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Kim J, Chung SJ, Kim WJ. Biomarkers of the relationship of particulate matter exposure with the progression of chronic respiratory diseases. Korean J Intern Med 2024; 39:25-33. [PMID: 38225823 PMCID: PMC10790040 DOI: 10.3904/kjim.2023.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/30/2023] [Accepted: 11/17/2023] [Indexed: 01/17/2024] Open
Abstract
A high level of particulate matter (PM) in air is correlated with the onset and development of chronic respiratory diseases. We conducted a systematic literature review, searching the MEDLINE, EMBASE, and Cochrane databases for studies of biomarkers of the effect of PM exposure on chronic respiratory diseases and the progression thereof. Thirty-eight articles on biomarkers of the progression of chronic respiratory diseases after exposure to PM were identified, four of which were eligible for review. Serum, sputum, urine, and exhaled breath condensate biomarkers of the effect of PM exposure on chronic obstructive pulmonary disease (COPD) and asthma had a variety of underlying mechanisms. We summarized the functions of biomarkers linked to COPD and asthma and their biological plausibility. We identified few biomarkers of PM exposure-related progression of chronic respiratory diseases. The included studies were restricted to those on biomarkers of the relationship of PM exposure with the progression of chronic respiratory diseases. The predictive power of biomarkers of the effect of PM exposure on chronic respiratory diseases varies according to the functions of the biomarkers.
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Affiliation(s)
- Junghyun Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong,
Korea
| | - Soo Jie Chung
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong,
Korea
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, Chuncheon,
Korea
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon,
Korea
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Zhang Y, Xu X, Zhang G, Li Q, Luo Z. The association between PM2.5 concentration and the severity of acute asthmatic exacerbation in hospitalized children: A retrospective study in Chongqing, China. Pediatr Pulmonol 2023; 58:2733-2745. [PMID: 37530510 DOI: 10.1002/ppul.26557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 05/07/2023] [Accepted: 06/07/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Ambient PM2.5 is associated with asthma exacerbation. The association between the concentration of PM2.5 and the severity of asthma exacerbation has yet to be thoroughly clarified. The study aims to explore the association between the piror 30 days average concentration of PM2.5 and the severity of acute asthma exacerbation in hospitalized children. METHODS A total of 269 children with acute exacerbation of asthma were enrolled and divided into three groups according to the PM2.5 exposure concentrations: group 1 (PM2.5: <37.5 μg/m3 ), group 2 (PM2.5: 37.5-75 μg/m3 ), group 3 (PM2.5: ≥75 μg/m3 ), respectively. The ordered logistic regression modeling was conducted to explore the influence of daily PM2.5 concentration on the clinical severity of children's asthma exacerbation. Multiple linear regression was conducted to explore the association between the concentration of PM2.5 and the length of stay in the hospital (LOS). We also conducted a receiver operating characteristic (ROC) curve analysis to explore the cutoff value of PM2.5 to predict the children's asthma exacerbation. RESULTS There was no statistical difference among the three groups of children in gender, age, body mass index, ethnicity, the first diagnosis of asthma, allergic history, passive smoke exposure, or family history of asthma. There was a statistically significant difference in many hospitalization characteristics (p < 0.05) among the three groups of children. Significant differences were found in terms of accessory muscles of respiration (p = 0.005), respiratory failure (p = 0.012), low respiratory tract infectious (p = 0.020), and the severity of asthma exacerbation (p < 0.001) among the three groups. PM2.5 concentration was primarily positively correlated to neutrophile inflammation. The ordered multivariate logistic regression model showed that higher PM2.5 concentrations were significantly associated with greater odds of more severe asthma exacerbation in one and two-pollutant models. The adjusted odds ratio of severe asthma exacerbation was 1.029 (1.009, 1.049) in the one-pollutant model. The most significant odds ratio of severe asthma exacerbation was 1.050 (1.027, 1.073) when controlling NO2 in the two-pollutant models. Multiple linear regression showed that PM2.5 concentration was significantly associated with longer LOS in both one-pollutant and two-pollutant models. By performing ROC analysis, the average daily concentration of 44.5 µg/m3 of PM2.5 (AUC = 0.622, p = 0.002) provided the best performance to predict severe asthma of children exacerbation with a sensitivity of 59.2% and a specificity of 63.8%. CONCLUSION The increased prior 30 days average concentration of PM2.5 was associated with greater asthma exacerbation severity and longer length of stay in the hospital of children with asthma exacerbation.
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Affiliation(s)
- Yueming Zhang
- Department of Respiratory Medicine, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Respiratory, Xi'an Children's Hospital, Xi'an, Shaanxi, China
| | - Ximing Xu
- Department of Respiratory Medicine, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- Big Data Center for Children's Medical Care, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Guangli Zhang
- Department of Respiratory Medicine, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Qinyuan Li
- Department of Respiratory Medicine, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Zhengxiu Luo
- Department of Respiratory Medicine, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
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Hashim JH, Hashim Z, Hod R, Jalaludin J, Mohamed N, Karuppannan S, Mazeli AR, Sahrani S, Zulkaflli ZA. A priority list of environmental health issues for Malaysia. REVIEWS ON ENVIRONMENTAL HEALTH 2023; 38:349-359. [PMID: 35468665 DOI: 10.1515/reveh-2022-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/28/2022] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Environmental risk factors contribute to 24% of the global burden of disease from all causes in disability-adjusted life years (DALYs), and to 23% of all global deaths. Malaysia being an advanced developing country, there is a need to prioritise environmental health issues to enable environmental health practitioners to focus on the most significant and urgent environmental health concerns. CONTENT This project was undertaken by a Thematic Working Group on Environmental Health Experts (TWG 10) under the Malaysian National Environmental Health Action Plan. Sixteen pre-selected environmental health issues were presented to a two focus group discussions among 20 environmental health and related professionals who then scored each issue on its magnitude and severity scale. SUMMARY The total of these scores generated a list of priority environmental health issues for Malaysia. Children environmental health came out as the environmental health issue of the highest priority. OUTLOOK We hope that this list of priority environmental health issues will be used for prioritising academic and professional manpower training, research funding allocation and planning for intervention programmes by various stakeholders.
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Affiliation(s)
- Jamal Hisham Hashim
- Department of Environmental Health and Occupational Safety, Universiti Selangor, Shah Alam Campus, Shah Alam, Selangor, Malaysia
| | - Zailina Hashim
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Rozita Hod
- Department of Community Health, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Juliana Jalaludin
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Norlen Mohamed
- Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Subramaniam Karuppannan
- Environmental Management and Research Association of Malaysia, Petaling Jaya, Selangor, Malaysia
| | - Ahmad Riadz Mazeli
- Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Suhaily Sahrani
- Engineering Services Division, Ministry of Health Malaysia, Putrajaya, Malaysia
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Mohd Isa KN, Jalaludin J, Mohd Elias S, Mohamed N, Hashim JH, Hashim Z. Evaluation of the Relationship between Fractional Exhaled Nitric Oxide (FeNO) with Indoor PM 10, PM 2.5 and NO 2 in Suburban and Urban Schools. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084580. [PMID: 35457448 PMCID: PMC9031949 DOI: 10.3390/ijerph19084580] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 12/31/2022]
Abstract
Numerous epidemiological studies have evaluated the association of fractional exhaled nitric oxide (FeNO) and indoor air pollutants, but limited information available of the risks between schools located in suburban and urban areas. We therefore investigated the association of FeNO levels with indoor particulate matter (PM10 and PM2.5), and nitrogen dioxide (NO2) exposure in suburban and urban school areas. A comparative cross-sectional study was undertaken among secondary school students in eight schools located in the suburban and urban areas in the district of Hulu Langat, Selangor, Malaysia. A total of 470 school children (aged 14 years old) were randomly selected, their FeNO levels were measured, and allergic skin prick tests were conducted. The PM2.5, PM10, NO2, and carbon dioxide (CO2), temperature, and relative humidity were measured inside the classrooms. We found that the median of FeNO in the school children from urban areas (22.0 ppb, IQR = 32.0) were slightly higher as compared to the suburban group (19.5 ppb, IQR = 24.0). After adjustment of potential confounders, the two-level hierarchical multiple logistic regression models showed that the concentrations of PM2.5 were significantly associated with elevated of FeNO (>20 ppb) in school children from suburban (OR = 1.42, 95% CI = 1.17−1.72) and urban (OR = 1.30, 95% CI = 1.10−1.91) areas. Despite the concentrations of NO2 being below the local and international recommendation guidelines, NO2 was found to be significantly associated with the elevated FeNO levels among school children from suburban areas (OR = 1.11, 95% CI = 1.06−1.17). The findings of this study support the evidence of indoor pollutants in the school micro-environment associated with FeNO levels among school children from suburban and urban areas.
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Affiliation(s)
- Khairul Nizam Mohd Isa
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang 43400, Selangor, Malaysia; (K.N.M.I.); (S.M.E.); (Z.H.)
- Environmental Health Research Cluster (EHRc), Environmental Healthcare Section, Institute of Medical Science Technology, Universiti Kuala Lumpur, Kajang 43000, Selangor, Malaysia
| | - Juliana Jalaludin
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang 43400, Selangor, Malaysia; (K.N.M.I.); (S.M.E.); (Z.H.)
- Correspondence: ; Tel.: +603-97692397
| | - Saliza Mohd Elias
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang 43400, Selangor, Malaysia; (K.N.M.I.); (S.M.E.); (Z.H.)
| | - Norlen Mohamed
- Environmental Health Unit, Level 2, E3, Disease Control Division, Ministry of Health, Putrajaya 62590, Wilayah Persekutuan Putrajaya, Malaysia;
| | - Jamal Hisham Hashim
- Department of Health Sciences, Faculty of Engineering and Life Science, Universiti Selangor, Shah Alam Campus, Seksyen 7, Shah Alam 40000, Selangor, Malaysia;
| | - Zailina Hashim
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang 43400, Selangor, Malaysia; (K.N.M.I.); (S.M.E.); (Z.H.)
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Hu D, Tobon Y, Agostini A, Grosselin B, Chen Y, Robin C, Yahyaoui A, Colin P, Mellouki A, Daële V. Diurnal variation and potential sources of indoor formaldehyde at elementary school, high school and university in the Centre Val de Loire region of France. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 811:152271. [PMID: 34902409 DOI: 10.1016/j.scitotenv.2021.152271] [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: 10/17/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 06/14/2023]
Abstract
Formaldehyde (HCHO) is one of the abundant indoor pollutants and has been classified as a human carcinogen by the International Agency for Research on Cancer (IARC). Indoor HCHO at schools is particularly important due to the high occupancy density and the health effects on children. In this study, high time resolved measurement of formaldehyde concentration was conducted in the classrooms at elementary school, high school and university under normal students' activities in three different locations in the Region Centre Val de Loire-France. Indoor average formaldehyde concentrations at those three educational institutions were observed to be in the range 10.96-17.95 μg/m3, not exceeding the World Health Organization (WHO) guideline value of 100 μg/m3. As expected, ventilation was found playing an important role in the control of indoor formaldehyde concentration. After opening windows for 30 min, formaldehyde level decreased by ~25% and 38% in the classroom at the elementary school and the high school, respectively. In addition to the primary sources, the objective of this study was also to determine potential secondary sources of indoor formaldehyde in these schools by measuring the other volatile organic compounds (VOCs) present in the classrooms by a Proton Transfer Reaction Time-of-Flight Mass Spectrometry (PTR-ToF-MS). The measurements suggest that the release of residue from tobacco smokers is one of the major sources of indoor HCHO at the high school, which increases HCHO by ~55% averagely within 1 h. Moreover, the control experiments conducted in the university suggests that VOCs such as that released from cleaning products like terpenes, can contribute to the increase of indoor formaldehyde levels through chemical reactions with ozone. This study confirms simple recommendations to reduce the indoors HCHO concentration in schools: use ventilation systems, limit the emissions like cigarette smoke or cleaning products. It also points out that the secondary sources of formaldehyde must be also considered in the classroom.
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Affiliation(s)
- Dawei Hu
- Institut de Combustion, Aérothermique, Réactivité et Environnement, Centre National de la Recherche Scientifique, ICARE-CNRS/INSIS, 1C, Avenue de la Recherche Scientifique, 45071 Orléans cedex 2, France; Department of Earth and Environmental Sciences, University of Manchester, UK.
| | - Yeny Tobon
- Institut de Combustion, Aérothermique, Réactivité et Environnement, Centre National de la Recherche Scientifique, ICARE-CNRS/INSIS, 1C, Avenue de la Recherche Scientifique, 45071 Orléans cedex 2, France
| | - Aymeric Agostini
- Institut de Combustion, Aérothermique, Réactivité et Environnement, Centre National de la Recherche Scientifique, ICARE-CNRS/INSIS, 1C, Avenue de la Recherche Scientifique, 45071 Orléans cedex 2, France
| | - Benoit Grosselin
- Institut de Combustion, Aérothermique, Réactivité et Environnement, Centre National de la Recherche Scientifique, ICARE-CNRS/INSIS, 1C, Avenue de la Recherche Scientifique, 45071 Orléans cedex 2, France
| | - Ying Chen
- Lancaster Environment Centre (LEC), Lancaster University, UK
| | - Corinne Robin
- Lig'Air - Réseau de surveillance de la qualité de l'air en région Centre, 260, Avenue de la Pomme de Pin, 45590 Saint-Cyr-en-Val, France
| | - Abderrazak Yahyaoui
- Lig'Air - Réseau de surveillance de la qualité de l'air en région Centre, 260, Avenue de la Pomme de Pin, 45590 Saint-Cyr-en-Val, France
| | - Patrice Colin
- Lig'Air - Réseau de surveillance de la qualité de l'air en région Centre, 260, Avenue de la Pomme de Pin, 45590 Saint-Cyr-en-Val, France
| | - Abdelwahid Mellouki
- Institut de Combustion, Aérothermique, Réactivité et Environnement, Centre National de la Recherche Scientifique, ICARE-CNRS/INSIS, 1C, Avenue de la Recherche Scientifique, 45071 Orléans cedex 2, France
| | - Véronique Daële
- Institut de Combustion, Aérothermique, Réactivité et Environnement, Centre National de la Recherche Scientifique, ICARE-CNRS/INSIS, 1C, Avenue de la Recherche Scientifique, 45071 Orléans cedex 2, France.
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Analysis of 19 urinary biomarkers of oxidative stress, nitrative stress, metabolic disorders, and inflammation using liquid chromatography–tandem mass spectrometry. Anal Bioanal Chem 2022; 414:2103-2116. [PMID: 35013809 PMCID: PMC8747998 DOI: 10.1007/s00216-021-03844-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/23/2021] [Accepted: 12/09/2021] [Indexed: 01/23/2023]
Abstract
Environmental chemical exposures have been associated with cancer, diabetes, hormonal and immunological disorders, and cardiovascular diseases. Some direct effects of chemical exposure that are precursors to adverse health outcomes, including oxidative stress, nitrative stress, hormonal imbalance, neutrophilia, and eosinophilia, can be assessed through the analysis of biomarkers in urine. In this study, we describe a novel methodology for the determination of 19 biomarkers of health effects: malondialdehyde (MDA), 8-isoprostaglandin-F2α (8-PGF2α), 11-β-prostaglandin-F2α (11-PGF2α), 15-prostaglandin-F2α (15-PGF2α), 8-iso-15-prostaglandin-F2α (8,15-PGF2α), 8-hydroxy-2′-deoxyguanosine (8-OHdG), 8-hydroxyguanosine (8-HdG), 8-hydroxyguanine (8-HG), dityrosine (diY), allantoin (Alla), and two metabolic products of 4-hydroxynonenal (HNE), namely 4-hydroxy-2-nonenal glutathione (HNE-GSH) and 4-hydroxy-2-nonenal mercapturic acid (HNE-MA) (in total, 12 oxidative stress biomarkers, OSBs); 8-nitroguanosine (8-NdG), 8-nitroguanine (8-NG), and 3-nitrotyrosine (NY) (3 nitrative stress biomarkers, NSBs); chlorotyrosine (CY) and bromotyrosine (BY) (2 inflammatory biomarkers); and the advanced glycation end-products (AGEs) Nε-carboxymethyllysine (CML) and Nε-carboxyethyllysine (CEL) (2 metabolic disorder biomarkers). Since these biomarkers are trigged by a variety of environmental insults and produced by different biomolecular pathways, their selective and sensitive determination in urine would help broadly elucidate the pathogenesis of diseases mediated by environmental factors.
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Isa KNM, Jalaludin J, Elias SM, Than LTL, Jabbar MA, Saudi ASM, Norbäck D, Hashim JH, Hashim Z. Metagenomic characterization of indoor dust fungal associated with allergy and lung inflammation among school children. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 221:112430. [PMID: 34147866 DOI: 10.1016/j.ecoenv.2021.112430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 06/10/2021] [Accepted: 06/14/2021] [Indexed: 06/12/2023]
Abstract
The exposure of school children to indoor air pollutants has increased allergy and respiratory diseases. The objective of this study were to determine the toxicodynamic interaction of indoor pollutants exposure, biological and chemical with expression of adhesion molecules on eosinophil and neutrophil. A self-administered questionnaire, allergy skin test, and fractional exhaled nitric oxide (FeNO) analyser were used to collect information on health status, sensitization to allergens and respiratory inflammation, respectively among school children at age of 14 years. The sputum induced were analysed to determine the expression of CD11b, CD35, CD63 and CD66b on eosinophil and neutrophil by using flow cytometry technique. The particulate matter (PM2.5 and PM10), NO2, CO2, and formaldehyde, temperature, and relative humidity were measured inside the classrooms. The fungal DNA were extracted from settled dust collected from classrooms and evaluated using metagenomic techniques. We applied chemometric and regression in statistical analysis. A total of 1869 unique of operational taxonomic units (OTUs) of fungi were identified with dominated at genus level by Aspergillus (15.8%), Verrucoconiothyrium (5.5%), and Ganoderma (4.6%). Chemometric and regression results revealed that relative abundance of T. asahii were associated with down regulation of CD66b expressed on eosinophil, and elevation of FeNO levels in predicting asthmatic children with model accuracy of 63.6%. Meanwhile, upregulation of CD11b expressed on eosinophil were associated with relative abundance of A. clavatus and regulated by PM2.5. There were significant association of P. bandonii with upregulation of CD63 expressed on neutrophil and exposure to NO2. Our findings indicate that exposure to PM2.5, NO2, T. asahii, P.bandonii and A.clavatus are likely interrelated with upregulation of activation and degranulation markers on both eosinophil and neutrophil.
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Affiliation(s)
- Khairul Nizam Mohd Isa
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang, Selangor, Malaysia; Environmental Health Research Cluster (EHRc), Environmental Healthcare Section, Institute of Medical Science Technology, Universiti Kuala Lumpur, Kajang, Selangor, Malaysia
| | - Juliana Jalaludin
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang, Selangor, Malaysia.
| | - Saliza Mohd Elias
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang, Selangor, Malaysia
| | - Leslie Thian Lung Than
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, 43400 Serdang, Selangor, Malaysia
| | - Mohammed Abdulrazzaq Jabbar
- Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Jalan Sungai Long, Bandar Sungai Long, Kajang, Selangor, Malaysia
| | - Ahmad Shakir Mohd Saudi
- Environmental Health Research Cluster (EHRc), Environmental Healthcare Section, Institute of Medical Science Technology, Universiti Kuala Lumpur, Kajang, Selangor, Malaysia
| | - Dan Norbäck
- Department of Medical Science, Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Jamal Hisham Hashim
- Department of Health Sciences, Faculty of Engineering and Life Science, Universiti Selangor, Shah Alam Campus, Seksyen 7, Shah Alam, Selangor, Malaysia
| | - Zailina Hashim
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang, Selangor, Malaysia
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Federico MJ, Denlinger LC, Corren J, Szefler SJ, Fuhlbrigge AL. Exacerbation-Prone Asthma: A Biological Phenotype or a Social Construct. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:2627-2634. [PMID: 34051392 DOI: 10.1016/j.jaip.2021.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 12/14/2022]
Abstract
Asthma is a complex syndrome with multiple phenotypes and endotypes. Asthma exacerbations are not only the clearest indictor of the morbidity of asthma and of the risk for mortality due to asthma, but also comprise a significant amount of the cost to care for poorly controlled asthma. There continues to be significant disparity in the prevalence, mortality, and morbidity due to asthma. Patients with asthma who suffer recurrent exacerbations are considered to have exacerbation-prone asthma (EPA). Efforts to characterize patients with frequent exacerbations show that the etiology is likely multifactorial. Research to determine the intrinsic risk factors for EPA include studies of both genetic and inflammatory biomarkers. External factors contributing to exacerbations have been extensively reviewed and include viral infection, environmental exposures, air pollution, and psychosocial and economic barriers to optimizing health. It is likely that EPA occurs when patients who have an increased underlying intrinsic/biological risk are placed in a given exposome (environments with a variety of exposures and triggers including allergens, pollution, stress, barriers, and occupational exposures). It is the social construct combined with underlying biology that frequently drives an EPA phenotype.
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Affiliation(s)
- Monica J Federico
- The Breathing Institute, Children's Hospital Colorado, and Department of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colo.
| | - Loren C Denlinger
- Division of Allergy, Pulmonary, and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Jonathan Corren
- Departments of Medicine and Pediatrics, Divisions of Allergy and Clinical Immunology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, Calif
| | - Stanley J Szefler
- The Breathing Institute, Children's Hospital Colorado, and Department of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colo
| | - Anne L Fuhlbrigge
- Pulmonary Sciences and Critical Care, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colo
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Canha N, Diapouli E, Almeida SM. Integrated Human Exposure to Air Pollution. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052233. [PMID: 33668253 PMCID: PMC7956776 DOI: 10.3390/ijerph18052233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 02/20/2021] [Indexed: 12/30/2022]
Abstract
Air pollution is one of the major environmental health problems that people face nowadays, affecting everyone in the world [...].
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Affiliation(s)
- Nuno Canha
- Centro de Ciências e Tecnologias Nucleares (CTN), Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10, Km 139.7, 2695-066 Bobadela LRS, Portugal;
- Centre for Environmental and Marine Studies (CESAM), Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
- Correspondence:
| | - Evangelia Diapouli
- National Centre for Scientific Research “Demokritos”, Agia Paraskevi, 15341 Athens, Greece;
| | - Susana Marta Almeida
- Centro de Ciências e Tecnologias Nucleares (CTN), Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10, Km 139.7, 2695-066 Bobadela LRS, Portugal;
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