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Klement L, Jansakun C, Yan B, Staffer S, Tuma-Kellner S, Altamura S, Muckenthaler M, Merle U, Chamulitrat W. Myeloid-specific deletion of group VIA calcium-independent phospholipase A2 induces pro-inflammatory LPS response predominantly in male mice via MIP-1α activation. Biochim Biophys Acta Mol Basis Dis 2024; 1870:167016. [PMID: 38198970 DOI: 10.1016/j.bbadis.2024.167016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/15/2023] [Accepted: 12/31/2023] [Indexed: 01/12/2024]
Abstract
Polymorphisms of group VIA calcium-independent phospholipase A2 (PLA2G6) are associated with blood C-reactive protein suggesting its role in inflammation. We showed that myeloid-specific Pla2g6-deficiency in Pla2g6M-/- mice led to exaggerated inflammation and fibrosis in a lean fatty liver model. We here investigated whether these mutants display alteration in immune response after treatment with E. coli lipopolysaccharides (LPS) under acute (a single dose) and persistent (four doses) conditions. Without LPS treatment, male Pla2g6M-/- (but not Flox) mice at 12 months of age exhibited splenomegaly and hepatic necrosis, and ~ 30 % of them exhibited autoimmune hepatitis showing lymphoplasma cells with CD3(+) and CD45R(+) staining. Under acute LPS, male mutants showed an elevation of plasma MIP-1α and immunoglobulinA as well as upregulation of hepatic apoptosis and fibrosis PARP-1, Bax, MCP-1, α-SMA, and collagen I proteins. Their bone-marrow-derived macrophages also showed an elevation of MIP-1α release upon LPS stimulation in vitro. Female mutants under acute LPS showed a moderate increase in plasma KC/CXCL1, MCP-1, and IL10, and they showed no remarkable increase in hepatic fibrosis under acute or persistent LPS. Male mutants under persistent LPS displayed an elevation of aspartate aminotransferase, blood eosinophils, and hepatic apoptosis. Moreover, ~30 % of these mutants exhibited eosinophilic sclerosing portal hepatitis associated with an upregulated protein expression of hepatic CD8α, CD68, eosinophilic cationic protein, and Ly6G. Thus, myeloid-PLA2G6 deficiency led to an autoimmune and LPS-induced inflammatory liver disease via MIP-1α in a male-predominant manner. Our results may be applicable to patients with PLA2G6 mutations who undergo bacterial infection and sepsis.
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Affiliation(s)
- Lukas Klement
- Internal Medicine IV, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Chutima Jansakun
- Internal Medicine IV, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany; School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80161, Thailand
| | - Bin Yan
- Internal Medicine IV, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Simone Staffer
- Internal Medicine IV, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Sabine Tuma-Kellner
- Internal Medicine IV, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Sandro Altamura
- Department of Pediatric Oncology, Hematology and Immunology, University Hospital Heidelberg, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany
| | - Martina Muckenthaler
- Department of Pediatric Oncology, Hematology and Immunology, University Hospital Heidelberg, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), German Centre for Cardiovascular Research, Partner Site, University of Heidelberg, Germany
| | - Uta Merle
- Internal Medicine IV, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Walee Chamulitrat
- Internal Medicine IV, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
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Gumtorntip W, Kasitanon N, Louthrenoo W, Chattipakorn N, Chattipakorn SC. Potential roles of air pollutants on the induction and aggravation of rheumatoid arthritis: From cell to bedside studies. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 334:122181. [PMID: 37453681 DOI: 10.1016/j.envpol.2023.122181] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/03/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
Rheumatoid arthritis (RA) is an involving chronic systemic inflammatory disease which mainly affects the joints. Several factors including genetic, environment and infections have been acknowledged as being involved in the pathogenesis and aggravation of RA. Air pollution, particularly particulate matter is widely recognized as a cause of health problems. This review is to summarize and discuss the association between air pollutants and the development or the aggravation of RA based on evidence from in vitro, in vivo and clinical studies. The results from the review found that air pollutants can stimulate immunological processes and stimulate inflammatory mediators and autoantibodies productions, both in intro and in vivo studies. In addition, air pollutants can induce RA and aggravate RA disease activity. Unfortunately, there also are some discrepancies in the results, which might be due to the type cell line and the concentration of air pollutants used in the in vitro and in vivo studies, as well as the concentration and duration of exposure in human studies. These findings suggest that future studies focused on elucidating these mechanisms using advanced techniques and identifying reliable biomarkers to assess individual susceptibility and disease activity should be carried out. Longitudinal studies, intervention strategies, and policy implications also should be explored. A comprehensive understanding on these association will facilitate targeted approaches for prevention and management of air pollutant-induced RA and improve health outcome.
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Affiliation(s)
- Wanitcha Gumtorntip
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nuntana Kasitanon
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Worawit Louthrenoo
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nipon Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Siriporn C Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand; Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand.
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Mikuls TR, Gaurav R, Thiele GM, England BR, Wolfe MG, Shaw BP, Bailey KL, Wyatt TA, Nelson AJ, Duryee MJ, Hunter CD, Wang D, Romberger DJ, Ascherman DP, Poole JA. The impact of airborne endotoxin exposure on rheumatoid arthritis-related joint damage, autoantigen expression, autoimmunity, and lung disease. Int Immunopharmacol 2021; 100:108069. [PMID: 34461491 PMCID: PMC8551041 DOI: 10.1016/j.intimp.2021.108069] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/15/2021] [Accepted: 07/15/2021] [Indexed: 12/11/2022]
Abstract
Airborne biohazards are risk factors in the development and severity of rheumatoid arthritis (RA) and RA-associated lung disease, yet the mechanisms explaining this relationship remain unclear. Lipopolysaccharide (LPS, endotoxin) is a ubiquitous inflammatory agent in numerous environmental and occupational air pollutant settings recognized to induce airway inflammation. Combining repetitive LPS inhalation exposures with the collagen induced arthritis (CIA) model, DBA1/J mice were assigned to either: sham (saline injection/saline inhalation), CIA (CIA/saline), LPS (saline/LPS 100 ng inhalation), or CIA + LPS for 5 weeks. Serum anti-citrullinated (CIT) protein antibody (ACPA) and anti-malondialdehyde-acetaldehyde (MAA) antibodies were strikingly potentiated with co-exposure (CIA + LPS). CIT- and MAA-modified lung proteins were increased with co-exposure and co-localized across treatment groups. Inhaled LPS exacerbated arthritis with CIA + LPS > LPS > CIA versus sham. Periarticular bone loss was demonstrated in CIA and CIA + LPS but not in LPS alone. LPS induced airway inflammation and neutrophil infiltrates were reduced with co-exposure (CIA + LPS). Potentially signaling transition to pro-fibrotic processes, there were increased infiltrates of activated CD11c+CD11b+ macrophages and transitioning CD11c+CD11bint monocyte-macrophage populations with CIA + LPS. Moreover, several lung remodeling proteins including fibronectin and matrix metalloproteinases as well as complement C5a were potentiated with CIA + LPS compared to other treatment groups. IL-33 concentrations in lung homogenates were enhanced with CIA + LPS with IL-33 lung staining driven by LPS. IL-33 expression was also significantly increased in lung tissues from patients with RA-associated lung disease (N = 8) versus controls (N = 7). These findings suggest that patients with RA may be more susceptible to developing interstitial lung disease following airborne biohazard exposures enriched in LPS.
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MESH Headings
- Air Pollutants/adverse effects
- Animals
- Arthritis, Experimental/complications
- Arthritis, Experimental/diagnosis
- Arthritis, Experimental/immunology
- Arthritis, Experimental/pathology
- Arthritis, Rheumatoid/complications
- Arthritis, Rheumatoid/diagnosis
- Arthritis, Rheumatoid/immunology
- Arthritis, Rheumatoid/pathology
- Autoantibodies/immunology
- Autoantigens/immunology
- Case-Control Studies
- Dust
- Healthy Volunteers
- Humans
- Inhalation Exposure/adverse effects
- Interleukin-33/analysis
- Interleukin-33/metabolism
- Lipopolysaccharides/adverse effects
- Lung/immunology
- Lung/pathology
- Lung Diseases, Interstitial/immunology
- Lung Diseases, Interstitial/pathology
- Male
- Mice
- Severity of Illness Index
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Affiliation(s)
- Ted R Mikuls
- Veterans Affairs Nebraska-Western Iowa Health Care System, Research Service, Omaha, NE, USA; Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Rohit Gaurav
- Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Geoffrey M Thiele
- Veterans Affairs Nebraska-Western Iowa Health Care System, Research Service, Omaha, NE, USA; Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Bryant R England
- Veterans Affairs Nebraska-Western Iowa Health Care System, Research Service, Omaha, NE, USA; Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Madison G Wolfe
- Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Brianna P Shaw
- Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kristina L Bailey
- Veterans Affairs Nebraska-Western Iowa Health Care System, Research Service, Omaha, NE, USA; Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Todd A Wyatt
- Veterans Affairs Nebraska-Western Iowa Health Care System, Research Service, Omaha, NE, USA; Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA; Department of Environmental, Agricultural & Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Amy J Nelson
- Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Michael J Duryee
- Veterans Affairs Nebraska-Western Iowa Health Care System, Research Service, Omaha, NE, USA; Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Carlos D Hunter
- Veterans Affairs Nebraska-Western Iowa Health Care System, Research Service, Omaha, NE, USA; Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Dong Wang
- Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Debra J Romberger
- Veterans Affairs Nebraska-Western Iowa Health Care System, Research Service, Omaha, NE, USA; Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Dana P Ascherman
- Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jill A Poole
- Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
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Sikdar S, Wyss AB, Lee MK, Hoang TT, Richards M, Beane Freeman LE, Parks C, Thorne PS, Hankinson JL, Umbach DM, Motsinger-Reif A, London SJ. Interaction between Genetic Risk Scores for reduced pulmonary function and smoking, asthma and endotoxin. Thorax 2021; 76:1219-1226. [PMID: 33963087 PMCID: PMC8572320 DOI: 10.1136/thoraxjnl-2020-215624] [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: 06/23/2020] [Revised: 02/17/2021] [Accepted: 03/22/2021] [Indexed: 01/04/2023]
Abstract
Rationale Genome-wide association studies (GWASs) have identified numerous loci associated with lower pulmonary function. Pulmonary function is strongly related to smoking and has also been associated with asthma and dust endotoxin. At the individual SNP level, genome-wide analyses of pulmonary function have not identified appreciable evidence for gene by environment interactions. Genetic Risk Scores (GRSs) may enhance power to identify gene–environment interactions, but studies are few. Methods We analysed 2844 individuals of European ancestry with 1000 Genomes imputed GWAS data from a case–control study of adult asthma nested within a US agricultural cohort. Pulmonary function traits were FEV1, FVC and FEV1/FVC. Using data from a recent large meta-analysis of GWAS, we constructed a weighted GRS for each trait by combining the top (p value<5×10−9) genetic variants, after clumping based on distance (±250 kb) and linkage disequilibrium (r2=0.5). We used linear regression, adjusting for relevant covariates, to estimate associations of each trait with its GRS and to assess interactions. Results Each trait was highly significantly associated with its GRS (all three p values<8.9×10−8). The inverse association of the GRS with FEV1/FVC was stronger for current smokers (pinteraction=0.017) or former smokers (pinteraction=0.064) when compared with never smokers and among asthmatics compared with non-asthmatics (pinteraction=0.053). No significant interactions were observed between any GRS and house dust endotoxin. Conclusions Evaluation of interactions using GRSs supports a greater impact of increased genetic susceptibility on reduced pulmonary function in the presence of smoking or asthma.
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Affiliation(s)
- Sinjini Sikdar
- Department of Mathematics and Statistics, Old Dominion University, Norfolk, Virginia, USA.,Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Annah B Wyss
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Mi Kyeong Lee
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Thanh T Hoang
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | | | - Laura E Beane Freeman
- Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Christine Parks
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Peter S Thorne
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa, USA
| | | | - David M Umbach
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Alison Motsinger-Reif
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Stephanie J London
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
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5
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Tefera Y, Schlünssen V, Kumie A, Deressa W, Moen BE, Bråtveit M. Personal inhalable dust and endotoxin exposure among workers in an integrated textile factory. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 75:415-421. [PMID: 32308145 DOI: 10.1080/19338244.2020.1743958] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of this study was to determine personal exposure to inhalable dust and endotoxin levels among workers in an integrated cotton-processing textile factory and exposure variability across the different work sections. Full shift measurements were carried out using inhalable conical samplers with 37 mm glass-fiber filters. Personal inhalable dust was determined gravimetrically, and endotoxin levels were analyzed by kinetic chromogenic Limulus Amebocytes Lysate assay. The geometric means of personal dust and endotoxin concentrations were 0.75 mg·m-3 and 831 EU·m-3, respectively. The highest dust and endotoxin concentrations were observed in carding section (1.34 mg·m-3 and 6,381 EU·m-3, respectively). Altogether, 11% of dust and 89% of endotoxin samples exceeded workplace exposure limits. This study showed a moderate correlation between inhalable dust and endotoxin (r = 0.450, p < 0.001). Our findings indicate that low dust exposure does not guarantee a low exposure to endotoxin.
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Affiliation(s)
- Yifokire Tefera
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Vivi Schlünssen
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Abera Kumie
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wakgari Deressa
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bente E Moen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Magne Bråtveit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Yen YC, Yang CY, Ho CK, Yen PC, Cheng YT, Mena KD, Lee TC, Chen PS. Indoor ozone and particulate matter modify the association between airborne endotoxin and schoolchildren's lung function. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 705:135810. [PMID: 31972944 DOI: 10.1016/j.scitotenv.2019.135810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 11/26/2019] [Accepted: 11/26/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND To date, the effect of household airborne pollutants on the association between airborne endotoxin and lung function of schoolchildren is unknown. OBJECTIVES The objective of this study is to evaluate whether indoor air pollutants such as carbon monoxide (CO), carbon dioxide (CO2), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), particulate matter with aerodynamic diameter <10 and 2.5 μm (PM10, PM2.5) can modify the association between airborne endotoxin and school children's lung function in a heavy industrial city in Taiwan. METHODS We recruited 120 elementary school-age children in Kaohsiung City, Taiwan. Aerosol samples were collected on a filter membrane for 24 h period and then analyzed for endotoxin. Air pollutants were measured for 24 h in living rooms while school children's lung function was measured. The modification of air pollutants on the relationship between airborne endotoxin and children's lung function was estimated after adjusting the gender, age, height, weight, and case-control status. RESULTS We found that both O3 and PM10 concentrations significantly modified the relationships between airborne endotoxin and school children's lung function. Among children living in homes with O3 ≥ 0.01 ppm or PM10 ≥ 62 μg/m3, airborne endotoxin was negatively associated with lung functions, whereas among those living in homes with O3 < 0.01 ppm or PM10 < 62 μg/m3, airborne endotoxin was positively associated with lung functions. CONCLUSIONS The indoor air pollutant concentration of O3 and PM10 modifies the association between airborne endotoxin and school children's lung function.
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Affiliation(s)
- Yu-Chuan Yen
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Chun-Yuh Yang
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Chi-Kung Ho
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Pei-Chun Yen
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Yu-Ting Cheng
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Kristina D Mena
- Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, TX, United States
| | - Tzu-Chi Lee
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Health Promotion and Health Education, National Taiwan Normal University, Taiwan
| | - Pei-Shih Chen
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung City, Taiwan; Institute of Environmental Engineering, College of Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Schmidt S. Microbial Toxins in E-Liquid: A Potential New Vaping-Related Exposure to Explore. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:94001. [PMID: 31478757 PMCID: PMC6791572 DOI: 10.1289/ehp5671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 06/05/2019] [Indexed: 06/10/2023]
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Lee MS, Allen JG, Christiani DC. Endotoxin and [Formula: see text] Contamination in Electronic Cigarette Products Sold in the United States. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:047008. [PMID: 31017484 PMCID: PMC6785222 DOI: 10.1289/ehp3469] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 03/13/2019] [Accepted: 03/19/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Cigarette smoke contains microbes and microbial toxins, such as endotoxin and [Formula: see text], that may have adverse respiratory effects. To our knowledge, the potential for contamination of electronic cigarette (EC) products sold in the United States has not been investigated. OBJECTIVES We aimed to determine whether popular cartridge and e-liquid EC products were contaminated with endotoxin or glucan and to examine differences according to the type and flavor of products. METHODS We selected 37 cartridges and 38 e-liquid products with the highest nicotine content from the ten top-selling U.S. brands. Flavors were classified into four groups: tobacco, menthol, fruit, and other. Endotoxin and glucan were measured using an endotoxin-specific kinetic turbidimetric assay and a Glucatell® Kinetic Assay (Associates of Cape Cod, Inc.), respectively. RESULTS Endotoxin concentrations were over the limit of detection (LOD) in 17 of 75 products tested (23%), and glucan concentrations were greater than LOD in 61 of 75 products (81%). After adjusting for brand and flavor, the mean glucan concentration was 3.2 times higher [95% confidence interval (CI): [Formula: see text], 18.4] in cartridge vs. e-liquid samples. After adjusting for brand and type of product, glucan concentrations in tobacco- and menthol-flavored ECs were 10.4 (95% CI: 1.8, 44.9) and 3.5 (95% CI: 0.1, 17.3) times higher than concentrations found in fruit-flavored products. CONCLUSIONS EC products may be contaminated with microbial toxins. Further studies with large representative samples of products are needed to confirm our findings, identify sources and routes of contamination, and evaluate health effects associated with the use of contaminated products. https://doi.org/10.1289/EHP3469.
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Affiliation(s)
- Mi-Sun Lee
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Joseph G. Allen
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - David C. Christiani
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
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Adaptation to Occupational Exposure to Moderate Endotoxin Concentrations: A Study in Sewage Treatment Plants in Germany. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018. [PMID: 30284691 DOI: 10.1007/5584_2018_261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register]
Abstract
Acute or chronic inhalation of endotoxin may lead to changes of lung function and inflammatory markers in the airways. Adaptation to workplace exposure may be possible. In this study, we investigated the possible difference in inflammatory markers assessed in nasal lavage fluid (NALF) in chronical exposure compared to voluntary subjects exposed acutely to endotoxin. We sought to define the variability of inflammatory markers in NALF and the dose-related changes after moderate exposure in naïve subjects. Endotoxin exposure (4-1039 EU/m3) resulted from routine work during one shift in sewage treatment plants. Subjects were matched to pairs (8 workers escorted by 10 students). Inflammatory markers were investigated before, directly after, and 16 h after the shift end. Additional NALF samples were collected in students without any specific exposure after 3 days. In NALF, total cell count, and interleukin (IL)-8 and IL-1β concentrations were significantly higher in workers than in students at all times pointing to workplace-related long-lasting exposure resulting in adaptation. However, concentration of inflammatory markers without specific exposure in students showed a great variability, covering the whole range of values recorded in the workers. The findings of this study make us to recommend a repeated assessment of inflammatory markers in healthy volunteers before the investigation of exposure-related changes and a sample size adequate for statistical analysis.
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House Dust Endotoxin Levels Are Associated with Adult Asthma in a U.S. Farming Population. Ann Am Thorac Soc 2018; 14:324-331. [PMID: 27977294 DOI: 10.1513/annalsats.201611-861oc] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
RATIONALE Endotoxin initiates a proinflammatory response from the innate immune system. Studies in children suggest that endotoxin exposure from house dust may be an important risk factor for asthma, but few studies have been conducted in adult populations. OBJECTIVES To investigate the association of house dust endotoxin levels with asthma and related phenotypes (wheeze, atopy, and pulmonary function) in a large U.S. farming population. METHODS Dust was collected from the bedrooms (n = 2,485) of participants enrolled in a case-control study of current asthma (927 cases) nested within the Agricultural Health Study. Dust endotoxin was measured by Limulus amebocyte lysate assay. Outcomes were measured by questionnaire, spirometry, and blood draw. We evaluated associations using linear and logistic regression. MEASUREMENTS AND MAIN RESULTS Endotoxin was significantly associated with current asthma (odds ratio [OR], 1.30; 95% confidence interval [CI], 1.14-1.47), and this relationship was modified by early-life farm exposure (born on a farm: OR, 1.18; 95% CI, 1.02-1.37; not born on a farm: OR, 1.67; 95% CI, 1.26-2.20; Interaction P = 0.05). Significant positive associations were seen with both atopic and nonatopic asthma. Endotoxin was not related to either atopy or wheeze. Higher endotoxin was related to lower FEV1/FVC in asthma cases only (Interaction P = 0.01). For asthma, there was suggestive evidence of a gene-by-environment interaction for the CD14 variant rs2569190 (Interaction P = 0.16) but not for the TLR4 variants rs4986790 and rs4986791. CONCLUSIONS House dust endotoxin was associated with current atopic and nonatopic asthma in a U.S. farming population. The degree of the association with asthma depended on early-life farm exposures. Furthermore, endotoxin was associated with lower pulmonary function in patients with asthma.
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Bolund AC, Miller MR, Sigsgaard T, Schlünssen V. The effect of organic dust exposure on long-term change in lung function: a systematic review and meta-analysis. Occup Environ Med 2017; 74:531-542. [PMID: 28404791 DOI: 10.1136/oemed-2016-103963] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 02/19/2017] [Accepted: 03/19/2017] [Indexed: 12/19/2022]
Abstract
Lung function is a predictor of morbidity and mortality, and the chronic nature of lung function decline allows for preventive initiatives. Proinflammatory constituents of organic dust are considered a possible cause of compromised respiratory health. The aim of this systematic review was to reveal the impact of organic dust exposure on long-term change in lung function. The literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Predefined criteria concerned study design: longitudinal, ≥1 year follow-up, ≥50 exposed; exposure measures: organic dust, measured or estimated, in different occupational settings; and outcome measures: change in lung function measured by spirometry. Based on these criteria, 1580 potentially relevant publications were narrowed down to 20 included publications. Quality was evaluated and discussed based on six objectively defined criteria. Overall, 14 studies found some type of association between exposure to organic dust and long-term change in lung function. However, the results were inconsistent and no specific work exposure showed more clear associations to change in lung function. Meta-analysis revealed an overall small significant excess loss in forced expiratory volume in the 1st s for exposed compared with controls of 4.92 mL/year (95% CI 0.14 to 9.69). No significant association was seen overall for forced vital capacity. 12 studies revealed a significant exposure-response relation between organic dust and change in lung function. The results were inconsistent across varying study design and different exposure measures and outcomes. We therefore conclude that there is limited evidence of a causal association between general exposure to organic dust and long-term excess decline in lung function.
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Affiliation(s)
- Anneli Cs Bolund
- Section for Environment, Occupation and Health, Department of Public Health and Danish Ramazzini Centre, University of Aarhus, Aarhus, Denmark
| | - Martin R Miller
- Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK
| | - Torben Sigsgaard
- Section for Environment, Occupation and Health, Department of Public Health and Danish Ramazzini Centre, University of Aarhus, Aarhus, Denmark
| | - Vivi Schlünssen
- Section for Environment, Occupation and Health, Department of Public Health and Danish Ramazzini Centre, University of Aarhus, Aarhus, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark
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12
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Janzen B, Karunanayake C, Rennie D, Pickett W, Lawson J, Kirychuk S, Hagel L, Senthilselvan A, Koehncke N, Dosman J, Pahwa P. Gender Differences in the Association of Individual and Contextual Exposures with Lung Function in a Rural Canadian Population. Lung 2016; 195:43-52. [PMID: 27738826 DOI: 10.1007/s00408-016-9950-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 10/01/2016] [Indexed: 01/25/2023]
Abstract
INTRODUCTION To investigate the association of individual and contextual exposures with lung function by gender in rural-dwelling Canadians. METHODS A cross-sectional mail survey obtained completed questionnaires on exposures from 8263 individuals; a sub-sample of 1609 individuals (762 men, 847 women) additionally participated in clinical lung function testing. The three dependent variables were forced expired volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio. Independent variables included smoking, waist circumference, body mass index, indoor household exposures (secondhand smoke, dampness, mold, musty odor), occupational exposures (grain dust, pesticides, livestock, farm residence), and socioeconomic status. The primary analysis was multiple linear regression, conducted separately for each outcome. The potential modifying influence of gender was tested in multivariable models using product terms between gender and each independent variable. RESULTS High-risk waist circumference was related to reduced FVC and FEV1 for both genders, but the effect was more pronounced in men. Greater pack-years smoking was associated with lower lung function values. Exposure to household smoke was related to reduced FEV1, and exposure to livestock, with increased FEV1. Lower income adequacy was associated with reduced FVC and FEV1. CONCLUSION High-risk waist circumference was more strongly associated with reduced lung function in men than women. Longitudinal research combined with rigorous exposure assessment is needed to clarify how sex and gender interact to impact lung function in rural populations.
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Affiliation(s)
- Bonnie Janzen
- Department of Community Health & Epidemiology, University of Saskatchewan, Health Science Building, 107 Wiggins Road, Saskatoon, SK, S7N-5E5, Canada.
| | - Chandima Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - Donna Rennie
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada.,College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - William Pickett
- Department of Public Health Sciences, Queens University, Kingston, ON, Canada
| | - Joshua Lawson
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - Louise Hagel
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Niels Koehncke
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - James Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - Punam Pahwa
- Department of Community Health & Epidemiology, University of Saskatchewan, Health Science Building, 107 Wiggins Road, Saskatoon, SK, S7N-5E5, Canada.,Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
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13
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Lai PS, Hang JQ, Zhang FY, Sun J, Zheng BY, Su L, Washko GR, Christiani DC. Imaging Phenotype of Occupational Endotoxin-Related Lung Function Decline. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:1436-1442. [PMID: 27138294 PMCID: PMC5010398 DOI: 10.1289/ehp195] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 12/04/2015] [Accepted: 04/19/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Although occupational exposures contribute to a significant proportion of obstructive lung disease, the phenotype of obstructive lung disease associated with work-related organic dust exposure independent of smoking remains poorly defined. OBJECTIVE We identified the relative contributions of smoking and occupational endotoxin exposure to parenchymal and airway remodeling as defined by quantitative computed tomography (CT). METHODS The Shanghai Textile Worker Study is a longitudinal study of endotoxin-exposed cotton workers and endotoxin-unexposed silk workers that was initiated in 1981. Spirometry, occupational endotoxin exposure, and smoking habits were assessed at 5-year intervals. High-resolution computed tomography (CT) was performed in 464 retired workers in 2011, along with quantitative lung densitometric and airway analysis. RESULTS Significant differences in all CT measures were noted across exposure groups. Occupational endotoxin exposure was associated with a decrease (-1.3%) in percent emphysema (LAAI-950), a 3.3-Hounsfield unit increase in 15th percentile density, an 18.1-g increase in lung mass, and a 2.3% increase in wall area percent. Current but not former smoking was associated with a similar CT phenotype. Changes in LAAI-950 were highly correlated with 15th percentile density (correlation -1.0). Lung mass was the only measure associated with forced expiratory volume in 1 sec (FEV1) decline, with each 10-g increase in lung mass associated with an additional loss (-6.1 mL) of FEV1 (p = 0.001) between 1981 and 2011. CONCLUSIONS There are many similarities between the effects of occupational endotoxin exposure and those of tobacco smoke exposure on lung parenchyma and airway remodeling. The effects of occupational endotoxin exposure appear to persist even after the cessation of exposure. LAAI-950 may not be a reliable indicator of emphysema in subjects without spirometric impairment. Lung mass is a CT-based biomarker of accelerated lung function decline. CITATION Lai PS, Hang J, Zhang F, Sun J, Zheng BY, Su L, Washko GR, Christiani DC. 2016. Imaging phenotype of occupational endotoxin-related lung function decline. Environ Health Perspect 124:1436-1442; http://dx.doi.org/10.1289/EHP195.
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Affiliation(s)
- Peggy S. Lai
- Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Jing-qing Hang
- Shanghai Putuo District People’s Hospital, Shanghai, China
| | | | - J. Sun
- Shanghai Putuo District People’s Hospital, Shanghai, China
| | - Bu-Yong Zheng
- Shanghai Putuo District People’s Hospital, Shanghai, China
| | - Li Su
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - George R. Washko
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - David C. Christiani
- Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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14
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Heederik D, Smit LAM. Gender differences in lung function recovery after cessation of occupational endotoxin exposure: a complex story. Occup Environ Med 2015; 72:543-4. [PMID: 25921450 DOI: 10.1136/oemed-2014-102783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 04/01/2015] [Indexed: 11/04/2022]
Affiliation(s)
- Dick Heederik
- IRAS Division Environmental Epidemiology, University of Utrecht, Utrecht, The Netherlands
| | - Lidwien A M Smit
- IRAS Division Environmental Epidemiology, University of Utrecht, Utrecht, The Netherlands
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