Effects of Particulate Matter Exposure on the Eustachian Tube and Middle Ear Mucosa of Rats

OBJECTIVES

Particulate matter (PM) is a risk factor for various diseases. Recent studies have established an association between otitis media (OM) and PM exposure. To confirm this relationship, we developed a novel exposure model designed to control the concentration of PM, and we observed the effects of PM exposure on the Eustachian tube (ET) and middle ear mucosa of rats.

METHODS

Forty healthy, 10-week-old, male Sprague-Dawley rats were divided into 3-day, 7-day, 14-day exposure, and control groups (each, n=10). The rats were exposed to incense smoke as the PM source for 3 hours per day. After exposure, bilateral ETs and mastoid bullae were harvested, and histopathological findings were compared using microscopy and transmission electron microscopy (TEM). The expression levels of interleukin (IL)-1β, IL-6, tumor necrosis factor-α, and vascular endothelial growth factor (VEGF) in the middle ear mucosa of each group were compared using real-time reverse transcription polymerase chain reaction (RT-PCR).

RESULTS

In the ET mucosa of the exposure group, the goblet cell count significantly increased after PM exposure (P=0.032). In the middle ear mucosa, subepithelial space thickening, increased angio-capillary tissue, and inflammatory cell infiltration were observed. Moreover, the thickness of the middle ear mucosa in the exposure groups increased compared to the control group (P<0.01). The TEM findings showed PM particles on the surface of the ET and middle ear mucosa, and RT-PCR revealed that messenger RNA (mRNA) expression of IL-1β significantly increased in the 3-day and 7-day exposure groups compared to the control group (P=0.035). VEGF expression significantly increased in the 7-day exposure group compared to the control and 3-day exposure groups (P<0.01).

CONCLUSION

The ET and middle ear mucosa of rats showed histopathologic changes after acute exposure to PM that directly reached the ET and middle ear mucosa. Therefore, acute exposure to PM may play a role in the development of OM.

Long-term incense use and the risk of end-stage renal disease among Chinese in Singapore: the Singapore Chinese health study

BACKGROUND

Experimental studies have shown that exposure to incense burning may have deleterious effects on kidney function and architecture. However, the association between chronic exposure to incense smoke and risk of end-stage renal disease (ESRD) has not been reported in epidemiologic studies.

METHODS

We investigated this association in the Singapore Chinese Health Study, a prospective population-based cohort of 63,257 Chinese men and women of 45-74 years of age in Singapore during recruitment from 1993 to 1998. Information on the practice of incense burning at home, diet, lifestyle and medical history was collected at baseline interviews. ESRD cases were identified through linkage with the nationwide Singapore Renal Registry through 2015. We used Cox proportional hazards regression analysis to estimate hazard ratio (HR) and 95% confidence interval (CI) of ESRD associated with domestic incense burning.

RESULTS

Among cohort participants, 76.9% were current incense users. After an average 17.5 years of follow-up, there were 1217 incident ESRD cases. Compared to never users, the multivariable-adjusted HR for ESRD risk was 1.05 (95% CI, 0.80 to 1.38) for former users and 1.26 (95% CI, 1.02 to1.57) for current users of incense. In analysis by daily or non-daily use and duration, the increased ESRD risk was observed in daily users who had used incense for > 20 years; HR was 1.25 (95% CI, 1.07 to 1.46). Conversely, the risk was not increased in those who did not use incense daily or who had used daily but for ≤20 years.

CONCLUSIONS

Our findings demonstrate that long-term daily exposure to domestic incense burning could be associated with a higher risk of ESRD in the general population.

Sacred Maya incense, copal (Protium copal - Burseraceae), has antianxiety effects in animal models

ETHNOPHARMACOLOGICAL RELEVANCE

The Maya have traditionally used copal, Protium copal, as incense during ceremonies since pre-Columbian times. Anecdotally, copal (when burned as incense), is thought to elicit mentally uplifting and calming effects. The main objective of this study was to determine whether the incense elicits anxiolytic-like behavior in animal models using rats. A second objective was to characterize active constituents and discern potential mechanism(s) of action, specifically the involvement of the GABAergic and endocannabinoid (eCB) systems. Despite the extensive Central American use of this resin, there are currently no known scientific behavioral or pharmacological studies done with the incense.

MATERIALS AND METHODS

Quantification of the triterpenes in the copal resin and cold trapped incense was achieved by HPLC MS. Behavioral effects in rats were assessed using the elevated plus maze (EPM), social interaction (SI) test, conditioned emotion response (CER) and Novel object recognition (NOR) paradigms. Rats were exposed to burning copal (200 mg) over 5 min in a smoking chamber apparatus and then immediately tested in each behavioral paradigm. Follow-up SI tests were done using two antagonists flumazenil (1 mg/kg) and AM251 (1 mg/kg) administered systemically. Inhibition of MAGL (monoacylglycerol lipase) was measured by microplate assay with recombinant human enzyme and probe substrate.

RESULTS

Phytochemical analysis revealed that copal resin and incense had high α- and β-amyrins and low lupeol triterpene content. Exposure to Protium copal incense significantly reduced anxiety-like behavior in the SI and CER tests. In contrast, no anxiolytic effects were observed in the EPM. The CER effect was time dependent. Both flumazenil and AM251 blocked the anxiolytic activity of copal revealing the involvement of GABAergic and endocannabinoid systems. Copal, as well as the identified triterpenes, potently inhibited monoacylglycerol lipase (MAGL) activity in vitro (IC₅₀ ≤ 811 ng/mL).

CONCLUSIONS

This is the first study to show that copal incense from Protium copal elicits anxiolytic-like effects in fear and social interaction models as evidenced by a reduced learned fear behavior and an increase in active social interaction. It's high α and β-amyrin content suggests behavioral effects may be mediated, in part, by the known action of these terpenes at the benzodiazepine receptor. Furthermore, P. copal's observed activity through the eCB system via MAGL offers a new potential mechanism underlying the anxiolytic activity.

Characterization of particulate-phase polycyclic aromatic hydrocarbons emitted from incense burning and their bioreactivity in RAW264.7 macrophage

This study investigated the effects of particle-bound polycyclic aromatic hydrocarbons (PAHs) produced from burning three incense types on and their bioreactivity in the RAW 264.7 murine macrophage cell line. Gas chromatography/mass spectrometry was used to determine the levels of 16 identified PAHs. Macrophages were exposed to incense particle extracts at concentrations of 0, 3.125, 6.25, 12.5, 25, 50, and 100 μg/mL for 24 h. After exposure, cell viability and nitric oxide (NO) and inflammatory mediator [tumor necrosis factor (TNF)-α] production of the cells were examined. The mean atomic hydrogen (H) to carbon (C) ratios in the environmentally friendly, binchotan charcoal, and lao shan incenses were 0.69, 1.13, and 1.71, respectively. PAH and total toxic equivalent (TEQ) mass fraction in the incenses ranged from 137.84 to 231.00 and 6.73-26.30 pg/μg, respectively. The exposure of RAW 264.7 macrophages to incense particles significantly increased TNF-α and NO production and reduced cell viability. The cells treated with particles collected from smoldering the environmentally friendly incense produced more NO and TNF-α compared to other incenses. Additionally, the TEQ of fluoranthene (FL), pyrene (Pyr), benzo[a]anthracene (BaA), chrysene (Chr), benzo[b]fluoranthene (BbF), benzo[k]fluoranthene (BkF), benzo[a]pyrene (BaP), indeno[1,2,3-cd]pyrene (INP), dibenz[a,h]anthracene (DBA), and benzo[g,h,i]perylene [B(ghi)P] had a significant correlation (R² = 0.64-0.98, P < 0.05) with NO and TNF-α production. The current findings indicate that incense particle-bound PAHs are biologically active and that burning an incense with a lower H/C ratio caused higher bioreactivity. The stimulatory effect of PAH-containing particles on molecular mechanisms of inflammation are critical for future study.

Characterization of chemical components and bioreactivity of fine particulate matter (PM2.5) during incense burning

The chemical and bioreactivity properties of fine particulate matter (PM2.5) emitted during controlled burning of different brands of incense were characterized. Incenses marketed as being environmentally friendly emitted lower mass of PM2.5 particulates than did traditional incenses. However, the environmentally friendly incenses produced higher total concentrations of non-volatile polycyclic aromatic hydrocarbons (PAHs) and some oxygenated polycyclic aromatic hydrocarbons (OPAHs). Human alveolar epithelial A549 cells were exposed to the collected PM2.5, followed by determining oxidative stress and inflammation. There was moderate to strong positive correlation (R > 0.60, p < 0.05) between selected PAHs and OPAHs against oxidative-inflammatory responses. Strong positive correlation was observed between interleukin 6 (IL-6) and summation of total Group B2 PAHs/OPAHs (∑7PAHs/ΣOPAHs). The experimental data indicate that emissions from the environmentally friendly incenses contained higher concentrations of several PAH and OPAH compounds than did traditional incense. Moreover, these PAHs and OPAHs were strongly correlated with inflammatory responses. The findings suggest a need to revise existing regulation of such products.

Measurements of VOC/SVOC emission factors from burning incenses in an environmental test chamber: influence of temperature, relative humidity, and air exchange rate

This study investigates the influence of three environmental indoor parameters (i.e., temperature, relative humidity, and air exchange rate) on the emission of 13 volatile organic compounds (VOCs) and semi-volatile organic compounds (SVOCs) during incense burning. Experiments have been carried out using an environmental test chamber. Statistical results from a classical two-level full factorial design highlight the predominant effect of ventilation on emission factors. The higher the ventilation, the higher the emission factor. Moreover, thanks to these results, an estimation of the concentration range for the compounds under study can be calculated and allows a quick look of indoor pollution induced by incense combustion. Carcinogenic substances (i.e., benzene, benzo(a)pyrene, and formaldehyde) produced from the incense combustion would be predicted in typical living indoors conditions to reach instantaneous concentration levels close to or higher than air quality exposure threshold values.