Link between environmental air pollution and allergic asthma: East meets West

Place of residence, gender, month of birth and age influence on the concentration of specific IgE antibodies in serum. The Epidemiology of Allergic Diseases in Poland (ECAP survey): part three

Introduction

Specific immunoglobulins E (sIgE) are important parameters to estimate the severity of allergic diseases.

Aim

To determine the influence of gender, age and place of residence on the concentration of specific IgE antibodies in serum.

Material and methods

The concentration of sIgE antibodies against allergens of Dermatophagoides pteronyssinus, cat dander, timothy grass, Alternaria alternata were determined in serum of 4077 respondents randomly selected from 8 regions (ECAP study). The positive results of sIgE (≥ 0.35 IU/ml) were correlated with answers to ECAP questionnaires.

Results

IgE antibodies are less frequently detected in respondents living in the country (p < 0.05 to p < 0.005); and they are less frequently detected in respondents living in cities of hardly industrialised regions than in respondents living in cities of industrialised regions (D. pteronyssinus p < 0.05, cat dander p < 0.01). IgE antibodies are more frequently detected in men (p < 0.005 to p < 0.001). IgE antibodies are more frequently detected in respondents born in May-July (timothy grass p < 0.005, Alternaria alternata p < 0.005) and less frequently detected in respondents born in August-October (timothy grass p < 0.005, Alternaria alternata p < 0.05).

Conclusions

Characteristics of the urban environment, non-specific factors and gender affect the concentration of specific IgE antibodies in serum. Influence of seasonal allergens within the first months of life and/or in the course of the foetal period alters the production of specific IgE antibodies.

Impact of Heavy PM2.5 Pollution Events on Mortality in 250 Chinese Counties

We explored the impact of heavy PM_2.5 pollution events on the health of residents in 250 counties in China. A time-series approach involving a two-stage analysis was applied to estimate the association between heavy PM_2.5 pollution events and mortality from 2013 to 2018. The associations between heavy (PM_2.5 ≥75 μg/m³ and <150 μg/m³) and extremely heavy (PM_2.5 ≥150 μg/m³) PM_2.5 pollution days with mortality were explored. The added effects of the heavy PM_2.5 pollution events were evaluated by controlling PM_2.5 concentration in the model. From 2013 to 2018, there were 57,279 county days of heavy PM_2.5 pollution and 21,248 county days of extremely heavy PM_2.5 pollution. The risks of mortality during this period of heavy PM_2.5 pollution events increased by 1.22% (95% CI: 0.82-1.63%), 1.14% (95% CI: 0.74-1.53%), 1.09% (95% CI: 0.58-1.60%), and 1.30% (95% CI: 0.40-2.20%), for all-cause, nonaccidental, circulatory, and respiratory mortality, respectively. We also observed that heavy PM_2.5 pollution events had an added effect on mortality risk associated with all-cause, nonaccidental, circulatory, and respiratory mortality, evident from an observed increase by 0.77% (95% CI: 0.29-1.24%), 0.73% (95% CI: 0.27-1.19%), 0.96% (95% CI: 0.37-1.55%), and 0.55% (95% CI: -0.52-1.63%), respectively. Heavy PM_2.5 pollution events increased mortality risks and caused an independent added effect. The findings serve as a foundation for policymakers in developing early warning systems and policy interventions.

Supervised Kohonen Self-Organizing Maps of Acute Asthma from Air Pollution Exposure

There are unanswered questions with regards to acute respiratory outcomes, particularly asthma, due to environmental exposures. In contribution to asthma research, the current study explored a computational intelligence paradigm of artificial neural networks (ANNs) called self-organizing maps (SOM). To train the SOM, air quality data (nitrogen dioxide, sulphur dioxide and particulate matter), interpolated to geocoded addresses of asthmatics, were used with clinical data to classify asthma outcomes. Socio-demographic data such as age, gender and race were also used to perform the classification by the SOM. All pollutants and demographic traits appeared to be important for the correct classification of asthma outcomes. Age was more important: older patients were more likely to have asthma. The resultant SOM model had low quantization error. The study concluded that Kohonen self-organizing maps provide effective classification models to study asthma outcomes, particularly when using multidimensional data. SO₂ was concluded to be an important pollutant that requires strict regulation, particularly where frail subpopulations such as the elderly may be at risk.

Bacterial community analysis of floor dust and HEPA filters in air purifiers used in office rooms in ILAS, Beijing

Air purifiers with high-efficiency particulate air (HEPA) filters remove not only particulate matter but also airborne microorganisms in indoor environments. We investigated the bacterial community in HEPA filters (used for 1 year) and that in the floor dust of 12 office rooms in Beijing. We found that the viable bacteria proportion in the filter was significantly higher than that in the floor dust (p < 0.001). The Non-Metric Multi-Dimensional Scaling analysis showed that the bacterial communities in the filters and dust were significantly different (p = 0.001). The Chao1, Shannon-Wiener and phylogenetic diversity values in the filter were significantly higher than those in the dust (p < 0.001). The predominant bacterial classes in the filter were Alphaproteobacteria and Actinobacteria, whereas those in the dust were Bacteroidia, Clostridia and Bacilli. Human occupancy contributed more to the bacterial community in the filter than that in the dust. Klebsiella and Alloprevotella in the dust and filters positively correlated with the occupancy density. Soil bacteria contributed to a significantly higher proportion of the bacteria in the HEPA filter (p < 0.001). In contrast, human oral, indoor air and outdoor haze contributed to a higher proportion of the bacteria in the dust samples (p < 0.001, p < 0.01 and p < 0.05, respectively). As HEPA filters serve as an ecological niche for indoor bacteria, they should be carefully investigated during the assessment of indoor environmental health.

Carbon load in airway macrophages, DNA damage and lung function in taxi drivers exposed to traffic-related air pollution

To evaluate the potential applicability of carbon load in airway macrophages as a marker of exposure to traffic-related air pollution (TRAP) and its association with parameters of comet assay as a marker of DNA damage, and pulmonary function tests (PFTs) in the group of taxi drivers in Iran. One hundred four male taxi drivers with at least 1-year job history were randomly selected from registered drivers in the taxi union. Airway macrophages were obtained via sputum induction, and then the area of airway macrophages occupied by carbon was measured. DNA damage was determined by comet assay. PFTs were measured by the spirometer. Most of the participants (89.4%) were non-smoker. In this study, 52.7% of non-smoker participants were able to give a sample of sputum with macrophage. Carbon content of airway macrophages was 0.2 μm². There was no significant difference in pulmonary function and comet assay parameters in terms of smoking status. There was an inverse correlation between carbon load with each of comet assay and PFTs parameters, although not statistically significant. This study identified that long-term exposure to TRAP can be a risk factor for pulmonary disorders.

Asthma, Environment and Pollution: Where the Rubber Hits the Road

The detrimental effects of environmental pollution on one's health are undeniable and have been demonstrated time and time again. Breathing in pollutants in ambient air often has consequences throughout the body, including cardiovascular disease, effects on the reproductive system, and oncologic implications. In the respiratory system, chronic exposure yields a number of outcomes, including chronic obstructive pulmonary disease (COPD) and asthma exacerbations, increased rates of hospitalizations, and increased severity of acute illnesses. On a macro-level, this morbidity and mortality then leads to vast and far-reaching public health consequences the world over, including the loss of billions of dollars' worth of labor. This is especially applicable in developing countries, which often undergo rapid growth, industrialization and urbanization with a resultant increase in vehicular traffic, coal combustion, and fuel emissions as a whole. For this reason, environmental pollutants have been studied extensively, and countries around the globe have established laws that regulate ambient air levels of so-called criteria pollutants. This article will explore several of these criteria pollutants, including particulate matter, nitrogen dioxide, sulfur dioxide, and ozone, and their individual relationships to asthma pathophysiology. However, it is also emphasized that though each one of these toxins yields its own effects, the group of them often works together to have cumulative consequences. For these reasons and many more, it is important to remain aware and educated about these omnipresent environmental pollutants.

Interaction Between Air Pollutants and Pollen Grains: The Role on the Rising Trend in Allergy

Asthma and allergic diseases cases have risen in recent decades. Plant pollen is considered as the main aeroallergen causing allergic reactions. According to available data, urban residents experience more respiratory allergies than rural residents mainly due to the interaction between chemical air pollutants and pollen grains. This interaction can occur through several mechanisms; chemical pollutants might facilitate pollen allergen release, act as adjuvants to stimulate IgE-mediated responses, modify allergenic potential, and enhance the expression of some allergens in pollen grains. This review focuses on the most recent theories explaining how air pollutants can interact with pollen grains and allergens.

Petroleum coke exposure leads to altered secretome profiles in human lung models

Petroleum coke (PC) is a coal-like product that is produced during the refinement of crude oil and bituminous sand. Fugitive dust from open storage of PC in urban areas is a potential human health concern. Animal inhalation studies suggest that PC leads to an adverse pulmonary histopathology, including areas of fibrosis and chronic inflammation; however, little is known about its impact on human health. In order to identify biomarkers and cellular pathways that are associated with exposure, we performed two-dimensional liquid chromatography-mass spectrometric analyses on secreted proteins from two human lung culture models. A total of 2795 proteins were identified and relatively quantified from an immortalized cell line and 2406 proteins from primary cultures that were either mock treated or exposed to particulate matter with a diameter of 2.5-10 μm PC or filtered urban air particulates for 16 h. Pathway analysis on secretomes from primary lung cultures indicated that PC exposure suppressed the secretion of proteins involved in the organization of the extracellular matrix and epithelial differentiation. Because these cellular processes could facilitate fibrosis, we performed chronic 12-day exposure studies on three-dimensional human lung cultures consisting of epithelia and stromal fibroblasts. Relative to mock-treated cells, matrix metallopeptidase 9 levels in the conditioned media were lower by 4 days postexposure and remained suppressed for the duration of the experiment. Immunocytochemical staining of collagen III, a marker associated with fibrosis, showed increased accumulation in the epithelial layer and at the air-liquid interface.

Environmental pollution and kidney diseases

The burden of disease and death attributable to environmental pollution is becoming a public health challenge worldwide, especially in developing countries. The kidney is vulnerable to environmental pollutants because most environmental toxins are concentrated by the kidney during filtration. Given the high mortality and morbidity of kidney disease, environmental risk factors and their effect on kidney disease need to be identified. In this Review, we highlight epidemiological evidence for the association between kidney disease and environmental pollutants, including air pollution, heavy metal pollution and other environmental risk factors. We discuss the potential biological mechanisms that link exposure to environmental pollutants to kidney damage and emphasize the contribution of environmental pollution to kidney disease. Regulatory efforts should be made to control environmental pollution and limit individual exposure to preventable or avoidable environmental risk. Population studies with accurate quantification of environmental exposure in polluted regions, particularly in developing countries, might aid our understanding of the dose-response relationship between pollutants and kidney diseases.

Effects of fine particulate matter and its constituents on emergency room visits for asthma in southern Taiwan during 2008-2010: a population-based study

This population-based study evaluated the short-term association between fine particulate matter (PM_2.5) concentrations and its constituents and hospital emergency room visits (ERVs) for asthma in southern Taiwan during the period 2008-2010. Data on hospital ERVs for asthma and ambient PM_2.5 levels and its constituents were obtained from the National Health Insurance Research database and the Environmental Protection Administration, respectively. The quasi-Poisson generalized additive model was used to explore the associations between PM_2.5 and hospital ERVs for asthma. During the study period, the average daily number of ERVs for asthma and mean 24-h average level of PM_2.5 was 20.0 and 39.4 μg m^-3, respectively. The estimated effects of PM_2.5 on asthma ERVs fluctuated with increasing tendencies after adjusting for O₃ and attenuating tendencies after adjusting for NO₂, SO₂, and CO. Children were more susceptible than other age groups to the effects of PM_2.5 exposure on asthma ERVs, with the relative risks (RRs) for every 10 μg m^-3 increase in PM_2.5 being 1.016 [95% confidence interval (CI) = 1.002-1.030] and 1.018 (95% CI = 1.002-1.034), respectively, at a lag 0 day (i.e., no lag days) and lag 0-1 days. The effect of PM_2.5 concentrations on asthma ERVs was similar in male and female. Furthermore, asthma ERVs was significantly associated with concentrations of nitrate (NO₃^-), with the RR for each 1 μg m^-3 increase in NO₃^- concentrations being 1.004 (95% CI = 1.001-1.007) at lag 0 day. In conclusion, both PM_2.5 concentrations and its chemical constituents are associated with ERVs for asthma; moreover, children were more susceptible to the effects of PM_2.5 in southern Taiwan. PM_2.5 constituent, nitrate, is more closely related to ERVs for asthma.

Socio-environmental exposures and health outcomes among persons with sickle cell disease

There is much variability in the expression of sickle cell disease (SCD) and recent works suggest that environmental and social factors may also influence this variability. This paper aims to use geographic information systems technology to examine the association between socio-environmental exposures and health outcomes in all persons who have attended or currently attend the Sickle Cell Unit in Jamaica. Rural patients presented for clinical care at older ages and had less annual visits to clinic. Persons travelled relatively long distances to seek SCD care and those travelling longer had less health maintenance visits. Urban patients had a higher prevalence of significant pain crises (69.4% vs. 55.8%, p value<0.001) and respiratory events (21.2% vs. 14%, p value<0.001). Prevalence of leg ulcers did not vary between rural and urban patients but was higher in males than in females. Females also had lower odds of having respiratory events but there was no sex difference in history of painful crises. Persons with more severe genotypes lived in higher poverty and travelled longer for healthcare services. Persons in areas with higher annual rainfall, higher mean temperatures and living farther from factories had less painful crises and respiratory events. The paper highlights a need for better access to healthcare services for Jamaicans with SCD especially in rural areas of the island. It also reports interesting associations between environmental climatic exposures and health outcomes.

A review on recent progress in observations, sources, classification and regulations of PM2.5 in Asian environments

Natural and human activities generate a significant amount of PM_2.5 (particles ≤2.5 μm in aerodynamic diameter) into the surrounding atmospheric environments. Because of their small size, they can remain suspended for a relatively longer time in the air than coarse particles and thus can travel long distances in the atmosphere. PM_2.5 is one of the key indicators of pollution and known to cause numerous types of respiratory and lung-related diseases. Due to poor implementation of regulations and a time lag in introducing the vehicle technology, levels of PM_2.5 in most Asian cities are much worse than those in European environments. Dedicated reviews on understanding the characteristics of PM_2.5 in Asian urban environments are currently missing but much needed. In order to fill the existing gaps in the literature, the aim of this review article is to describe dominating sources and their classification, followed by current status and health impact of PM_2.5, in Asian countries. Further objectives include a critical synthesis of the topics such as secondary and tertiary aerosol formation, chemical composition, monitoring and modelling methods, source apportionment, emissions and exposure impacts. The review concludes with the synthesis of regulatory guidelines and future perspectives for PM_2.5 in Asian countries. A critical synthesis of literature suggests a lack of exposure and monitoring studies to inform personal exposure in the household and rural areas of Asian environments.

Allergies in urban versus countryside settings in Poland as part of the Epidemiology of the Allergic Diseases in Poland (ECAP) study - challenge the early differential diagnosis

Introduction

The incidence of allergies depends on a number of factors, including adopting an urban “western” lifestyle, genetic predispositions, and different regions of residence.

Aim

To compare the prevalence of allergic conditions (seasonal allergic rhinitis (SAR) and perennial allergic rhinitis (PAR), bronchial asthma (BA), atopic dermatitis (AD)) in a group of countryside versus urban residents in Poland.

Material and methods

The prevalence of allergic conditions in urban versus countryside settings was assessed using the translated and approved questionnaire developed for international ECRHS II and ISAAC studies. Respondents were selected via random multistage sampling, with proportionate stratified sampling, and the Polish Resident Identification Number (PESEL) as the basis. A total of 18,617 respondents took part in the study. Subsequently, approximately 25% of the subjects underwent outpatient assessments: skin-prick, lung function, peak nasal inspiratory flow (PNIF) tests, as well as history-taking.

Results

Allergic rhinitis (AR) proved to be the most common condition in the entire study population. Children residing in the countryside were twice more likely to be diagnosed with BA (8.33% vs. 4%; p < 0.05). Conversely, in the adult subgroup, BA was more commonly observed in urban areas. Whereas reported symptom rates were much higher in AR and AD patients, symptomatic BA was proportionately lower with respect to the official diagnoses (underdiagnosed BA phenomenon). Atopic dermatitis was considerably more common in the metropolitan population. One factor that significantly correlated with allergic diseases was a positive family history.

Conclusions

Inhabitants of metropolitan areas are to a greater extent predisposed to allergic conditions. One factor significantly contributing to allergies is genetic predisposition. Given the scale of the problem, there is an urgent need to implement measures for early prevention and diagnosis of allergies to minimize distant health effects.

Generation of IL10 and TGFB1 coexpressed mice displaying resistance to ovalbumin-induced asthma

Asthma is a common chronic inflammatory disease in the airways with wide prevalence, and it is thought to be caused by the combinational factors in environment and genetics. A large body of studies has suggested that cell immunity played a vital role in regulating the airway hyperreactivity (AHR) and inflammation. Therefore, we here developed a mouse model of asthma by microinjecting the pronucleus with a vector spontaneously coding human IL10 and TGFB1 gene to explore the possible interaction between these two potent molecules during asthma progression. From the total 35 newborn mice, we successfully obtained 3 founders expressing exogenous genes. In the transgenic mice, we observed profoundly enhanced expression of IL10 and TGFB1. In the condition of ovalbumin challenge, transgenic mice displayed a 1.9-fold higher MCh50 score than wild-type counterparts, indicating reminiscent AHR. Meanwhile, a three-fold decrease of cell counts in bronchoalveolar lavage fluid (BALF) was recorded as well. These results suggested that IL10 and TGFB1 cooperatively protected the respiratory system in response to antigenic stimulus. To interrogate the respective behaviors of the two genes, we quantified the expression of downstream genes in IL10 signaling or TGFB1 signaling. We observed that the examined genes in IL10 signaling were significantly repressed, especially IL5, which showed 5.4-fold decreased expression. Most genes were not altered in TGFB1 signaling, and the production of endogenous TGFB1 was significantly inhibited. These evidences collectively proved that the activation of IL0 and TGFB1 protected the host from antigen-induced asthma, possibly through IL10 signaling. This study shed some light on the modulations of IL10 and TGFB1, and related networks to asthma progression.

Erratum to link between environmental air pollution and allergic asthma: East meets West

[This corrects the article on p. 14 in vol. 7, PMID: 25694814.].

Aryl Hydrocarbon Receptor Protects Lungs from Cockroach Allergen-Induced Inflammation by Modulating Mesenchymal Stem Cells

Exposure to cockroach allergen leads to allergic sensitization and increased risk of developing asthma. Aryl hydrocarbon receptor (AhR), a receptor for many common environmental contaminants, can sense not only environmental pollutants but also microbial insults. Mesenchymal stem cells (MSCs) are multipotent progenitor cells with the capacity to modulate immune responses. In this study, we investigated whether AhR can sense cockroach allergens and modulate allergen-induced lung inflammation through MSCs. We found that cockroach allergen-treated AhR-deficient (AhR(-/-)) mice showed exacerbation of lung inflammation when compared with wild-type (WT) mice. In contrast, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), an AhR agonist, significantly suppressed allergen-induced mouse lung inflammation. MSCs were significantly reduced in cockroach allergen-challenged AhR(-/-) mice as compared with WT mice, but increased in cockroach allergen-challenged WT mice when treated with TCDD. Moreover, MSCs express AhR, and AhR signaling can be activated by cockroach allergen with increased expression of its downstream genes cyp1a1 and cyp1b1. Furthermore, we tracked the migration of i.v.-injected GFP(+) MSCs and found that cockroach allergen-challenged AhR(-/-) mice displayed less migration of MSCs to the lungs compared with WT. The AhR-mediated MSC migration was further verified by an in vitro Transwell migration assay. Epithelial conditioned medium prepared from cockroach extract-challenged epithelial cells significantly induced MSC migration, which was further enhanced by TCDD. The administration of MSCs significantly attenuated cockroach allergen-induced inflammation, which was abolished by TGF-β1-neutralizing Ab. These results suggest that AhR plays an important role in protecting lungs from allergen-induced inflammation by modulating MSC recruitment and their immune-suppressive activity.