The role of nitric oxide and cytokines in asthma-like syndrome induced by sulfur dioxide exposure in agricultural environment

Association of short-term exposure to ambient air pollutants with exhaled nitric oxide in hospitalized patients with respiratory-system diseases

BACKGROUND

Previous studies have suggested that exposure to ambient air pollutants may adversely affect human health. However, few studies have examined the health effects of exposure to ambient air pollutants in hospitalized patients.

OBJECTIVES

To evaluate the association between short-term exposure to ambient air pollutants and exhaled nitric oxide fraction (FeNO) in a large cohort of hospitalized patients.

METHODS

FeNO was detected for 2986 hospitalized patients (ages 18-88 years). Daily average concentrations of SO₂, NO₂, O₃, CO, PM_2.5 and PM₁₀ in 2014 and 2015 were obtained from nine fixed-site monitoring stations. Multiple linear regression models were chosen to assess the associations of exposure to ambient air pollutants with FeNO while adjusting for confounding variables. Lagged variable models were selected to determine the association between FeNO and ambient air pollutants concentrations with lags of up to 7 days prior to FeNO testing.

RESULTS

Interquartile-range (IQR) increases in the daily average SO₂ (8.00 μg/m³) and PM_2.5 (37.0 μg/m³) were strongly associated with increases in FeNO, with increases of 3.41% [95% confidence interval (CI), 0.94-5.93%] and 2.72% (95%CI, -0.09% to 5.61%), respectively. However, FeNO levels were not statistically associated with PM₁₀, NO₂, O₃ or CO. In the two-pollutant models, the maximum correlation was for ambient SO₂. We also found that FeNO was associated with IQR increases in daily average ambient concentrations of SO₂ up to 3 and 4 days after the exposure events.

CONCLUSIONS

Short-term exposure to SO₂ and PM_2.5 were positively correlated with FeNO levels in hospitalized patients in Shanghai.

Work-Related Asthma

OBJECTIVE

Summarize developed evidence-based diagnostic and treatment guidelines for work-related asthma (WRA).

METHODS

Comprehensive literature reviews conducted with article critiquing and grading. Guidelines developed by a multidisciplinary expert panel and peer-reviewed.

RESULTS

Evidence supports spirometric testing as an essential early test. Serial peak expiratory flow rates measurement is moderately recommended for employees diagnosed with asthma to establish work-relatedness. Bronchial provocation testing is moderately recommended. IgE and skin prick testing for specific high-molecular weight (HMW) antigens are highly recommended. IgG testing for HMW antigens, IgE testing for low-molecular weight antigens, and nitric oxide testing for diagnosis are not recommended. Removal from exposure is associated with the highest probability of improvement, but may not lead to complete recovery.

CONCLUSION

Quality evidence supports these clinical practice recommendations. The guidelines may be useful to providers who diagnose and/or treat WRA.

Genotoxic effects of sulfur dioxide in human lymphocytes

Sulfur dioxide (SO2), which is used as food preservative in apricot sulfurization and several fabricated foods, is a common air pollutant. The aim of this study was to reveal the possible genotoxic effects of SO2 using in vitro human lymphocytes. The different endpoints of genotoxicity: sister chromatid exchange (SCE), micronuclei (MN) tests and cell growth kinetics such as mitotic index (MI) and replication index (RI) were studied. The cells were treated with 0.1, 0.5 and 1.0 ppm concentrations of SO2. It was shown that SO2 caused significant increases in the frequency of SCE and MN in the middle and high dosage groups and also induced mitotic delays and decreased MI and RI. In conclusion, the results have confirmed that SO2 has potent mutagenicity and it can cause genetic damage leading to a malignancy.

Effect of sulfur dioxide inhalation on CYP2B1/2 and CYP2E1 in rat liver and lung

Sulfur dioxide (SO2) is a ubiquitous air pollutant, present in low concentrations in the urban air and in higher concentrations in the working environment. In this study, we investigated the effects of inhaled SO2 on the O-dealkylase of pentoxyresorufin (PROD) and p-nitrophenol hydroxylases (p-NP) activities and mRNA levels of CYP2B1/2 and CYP2E1 in the lung and liver of Wistar rats. Male Wistar rats were housed in exposure chambers and treated with 14.11 +/- 1.53, 28.36 +/- 2.12, and 56.25 +/- 4.28 mg/m3 SO2 for 6 h/day for 7 days, while control rats were exposed to filtered air in the same condition. The mRNAs of CYP2B1/2 and -2E1 were analyzed in livers and lungs by using reverse-transcription polymerase chain reaction (RT-PCR). Our results showed that the PROD activities and mRNA of CYP2B1/2 were decreased in livers and lungs of rats exposed to SO2. The p-NP activities and mRNA of CYP2E1 were decreased in lungs but not in livers of rats exposed to SO2. Total liver microsomal cytochrome P-450 (CYP) contents were diminished in SO2-exposed rats. These results lead to two conclusions: (1) SO2 exposure can suppress CYP2B1/2 and CYP2E1 in lungs and CYP2B1/2 in livers of rats, thus modifying the liver and lung toxication/detoxication potential, and (2) the total liver microsomal CYP contents were diminished, although the activity and mRNA expression of CYP2E1 in rat livers were not affected by SO2 exposure.

Protective effect of ipratropium bromide on bronchoconstriction induced by sulfur dioxide exposure during apricot sufurization processes that causes asthma-like syndrome in agricultural environment

We previously showed that apricot sulfurization workers are exposed to high concentrations of sulfur dioxide (SO2), resulting in an asthma-like syndrome. The aim of this study was to investigate whether pre-treatment of ipratropium bromide protects bronchoconstriction induced by SO2 exposure during apricot sulfurization processes that causes asthma-like syndrome. Firstly, pulmonary function tests were measured before and immediately after SO2 exposure due to processes of apricot sulfurization in 21 healthy volunteer apricot sulfurization workers who did not use any medication in apricot farms. One week later, same measurements were repeated in the same workers when they were working in same farm but they were administered two puffs of ipratropium bromide (20 microg per dose) before 30 min second SO2 exposure for protection of SO2-induced bronchoconstriction. Occupational SO2 exposure caused significant decrement in forced vital capacity (FVC), forced expiratory volume (FEV1) and forced mid-expiratory flow rate (FEF25-75%) in the worker and these decrements were prevented by ipratropium bromide given 30 min before SO2 exposure. This result suggests that pre-treatment of ipratropium bromide protects SO2-induced bronchoconstriction in healthy worker during apricot sulfurization processes that causes asthma-like syndrome in agricultural environment.