adiponectin were observed among non-obese participants. CONCLUSION In persons without diabetes, we observed differing patterns of association between AP and diabetes-related biomarkers across a range of exposure windows, supporting the hypothesis that AP may play a role in the development of diabetes.
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Affiliation(s)
- Sarah Lucht
- Environmental Epidemiology Group, Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Institute for Medical Statistics, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | - Frauke Hennig
- Environmental Epidemiology Group, Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Institute for Medical Statistics, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Susanne Moebus
- Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Dagmar Führer-Sakel
- Department of Endocrinology and Metabolism, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Christian Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Karl-Heinz Jöckel
- Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Barbara Hoffmann
- Environmental Epidemiology Group, Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Abstract
Abstract
A vast majority of people today spend more time indoors than outdoors. However, the air quality indoors may be as bad as or even worse than the air quality outside. This is due to the continuous circulation of the same air without proper ventilation and filtration systems, causing a buildup of pollutants. As such, indoor air quality monitoring should be considered more seriously. Indoor air quality (IAQ) is a measure of the air quality within and around buildings and relates to the health and comfort of building occupants. To determine the IAQ, computer modeling is done to simulate the air flow and human exposure to the pollutant. Currently, very few instruments are available to measure the indoor air pollution index. In this paper, we will review the list of techniques available for measuring IAQ, but our emphasis will be on indoor air toxicity monitoring.
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26
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Ji X, Pan Z, Yu B, De La Cruz LK, Zheng Y, Ke B, Wang B. Click and release: bioorthogonal approaches to “on-demand” activation of prodrugs. Chem Soc Rev 2019; 48:1077-1094. [PMID: 30724944 DOI: 10.1039/c8cs00395e] [Citation(s) in RCA: 179] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This review summarizes recent developments in using bioorthogonal chemistry in prodrug design for the delivery of traditional small molecule- and gasotransmitter-based therapeutics.
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Affiliation(s)
- Xingyue Ji
- Laboratory of Anesthesia and Critical Care Medicine
- Department of Anesthesiology
- Translational Neuroscience Center
- West China Hospital and State Key Laboratory of Biotherapy
- Sichuan University
| | - Zhixiang Pan
- Department of Chemistry and Center for Diagnostics and Therapeutics
- Georgia State University
- Atlanta
- USA
| | - Bingchen Yu
- Department of Chemistry and Center for Diagnostics and Therapeutics
- Georgia State University
- Atlanta
- USA
| | - Ladie Kimberly De La Cruz
- Department of Chemistry and Center for Diagnostics and Therapeutics
- Georgia State University
- Atlanta
- USA
| | - Yueqin Zheng
- Department of Chemistry and Center for Diagnostics and Therapeutics
- Georgia State University
- Atlanta
- USA
| | - Bowen Ke
- Laboratory of Anesthesia and Critical Care Medicine
- Department of Anesthesiology
- Translational Neuroscience Center
- West China Hospital and State Key Laboratory of Biotherapy
- Sichuan University
| | - Binghe Wang
- Department of Chemistry and Center for Diagnostics and Therapeutics
- Georgia State University
- Atlanta
- USA
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27
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Sahlén A, Ljungman P, Erlinge D, Chan MY, Yap J, Hausenloy DJ, Yeo KK, Jernberg T. Air pollution in relation to very short-term risk of ST-segment elevation myocardial infarction: Case-crossover analysis of SWEDEHEART. Int J Cardiol 2018; 275:26-30. [PMID: 30509372 DOI: 10.1016/j.ijcard.2018.10.069] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 10/06/2018] [Accepted: 10/22/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Studies have related air pollution to myocardial infarction (MI) events over days or weeks, with few data on very short-term risks. We studied risk of ST-segment elevation MI (STEMI) within hours of exposure to air pollution while adjusting for weather. METHODS We performed a case-crossover study of STEMI cases in Stockholm, Sweden (Jan 2000-June 2014) based on SWEDEHEART. Exposures during hazard periods up to 24 h prior to admission were compared to bidirectionally sampled control periods. Risks attributable to sulphur dioxide (SO2), nitrogen dioxide (NO2), ozone and particulate pollutants (PM2.5, PM10) were studied in conditional logistic regression models for interquartile range increments. RESULTS Risk of STEMI (n = 14,601) was associated with NO2 (strongest at 15-h lag) and with PM2.5 (strongest at 20-h lag), in single-pollutant models adjusting for air temperature and humidity (NO2: odds ratio (OR; 95% confidence interval) 1.065 (1.031-1.101); PM2.5: 1.026 (1.001-1.054)). After adjusting models for atmospheric pressure (significantly associated with STEMI risk at 14-24-h lags), NO2 remained highly statistically significant (1.057 (1.022-1.094)) but not PM2.5 (1.024 (0.997-1.052)). No associations were seen for SO2, ozone or PM10. CONCLUSION Risk of STEMI rises within hours of exposure to air pollutants, with strongest impact of NO2. These findings are complementary to earlier reports which have not acknowledged widely the importance of very short-term fluctuations in air pollution.
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Affiliation(s)
- Anders Sahlén
- National Heart Centre Singapore, Singapore, Singapore; Karolinska Institutet, Stockholm, Sweden.
| | - Petter Ljungman
- Unit of Environmental Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - David Erlinge
- Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden
| | - Mark Y Chan
- Department of Medicine, Yong Loo Lin School of Medicine, Singapore, Singapore; National University Heart Centre, Singapore, Singapore
| | - Jonathan Yap
- National Heart Centre Singapore, Singapore, Singapore
| | - Derek J Hausenloy
- Cardiovascular & Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore, Singapore; National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore; Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore; The Hatter Cardiovascular Institute, University College London, London, UK; The National Institute for Health Research University College London Hospitals Biomedical Research Centre, Research & Development, London, UK; Department of Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, UK
| | | | - Tomas Jernberg
- Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden
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28
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Silber D, Lachmann J. Invasive Hemodynamics of Pulmonary Disease and the Right Ventricle. Interv Cardiol Clin 2017; 6:329-343. [PMID: 28600088 DOI: 10.1016/j.iccl.2017.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pulmonary hypertension (PH) falls into 5 groups, as defined by the World Health Organization. Swan-Ganz catheters determine precapillary versus postcapillary PH. The hemodynamic values of PH at rest and with vasodilatory challenge categorize the etiology of PH and guide treatment. RV maladaptations to increased pulmonary vascular resistance (PVR) and the chronicity of the right ventricle's (RV) response to increased PH and/or increased PVR can be understood with pressure-volume (PV) loops constructed with use of conductance catheters. These PV loops demonstrate the RV's ability to increase stroke volume in acutely and chronically increased PVR.
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Affiliation(s)
- David Silber
- Winthrop Cardiology Associates, PC, NYU-Winthrop Hospital, 212 Jericho Turnpike, Mineola, NY 11501, USA.
| | - Justine Lachmann
- Winthrop Cardiology Associates, PC, NYU-Winthrop Hospital, 212 Jericho Turnpike, Mineola, NY 11501, USA
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