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Bi Z, Meng Y, Ji Q, Zhang A, Liu M, Xu X, Zhan Y. Association between volatile organic compounds and serum neurofilament light chain in US adults. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 926:171893. [PMID: 38531449 DOI: 10.1016/j.scitotenv.2024.171893] [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: 12/16/2023] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE This study aimed to investigate the associations between exposure to blood volatile organic compounds (VOCs) and the level of serum neurofilament light chain (NfL) in adults. METHODS We analyzed data from the 2013-2014 National Health and Nutrition Examination Survey (NHANES), including 2008 participants aged 20 to 75 years old. Multiple linear regression models were used to examine the associations between 28 VOCs and NfL after adjusting for multiple potential confounders. Restricted cubic spline (RCS) was used to examine the potential non-linear associations. RESULTS The linear regression models showed that higher levels of 2,5-dimethylfuran (β = 0.042, 95 % confidence interval [CI]: 0.001, 0.096), ethyl acetate (β = 0.118, 95 % CI = 0.008, 0.304), and m-/p-xylene (β = 0.043, 95%CI = 0.012, 0.074) were associated with higher NfL levels. These estimates were largely consistent after adjusting for multiple confounders. CONCLUSION The findings of our study suggest a potential association between certain volatile organic compounds (2,5-dimethylfuran, ethyl acetate, and m-/p-xylene) and blood NfL levels, implying that they may have a role in revealing neurodegeneration and influencing neurological health.
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Affiliation(s)
- Zhuochang Bi
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong 518107, China
| | - Yaxian Meng
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong 518107, China
| | - Qianqian Ji
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong 518107, China
| | - Aijie Zhang
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong 518107, China
| | - Miao Liu
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Xiaowei Xu
- Department of Neurology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Yiqiang Zhan
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
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Rodríguez-Carrillo A, Verheyen VJ, Van Nuijs ALN, Fernández MF, Remy S. Brain-derived neurotrophic factor (BDNF): an effect biomarker of neurodevelopment in human biomonitoring programs. FRONTIERS IN TOXICOLOGY 2024; 5:1319788. [PMID: 38268968 PMCID: PMC10806109 DOI: 10.3389/ftox.2023.1319788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/13/2023] [Indexed: 01/26/2024] Open
Abstract
The present narrative review summarizes recent findings focusing on the role of brain-derived neurotrophic factor (BDNF) as a biomarker of effect for neurodevelopmental alterations during adolescence, based on health effects of exposure to environmental chemical pollutants. To this end, information was gathered from the PubMed database and the results obtained in the European project Human Biomonitoring for Europe (HBM4EU), in which BDNF was measured at two levels of biological organization: total BDNF protein (serum) and BDNF gene DNA methylation (whole blood) levels. The obtained information is organized as follows. First, human biomonitoring, biomarkers of effect and the current state of the art on neurodevelopmental alterations in the population are presented. Second, BDNF secretion and mechanisms of action are briefly explained. Third, previous studies using BDNF as an effect biomarker were consulted in PubMed database and summarized. Finally, the impact of bisphenol A (BPA), metals, and non-persistent pesticide metabolites on BDNF secretion patterns and its mediation role with behavioral outcomes are addressed and discussed. These findings were obtained from three pilot studies conducted in HBM4EU project. Published findings suggested that exposure to some chemical pollutants such as fine particle matter (PM), PFAS, heavy metals, bisphenols, and non-persistent pesticides may alter circulating BDNF levels in healthy population. Therefore, BDNF could be used as a valuable effect biomarker to investigate developmental neurotoxicity of some chemical pollutants.
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Affiliation(s)
- Andrea Rodríguez-Carrillo
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
- Toxicological Centre, University of Antwerp, Universiteitsplein, Wilrijk, Belgium
| | - Veerle J. Verheyen
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | | | - Mariana F. Fernández
- Biomedical Research Center and School of Medicine, Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), University of Granada, Granada, Spain
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
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Wang Y, Liu Q, Tian Z, Cheng B, Guo X, Wang H, Zhang B, Xu Y, Sun L, Hu B, Chen G, Sheng J, Liang C, Tao F, Wei J, Yang L. Short-term effects of ambient PM 1, PM 2.5, and PM 10 on internal metal/metalloid profiles in older adults: A distributed lag analysis in China. ENVIRONMENT INTERNATIONAL 2023; 182:108341. [PMID: 38006770 DOI: 10.1016/j.envint.2023.108341] [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: 07/29/2023] [Revised: 10/24/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023]
Abstract
There is limited evidence linking exposure to ambient particulate matter (PM) with internal doses of metals and metalloids (metal(loid)s). This study aimed to evaluate the effects of short-term exposure to ambient PM on urine metal(loid)s among Chinese older adults. Biological monitoring data of 15 urine metal(loid)s collected in 3, 970 community-dwelling older adults in Fuyang city, Anhui Province, China, from July to September 2018, were utilized. PMs with an aerodynamic diameter ≤ 1 µm (PM1), ≤ 2.5 µm (PM2.5), and ≤ 10 µm (PM10) up to eight days before urine collection were estimated by space-time extremely randomized trees (STET) model. Residential greenness was reflected by Normalized Difference Vegetation Index (NDVI). We used generalized additive model (GAM) combined with distributed lag linear/non-linear models (DLMs/DLNMs) to estimate the associations between short-term PM exposure and urine metal(loid)s. The results suggested that the cumulative exposures to PM1, PM2.5, or PM10 over two days (lag0-1 days) before urine collection were associated with elevated urine metal(loid)s in DLMs, while exhibited linear or "inverted U-shaped" relationships with seven urine metal(loid)s in DLNMs, including Gallium (Ga), Arsenic (As), Aluminum (Al), Magnesium (Mg), Calcium (Ca), Uranium (U), and Barium (Ba). Aforementioned results indicated robust rather than spurious associations between PMs and these seven metal(loid)s. After standardizations for three PMs, PM1 was the greatest contributor to U, PM2.5 made the greatest contributions to Ga, As, Al, and Ba, and PM10 contributed the most to Mg and Ca. Furthermore, the effects of three PMs on urine Ga, As, Al, Mg, Ca, and Ba were reduced when exposed to higher levels of NDVI. Overall, short-term exposures to ambient PMs contribute to elevated urinary metal(loid) levels in older adults, and three PMs exhibit various contributions to different urine metal(loid)s. Moreover, residential greenness may attenuate the effects of PMs on urine metal(loid)s.
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Affiliation(s)
- Yuan Wang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Qiang Liu
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Ziwei Tian
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Beijing Cheng
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Xianwei Guo
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China
| | - Hongli Wang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China
| | - Bo Zhang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China
| | - Yan Xu
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China
| | - Liang Sun
- Fuyang Center for Diseases Prevention and Control, Fuyang, Anhui 236069, China
| | - Bing Hu
- Fuyang Center for Diseases Prevention and Control, Fuyang, Anhui 236069, China
| | - Guimei Chen
- School of Health Services Management, Anhui Medical University, Hefei, Anhui 230032, China
| | - Jie Sheng
- Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Chunmei Liang
- School of Public Health, Department of Hygiene Inspection and Quarantine, Anhui Medical University, Hefei, Anhui 230032, China
| | - Fangbiao Tao
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, Anhui, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD 20740, USA.
| | - Linsheng Yang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, Anhui, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China.
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Huang H, Xie B, Liu Y, Dong GH, Liu R, Gui Z, Chen L, Li S, Guo Y, Yang L, Chen G. Long-term exposure to PM 2.5 compositions and O 3 and their interactive effects on DNA methylation of peripheral brain-derived neurotrophic factor promoter. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023:1-12. [PMID: 37939783 DOI: 10.1080/09603123.2023.2280157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/01/2023] [Indexed: 11/10/2023]
Abstract
This study examined the associations of long-term exposure to ambient fine particulate matter (PM2.5) compositions/ozone with methylation of peripheral brain-derived neurotrophic factor (BDNF) promoters. A total of 101 participants were recruited from a cohort in Shijiazhuang, Hebei province, China. They underwent baseline and follow-up surveys in 2011 and 2015. DNA methylation levels were detected by bisulfite-PCR amplification and pyrosequencing. Participants' three-year average levels of PM2.5 compositions and ozone were estimated. Bayesian kernel machine regression (BKMR) models were used to examine the joint effects of pollutants on methylation levels. Exposure to PM2.5 compositions and ozone mixtures at the 75th percentile was associated with increased methylation levels at CpG2 of BDNF promoter (203%, 95% CI: 89, 316) than the lowest level of exposure, and sulfate dominated the effect in the BKMR models.Our findings provide clues to the epigenetic mechanisms for the associations of PM2.5 compositions and ozone with BDNF.
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Affiliation(s)
- Haoyu Huang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bing Xie
- College of Forensic Medicine, Hebei Medical University, Shijiazhuang, China
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, Research Unit of Digestive Tract Microecosystem Pharmacology and Toxicology, Chinese Academy of Medical Sciences, Shijiazhuang, China
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Guang-Hui Dong
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ruqing Liu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhaohuan Gui
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lijun Chen
- College of Information Engineering, Hubei University of Chinese Medicine, Wuhan, China
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lei Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Hebei Key Laboratory of Environment and Human Health, Hebei Medical University, Shijiazhuang, China
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Tsai CY, Liu M, Huang HT, Hsu WH, Kuan YC, Majumdar A, Lee KY, Feng PH, Tseng CH, Chen KY, Kang JH, Lee HC, Wu CJ, Liu WT. Association between air pollutant exposure, body water distribution and sleep disorder indices in individuals with low-arousal-threshold obstructive sleep apnoea. BMJ Open Respir Res 2023; 10:e001802. [PMID: 37940353 PMCID: PMC10632889 DOI: 10.1136/bmjresp-2023-001802] [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: 04/30/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Air pollution may alter body water distribution, it may also be linked to low-arousal-threshold obstructive sleep apnoea (low-ArTH OSA). Here, we explored the mediation effects of air pollution on body water distribution and low-ArTH OSA manifestations. METHODS In this retrospective study, we obtained sleep centre data from healthy participants and patients with low-ArTH OSA (N=1924) in northern Taiwan. Air pollutant exposure at different time intervals (1, 3, 6 and 12 months) was estimated using the nearest station estimation method, and government air-quality data were also obtained. Regression models were used to assess the associations of estimated exposure, sleep disorder indices and body water distribution with the risk of low-ArTH OSA. Mediation analysis was performed to explore the relationships between air pollution, body water distribution and sleep disorder indices. RESULTS First, exposure to particulate matter (PM) with a diameter of ≤10 µm (PM10) for 1 and 3 months and exposure to PM with a diameter of ≤2.5 µm (PM2.5) for 3 months were significantly associated with the Apnoea-Hypopnoea Index (AHI), Oxygen Desaturation Index (ODI), Arousal Index (ArI) and intracellular-to-extracellular water ratio (I-E water ratio). Significant associations were observed between the risk of low-ArTH OSA and 1- month exposure to PM10 (OR 1.42, 95% CI 1.09 to 1.84), PM2.5 (OR 1.33, 95% CI 1.02 to 1.74) and ozone (OR 1.27, 95% CI 1.01 to 1.6). I-E water ratio alternation caused by 1-month exposure to PM10 and 3-month exposure to PM2.5 and PM10 had partial mediation effects on AHI and ODI. CONCLUSION Air pollution can directly increase sleep disorder indices (AHI, ODI and ArI) and alter body water distribution, thus mediating the risk of low-ArTH OSA.
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Affiliation(s)
- Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Ming Liu
- Department of Biology, University of Oxford, Oxford, UK
| | - Huei-Tyng Huang
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Wen-Hua Hsu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Chun Kuan
- Sleep Center, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
- Department of Neurology, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Neuroscience Institute, Taipei Medical University, Taipei, Taiwan
| | - Arnab Majumdar
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
- Division of Pulmonary Medicine,Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Po-Hao Feng
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
- Division of Pulmonary Medicine,Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chien-Hua Tseng
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
- Division of Pulmonary Medicine,Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kuan-Yuan Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Jiunn-Horng Kang
- Research Center of Artificial Intelligence in Medicine, Taipei Medical University College of Medicine, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Cheng-Jung Wu
- Department of Otolaryngology, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei, Taiwan
| | - Wen-Te Liu
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Sleep Center, Taipei Medical University-Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
- Research Center of Artificial Intelligence in Medicine, Taipei Medical University College of Medicine, Taipei, Taiwan
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Wang C, Jia X, Jin H, Meng Y, Ye W, Zhang N, Wang W, Kan H, Zhang J. Maternal exposure to fine particulate matter and brain-derived neurotrophic factor (BDNF) in the fetus: A prospective cohort study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 257:114912. [PMID: 37075646 DOI: 10.1016/j.ecoenv.2023.114912] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
Maternal exposure to ambient fine particulate matter (PM2.5) during pregnancy has been associated with impaired neurobehavioral development in children. However, the specific mechanism remains unclear. Brain derived neurotrophic factor (BDNF) is an important growth factor in the nervous system. We evaluated the associations of maternal PM2.5 exposures with fetal BDNF in the umbilical cord blood in a prospective cohort study. A total of 711 eligible mother-infant pairs from the Shanghai Birth Cohort were included in the current study. Daily maternal exposures to ambient PM2.5 were assessed with a gap-filling approach at 1 * 1 km2 resolution based on self-reported home addresses. The concentrations of BDNF in the cord blood were measured by ELISA. A linear regression model was applied to evaluate the association of maternal ambient PM2.5 exposure with fetal BDNF level at birth. The median concentration of BDNF was 13,403 pg/ml. Vaginal deliveries and female infants had higher BDNF levels than cesarean deliveries and male infants. One natural log (ln) unit increase in maternal PM2.5 exposure during the second trimester was significantly associated with - 0.20 (95% CI: -0.36, -0.05) ln-unit decrease in BDNF level in all births. These effects were stronger and more significant in vaginal deliveries and in male infants. Our study suggests that BDNF in the cord blood may serve as a potential biomarker in assessing the neurodevelopmental effects of maternal PM2.5 exposure.
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Affiliation(s)
- Cuiping Wang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaojun Jia
- Department of Obstetrics and Gynecology, Shanghai Putuo Maternity and Infant Hospital, 517 Tong Pu Road, Shanghai 200062, China
| | - Hong Jin
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Meng
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiping Ye
- Department of Obstetrics and Gynecology, Shanghai Putuo Maternity and Infant Hospital, 517 Tong Pu Road, Shanghai 200062, China
| | - Na Zhang
- Shanghai Jiao Tong University School of Public Health, Shanghai, China
| | - Weidong Wang
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA 01002, USA
| | - Haidong Kan
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China.
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Jiao Tong University School of Public Health, Shanghai, China.
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Wu L, Cui F, Zhang S, Ding X, Gao W, Chen L, Ma J, Niu P. Associations between multiple heavy metals exposure and neural damage biomarkers in welders: A cross-sectional study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 869:161812. [PMID: 36706997 DOI: 10.1016/j.scitotenv.2023.161812] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/15/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Both occupational and environmental exposure to heavy metals are associated with various neurodegenerative diseases. However, limited evidence is available on the potential effects of exposure to metallic mixtures and neural damage. OBJECTIVES This study aimed to evaluate the association between metal mixtures in urine and neural damage biomarkers in welders. METHODS In this cross-sectional study, a total of 186 workers were recruited from steel mills. Twenty-three metals in urine were measured by inductively coupled plasma mass spectrometry. Serum neural damage biomarkers, including neurofilament light chain (NfL), sphingosine-1-phosphate (S1P), prolactin (PRL), and dopamine (DA) were detected using enzyme-linked immunosorbent assay kits. Multivariable linear regression, Bayesian kernel machine regression (BKMR), and Quantile g-computation (QG-C) were employed to estimate the association between metals exposure and neural damage biomarkers. RESULTS Inverted u-shaped associations of nickel with NfL, S1P, and DA were observed in the BKMR model. A non-linear relationship was also found between Fe and PRL. Urinary cobalt was positively associated with serum PRL and had the strongest positive weights in the QG-C model. Urinary lead was associated with higher serum S1P levels. We also found the interaction among nickel, zinc, arsenic, strontium, iron, and lead with the neural damage biomarkers. CONCLUSION This study provides new evidence of a direct association between metal mixture exposure and the serum biomarkers of neural damage. Several metals Ni, Co, Pb, Sr, As and Fe, may have adverse effects on the nervous system, while Zn may have neuroprotective effects.
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Affiliation(s)
- Luli Wu
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, 100069 Beijing, China; Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, 100069 Beijing, China
| | - Fengtao Cui
- Occupational Disease Prevention and Control Hospital of Huaibei Mining Co., Ltd, Huaibei, Anhui Province 235000, China
| | - Shixuan Zhang
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, 100069 Beijing, China; Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, 100069 Beijing, China
| | - Xinping Ding
- Occupational Disease Prevention and Control Hospital of Huaibei Mining Co., Ltd, Huaibei, Anhui Province 235000, China
| | - Wei Gao
- Occupational Disease Prevention and Control Hospital of Huaibei Mining Co., Ltd, Huaibei, Anhui Province 235000, China
| | - Li Chen
- Experimental Teaching Center, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Junxiang Ma
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, 100069 Beijing, China; Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, 100069 Beijing, China.
| | - Piye Niu
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, 100069 Beijing, China; Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, 100069 Beijing, China.
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Yan Z, Li S, Chen R, Xie H, Wu M, Nan N, Xing Q, Yun Y, Qin G, Sang N. Effects of differential regional PM 2.5 induced hepatic steatosis and underlying mechanism. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 323:121220. [PMID: 36746292 DOI: 10.1016/j.envpol.2023.121220] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/28/2023] [Accepted: 02/04/2023] [Indexed: 06/18/2023]
Abstract
Emerging evidence suggests that exposure to PM2.5 is associated with a high risk of nonalcoholic fatty liver disease (NAFLD). NAFLD is typically characterised by hepatic steatosis. However, the underlying mechanisms and critical components of PM2.5-induced hepatic steatosis remain to be elucidated. In this study, ten-month-old C57BL/6 female mice were exposed to PM2.5 from four cities in China (Taiyuan, Beijing, Hangzhou, and Guangzhou) via oropharyngeal aspiration every other day for four weeks. After the exposure period, hepatic lipid accumulation was evaluated by biochemical and histopathological analyses. The expression levels of genes related to lipid metabolism and metabolomic profiles were assessed in the mouse liver. The association between biomarkers of hepatic steatosis (hepatic Oil Red O staining area and serum and liver triglyceride contents) and typical components of PM2.5 was identified using Pearson correlation analysis. Oil Red O staining and biochemical results indicated that PM2.5 from four cities significantly induced hepatic lipid accumulation. The most severe hepatic steatosis was observed after Guangzhou PM2.5 exposure. Moreover, Guangzhou PM2.5-induced the most significant changes in gene expression associated with lipid metabolism, including increased hepatic fatty acid uptake and lipid droplet formation and decreased fatty acid synthesis and lipoprotein secretion. Contemporaneously, exposure to Guangzhou PM2.5 significantly perturbed hepatic lipid metabolism. According to metabolomic analysis, disturbed hepatic lipid metabolism was primarily concentrated in linoleic acid, α-linoleic acid, and arachidonic acid metabolism. Finally, correlation analysis revealed that copper (Cu) and other inorganic components, as well as the majority of polycyclic aromatic hydrocarbons (PAHs), were related to changes in biomarkers of hepatic steatosis. These findings showed that PM2.5 exposure caused hepatic steatosis in aged mice, which could be related to the critical chemical components of PM2.5. This study provides critical information regarding the components of PM2.5, which cause hepatic steatosis.
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Affiliation(s)
- Zhipeng Yan
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Shanxi, 030006, PR China
| | - Shuyue Li
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Shanxi, 030006, PR China
| | - Rui Chen
- Beijing Key Laboratory of Occupational Safety and Health, Institute of Urban Safety and Environmental Science, Beijing Academy of Science and Technology, Beijing, 100054, PR China; Beijing City University, Beijing, 11418, PR China
| | - Haohan Xie
- Beijing Key Laboratory of Occupational Safety and Health, Institute of Urban Safety and Environmental Science, Beijing Academy of Science and Technology, Beijing, 100054, PR China
| | - Meiqiong Wu
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Shanxi, 030006, PR China; School of Public Health, Shanxi Medical University, Shanxi, 030001, PR China
| | - Nan Nan
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Shanxi, 030006, PR China
| | - Qisong Xing
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Shanxi, 030006, PR China
| | - Yang Yun
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Shanxi, 030006, PR China
| | - Guohua Qin
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Shanxi, 030006, PR China.
| | - Nan Sang
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Shanxi, 030006, PR China
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Auto repair workers exposed to PM2.5 particulate matter in Barranquilla, Colombia: telomere length and hematological parameters. MUTATION RESEARCH/GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2023; 887:503597. [PMID: 37003649 DOI: 10.1016/j.mrgentox.2023.503597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/17/2023]
Abstract
Exposure to 2.5 µm particulate matter (PM2.5) in automotive repair shops is associated with risks to health. We evaluated the effects of occupational exposure to PM2.5 among auto repair-shop workers. Blood and urine samples were collected from 110 volunteers from Barranquilla, Colombia: 55 active workers and 55 controls. PM2.5 concentrations were assessed at each of the sampling sites and chemical content was analyzed by SEM-EDS electron microscopy. The biological samples obtained were peripheral blood (hematological profiling, DNA extraction) and urine (malondialdehyde concentration). Telomere length was assessed by qPCR and polymorphisms in the glutathione transferase genes GSTT1 and GSTM1 by PCR-RFLP, with confirmation by allelic exclusion. White blood cell (WBC), lymphocyte (LYM%) and platelet (PLT) counts and the malondialdehyde concentration were higher (4.10 ± 0.93) in the exposed group compared to the control group (1.56 ± 0.96). TL was shorter (5071 ± 891) in the exposed individuals compared to the control group (6271 ± 805). White blood cell (WBC) and platelet counts were positively associated with exposure. Age and TBARS were correlated with TL in exposed individuals. The GSTT1 gene alleles were not in Hardy-Weinberg (H-W) equilibrium. The GSTM1 gene alleles were in H-W equilibrium and allelic exclusion analysis confirmed the presence of heterozygous GSTM1 genotypes. SEM-EDS analysis showed the presence of potentially toxic elements, including Mg, Al, Fe, Mn, Rh, Zn, and Cu. Auto repair shop workers showed effects that may be associated with exposure to mixtures of pollutants present in PM2.5. The GSTM1 and GSTT1 genes had independent modulatory effects.
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Chen YC, Gui ZH, Bao WW, Liang JH, Zhang SX, Zhao Y, Jiang N, Chen YJ. Chronic exposure to indoor air pollutants in association with attention-deficit/hyperactivity disorder symptoms in Chinese schoolchildren: A cross-sectional study. Neurotoxicology 2023; 94:182-190. [PMID: 36509211 DOI: 10.1016/j.neuro.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/17/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND While increasing studies confirmed the adverse effects of indoor air pollution (IAP) on cardiopulmonary systems, less is known about the impact of IAP on child's brain. OBJECTIVE To explore the associations between multiple indoor air pollutants exposures and attention-deficit/hyperactivity disorder (ADHD) symptoms in Chinese schoolchildren. METHODS We invited 8630 individuals aged 6-12 years from an ongoing school-based cohort study across Guangzhou from April to May 2019. There are 7495 and 7245 children were respectively evaluated on the parent- and teacher-rated Conner's Rating Scale-Revised, and 7087 children were assessed on both versions. Indoor air pollutants exposures including cooking oil fumes, incense burning, home renovation, and secondhand smoke, were measured using a questionnaire reported by parents and children, and further converted into an index. Generalized linear mixed-effects models were performed to evaluate the associations between indoor air pollutants exposures and ADHD index and the presence of ADHD symptoms. RESULTS As reported by parents, 321 (4.3%) children had ADHD symptoms. Each of the four pollutants was positively associated with higher ADHD index and higher odds of ADHD symptoms. Children exposed to 1, 2, and ≥ 3 types of indoor air pollutants had higher ADHD index and higher odds of ADHD symptoms than those non-exposed children. For parent-reported ADHD symptoms, the odds ratios ranged from 1.24 [95% confidence interval (CI): 0.92-1.67] to 2.73 (95% CI: 1.86-4.01). These associations were consistent in parent- and teacher-reported ADHD symptoms, and the combination of both. CONCLUSION Indoor air pollutants exposures were positively associated with higher prevalence of children's ADHD symptoms assessed by whether parents or teachers.
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Affiliation(s)
- Yi-Can Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, PR China.
| | - Zhao-Huan Gui
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, PR China.
| | - Wen-Wen Bao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, PR China.
| | - Jing-Hong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, PR China.
| | - Shu-Xin Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, PR China.
| | - Yu Zhao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, PR China.
| | - Nan Jiang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, PR China.
| | - Ya-Jun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, PR China.
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11
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De Jonge K, Laverge J. Time-resolved dynamic disability adjusted life-years estimation. INDOOR AIR 2022; 32:e13149. [PMID: 36437650 DOI: 10.1111/ina.13149] [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: 09/09/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
The quantification of how healthy the indoor air is, is a complex issue comprising of a large number of contaminants of various sources. The health implication of exposure to each of the contaminant deemed of importance can be expressed using Disability Adjusted Life Years (DALYs). The sum of all DALYs indicates how harmful the indoor air was during the investigated time-frame. This metric was originally developed by the World Bank and the WHO. In 2012, Logue et. al described two methods to estimate the DALYs related to exposure to contaminants in the indoor air based on the yearly mean exposure concentration of a population. The downside of these methods is that, when detailed exposure concentration profiles are available the method results in a loss of information. A novel method was developed to estimate DALYs originating from exposure to indoor pollutants that can be used for time-resolved exposure concentration data without this loss of information: Dynamic DALYs. The advantage of this method is that it can be calculated in real-time and for short or long periods of data. As such it can be used for pin-pointing problematic events in the exposure profile of a person and, as it can be calculated in real-time, makes it a candidate for use in automated optimization problems. The use of Dynamic DALYs is demonstrated for a simulation case-study of an occupied apartment. One continuously ventilated system (Dcont) and one smart ventilation system (Dsmart) are compared. Sources of typically indoor generated Volatile Organic Compounds (VOCs) were added and the related exposure profile and Dynamic DALY results of the working adult were analyzed. The results showcase detailed and more summative results with regards to health and energy use using the novel indicator. For Dcont and Dsmart the total Dynamic DALYs are 2.2 years and 8.6 years, respectively (population of 100 000, duration of 1 year), for the VOCs and sources considered in the analysis.
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Affiliation(s)
- Klaas De Jonge
- FWO - Flanders Research Foundation, Brussels, Belgium
- Department of Architecture and Urban Planning, Ghent University, Ghent, Belgium
| | - Jelle Laverge
- Department of Architecture and Urban Planning, Ghent University, Ghent, Belgium
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12
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Wang P, Zhou Y, Zhao Y, Zhao W, Wang H, Li J, Zhang L, Wu M, Xiao X, Shi H, Ma W, Zhang Y. Prenatal fine particulate matter exposure associated with placental small extracellular vesicle derived microRNA and child neurodevelopmental delays. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 841:156747. [PMID: 35716750 DOI: 10.1016/j.scitotenv.2022.156747] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/12/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND AIMS Prenatal fine particulate matter (PM2.5) exposure has been linked to adverse neurodevelopment. However, epidemiological evidence remains inconclusive and little information about the effects of various PM2.5 components on child neurodevelopment is currently known. The underlying mechanism was also not elucidated. The study aimed to evaluate the effects of PM2.5 and components exposure on child neurodevelopmental delays and the role of placental small extracellular vesicles (sEVs)-derived miRNAs in the associations. METHODS We included 267 mother-child pairs in this analysis. Prenatal PM2.5 and components (i.e. elements, water-soluble ions, and PAHs) exposure during three trimesters were monitored through personal PM2.5 sampling. Child neurodevelopment at 2, 6, and 12 months old were evaluated by Ages and Stages Questionnaire (ASQ). We isolated sEVs from placental tissue to analyze the change of sEVs-derived miRNAs in response to PM2.5. Associations between the PM2.5-associated miRNAs and child neurodevelopment were evaluated using multivariate linear regression models. RESULTS The PM2.5 exposure levels in the three trimesters range from 2.51 to 185.21 μg/m3. Prenatal PM2.5 and the components of Pb, Al, V and Ti exposure in the second and third trimester were related to decreased ASQ scores communication, problem-solving and personal-social domains in children aged 2 or 6 months. RNA sequencing identified fifteen differentially expressed miRNAs. The miR-101-3p and miR-520d-5p were negatively associated with PM2.5 and Pb component. miR-320a-3p expression was positively associated with PM2.5 and V component. Meanwhile, the miR-320a-3p was associated with decreased ASQ scores, as reflected by ASQ-T (β: -2.154, 95 % CI: -4.313, -0.516) and problem-solving domain (β: -0.605, 95 % CI: -1.111, -0.099) in children aged 6 months. CONCLUSION Prenatal exposure to PM2.5 and its Pb, Al, V & Ti component were associated with infant neurodevelopmental delays. The placenta sEVs derived miRNAs, especially miR-320a-3p, might contribute to an increased risk of neurodevelopmental delays.
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Affiliation(s)
- Pengpeng Wang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yuhan Zhou
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yingya Zhao
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Wenxuan Zhao
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Hang Wang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Jinhong Li
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Liyi Zhang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Min Wu
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Xirong Xiao
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Huijing Shi
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Wenjuan Ma
- Minhang Hospital, Fudan University, Shanghai 201199, China.
| | - Yunhui Zhang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
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Song J, Han K, Wang Y, Qu R, Liu Y, Wang S, Wang Y, An Z, Li J, Wu H, Wu W. Microglial Activation and Oxidative Stress in PM2.5-Induced Neurodegenerative Disorders. Antioxidants (Basel) 2022; 11:antiox11081482. [PMID: 36009201 PMCID: PMC9404971 DOI: 10.3390/antiox11081482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/20/2022] [Accepted: 07/27/2022] [Indexed: 11/22/2022] Open
Abstract
Fine particulate matter (PM2.5) pollution remains a prominent environmental problem worldwide, posing great threats to human health. The adverse effects of PM2.5 on the respiratory and cardiovascular systems have been extensively studied, while its detrimental effects on the central nervous system (CNS), specifically neurodegenerative disorders, are less investigated. Neurodegenerative disorders are characterized by reduced neurogenesis, activated microglia, and neuroinflammation. A variety of studies involving postmortem examinations, epidemiological investigations, animal experiments, and in vitro cell models have shown that PM2.5 exposure results in neuroinflammation, oxidative stress, mitochondrial dysfunction, neuronal apoptosis, and ultimately neurodegenerative disorders, which are strongly associated with the activation of microglia. Microglia are the major innate immune cells of the brain, surveilling and maintaining the homeostasis of CNS. Upon activation by environmental and endogenous insults, such as PM exposure, microglia can enter an overactivated state that is featured by amoeboid morphology, the over-production of reactive oxygen species, and pro-inflammatory mediators. This review summarizes the evidence of microglial activation and oxidative stress and neurodegenerative disorders following PM2.5 exposure. Moreover, the possible mechanisms underlying PM2.5-induced microglial activation and neurodegenerative disorders are discussed. This knowledge provides certain clues for the development of therapies that may slow or halt the progression of neurodegenerative disorders induced by ambient PM.
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Affiliation(s)
- Jie Song
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China; (J.S.); (K.H.); (R.Q.); (Y.L.); (S.W.); (Y.W.); (Z.A.); (J.L.); (H.W.)
| | - Keyang Han
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China; (J.S.); (K.H.); (R.Q.); (Y.L.); (S.W.); (Y.W.); (Z.A.); (J.L.); (H.W.)
| | - Ya Wang
- Nursing School, Zhenjiang College, Zhenjiang 212028, China;
| | - Rongrong Qu
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China; (J.S.); (K.H.); (R.Q.); (Y.L.); (S.W.); (Y.W.); (Z.A.); (J.L.); (H.W.)
| | - Yuan Liu
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China; (J.S.); (K.H.); (R.Q.); (Y.L.); (S.W.); (Y.W.); (Z.A.); (J.L.); (H.W.)
| | - Shaolan Wang
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China; (J.S.); (K.H.); (R.Q.); (Y.L.); (S.W.); (Y.W.); (Z.A.); (J.L.); (H.W.)
| | - Yinbiao Wang
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China; (J.S.); (K.H.); (R.Q.); (Y.L.); (S.W.); (Y.W.); (Z.A.); (J.L.); (H.W.)
| | - Zhen An
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China; (J.S.); (K.H.); (R.Q.); (Y.L.); (S.W.); (Y.W.); (Z.A.); (J.L.); (H.W.)
| | - Juan Li
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China; (J.S.); (K.H.); (R.Q.); (Y.L.); (S.W.); (Y.W.); (Z.A.); (J.L.); (H.W.)
| | - Hui Wu
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China; (J.S.); (K.H.); (R.Q.); (Y.L.); (S.W.); (Y.W.); (Z.A.); (J.L.); (H.W.)
| | - Weidong Wu
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China; (J.S.); (K.H.); (R.Q.); (Y.L.); (S.W.); (Y.W.); (Z.A.); (J.L.); (H.W.)
- Correspondence:
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