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Yount CS, Scheible K, Thurston SW, Qiu X, Ge Y, Hopke PK, Lin Y, Miller RK, Murphy SK, Brunner J, Barrett E, O'Connor TG, Zhang J, Rich DQ. Short term air pollution exposure during pregnancy and associations with maternal immune markers. ENVIRONMENTAL RESEARCH 2024; 260:119639. [PMID: 39034020 PMCID: PMC11421383 DOI: 10.1016/j.envres.2024.119639] [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: 04/02/2024] [Revised: 07/16/2024] [Accepted: 07/17/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Air pollution exposure during pregnancy has been associated with numerous adverse pregnancy, birth, and child health outcomes. One proposed mechanism underlying these associations is maternal immune activation and dysregulation. We examined associations between PM2.5 and NO2 exposure during pregnancy and immune markers within immune function groups (TH1, TH2, TH17, Innate/Early Activation, Regulatory, Homeostatic, and Proinflammatory), and examined whether those associations changed across pregnancy. METHODS In a pregnancy cohort study (n = 290) in Rochester, New York, we measured immune markers (using Luminex) in maternal plasma up to 3 times during pregnancy. We estimated ambient PM2.5 and NO2 concentrations at participants' home addresses using a spatial-temporal model. Using mixed effects models, we estimated changes in immune marker concentrations associated with interquartile range increases in PM2.5 (2.88 μg/m3) and NO2 (7.82 ppb) 0-6 days before blood collection, and assessed whether associations were different in early, mid, and late pregnancy. RESULTS Increased NO2 concentrations were associated with higher maternal immune markers, with associations observed across TH1, TH2, TH17, Regulatory, and Homeostatic groups of immune markers. Furthermore, the largest increases in immune markers associated with each 7.82 ppb increase in NO2 concentration were in late pregnancy (e.g., IL-23 = 0.26 pg/ml, 95% CI = 0.07, 0.46) compared to early pregnancy (e.g., IL-23 = 0.08 pg/ml, 95% CI = -0.11, 0.26). CONCLUSIONS Results were suggestive of NO2-related immune activation. Increases in effect sizes from early to mid to late pregnancy may be due to changes in immune function over the course of pregnancy. These findings provide a basis for immune activation as a mechanism for previously observed associations between air pollution exposure during pregnancy and reduced birthweight, fetal growth restriction, and pregnancy complications.
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Affiliation(s)
- C S Yount
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - K Scheible
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - S W Thurston
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - X Qiu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Y Ge
- Nicholas School of the Environment & Duke Global Health Institute, Duke University, Durham, NC, USA
| | - P K Hopke
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Center for Air and Aquatic Resources Engineering and Sciences, Clarkson University, Potsdam, NY, USA
| | - Y Lin
- Nicholas School of the Environment & Duke Global Health Institute, Duke University, Durham, NC, USA
| | - R K Miller
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - S K Murphy
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - J Brunner
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
| | - E Barrett
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA; Department of Biostatistics and Epidemiology, Rutgers University School of Public Health, Piscataway, NJ, USA
| | - T G O'Connor
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA; Department of Psychology, University of Rochester, Rochester, NY, USA; Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - J Zhang
- Nicholas School of the Environment & Duke Global Health Institute, Duke University, Durham, NC, USA
| | - D Q Rich
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA; Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
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Percival E, Collison AM, da Silva Sena CR, De Queiroz Andrade E, De Gouveia Belinelo P, Gomes GMC, Oldmeadow C, Murphy VE, Gibson PG, Karmaus W, Mattes J. The association of exhaled nitric oxide with air pollutants in young infants of asthmatic mothers. Environ Health 2023; 22:84. [PMID: 38049853 PMCID: PMC10696885 DOI: 10.1186/s12940-023-01030-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 11/08/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Exhaled nitric oxide is a marker of airway inflammation. Air pollution induces airway inflammation and oxidative stress. Little is known about the impact of air pollution on exhaled nitric oxide in young infants. METHODS The Breathing for Life Trial recruited pregnant women with asthma into a randomised controlled trial comparing usual clinical care versus inflammometry-guided asthma management in pregnancy. Four hundred fifty-seven infants from the Breathing for Life Trial birth cohort were assessed at six weeks of age. Exhaled nitric oxide was measured in unsedated, sleeping infants. Its association with local mean 24-h and mean seven-day concentrations of ozone, nitric oxide, nitrogen dioxide, carbon monoxide, sulfur dioxide, ammonia, particulate matter less than 10 μm (PM10) and less than 2.5 μm (PM2.5) in diameter was investigated. The air pollutant data were sourced from local monitoring sites of the New South Wales Air Quality Monitoring Network. The association was assessed using a 'least absolute shrinkage and selection operator' (LASSO) approach, multivariable regression and Spearman's rank correlation. RESULTS A seasonal variation was evident with higher median exhaled nitric oxide levels (13.6 ppb) in warmer months and lower median exhaled nitric oxide levels (11.0 ppb) in cooler months, P = 0.008. LASSO identified positive associations for exhaled nitric oxide with 24-h mean ammonia, seven-day mean ammonia, seven-day mean PM10, seven-day mean PM2.5, and seven-day mean ozone; and negative associations for eNO with seven-day mean carbon monoxide, 24-h mean nitric oxide and 24-h mean sulfur dioxide, with an R-square of 0.25 for the penalized coefficients. These coefficients selected by LASSO (and confounders) were entered in multivariable regression. The achieved R-square was 0.27. CONCLUSION In this cohort of young infants of asthmatic mothers, exhaled nitric oxide showed seasonal variation and an association with local air pollution concentrations.
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Affiliation(s)
- Elizabeth Percival
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Adam M Collison
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Carla Rebeca da Silva Sena
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Ediane De Queiroz Andrade
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Patricia De Gouveia Belinelo
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Gabriela Martins Costa Gomes
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | | | - Vanessa E Murphy
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Peter G Gibson
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia
| | - Wilfried Karmaus
- Division of Epidemiology, School of Public Health, and Environmental Health Science, University of Memphis, BiostatisticsMemphis, TN, 38152, USA
| | - Joerg Mattes
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia.
- Department of Paediatric Respiratory & Sleep Medicine, John Hunter Children's Hospital, Newcastle, NSW, Australia.
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Aguilera J, Konvinse K, Lee A, Maecker H, Prunicki M, Mahalingaiah S, Sampath V, Utz PJ, Yang E, Nadeau KC. Air pollution and pregnancy. Semin Perinatol 2023; 47:151838. [PMID: 37858459 PMCID: PMC10843016 DOI: 10.1016/j.semperi.2023.151838] [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] [Indexed: 10/21/2023]
Abstract
Increased fossil fuel usage and extreme climate change events have led to global increases in greenhouse gases and particulate matter with 99% of the world's population now breathing polluted air that exceeds the World Health Organization's recommended limits. Pregnant women and neonates with exposure to high levels of air pollutants are at increased risk of adverse health outcomes such as maternal hypertensive disorders, postpartum depression, placental abruption, low birth weight, preterm birth, infant mortality, and adverse lung and respiratory effects. While the exact mechanism by which air pollution exerts adverse health effects is unknown, oxidative stress as well as epigenetic and immune mechanisms are thought to play roles. Comprehensive, global efforts are urgently required to tackle the health challenges posed by air pollution through policies and action for reducing air pollution as well as finding ways to protect the health of vulnerable populations in the face of increasing air pollution.
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Affiliation(s)
- Juan Aguilera
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health, El Paso, Texas
| | | | - Alexandra Lee
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, Palo Alto, CA
| | - Holden Maecker
- Institute for Immunity, Transplantation, and Infection, School of Medicine, Stanford University, Stanford, CA
| | - Mary Prunicki
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA
| | - Shruthi Mahalingaiah
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA; Division of Reproductive Endocrinology and Infertility, Department of OB/GYN, Massachusetts General Hospital, Boston, MA
| | - Vanitha Sampath
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA
| | - Paul J Utz
- Department of Medicine, Stanford University, Palo Alto, CA
| | - Emily Yang
- Department of Medicine, Stanford University, Palo Alto, CA
| | - Kari C Nadeau
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA.
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Chung HW, Hsieh HM, Lee CH, Lin YC, Tsao YH, Wu HW, Kuo FC, Hung CH. Prenatal and Postnatal Exposure to Ambient Air Pollution and Preschool Asthma in Neonatal Jaundice Infants. J Inflamm Res 2022; 15:3771-3781. [PMID: 35832831 PMCID: PMC9271683 DOI: 10.2147/jir.s366336] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/16/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Both air pollutant exposure and neonatal jaundice (NJ) have known effects on childhood asthma, but a higher total serum bilirubin (TSB) level has been associated with lung protection. This study aimed to assess whether prenatal/postnatal exposure to ambient air pollutants is related to the development of asthma in infants with NJ. Patients and Methods A nested case–control retrospective study was performed using the data of infants with NJ in the Kaohsiung Medical University Hospital Research Database. Data on average ambient air pollution concentrations within six months, the first year and second year after birth, and in the first, second and third prenatal trimesters were collected. NJ was defined as TSB levels ≥ 2 mg/dl with the diagnosis less than one-month-old. Asthma was defined as a diagnosis with medication use. We constructed conditional logistic regression models to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Results Exposure to NO and SO2 at all six time points in the study was significantly associated with an increased risk of preschool asthma in infants with NJ. The overall peak OR (95% CI) of SO2, PM2.5, PM10, NO, NO2, and NOX were 1.277 (1.129–1.444), 1.057 (1.023–1.092), 1.035 (1.011–1.059), 1.272 (1.111–1.455), 1.168 (1.083–1.259) and 1.104 (1.051–1.161), respectively. Fetuses in the first and second trimester were most vulnerable to ambient air pollutant exposure such as SO2 PM2.5, NO, NO2 and NOX during the prenatal period. Exposure to all six ambient air pollutants during the first and second years after birth significantly affected preschool asthma in NJ infants. Conclusion In different time windows, prenatal and postnatal exposure to SO2, PM2.5, PM10, NO, NO2, and NOX were associated with preschool asthma in NJ infants. The relatively high impact of NO and SO2 exposure in infants with NJ requires further studies and prevention measures.
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Affiliation(s)
- Hao-Wei Chung
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.,Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Hui-Min Hsieh
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chung-Hsiang Lee
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yi-Ching Lin
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Division of Pharmacology and Toxicology, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Doctoral Degree Program of Toxicology, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Hsiang Tsao
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Huang-Wei Wu
- Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Fu-Chen Kuo
- Department of Obstetrics & Gynecology, E-Da Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chih-Hsing Hung
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.,Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Pediatrics, Faculty of Pediatrics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Lin J, Yuan S, Dong B, Zhang J, Zhang L, Wu J, Chen J, Tang M, Zhang B, Wang H, Dai Y, Liu S, Hu Y, Qi X, Xu L, Zhao L, Yin Y. The Associations of Caesarean Delivery With Risk of Wheezing Diseases and Changes of T Cells in Children. Front Immunol 2022; 12:793762. [PMID: 34970272 PMCID: PMC8712489 DOI: 10.3389/fimmu.2021.793762] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/29/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives This study aimed to assess the associations of caesarean delivery (CD) with risk of wheezing diseases and changes of immune cells in children. Design The cross-sectional study was conducted between May, 2020 and April, 2021. Setting and participants The study was conducted in Shanghai Children’s Medical Center, Shanghai, China. A total of 2079 children with a mean age of 36.97 ± 40.27 months and their guardians were included in the present study via face-to-face inquiry and physical examination by clinicians. Methods Logistic regression was applied to estimate odds ratio (ORs) and 95% confidence intervals (CIs) for the association between CD and first episode of wheezing (FEW) or asthma. Models were adjusted for premature or full-term delivery, exclusive breastfeeding (at least 4 months) or not. Results Among the 2079 children, 987 children (47.47%) were born by CD and 1092 (52.53%) by vaginal delivery (VD). Children delivered by caesarean had significantly lower gestational age (P<0.01) compared with those who delivered vaginally. Our results also showed that CD was related to increased risk of FEW by the age of 3(adjusted OR 1.50, 95%CI 1.06, 2.12) and increased tendency to develop asthma by the age of 4 (adjusted OR 3.16, 95%CI 1.25, 9.01). The subgroup analysis revealed that the negative effects of CD on asthma were more obvious in children without exclusive breastfeeding (adjusted OR 4.93, 95%CI 1.53, 21.96) or without postnatal smoking exposure (adjusted OR 3.58, 95%CI 1.20, 13.13). Furthermore, compared with children born through VD, a significant change of the T cells (increased proportion of CD4+ T cells and decreased number and proportion of CD8+ T cells) were observed before the age of one in the CD group. However, the changes were insignificant in children over 1 year old. Conclusions This study showed age-dependent associations of CD with asthma and FEW in offspring. Moreover, CD appeared to have an effect on the cellular immunity in infants, the disorder of which may contribute to the development of asthma in children.
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Affiliation(s)
- Jilei Lin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shuhua Yuan
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Bin Dong
- Pediatric AI Clinical Application and Research Center, Shanghai Children's Medical Center, Shanghai, China.,Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
| | - Jing Zhang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lei Zhang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jinhong Wu
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jiande Chen
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Mingyu Tang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Bin Zhang
- Pediatric AI Clinical Application and Research Center, Shanghai Children's Medical Center, Shanghai, China.,Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
| | - Hansong Wang
- Pediatric AI Clinical Application and Research Center, Shanghai Children's Medical Center, Shanghai, China.,Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
| | - Yuanyuan Dai
- Department of Neonatology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shijian Liu
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yabin Hu
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xinyi Qi
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Liangye Xu
- Department of information, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Liebin Zhao
- Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
| | - Yong Yin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Pediatric AI Clinical Application and Research Center, Shanghai Children's Medical Center, Shanghai, China.,Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
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