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Ścibor M, Leoszkiewicz K, Micek A, Chomoncik K, Dubas-Jakóbczyk K, Kocot E, Bąk A, Kucińska J, Dziurda D, Topór-Mądry R. The association between air pollutions and emergency hospitalizations due to COPD and asthma across 16 Polish cities: population-based study. Int J Occup Med Environ Health 2024; 37:110-127. [PMID: 38385199 PMCID: PMC10959279 DOI: 10.13075/ijomeh.1896.02197] [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: 03/27/2023] [Accepted: 12/19/2023] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVES In recent years numerous initiatives aimed at reducing air pollution have been undertaken in Poland. The general objective was to examine the correlation between air pollution measured by the level of particulate matter ≤10 μm in diameter (PM10) and emergency hospitalizations due to chronic obstructive pulmonary disease (COPD) and asthma in 16 Polish cities (capitals of the regions). MATERIAL AND METHODS The authors aimed to diagnose the situation across 16 cities over a 5‑year period (2014-2019). Data on the number of hospitalizations was retrieved from the national public insurance system, the National Health Fund. A total number of 22 600 emergency hospitalizations was analyzed (12 000 and 10 600 in 2014 and 2019, respectively). The data on air pollution was accessed via the public register of the Chief Inspectorate for Environmental Protection air quality database. The authors of this article have used the data on PM10 daily exposure in each of the 16 cities in 2014 and 2019. Statistical methods included: non-parametric tests, a 2-stage modelling approach for time-series data, and multivariate meta-analysis of the results. RESULTS The results indicated that there was a statistically significant decrease in PM10 concentration in 2019 in comparison to 2014 in all cities, mainly in the autumn and winter season. However, the correlation between the improvement in the air quality and a decrease in emergency hospitalizations due to asthma and COPD turned out to not be as strong as expected. The authors observed a strong correlation between PM10 concentrations and hospitalizations due to asthma and COPD, but only when air quality norms were significantly above acceptable levels. CONCLUSIONS Air pollution measured by PM10 concentration might be used as one of the predictors of the asthma and COPD emergency hospitalization risk, yet other factors like respiratory tract infection, health care organizational aspect, patient self-control, compliance and comorbidities should also be taken into consideration. Int J Occup Med Environ Health. 2024;37(1):110-27.
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Affiliation(s)
- Monika Ścibor
- Jagiellonian University Medical College, Department of Environmental Health, Kraków, Poland
| | | | - Agnieszka Micek
- Jagiellonian University Medical College, Statistical Laboratory, Kraków, Poland
| | - Karol Chomoncik
- Jagiellonian University, Student of Computer Science, Kraków, Poland
| | - Katarzyna Dubas-Jakóbczyk
- Jagiellonian University Medical College, Health Economics and Social Security Department, Kraków, Poland
| | - Ewa Kocot
- Jagiellonian University Medical College, Health Economics and Social Security Department, Kraków, Poland
| | - Agata Bąk
- Agency for Health Technology Assessment and Tariff System, Warsaw, Poland
| | - Jolanta Kucińska
- Agency for Health Technology Assessment and Tariff System, Warsaw, Poland
| | - Dominik Dziurda
- Agency for Health Technology Assessment and Tariff System, Warsaw, Poland
| | - Roman Topór-Mądry
- Agency for Health Technology Assessment and Tariff System, Warsaw, Poland
- Jagiellonian University Medical College, Department of Epidemiology and Population Studies, Kraków, Poland
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Cao J, Hou S, Chen Z, Yan J, Chao L, Qian Y, Li J, Yan X. Interleukin-37 relieves PM2.5-triggered lung injury by inhibiting autophagy through the AKT/mTOR signaling pathway in vivo and in vitro. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 269:115816. [PMID: 38091678 DOI: 10.1016/j.ecoenv.2023.115816] [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: 08/27/2023] [Revised: 11/27/2023] [Accepted: 12/09/2023] [Indexed: 01/12/2024]
Abstract
Autophagy mediates PM2.5-related lung injury (LI) and is tightly linked to inflammation and apoptosis processes. IL-37 has been demonstrated to regulate autophagy. This research aimed to examine the involvement of IL-37 in the progression of PM2.5-related LI and assess whether autophagy serves as a mediator for its effects.To create a model of PM2.5-related LI, this research employed a nose-only PM2.5 exposure system and utilized both human IL-37 transgenic mice and wild-type mice. The hIL-37tg mice demonstrated remarkable reductions in pulmonary inflammation and pathological LI compared to the WT mice. Additionally, they exhibited activation of the AKT/mTOR signaling pathway, which served to regulate the levels of autophagy and apoptosis.Furthermore, in vitro experiments revealed a dose-dependent upregulation of autophagy and apoptotic proteins following exposure to PM2.5 DMSO extraction. Simultaneously, p-AKT and p-mTOR expression was found to decrease. However, pretreatment with IL-37 demonstrated a remarkable reduction in the levels of autophagy and apoptotic proteins, along with an elevation of p-AKT and p-mTOR. Interestingly, pretreatment with rapamycin, an autophagy inducer, weakened the therapeutic impact of IL-37. Conversely, the therapeutic impact of IL-37 was enhanced when treated with 3-MA, a potent autophagy inhibitor. Moreover, the inhibitory effect of IL-37 on autophagy was successfully reversed by administering AKT inhibitor MK2206. The findings suggest that IL-37 can inhibit both the inflammatory response and autophagy, leading to the alleviation of PM2.5-related LI. At the molecular level, IL-37 may exert its anti autophagy and anti apoptosis effects by activating the AKT/mTOR signaling pathway.
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Affiliation(s)
- Jing Cao
- The First Department of Pulmonary and Critical Care Medicine, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Respiratory Critical Care Medicine, Hebei Institute of Respiratory Diseases, Shijiazhuang, Hebei 050000, China
| | - Shujie Hou
- The First Department of Pulmonary and Critical Care Medicine, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Respiratory Critical Care Medicine, Hebei Institute of Respiratory Diseases, Shijiazhuang, Hebei 050000, China
| | - Zixiao Chen
- The First Department of Pulmonary and Critical Care Medicine, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Respiratory Critical Care Medicine, Hebei Institute of Respiratory Diseases, Shijiazhuang, Hebei 050000, China
| | - Jie Yan
- Department of Cardiovascular Medicine,The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China
| | - Lingshan Chao
- The First Department of Pulmonary and Critical Care Medicine, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Respiratory Critical Care Medicine, Hebei Institute of Respiratory Diseases, Shijiazhuang, Hebei 050000, China
| | - Yuxing Qian
- The First Department of Pulmonary and Critical Care Medicine, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Respiratory Critical Care Medicine, Hebei Institute of Respiratory Diseases, Shijiazhuang, Hebei 050000, China
| | - Jingwen Li
- The First Department of Pulmonary and Critical Care Medicine, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Respiratory Critical Care Medicine, Hebei Institute of Respiratory Diseases, Shijiazhuang, Hebei 050000, China
| | - Xixin Yan
- The First Department of Pulmonary and Critical Care Medicine, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Respiratory Critical Care Medicine, Hebei Institute of Respiratory Diseases, Shijiazhuang, Hebei 050000, China.
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Yan R, Ying S, Jiang Y, Duan Y, Chen R, Kan H, Fu Q, Gu Y. Associations between ultrafine particle pollution and daily outpatient visits for respiratory diseases in Shanghai, China: a time-series analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:3004-3013. [PMID: 38072886 DOI: 10.1007/s11356-023-31248-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/22/2023] [Indexed: 01/18/2024]
Abstract
Previous epidemiological studies have linked short-term exposure to particulate matter with outpatient visits for respiratory diseases. However, evidence on ultrafine particle (UFP) is still scarce in China. To investigate the association between short-term UFP exposure and outpatient visits for respiratory diseases as well as the corresponding lag patterns, information on outpatient visits for main respiratory diseases during January 1, 2017, to December 31, 2019 was collected from electronic medical records of two large tertiary hospitals in Shanghai, China. Generalized additive models employing a Quasi-Poisson distribution were employed to investigate the relationships between UFP and respiratory diseases. We computed the percentage change and its corresponding 95% confidence interval (CI) for outpatient visits related to respiratory diseases per interquartile range (IQR) increase in UFP concentrations. Based on a total of 1,034,394 hospital visits for respiratory diseases in Shanghai, China, we found that the strongest associations of total UFP with acute upper respiratory tract infection (AURTI), bronchitis, chronic obstructive pulmonary disease (COPD), and pneumonia occurred at lag 03, 03, 0, and 03 days, respectively. Each IQR increase in the total UFP concentrations was associated with increments of 9.02% (95% CI: 8.64-9.40%), 3.94% (95% CI: 2.84-5.06%), 4.10% (95% CI: 3.01-5.20%), and 10.15% (95% CI: 9.32-10.99%) for AURTI, bronchitis, COPD, and pneumonia, respectively. Almost linear concentration-response relationship curves without apparent thresholds were observed between total UFP and outpatient-department visits for four respiratory diseases. Stratified analyses illustrated significantly stronger associations of total UFP with AURTI, bronchitis, and pneumonia among female patients, while that with COPD was stronger among male patients. After adjustment of criteria air pollutants, these associations all remained robust. This time-series study indicates that short-term exposure to UFP was associated with increased risk of hospital visits for respiratory diseases, underscoring the importance of reducing ambient UFP concentrations for respiratory diseases control and prevention.
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Affiliation(s)
- Ran Yan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Shengjie Ying
- Shanghai Minhang District Center for Disease Control and Prevention, Shanghai, 201101, China
| | - Yixuan Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Yusen Duan
- Shanghai Environmental Monitoring Center, Shanghai, 200235, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Qingyan Fu
- Shanghai Environmental Monitoring Center, Shanghai, 200235, China
| | - Yiqin Gu
- Shanghai Minhang District Center for Disease Control and Prevention, Shanghai, 201101, China.
- Shanghai Minhang Dental Disease Prevention and Treatment Institute, Shanghai, 201103, China.
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Li J, Liang L, Lyu B, Cai YS, Zuo Y, Su J, Tong Z. Double trouble: The interaction of PM 2.5 and O 3 on respiratory hospital admissions. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 338:122665. [PMID: 37806428 DOI: 10.1016/j.envpol.2023.122665] [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: 06/12/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/10/2023]
Abstract
The co-occurrence of fine particulate matter (PM2.5) and ozone (O3) pollution during the warm season has become a growing public health concern. The interaction between PM2.5 and O3 and its contribution to disease burden associated with co-pollution has not been thoroughly examined. We collected data on hospital admissions for respiratory diseases from a city-wide hospital discharge database in Beijing between 2013 and 2019. City-wide 24-h mean PM2.5 and daily maximum 8-h mean O3 were averaged from 35 monitoring stations across Beijing. Conditional Poisson regression was employed to estimate the interaction between warm-season PM2.5 and O3 on respiratory admissions. A model incorporating a tensor product term was used to fit the non-linear interaction and estimate the number of respiratory admissions attributable to PM2.5 and O3 pollution. From January 18, 2013 to December 31, 2019, 1,191,308 respiratory admissions were recorded. We observed multiplicative interactions between warm-season PM2.5 and O3 on upper respiratory infections (P = 0.004), pneumonia (P = 0.002), chronic obstructive pulmonary disease (P = 0.041), and total respiratory disease (P < 0.001). PM2.5-O3 co-pollution during warm season exhibited a super-additive effect on respiratory admissions, with a relative excess risk due to interaction of 1.65% (95%CI: 0.46%-2.84%). There was a non-linear pattern of the synergistic effect between PM2.5 and O3 on respiratory admissions. Based on the World Health Organization global air quality guidelines, 12,421 respiratory admissions would be reduced if both daily PM2.5 and O3 concentrations had not exceeded the target (PM2.5 15 μg/m3, O3 100 μg/m3). The number of respiratory admissions attributable to either PM2.5 or O3 pollution decreased by 48.7% from 2013 to 2019. Prioritizing O3 control during the warm season is a cost-effective strategy for Beijing. These findings underscore the significance of concurrently addressing both PM2.5 pollution and O3 pollution during the warm season to alleviate the burden of respiratory diseases.
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Affiliation(s)
- Jiachen Li
- Department of Clinical Epidemiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
| | - Lirong Liang
- Department of Clinical Epidemiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
| | - Baolei Lyu
- Huayun Sounding Meteorology Technology Corporation, Beijing, China; Jiangsu Collaborative Innovation Center of Atmospheric Environment and Equipment Technology (CICAEET), Nanjing University of Information Science & Technology, Nanjing, China.
| | - Yutong Samuel Cai
- Centre for Environmental Health and Sustainability, Department of Population Health Sciences, University of Leicester, Leicester, UK.
| | - Yingting Zuo
- Department of Clinical Epidemiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
| | - Jian Su
- School of Economics, Peking University, Beijing, China.
| | - Zhaohui Tong
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao Yang Hospital, Capital Medical University, Beijing, China.
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Zhu PP, Gao Y, Zhou GZ, Liu R, Li XB, Fu XX, Fu J, Lin F, Zhou YP, Li L. Short-term effects of high-resolution (1-km) ambient PM 2.5 and PM 10 on hospital admission for pulmonary tuberculosis: a case-crossover study in Hainan, China. Front Public Health 2023; 11:1252741. [PMID: 37736088 PMCID: PMC10509552 DOI: 10.3389/fpubh.2023.1252741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/16/2023] [Indexed: 09/23/2023] Open
Abstract
Introduction There is limited evidence regarding particulate matter (PM)'s short-term effects on pulmonary tuberculosis (PTB) hospital admission. Our study aimed to determine the short-term associations of the exposure to ambient PM with aerodynamic diameters <2.5 μm (PM2.5) and < 10 μm (PM10) with hospital admission for PTB in Hainan, a tropical province in China. Methods We collected individual data on patients hospitalized with PTB, PM2.5, PM10, and meteorological data from 2016 to 2019 in Hainan Province, China. Conditional logistic regression models with a time-stratified case-crossover design were used to assess the short-term effects of PM2.5 and PM10 on hospital admission for PTB at a spatial resolution of 1 km × 1 km. Stratified analyses were performed according to age at admission, sex, marital status, administrative division, and season of admission. Results Each interquartile range (IQR) increases in the concentrations of PM2.5 and PM10 were associated with 1.155 (95% confidence interval [CI]: 1.041-1.282) and 1.142 (95% CI: 1.033-1.263) hospital admission risks for PTB at lag 0-8 days, respectively. The stratified analyses showed that the effects of PM2.5 and PM10 were statistically significant for patients aged ≥65 years, males, married, and those residing in prefecture-level cities. Regarding seasonal differences, the associations between PM and hospital admission for PTB were statistically significant in the warm season but not in the cold season. The effect of PM2.5 was consistently stronger than that of PM10 in most subgroups. Conclusion Short-term exposure to PM increases the risk of hospital admission for PTB. The potential impact of PM with smaller aerodynamic diameter is more detrimental. Our findings highlight the importance of reducing ambient PM level to alleviate the burden of PTB.
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Affiliation(s)
- Pan-Pan Zhu
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Yi Gao
- Department of Infectious Disease and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Department of Infectious Disease, Hainan General Hospital, Hainan Medical University, Haikou, Hainan, China
| | - Gui-Zhong Zhou
- Department of Infectious Disease, The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan, China
| | - Rui Liu
- Department of Infectious Disease, The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan, China
| | - Xiao-Bo Li
- Department of Neurosurgery, Haikou Municipal People’s Hospital and Central South University Xiangya Medical College Affiliated Hospital, Haikou, Hainan, China
| | - Xian-Xian Fu
- Clinical Lab, Haikou Municipal People’s Hospital and Central South University Xiangya Medical College Affiliated Hospital, Haikou, Hainan, China
| | - Jian Fu
- Department of Infectious Disease, Hainan General Hospital, Hainan Medical University, Haikou, Hainan, China
| | - Feng Lin
- Department of Infectious Disease, Hainan General Hospital, Hainan Medical University, Haikou, Hainan, China
| | - Yuan-Ping Zhou
- Department of Infectious Disease and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Li Li
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
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Lei J, Chen R, Liu C, Zhu Y, Xue X, Jiang Y, Shi S, Gao Y, Kan H, Xuan J. Fine and coarse particulate air pollution and hospital admissions for a wide range of respiratory diseases: a nationwide case-crossover study. Int J Epidemiol 2023; 52:715-726. [PMID: 37159523 DOI: 10.1093/ije/dyad056] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 04/20/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND The associations between fine and coarse particulate matter (PM2.5 and PM2.5-10) air pollution and hospital admissions for full-spectrum respiratory diseases were rarely investigated, especially for age-specific associations. We aim to estimate the age-specific associations of short-term exposures to PM2.5 and PM2.5-10 with hospital admissions for full-spectrum respiratory diseases in China. METHODS We conducted an individual-level case-crossover study based on a nationwide hospital-based registry including 153 hospitals across 20 provincial regions in China in 2013-20. We applied conditional logistic regression models and distributed lag models to estimate the exposure- and lag-response associations. RESULTS A total of 1 399 955 hospital admission records for various respiratory diseases were identified. The associations of PM2.5 and PM2.5-10 with total respiratory hospitalizations lasted for 4 days, and an interquartile range increase in PM2.5 (34.5 μg/m3) and PM2.5-10 (26.0 μg/m3) was associated with 1.73% [95% confidence interval (95% CI): 1.34%, 2.12%)] and 1.70% (95% CI: 1.31%, 2.10%) increases, respectively, in total respiratory hospitalizations over lag 0-4 days. Acute respiratory infections (i.e. pneumonia, bronchitis and bronchiolitis) were consistently associated with PM2.5 or PM2.5-10 exposure across different age groups. We found the disease spectrum varied by age, including rarely reported findings (i.e. acute laryngitis and tracheitis, and influenza) among children and well-established associations (i.e. chronic obstructive pulmonary disease, asthma, acute bronchitis and emphysema) among older populations. Besides, the associations were stronger in females, children and older populations. CONCLUSIONS This nationwide case-crossover study provides robust evidence that short-term exposure to both PM2.5 and PM2.5-10 was associated with increased hospital admissions for a wide range of respiratory diseases, and the spectra of respiratory diseases varied by age. Females, children and older populations were more susceptible.
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Affiliation(s)
- Jian Lei
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Renjie Chen
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Cong Liu
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Yixiang Zhu
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Xiaowei Xue
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Yixuan Jiang
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Su Shi
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Ya Gao
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
- National Center for Children's Health, Children's Hospital of Fudan University, Shanghai, China
| | - Jianwei Xuan
- Health Economic Research Institute, School of Pharmacy, Sun Yat-Shen University, Guangzhou, China
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Cheng C, Han C, Fang Q, Liu Y, Chi X, Li X. Associations between air pollutants and hospital admissions for chronic obstructive pulmonary disease in Jinan: potential benefits from air quality improvements. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:46435-46445. [PMID: 36717420 PMCID: PMC9887246 DOI: 10.1007/s11356-023-25567-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/19/2023] [Indexed: 06/01/2023]
Abstract
Evidence between air pollution and chronic obstructive pulmonary disease (COPD) is inconsistent and limited in China. In this study, we aim to examine the associations between air pollutants and hospital admissions for COPD, hoping to provide practical advice for prevention and control of COPD. Hospital admissions for COPD were collected from a Grade-A tertiary hospital in Jinan from 2014 to 2020. A generalized additive model (GAM) was used to examine the associations between air pollutants and hospital admissions for COPD. Stratified analysis was also conducted for gender, age (20-74 and ≥75 years), and season (warm and cold). The avoidable number of COPD hospital admissions was calculated when air pollutants were controlled under national and WHO standards. Over the study period, a total of 4,012 hospital admissions for COPD were recorded. The daily hospital admissions of COPD increased by 2.36% (95%CI: 0.13-4.65%) and 2.39% (95%CI: 0.19-4.65%) for per 10 μg/m3 increase of NO2 and SO2 concentrations at lag2, respectively. There was no statistically significant difference in health effects caused by increased concentrations of PM2.5, PM10, CO, and O3. The health effects of increased SO2 concentration were stronger in women, the ≥75 years old people and the cold season. About 2 (95%CI: 0-3), 64 (95%CI: 4-132) and 86 (95%CI: 6-177) COPD admissions would be avoided when the SO2 concentration was controlled below the NAAQS-II (150 μg/m3), NAAQS-I (50 μg/m3), and WHO's AQG2021 standard (40 μg/m3), respectively. These findings suggest that short-term exposure to NO2 and SO2 was associated with increased risks of daily COPD admissions, especially for females and the elderly. The control of SO2 and NO2 under the national and WHO standards could avoid more COPD admissions and obtain greater health benefits.
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Affiliation(s)
- Chuanlong Cheng
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Chuang Han
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Qidi Fang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Ying Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Xiangyu Chi
- Department of Geriatric Respiratory Disease, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xiujun Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China.
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Su M, Qi H, Huang Q, Wang L, Guo X, Wang Q. Acute arsenic exposure exacerbates lipopolysaccharide-induced lung injury possibly by compromising the integrity of the lung epithelial barrier in rats. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159561. [PMID: 36265643 DOI: 10.1016/j.scitotenv.2022.159561] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/14/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
Inhalation of large amounts of arsenic can damage the respiratory tract and may exacerbate the development of bacterial pneumonia, but the exact mechanism remains unclear. In this study, male Wistar rats were randomly divided into control, arsenic trioxide (16.0 μg/kg ATO), lipopolysaccharide (0.5 mg/kg LPS), and ATO combined with LPS (16.0 μg/kg ATO + 0.5 mg/kg LPS) groups. Blood and lung tissue samples were collected from each group 12 h after exposure. The results showed that exposure to ATO or LPS alone produced different effects on leukocytes and inflammatory factors, while combined exposure significantly increased serum interleukin-6, interleukin-10, lung water content, lung lavage fluid protein, and p38 protein phosphorylation levels. Alveolar interstitial thickening, alveolar membrane edema, alveolar type I and II cell matrix vacuolization, and nuclear pyknosis were observed in rats exposed to either ATO or LPS. More severe ultrastructural changes were found in the combined exposure group, and chromatin splitting was observed in alveolar type I cells. Lanthanum nitrate particles leaked from the alveolar vascular lumen in the ATO-exposed group, whereas in the combined exposure group, Evans Blue levels were increased and lanthanum nitrate particles were present in the lung parenchyma. Claudin-3 protein expression increased and claudin-4 expression decreased after ATO or LPS exposure, while claudin-18 expression was unchanged. The changes in claudin-3 and claudin-4 protein expression were further exacerbated by combined exposure. In conclusion, these results suggest that inhalation of ATO may exacerbate the development of bacterial pneumonia and that common mechanisms may exist to synergistically disrupt epithelial barrier integrity.
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Affiliation(s)
- Mingxing Su
- Chinese People's Liberation Army Center of Disease Control and Prevention, Beijing 100071, China; The Northern District of PLA General Hospital, Beijing 100094, China
| | - Huixiu Qi
- Chinese People's Liberation Army Center of Disease Control and Prevention, Beijing 100071, China; School of Public Health, Hebei University, Baoding 071000, China
| | - Qingzhen Huang
- Chinese People's Liberation Army Center of Disease Control and Prevention, Beijing 100071, China
| | - Lili Wang
- Chinese People's Liberation Army Center of Disease Control and Prevention, Beijing 100071, China
| | - Xueqi Guo
- Chinese People's Liberation Army Center of Disease Control and Prevention, Beijing 100071, China
| | - Qiang Wang
- Chinese People's Liberation Army Center of Disease Control and Prevention, Beijing 100071, China.
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9
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Lv S, Liu X, Li Z, Lu F, Guo M, Liu M, Wei J, Wu Z, Yu S, Li S, Li X, Gao W, Tao L, Wang W, Xin J, Guo X. Causal effect of PM 1 on morbidity of cause-specific respiratory diseases based on a negative control exposure. ENVIRONMENTAL RESEARCH 2023; 216:114746. [PMID: 36347395 DOI: 10.1016/j.envres.2022.114746] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/27/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Extensive studies have linked PM2.5 and PM10 with respiratory diseases (RD). However, few is known about causal association between PM1 and morbidity of RD. We aimed to assess the causal effects of PM1 on cause-specific RD. METHODS Hospital admission data were obtained for RD during 2014 and 2019 in Beijing, China. Negative control exposure and extreme gradient boosting with SHapley Additive exPlanation was used to explore the causality and contribution between PM1 and RD. Stratified analysis by gender, age, and season was conducted. RESULTS A total of 1,183,591 admissions for RD were recorded. Per interquartile range (28 μg/m3) uptick in concentration of PM1 corresponded to a 3.08% [95% confidence interval (CI): 1.66%-4.52%] increment in morbidity of total RD. And that was 4.47% (95% CI: 2.46%-6.52%) and 0.15% (95% CI: 1.44%-1.78%), for COPD and asthma, respectively. Significantly positive causal associations were observed for PM1 with total RD and COPD. Females and the elderly had higher effects on total RD, COPD, and asthma only in the warm months (Z = 3.03, P = 0.002; Z = 4.01, P < 0.001; Z = 3.92, P < 0.001; Z = 2.11, P = 0.035; Z = 2.44, P = 0.015). Contribution of PM1 ranked first, second and second for total RD, COPD, and asthma among air pollutants. CONCLUSION PM1 was causally associated with increased morbidity of total RD and COPD, but not causally associated with asthma. Females and the elderly were more vulnerable to PM1-associated effects on RD.
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Affiliation(s)
- Shiyun Lv
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Xiangtong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Zhiwei Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Feng Lu
- Beijing Municipal Health Commission Information Center, Beijing, 100034, China
| | - Moning Guo
- Beijing Municipal Health Commission Information Center, Beijing, 100034, China
| | - Mengmeng Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China; National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD 20740, USA
| | - Zhiyuan Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Siqi Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Shihong Li
- Department of Respiratory, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, 3086, Australia
| | - Wenkang Gao
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry (LAPC), Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Wei Wang
- School of Medical Sciences and Health, Edith Cowan University, WA6027, Perth, Australia
| | - Jinyuan Xin
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry (LAPC), Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China.
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China; National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing, China.
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Liu Y, He X, Liu J, Zhang L, Xiong A, Wang J, Liu S, Jiang M, Luo L, Xiong Y, Li G. Transcriptome analysis identifies IL24 as an autophagy modulator in PM2.5 caused lung dysfunction. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 244:114039. [PMID: 36049333 DOI: 10.1016/j.ecoenv.2022.114039] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/19/2022] [Accepted: 08/27/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Evidence suggests that exposure to PM2.5 increased hospitalization and mortality rates of respiratory diseases. However, the potential biomarkers and targets associated with PM2.5-induced lung dysfunction are not fully discovered. METHODS Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and HALLMARK enrichment analysis of the RNA-seq data (Beas-2B cells treated with PM2.5) were applied. Gene set enrichment analysis (GSEA) was performed to identify the biological processes correlated with autophagy. Three gene expression profile datasets (GSE158954, GSE155616 and GSE182199) were downloaded from the Gene Expression Omnibus (GEO) database to identify the potential targets. PM2.5-exposed mice were constructed. Real-time qPCR, siRNA transfection, western blot, immunofluorescence, and pathological staining were applied for validation both in vitro and in vivo studies. RESULTS GO, KEGG and HALLMARK enrichment based on RNA-seq data showed that the differentially expressed genes (DEGs) were associated with autophagy like lysosome and macroautophagy. GSEA analysis revealed that PM2.5 was positively correlated with autophagy-related biological processes compared with control group. Venn diagrams identified IL24 was upregulated in our data as well as in these three datasets (GSE158954, GSE155616 and GSE182199) after PM2.5 exposure. Consistent with the analysis, activation of autophagy by PM2.5 was validated in vivo and in vitro. In PM2.5-exposed mice, lung pathological changes were observed, including airway inflammation and mucus secretion. The mRNA and protein levels of the key gene, IL24, were significantly increased. Moreover, Bafilomycin A1, the inhibitor of autophagy, inhibited the autophagy and ameliorated lung injury induced by PM2.5. Furthermore, downregulation of IL24 decreased autophagy activity. Meanwhile, IL24 was regulated by mTOR signaling. CONCLUSIONS In summary, we discovered a potential relationship between IL24 and autophagy during PM2.5 exposure. IL24 might be a novel potential biomarker or therapeutic target in PM2.5 caused lung dysfunction through regulation of autophagy.
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Affiliation(s)
- Yao Liu
- School of Medicine, Southwest Jiaotong University, Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu 610031, China; Department of Pulmonary and Critical Care Medicine, Chengdu Third People's Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu 610031, China
| | - Xiang He
- School of Medicine, Southwest Jiaotong University, Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu 610031, China.
| | - Jiliu Liu
- School of Medicine, Southwest Jiaotong University, Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu 610031, China; Department of Pulmonary and Critical Care Medicine, Chengdu Third People's Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu 610031, China
| | - Lei Zhang
- School of Medicine, Southwest Jiaotong University, Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu 610031, China; Department of Pulmonary and Critical Care Medicine, Chengdu Third People's Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu 610031, China
| | - Anying Xiong
- School of Medicine, Southwest Jiaotong University, Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu 610031, China; Department of Pulmonary and Critical Care Medicine, Chengdu Third People's Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu 610031, China
| | - Junyi Wang
- School of Medicine, Southwest Jiaotong University, Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu 610031, China; Department of Pulmonary and Critical Care Medicine, Chengdu Third People's Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu 610031, China
| | - Shengbin Liu
- School of Medicine, Southwest Jiaotong University, Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu 610031, China; Department of Pulmonary and Critical Care Medicine, Chengdu Third People's Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu 610031, China
| | - Manling Jiang
- School of Medicine, Southwest Jiaotong University, Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu 610031, China; Department of Pulmonary and Critical Care Medicine, Chengdu Third People's Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu 610031, China
| | - Li Luo
- School of Medicine, Southwest Jiaotong University, Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu 610031, China; Department of Pulmonary and Critical Care Medicine, Chengdu Third People's Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu 610031, China
| | - Ying Xiong
- Department of Pulmonary and Critical Care Medicine, Sichuan Friendship Hospital, Chengdu 610000, China.
| | - Guoping Li
- School of Medicine, Southwest Jiaotong University, Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu 610031, China; Department of Pulmonary and Critical Care Medicine, Chengdu Third People's Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu 610031, China.
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Zhou L, Tao Y, Su X, Chen X, Li L, Fu Q, Xie J, Chen R. Short-Term Associations between Size-Fractioned Particles and Cardiopulmonary Function in COPD Patients: A Panel Study in Shanghai, China, during 2014-2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12473. [PMID: 36231774 PMCID: PMC9566564 DOI: 10.3390/ijerph191912473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/16/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
It remains unknown which size fractions dominate the adverse cardiopulmonary effects of particulate matter (PM). Therefore, this study aimed to explore the differential associations between size-fractioned particle number concentrations (PNCs) and cardiopulmonary function measures, including the forced expiratory volume in one second (FEV1), the forced vital capacity (FVC), and the left ventricular ejection fraction (LVEF). We conducted a panel study among 211 patients with chronic obstructive pulmonary disease (COPD) in Shanghai, China, between January 2014 and December 2021. We applied linear mixed-effect models to determine the associations between cardiopulmonary function measures and PNCs ranging from 0.01 to 10 μm in diameter. Generally, only particles <1 μm showed significant associations, i.e., ultrafine particles (UFPs, <0.1 μm) for FVC and particles ranging from 0.1 to 1 µm for FEV1 and LVEF. An interquartile range (IQR) increment in UFP was associated with decreases of 78.4 mL in FVC. PNC0.1-0.3 and PNC0.3-1 corresponded to the strongest effects on FEV1 (119.5 mL) and LVEF (1.5%) per IQR increment. Particles <1 µm might dominate the cardiopulmonary toxicity of PM, but UFPs might not always have the strongest effect. Tailored regulations towards particles <1 µm should be intensified to reduce PM pollution and protect vulnerable populations.
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Affiliation(s)
- Lu Zhou
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yingmin Tao
- Division of General Practice, The Fifth People’s Hospital of Shanghai, Fudan University, Shanghai 200240, China
- Center of Community-Based Health Research, Fudan University, Shanghai 200240, China
| | - Xiaozhen Su
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China
| | - Xiyin Chen
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Liang Li
- Division of General Practice, The Fifth People’s Hospital of Shanghai, Fudan University, Shanghai 200240, China
- Center of Community-Based Health Research, Fudan University, Shanghai 200240, China
| | - Qingyan Fu
- Shanghai Environmental Monitoring Center, Shanghai 200235, China
| | - Juan Xie
- Division of General Practice, The Fifth People’s Hospital of Shanghai, Fudan University, Shanghai 200240, China
- Center of Community-Based Health Research, Fudan University, Shanghai 200240, China
| | - Renjie Chen
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China
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12
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Ma Y, Qiu S, Zhou R. Osteoporosis in Patients With Respiratory Diseases. Front Physiol 2022; 13:939253. [PMID: 35903070 PMCID: PMC9315364 DOI: 10.3389/fphys.2022.939253] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Climate change, environmental pollution, and virus epidemics have sharply increased the number of patients suffering from respiratory diseases in recent years. Prolonged periods of illness and drug use increase the occurrence of complications in these patients. Osteoporosis is the common bone metabolism disease with respiratory disturbance, which affects prognosis and increases mortality of patients. The problem of osteoporosis in patients with respiratory diseases needs more attention. In this review, we concluded the characteristics of osteoporosis in some respiratory diseases including COPD, asthma, COVID-19, tuberculosis, and lung cancer. We revealed that hypoxia was the common pathogenesis of osteoporosis secondary to respiratory diseases, with malnutrition and corticosteroid abuse driving the progression of osteoporosis. Hypoxia-induced ROS accumulation and activated HIF-1α lead to attenuated osteogenesis and enhanced osteoclastogenesis in patients with respiratory diseases. Tuberculosis and cancer also invaded bone tissue and reduced bone strength by direct infiltration. For the treatment of osteoporosis in respiratory patients, oral-optimized bisphosphonates were the best treatment modality. Vitamin D was a necessary supplement, both for calcium absorption in osteogenesis and for improvement of respiratory lesions. Reasonable adjustment of the dose and course of corticosteroids according to the etiology and condition of patients is beneficial to prevent the occurrence and development of osteoporosis. Additionally, HIF-1α was a potential target for the treatment of osteoporosis in respiratory patients, which could be activated under hypoxia condition and involved in the process of bone remodeling.
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Affiliation(s)
- Yue Ma
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shui Qiu
- Department of Orthopedics, First Hospital of China Medical University, Shenyang, China
| | - Renyi Zhou
- Department of Orthopedics, First Hospital of China Medical University, Shenyang, China
- *Correspondence: Renyi Zhou,
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