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van Duuren IC, van Hengel ORJ, Penders J, Duijts L, Smits HH, Tramper-Stranders GA. The developing immune system in preterm born infants: From contributor to potential solution for respiratory tract infections and wheezing. Allergy 2024. [PMID: 39382056 DOI: 10.1111/all.16342] [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: 06/07/2024] [Revised: 09/05/2024] [Accepted: 09/17/2024] [Indexed: 10/10/2024]
Abstract
Moderate-late preterm-born infants experience more frequent and severe respiratory tract infections and wheezing compared to term-born infants. Decreasing the risk on respiratory tract infections and wheezing in this group is vital to improve quality of life and reduce medical consumption during infancy, but also to reduce the risk on asthma and COPD later in life. Until now, moderate-late preterm infants are underrepresented in research and mechanisms underlying their morbidity are largely unknown, although they represent 80% of all preterm-born infants. In order to protect these infants effectively, it is essential to understand the role of the immune system in early life respiratory health and to identify strategies to optimize immune development and respiratory health. This review elaborates on risk factors and preventative measures concerning respiratory tract infections and wheezing in preterm-born infants, exploring their impact on the immune system and microbiome. Factors discussed are early life antibiotic use, birth mode, feeding type and living environment. Further, differences in adaptive and innate immune maturation between term and preterm infants are discussed, as well as differences in local immune reactions in the lungs. Finally, preventative strategies are being explored, including microbiota transplantation, immune modulation (through pre-, pro-, syn- and postbiotics, bacterial lysates, vaccinations, and monoclonal antibodies) and antibiotic prophylaxis.
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Affiliation(s)
- Inger C van Duuren
- Department of Paediatrics, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Sophia Children's Hospital - Erasmus MC, Rotterdam, The Netherlands
| | - Oscar R J van Hengel
- Leiden University Center of Infectious Disease (LU-CID), Leiden, The Netherlands
| | - John Penders
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Liesbeth Duijts
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Sophia Children's Hospital - Erasmus MC, Rotterdam, The Netherlands
| | - Hermelijn H Smits
- Leiden University Center of Infectious Disease (LU-CID), Leiden, The Netherlands
| | - Gerdien A Tramper-Stranders
- Department of Paediatrics, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
- Department of Neonatal and Pediatric Intensive Care, Division of Neonatology, Sophia Children's Hospital, ErasmusMC, Rotterdam, The Netherlands
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Xu S, Marcon A, Bertelsen RJ, Benediktsdottir B, Brandt J, Frohn LM, Geels C, Gislason T, Heinrich J, Holm M, Janson C, Markevych I, Modig L, Orru H, Schlünssen V, Sigsgaard T, Johannessen A. Associations of long-term exposure to air pollution and greenness with incidence of chronic obstructive pulmonary disease in Northern Europe: The Life-GAP project. ENVIRONMENTAL RESEARCH 2024; 257:119240. [PMID: 38821462 DOI: 10.1016/j.envres.2024.119240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/09/2024] [Accepted: 05/26/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Prolonged exposure to air pollution has been linked to adverse respiratory health, yet the evidence concerning its association with chronic obstructive pulmonary disease (COPD) is inconsistent. The evidence of a greenness effect on chronic respiratory diseases is limited. OBJECTIVE This study aimed to investigate the association between long-term exposure to particulate matter (PM2.5 and PM10), black carbon (BC), nitrogen dioxide (NO2), ozone (O3) and greenness (as measured by the normalized difference vegetation index - NDVI) and incidence of self-reported chronic bronchitis or COPD (CB/COPD). METHODS We analyzed data from 5355 adults from 7 centers participating in the Respiratory Health in Northern Europe (RHINE) study. Mean exposures to air pollution and greenness were assessed at available residential addresses in 1990, 2000 and 2010 using air dispersion models and satellite data, respectively. Poisson regression with log person-time as an offset was employed to analyze the association between air pollution, greenness, and CB/COPD incidence, adjusting for confounders. RESULTS Overall, there were 328 incident cases of CB/COPD during 2010-2023. Despite wide statistical uncertainty, we found a trend for a positive association between NO2 exposure and CB/COPD incidence, with incidence rate ratios (IRRs) per 10 μg/m³ difference ranging between 1.13 (95% CI: 0.90-1.41) in 1990 and 1.18 (95% CI: 0.96-1.45) in 2000. O3 showed a tendency for inverse association with CB/COPD incidence (IRR from 0.84 (95% CI: 0.66-1.07) in 2000 to 0.88 (95% CI: 0.69-1.14) in 2010. No consistent association was found between PM, BC and greenness with CB/COPD incidence across different exposure time windows. CONCLUSION Consistent with prior research, our study suggests that individuals exposed to higher concentrations of NO2 may face an elevated risk of developing COPD, although evidence remains inconclusive. Greenness was not associated with CB/COPD incidence, while O3 showed a tendency for an inverse association with the outcome.
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Affiliation(s)
- Shanshan Xu
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Bryndis Benediktsdottir
- Department of Respiratory Medicine and Sleep, Landspitali - the National University Hospital of Iceland, Reykjavik, Iceland; University of Iceland, Medical Faculty, Iceland
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Lise Marie Frohn
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Thorarinn Gislason
- Department of Respiratory Medicine and Sleep, Landspitali - the National University Hospital of Iceland, Reykjavik, Iceland; University of Iceland, Medical Faculty, Iceland
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Mathias Holm
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Iana Markevych
- Institute of Psychology, Jagiellonian University, Krakow, Poland; Health and Quality of Life in a Green and Sustainable Environment", Strategic Research and Innovation Program for the Development of MU - Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Lars Modig
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, United States
| | - Hans Orru
- Department of Public Health, Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Vivi Schlünssen
- Department of Public Health, Research unit for Environment Occupation and Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
| | - Torben Sigsgaard
- Department of Public Health, Research unit for Environment Occupation and Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
| | - Ane Johannessen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Takashima MD, Grimwood K, Vilcins D, Knibbs LD, Sly PD, Lambert SB, Ware RS. Association of antenatal and early childhood air pollution and greenspace exposures with respiratory pathogen upper airway acquisitions and respiratory health outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:3147-3160. [PMID: 38245844 DOI: 10.1080/09603123.2023.2299225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/20/2023] [Indexed: 01/22/2024]
Abstract
The association of air pollution and greenspace with respiratory pathogen acquisition and respiratory health was investigated in a community-based birth-cohort of 158 Australian children. Weekly nasal swabs and daily symptom-diaries were collected for 2-years, with annual reviews from ages 3-7-years. Annual exposure to fine-particulate-matter (PM2.5), nitrogen-dioxide (NO2), and normalised-difference-vegetation-index (NDVI) was estimated for pregnancy and the first 2-years-of-life. We examined rhinovirus, any respiratory virus, Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae detections in the first 3-months-of-life, age at initial pathogen detection, wheezing in the first 2-years, and asthma at ages 5-7-years. Our findings suggest that higher NDVI was associated with fewer viral and M. catarrhalis detections in the first 3-months, while increased PM2.5 and NO2 were linked to earlier symptomatic rhinovirus and H. influenzae detections, respectively. However, no associations were observed with wheezing or asthma. Early-life exposure to air pollution and greenspace may influence early-life respiratory pathogen acquisition and illness. .
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Affiliation(s)
- Mari D Takashima
- Menzies Health Institute Queensland and School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
- Paediatric Nursing and Patient Safety, Child Health Research Centre, The University of Queensland, South Brisbane, Australia
| | - Keith Grimwood
- Menzies Health Institute Queensland and School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
- Departments of Infectious Diseases and Paediatrics, Gold Coast Health, Gold Coast, Australia
| | - Dwan Vilcins
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane, Australia
| | - Luke D Knibbs
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney 2006, New South Wales, Australia
- Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Camperdown, Australia
| | - Peter D Sly
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, Queensland, Australia
| | - Stephen B Lambert
- UQ Centre for Clinical Research, The University of Queensland, Herston, Australia
- National Centre for Immunisation Research and Surveillance, Westmead, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland and School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
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Sinsamala RM, Johannessen A, Bertelsen RJ, Accordini S, Brandt J, Frohn LM, Geels C, Gislason T, Holm M, Janson C, Markevych I, Orru H, Real FG, Sigsgaard T, Skulstad SM, Svanes C, Marcon A. Pregnancy outcomes as related to in utero exposure to air pollution and greenness: The Life-GAP Project. Environ Epidemiol 2024; 8:e318. [PMID: 38919266 PMCID: PMC11196084 DOI: 10.1097/ee9.0000000000000318] [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: 01/16/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
Background Lower birth weight and preterm birth may increase the risk of adverse health outcomes later in life. We examined whether maternal exposure to air pollution and greenness during pregnancy is associated with offspring birth weight and preterm birth. Methods We analyzed data on 4286 singleton births from 2358 mothers from Respiratory Health in Northern Europe, a prospective questionnaire-based cohort study (1990-2010). Mixed-effects regression models with random intercepts for mothers and centers were used to estimate the association of exposures to particulate matter (PM2.5 and PM10), nitrogen dioxide (NO2), ozone (O3), black carbon (BC), and greenness (Normalized Difference Vegetation Index in 300m-buffers [NDVI300m]) with birth outcomes, adjusting for potential confounders. Results Median (interquartile range [IQR]) exposures to PM2.5, PM10, NO2, O3, BC, and NDVI300m during pregnancy were 8.4(5.0) µg/m3, 14.4(8.3) µg/m3, 14.0(11.0) µg/m3, 54.7(10.2) µg/m3, 0.47(0.41) µg/m3, and 0.31(0.20), respectively. IQR increases in air pollution exposures during pregnancy were associated with decreased birth weight and the strongest association was seen for PM2.5 (-49g; 95% confidence interval [CI] = -83, -16). However, O3 showed an opposite association. IQR increase in NDVI300m was associated with an increase in birth weight of 25 g (95% CI = 7, 44). Preterm birth was not associated with the exposures. Conclusion Increased greenness and decreased air pollution may contribute to healthier pregnancies and improve overall health in the next generation. This emphasizes the need to adopt policies that target the reduction of air pollution emissions and exposure of the population.
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Affiliation(s)
- Robin M. Sinsamala
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Ane Johannessen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Frederiks-borgvej, Roskilde, Denmark
| | - Lise M. Frohn
- Department of Environmental Science, Aarhus University, Frederiks-borgvej, Roskilde, Denmark
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, Frederiks-borgvej, Roskilde, Denmark
| | - Thorarinn Gislason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Sleep, Landspitali University Hospital
| | - Mathias Holm
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy & Sleep Research, Uppsala University, Uppsala Sweden
| | - Iana Markevych
- Institute of Psychology, Jagiellonian University, Krakow, Poland
- Health and Quality of Life in a Green and Sustainable Environment, SRIPD-MUP, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Francisco Gómez Real
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Torben Sigsgaard
- Department of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Svein M. Skulstad
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Cecilie Svanes
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Duquesne L, Anassour Laouan Sidi E, Plante C, Liu Y, Zhao N, Lavigne É, Zinszer K, Sousa-Silva R, Fournier M, J. Villeneuve P, Kaiser DJ, Smargiassi A. The influence of urban trees and total vegetation on asthma development in children. Environ Epidemiol 2023; 7:e280. [PMID: 38912389 PMCID: PMC11189683 DOI: 10.1097/ee9.0000000000000280] [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: 05/04/2023] [Accepted: 10/23/2023] [Indexed: 06/25/2024] Open
Abstract
Objective We aimed to assess whether the influence of urban vegetation on asthma development in children (<13 years) varies by type (e.g., total vegetation, tree type, and grass) and season. Methods We used a cohort of all children born in Montreal, Canada, between 2000 and 2015. Children and cases were identified from linked medico-administrative databases. Exposure to residential vegetation was estimated using the Normalized Difference Vegetation Index (NDVI) for total vegetation and using the total area covered by deciduous and evergreen crowns for trees in 250 m buffers centered on residential postal codes. Seasonal variations in vegetation were modeled by setting values to zero on days outside of pollen and leaf-on seasons. Cox models with vegetation exposures, age as a time axis, and adjusted for sex, material deprivation, and health region were used to estimate hazard ratios (HR) for asthma development. Results We followed 352,946 children for a total of 1,732,064 person-years and identified 30,816 incident cases of asthma. While annual vegetation (total and trees) measures did not appear to be associated with asthma development, models for pollen and leaf-on seasons yielded significant nonlinear associations. The risk of developing asthma was lower in children exposed to high levels (>33,300 m2) of deciduous crown area for the leaf-on season (HR = 0.69; 95% confidence interval [CI] = 0.67, 0.72) and increased for the pollen season (HR = 1.07; 95% CI =1.02, 1.12), compared with unexposed children. Similar results were found with the Normalized Difference Vegetation Index. Conclusion The relationship between urban vegetation and childhood asthma development is nonlinear and influenced by vegetation characteristics, from protective during the leaf-on season to harmful during the pollen season.
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Affiliation(s)
- Louise Duquesne
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, Montreal, Canada
| | | | - Céline Plante
- Center for Public Health Research (CReSP), University of Montreal and CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
| | - Ying Liu
- Center for Public Health Research (CReSP), University of Montreal and CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
| | - Naizhuo Zhao
- Centre for Forest Research, Université du Québec à Montréal, Montreal, Quebec, Canada
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Éric Lavigne
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Water and Air Quality Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Kate Zinszer
- Center for Public Health Research (CReSP), University of Montreal and CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
| | - Rita Sousa-Silva
- Young Academy for Sustainability Research, Freiburg Institute for Advanced Studies, University of Freiburg, Germany
| | - Michel Fournier
- Montreal Regional Department of Public health, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
| | - Paul J. Villeneuve
- School of Mathematics and Statistics, Carleton University, Ottawa, Ontario, Canada
| | - David J. Kaiser
- Montreal Regional Department of Public health, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Audrey Smargiassi
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, Montreal, Canada
- National Institute of Public Health of Quebec, Montreal, Quebec, Canada
- Center for Public Health Research (CReSP), University of Montreal and CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
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