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Niu Y, Yang T, Gu X, Chen R, Meng X, Xu J, Yang L, Zhao J, Zhang X, Bai C, Kang J, Ran P, Shen H, Wen F, Huang K, Chen Y, Sun T, Shan G, Lin Y, Wu S, Zhu J, Wang R, Shi Z, Xu Y, Ye X, Song Y, Wang Q, Zhou Y, Ding L, Yang T, Yao W, Guo Y, Xiao F, Lu Y, Peng X, Zhang B, Xiao D, Wang Z, Zhang H, Bu X, Zhang X, An L, Zhang S, Cao Z, Zhan Q, Yang Y, Liang L, Cao B, Dai H, Wu T, He J, Li H, Kan H, Wang C. Long-term Ozone Exposure and Small Airways Dysfunction: The China Pulmonary Health (CPH) Study. Am J Respir Crit Care Med 2021; 205:450-458. [PMID: 34813411 DOI: 10.1164/rccm.202107-1599oc] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONALE It remains unknown whether long-term ozone exposure can impair lung function. OBJECTIVES To investigate the associations between long-term ozone exposure and adult lung function in China. METHODS Lung function results and diagnosis of small airways dysfunction (SAD) were collected from a cross-sectional study, China Pulmonary Health Study (N=50,991). We used multivariate linear and logistic regression models to examine the associations of long-term ozone exposure with lung function parameters and SAD, respectively, adjusting for demographic characteristics, individual risk factors, and longitudinal trend. We then performed a stratification analysis by chronic obstructive pulmonary disease (COPD). MEASUREMENTS AND MAIN RESULTS We observed each 1-standard deviation (SD, 4.9 ppb) increase in warm-season ozone concentrations was associated with a 14.2 mL/s [95% confidence interval (CI): 8.8, 19.6] decrease in forced expiratory flow at 75th percentile of vital capacity and a 29.5 mL/s (95% CI: 19.6, 39.5) decrease in mean forced expiratory flow between the 25th and 75th percentile of vital capacity. The odds ratio of SAD was 1.09 (95% CI: 1.06, 1.11) for a 1-SD increase in warm-season ozone concentrations. Meanwhile, we observed a significant association with a decreased ratio of expiratory volume in 1 second to forced vital capacity (FEV1/FVC) but not with FEV1 or FVC. The association estimates were greater in the COPD group than in the non-COPD group. CONCLUSION We found independent associations of long-term ozone exposure with impaired small airways function and higher SAD risks, while the associations with airflow obstruction were weak. COPD patients appear to be more vulnerable.
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Affiliation(s)
- Yue Niu
- Fudan University, 12478, Shanghai, China
| | - Ting Yang
- National Clinical Research Center for Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship Hospital; Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital; Peking University Health Science Center, Beijing, China
| | - Xiaoying Gu
- China-Japan Friendship Hospital, Beijing, China
| | - Renjie Chen
- School of Public Health, Fudan University, Shanghai, China
| | - Xia Meng
- Fudan University, 12478, Shanghai, China
| | | | - Lan Yang
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jianping Zhao
- Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Department of Respiratory and Critical Care Medicine, Wuhan, China
| | | | - Chunxue Bai
- Zhongshan Hospital, Fudan University, Pulmonary medicnie, Shanghai, China
| | - Jian Kang
- The First Hospital of China Medical University, Shenyang, China
| | - Pixin Ran
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huahao Shen
- Zhejiang University School of Medicine, Respiratory and Critical Care Medicine, Hangzhou, China.,State Key Lab for Respiratory Diseases, Guangzhou, China
| | - Fuqiang Wen
- West China Hospital of Sichuan University, Chengdu, China
| | - Kewu Huang
- Capital Medical University, 12517, Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Beijing, China
| | - Yahong Chen
- Peking University,Third Hospital, Respiratory Department, Beijing, China
| | | | - Guangliang Shan
- Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, 196536, Beijing, China
| | | | - Sinan Wu
- China-Japan Friendship Hospital, 36635, Beijing, China
| | - Jianguo Zhu
- National Center of Gerontology, Beijing, China
| | | | - Zhihong Shi
- The First Affiliated Hospital of Xi'an Jiaotong University, xi'an, China
| | - Yongjian Xu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Xianwei Ye
- Guizhou Provincial People's Hospital, Guiyang, China
| | - Yuanlin Song
- Zhongshan Hospital, Fudan University, Department of Pulmonary medicnie, Shanghai, China
| | - Qiuyue Wang
- The First Hospital of China Medical University, 159407, Department of Pulmonary and Critical Care Medicine, Shenyang, China
| | - Yumin Zhou
- The First Affiliated Hospital, Guangzhou Medical University, Guangzhou Institute of Respiratory Diseases, State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital, Department of Laboratory Medicine, Guangzhou, China
| | - Liren Ding
- Zhejiang University School of Medicine Second Affiliated Hospital, 89681, Hangzhou, China
| | - Ting Yang
- Sichuan University West China Hospital, 34753, Chengdu, China
| | - Wanzhen Yao
- Peking University,Third Hospital, Respiratory Department, Beijing, China
| | - Yanfei Guo
- Beijing Hospital, Department of Pulmonary and Critical Care Medicine, Beijing, China
| | - Fei Xiao
- Beijing Hospital, Beijing Institute of Geriatrics, Beijing, China
| | - Yong Lu
- Beijing Chao-Yang Hospital, Department of Pulmonary and Critical Care Medicine, Beijing, China.,Beijing Institute of Respiratory Diseases, 74699, Department of Pulmonary and Critical Care Medicine, Beijing, China
| | - Xiaoxia Peng
- Beijing Children's Hospital, 117984, Beijing, China
| | - Biao Zhang
- Peking Union Medical College School of Basic Medicine, 196536, Beijing, China
| | - Dan Xiao
- China-Japan Friendship Hospital, 36635, Beijing, China
| | - Zuomin Wang
- Beijing Chao-Yang Hospital, 74639, Beijing, China
| | - Hong Zhang
- Beijing Chao-Yang Hospital, 74639, Beijing, China
| | - Xiaoning Bu
- Beijing Chao-Yang Hospital, 74639, Beijing, China
| | - Xiaolei Zhang
- China-Japan Friendship Hospital, 36635, Beijing, China
| | - Li An
- Beijing Chao-Yang Hospital, 74639, Beijing, China
| | - Shu Zhang
- Beijing Chao-Yang Hospital, 74639, Beijing, China
| | - Zhixin Cao
- Beijing Chao-Yang Hospital, 74639, Beijing, China
| | - Qingyuan Zhan
- China-Japan Friendship Hospital, 36635, Beijing, China
| | - Yuanhua Yang
- Beijing Chao Yang Hospital,Capital Medical University, Beijing Institute of Respiratory Medicine, Beijing, China
| | - Lirong Liang
- Beijing Institute of Respiratory Medicine, Beijing, China
| | - Bin Cao
- Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China
| | - Huaping Dai
- Beijing Chao Yang Hospital,Capital Medical University, Beijing Institute of Respiratory Medicine, Beijing, China
| | - Tangchun Wu
- Tongji Medical College, HUST, Institute of Occupational Medicine, Wuhan, China
| | - Jiang He
- Tulane University School of Public Health and Tropical Medicine, Epidemiology, New Orleans, Louisiana, United States
| | - Huichu Li
- Harvard University, 1812, Cambridge, Massachusetts, United States
| | - Haidong Kan
- Fudan University, 12478, Department of Environmental Health, Shanghai, China
| | - Chen Wang
- Beijing Chaoyang Hospital-Affiliate of Capital University of Medical Sciences, Beijing, China;
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Frampton MW, Pietropaoli A, Dentler M, Chalupa D, Little EL, Stewart J, Frasier L, Oakes D, Wiltshire J, Vora R, Utell MJ. Cardiovascular effects of ozone in healthy subjects with and without deletion of glutathione-S-transferase M1. Inhal Toxicol 2015; 27:113-9. [PMID: 25600221 DOI: 10.3109/08958378.2014.996272] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Exposure to ozone has acute respiratory effects, but few human clinical studies have evaluated cardiovascular effects. OBJECTIVE We hypothesized that ozone exposure alters pulmonary and systemic vascular function, and cardiac function, with more pronounced effects in subjects with impaired antioxidant defense from deletion of the glutathione-S-transferase M1 gene (GSTM1 null). METHODS Twenty-four young, healthy never-smoker subjects (12 GSTM1 null) inhaled filtered air, 100 ppb ozone and 200 ppb ozone for 3 h, with intermittent exercise, in a double-blind, randomized, crossover fashion. Exposures were separated by at least 2 weeks. Vital signs, spirometry, arterial and venous blood nitrite levels, impedance cardiography, peripheral arterial tonometry, estimation of pulmonary capillary blood volume (Vc), and blood microparticles and platelet activation were measured at baseline and during 4 h after each exposure. RESULTS Ozone inhalation decreased lung function immediately after exposure (mean ± standard error change in FEV1, air: -0.03 ± 0.04 L; 200 ppb ozone: -0.30 ± 0.07 L; p < 0.001). The immediate post-exposure increase in blood pressure, caused by the final 15-min exercise period, was blunted by 200 ppb ozone exposure (mean ± standard error change for air: 16.7 ± 2.6 mmHg; 100 ppb ozone: 14.5 ± 2.4 mmHg; 200 ppb ozone: 8.5 ± 2.5 mmHg; p = 0.02). We found no consistent effects of ozone on any other measure of cardiac or vascular function. All results were independent of the GSTM1 genotype. CONCLUSIONS We did not find convincing evidence for early acute adverse cardiovascular consequences of ozone exposure in young healthy adults. The ozone-associated blunting of the blood pressure response to exercise is of unclear clinical significance.
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Ghio AJ, Soukup JM, Dailey LA, Richards JH, Duncan KE, Lehmann J. Iron decreases biological effects of ozone exposure. Inhal Toxicol 2014; 26:391-9. [DOI: 10.3109/08958378.2014.908330] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Bates ML, Brenza TM, Ben-Jebria A, Bascom R, Eldridge MW, Ultman JS. Pulmonary function responses to ozone in smokers with a limited smoking history. Toxicol Appl Pharmacol 2014; 278:85-90. [PMID: 24747805 DOI: 10.1016/j.taap.2014.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 04/04/2014] [Accepted: 04/08/2014] [Indexed: 11/25/2022]
Abstract
In non-smokers, ozone (O3) inhalation causes decreases in forced expiratory volume (FEV1) and dead space (VD) and increases the slope of the alveolar plateau (SN). We previously described a population of smokers with a limited smoking history that had enhanced responsiveness to brief O3 boluses and aimed to determine if responsiveness to continuous exposure was also enhanced. Thirty smokers (19M, 11F, 24±4 years, 6±4 total years smoking,4±2 packs/week) and 30 non-smokers (17M, 13F, 25±6 years) exercised for 1h on a cycle ergometer while breathing 0.30ppm O3. Smokers and non-smokers were equally responsive in terms of FEV1 (-9.5±1.8% vs -8.7±1.9%). Smokers alone were responsive in terms of VD (-6.1±1.2%) and SN (9.1±3.4%). There was no difference in total delivered dose. Dead space ventilation (VD/VT) was not initially different between the two groups, but increased in the non-smokers (16.4±2.8%) during the exposure, suggesting that the inhaled dose may be distributed more peripherally in smokers. We also conclude that these cigarette smokers retain their airway responsiveness to O3 and, uniquely, experience changes in VD that lead to heterogeneity in airway morphometry and an increase in SN.
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Affiliation(s)
- Melissa L Bates
- Interdisciplinary Graduate Degree Program in Physiology, Pennsylvania State University, University Park, PA 16802, USA; Department of Pediatrics, Critical Care Division, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA; John Rankin Laboratory of Pulmonary Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA.
| | - Timothy M Brenza
- Department of Chemical Engineering, Pennsylvania State University, University Park, PA 16802, USA
| | - Abdellaziz Ben-Jebria
- Interdisciplinary Graduate Degree Program in Physiology, Pennsylvania State University, University Park, PA 16802, USA; Department of Chemical Engineering, Pennsylvania State University, University Park, PA 16802, USA
| | - Rebecca Bascom
- Division of Pulmonary, Allergy and Critical Care Medicine, Penn State College of Medicine, Hershey, PA 17033, USA
| | - Marlowe W Eldridge
- Department of Pediatrics, Critical Care Division, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA; John Rankin Laboratory of Pulmonary Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA; Department of Kinesiology, University of Wisconsin-Madison, Madison, WI 53792, USA; Department of Bioengineering, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - James S Ultman
- Interdisciplinary Graduate Degree Program in Physiology, Pennsylvania State University, University Park, PA 16802, USA; Department of Chemical Engineering, Pennsylvania State University, University Park, PA 16802, USA
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Bartoli ML, Vagaggini B, Malagrinò L, Bacci E, Cianchetti S, Dente FL, Novelli F, Costa F, Paggiaro P. Baseline airway inflammation may be a determinant of the response to ozone exposure in asthmatic patients. Inhal Toxicol 2013; 25:127-33. [PMID: 23421484 DOI: 10.3109/08958378.2013.763313] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT It is well known that ozone exposure decreases lung function and increases airway neutrophilia, but large variability has been observed among asthmatic patients. OBJECTIVE To find possible predictors of functional and inflammatory airway response to ozone in asthmatic patients. MATERIALS AND METHODS We studied 120 patients with mild-to-moderate asthma, randomly exposed to either air or ozone (0.3 ppm for 2 h) in a challenge chamber. Symptoms and pulmonary function test (PFT) were measured before and immediately after exposure. Six hours after exposure, induced sputum was collected. Patients were evaluated according to their functional (FEV₁ responders) or neutrophilic (neutrophil responders) response to ozone. We considered, as possible predictors of response: age, baseline FEV₁, previous treatment with inhaled corticosteroids (ICS), baseline sputum neutrophils, baseline sputum eosinophils, methacholine responsiveness, atopy and smoking habit. RESULTS FEV₁ responders had lower baseline FEV₁, and a lower percentage of these had received ICS treatment. Neutrophil responders were younger, with lower baseline sputum inflammation and greater methacholine responsiveness. These results were confirmed by multivariate logistic analysis. DISCUSSION AND CONCLUSION Patients not previously treated with ICS and patients with lower FEV₁ are more prone to functional response to ozone. Lower baseline airway inflammation and greater bronchial hyperresponsiveness may predict neutrophilic airway response to ozone in asthmatic patients. Thus, determinants of functional and inflammatory responses to ozone are different.
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Tjalvin G, Hag R, Skorge TD, Aasen TB, Moen BE, Svanes C. [Two men who acquired acute respiratory symptoms while working at a water treatment plant]. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2012; 132:1763-6. [PMID: 22929946 DOI: 10.4045/tidsskr.11.1311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Affiliation(s)
- Gro Tjalvin
- Yrkesmedisinsk avdeling, Haukeland universitetssykehus og Institutt for samfunnsmedisinske fag, Universitetet i Bergen, Norway.
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Rabinovitch N, Silveira L, Gelfand EW, Strand M. The response of children with asthma to ambient particulate is modified by tobacco smoke exposure. Am J Respir Crit Care Med 2011; 184:1350-7. [PMID: 21868505 DOI: 10.1164/rccm.201010-1706oc] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Ambient particulate matter concentrations have been positively associated with urinary leukotriene E(4) (LTE(4)) levels and albuterol usage in children with asthma but interactions with environmental tobacco smoke (ETS) exposure have not been demonstrated despite obvious exposure to both pollutants in an urban setting. OBJECTIVES To assess the health effects of concurrent ETS and ambient particulate matter exposure in children with asthma. METHODS Albuterol usage and LTE(4) levels were monitored in 82 urban schoolchildren with asthma over three consecutive fall to spring school periods. Concentrations of morning maximum ambient particulate matter <2.5 μm in aerodynamic diameter (mmPM(2.5)) and urine cotinine levels were also measured daily. MEASUREMENTS AND MAIN RESULTS Albuterol usage and LTE(4) were related to mmPM(2.5) concentrations on days when urine cotinine levels were low (<10 ng/ml/mg creatinine); on these days, mean albuterol usage and LTE(4) increased up to 5 or 6% per 10 μg/m(3) increase in mmPM(2.5). In contrast, no significant relationship was observed when cotinine was high, although mean albuterol usage and LTE(4) levels were greater in this case. Model fits for LTE(4) levels as a function of mmPM(2.5) concentrations were improved when mmPM(2.5) concentrations were logged, suggesting a nonlinear dose-response relationship between particulate matter exposure concentrations and airway mediators of asthma, for which the relationship tends to flatten at higher concentrations. CONCLUSIONS This study suggests that ETS modifies the acute effects of low-level ambient PM(2.5) exposure on childhood asthma. This negative interaction, the smaller effect of particulate matter exposure in children exposed to higher ETS, may be related to a nonlinear dose-response relationship between asthma mediators and particulate exposures.
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Affiliation(s)
- Nathan Rabinovitch
- Division of Allergy/Immunology, Department of Pediatrics, National Jewish Health, Denver, CO 80206, USA.
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Pehnec G, Jazbec A, Vađić V, Pavlović M. Effect of summer ozone concentrations on the lung function of walkers in the Medvednica Mountain Nature Park, Croatia. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2011; 66:223-230. [PMID: 22014195 DOI: 10.1080/19338244.2011.564229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The study examines the influence of naturally elevated ozone concentrations and some meteorological variables on the lung function of untrained volunteers walking in an unpolluted mountain area. Forty male participants between 18 and 70 years (smokers and nonsmokers) walked at the top of Medvednica Mountain near Zagreb, Croatia, at approximately 1000 m above sea level (a.s.l.) and engaged in other recreational activities for at least 1 hour. Forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV(1)) of the participants were measured at arrival and before they left the mountain. Regression analysis showed a statistically significant influence of environmental variables on lung function tests. However, all variables together explained less than 35% variability of FVC and 41% variability of FEV(1). The results suggest that short-term exposure to ozone may affect lung function tests, but no more than temperature and humidity. FEV(1) was found to be more sensitive to ozone than FVC. Smoking habit also had an important role in subject's sensitivity to ozone.
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Affiliation(s)
- Gordana Pehnec
- Institute for Medical Research and Occupational Health, Ksaverska c. 2, Zagreb, Croatia.
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Vagaggini B, Bartoli MLE, Cianchetti S, Costa F, Bacci E, Dente FL, Di Franco A, Malagrinò L, Paggiaro P. Increase in markers of airway inflammation after ozone exposure can be observed also in stable treated asthmatics with minimal functional response to ozone. Respir Res 2010; 11:5. [PMID: 20085630 PMCID: PMC2817658 DOI: 10.1186/1465-9921-11-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2008] [Accepted: 01/19/2010] [Indexed: 11/12/2022] Open
Abstract
Background The discrepancy between functional and inflammatory airway response to ozone has been reported in normal subjects, but few data are available for stable asthmatics regularly treated with inhaled corticosteroids. Methods Twenty-three well controlled, regularly treated, mild-to-moderate asthmatic patients underwent two sequential randomised exposures to either filtered air or ozone (0.3 ppm for 2 hours) in a challenge chamber. Pulmonary function (PF) was monitored, and patients with FEV1 decrease greater than 10% from pre-challenge value were considered as responders. Immediately after each exposure, exhaled breath condensate (EBC) was collected to measure malondialdehyde (MDA). Six hours after each exposure, PF and EBC collection were repeated, and sputum was induced to measure inflammatory cell counts and soluble mediators (IL-8 and neutrophil elastase). The response to ozone was also evaluated according to the presence of polymorphism in oxidative stress related NQO1 and GSTM1 genes. Results After ozone exposure, sputum neutrophils significantly increased in responders (n = 8), but not in nonresponders (n = 15). Other markers of neutrophil activation in sputum supernatant and MDA in EBC significantly increased in all patients, but only in nonresponders the increase was significant. In nonresponders, sputum eosinophils also significantly increased after ozone. There was a positive correlation between ozone-induced FEV1 fall and increase in sputum neutrophils. No difference in functional or inflammatory response to ozone was observed between subjects with or without the combination of NQO1wt- GSTM1null genotypes. Conclusions Markers of neutrophilic inflammation and oxidative stress increase also in asthmatic subjects not responding to ozone. A greater functional response to ozone is associated with greater neutrophil airway recruitment in asthmatic subjects.
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Affiliation(s)
- Barbara Vagaggini
- Cardio-Thoracic and Vascular Department, University of Pisa, Pisa, Italy
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McClellan RO, Frampton MW, Koutrakis P, McDonnell WF, Moolgavkar S, North DW, Smith AE, Smith RL, Utell MJ. Critical considerations in evaluating scientific evidence of health effects of ambient ozone: a conference report. Inhal Toxicol 2010; 21 Suppl 2:1-36. [PMID: 19731972 DOI: 10.1080/08958370903176735] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The U.S. Environmental Protection Agency (EPA), under the authority of the Clean Air Act (CAA), is required to promulgate National Ambient Air Quality Standards (NAAQSs) for criteria air pollutants, including ozone. Each NAAQS includes a primary health-based standard and a secondary or welfare-based standard. This paper considers only the science used for revision of the primary standard for ozone in 2008. This paper summarizes deliberations of a small group of scientists who met in June 2007 to review the scientific information informing the EPA Administrator's proposed revision of the 1997 standard. The Panel recognized that there is no scientific methodology that, in the absence of judgment, can define the precise numerical level, related averaging time, and statistical form of the NAAQS. The selection of these elements of the NAAQS involves policy judgments that should be informed by scientific information and analyses. Thus, the Panel members did not feel it appropriate to offer either their individual or collective judgment on the specific numerical level of the NAAQS for ozone. The Panel deliberations focused on the scientific data available on the health effects of exposure to ambient concentrations of ozone, controlled ozone exposure studies with human volunteers, long-term epidemiological studies, time- series epidemiological studies, human panel studies, and toxicological investigations. The deliberations also dealt with the issue of background levels of ozone of nonanthropogenic origin and issues involved with conducting formal risk assessments of the health impacts of current and prospective levels of ambient ozone. The scientific issues that were central to the EPA Administrator's 2008 revision of the NAAQS for ozone will undoubtedly also be critical to the next review of the ozone standard. That review should begin very soon if it is to be completed within the 5-year cycle specified in the CAA. It is hoped that this Report will stimulate discussion of these scientific issues, conduct of additional research, and conduct of new analyses that will provide an improved scientific basis for the policy judgment that will have to be made by a future EPA Administrator in considering potential revision of the ozone standard.
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Affiliation(s)
- Roger O McClellan
- Toxicology and Human Health Risk Analysis, Albuquerque, NM 87111, USA.
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Moderate increases in ambient PM2.5 and ozone are associated with lung function decreases in beach lifeguards. J Occup Environ Med 2008; 50:202-11. [PMID: 18301177 DOI: 10.1097/jom.0b013e31816386b4] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Exposure to pollutants would adversely affect lung function of healthy athletes. METHODS Pulmonary function was recorded on beach lifeguards at three different times during the day. Daily and average peak pollutant levels were calculated. Linear regression analyses were made comparing lung function changes in response to pollutant levels. A multivariate model was constructed to explain the combined effects of pollutants. RESULTS Afternoon forced vital capacity (FVC) and forced expired volume in 1 second (FEV1) decreased significantly compared with morning values and decreased with increasing fine particulates (PM2.5). FEV1/FVC decreased with increasing ozone (O3) levels. CONCLUSION The deleterious effect of PM2.5 and O3 were transient and occurred at pollutant levels far below national standards. At low levels of exposure, PM2.5 was associated with reduced lung volumes, while increasing O3 levels were associated with airway obstruction.
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Is there an association between lifetime cumulative exposure and acute pulmonary responses to ozone? J Occup Environ Med 2008; 50:341-9. [PMID: 18332784 DOI: 10.1097/jom.0b013e318162f5eb] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the potential effects of lifetime cumulative ozone (O3) exposure on acute pulmonary responses to O3. METHODS Fifteen healthy subjects from a larger cohort of young adults were exposed to 200 ppb O3 for 4 hours followed by bronchoscopy and bronchoalveolar lavage 18 hours later. Lung function, symptom questionnaires, and blood samples were obtained before and after each exposure. Subjects' lifetime cumulative O3 exposures were estimated from residential histories and air-quality monitoring data. RESULTS Acute exposure to O3 caused decrements in forced expiratory volume in 1 second (FEV1), maximal mid-expiratory flow rate (FEF25-75), and forced expiratory flow rate at 75% of forced vital capacity (FEF75), and an increase in plasma clara cell protein (CC16) level. Changes in CC16 and lower respiratory symptoms, but not in lung function, were positively correlated with lifetime cumulative O3 exposure. CONCLUSION Higher lifetime cumulative O3 exposure was associated with airway injury and respiratory symptom responses, but not with airway inflammatory or lung function responses, to acute O3 exposure.
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Lung Defenses. DAIL AND HAMMAR’S PULMONARY PATHOLOGY 2008. [PMCID: PMC7120004 DOI: 10.1007/978-0-387-68792-6_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We breathe to live, but the air we breathe carries many potentially harmful agents. To protect us against these constant challenges, our lungs have defenses that are remarkably effective, biologically complex, and scientifically fascinating. It is not hyperbole to say that the pathogenesis of most lung disease begins with a breach of these defenses. This chapter surveys these normal lung defense systems. Just as this text assumes familiarity with general pathology, we also assume knowledge of basic immunology. This chapter emphasizes the lung’s variations on themes of innate and adaptive immunity, and discusses the special role of granulomatous inflammation in lung defenses.
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Ghio AJ, Turi JL, Madden MC, Dailey LA, Richards JD, Stonehuerner JG, Morgan DL, Singleton S, Garrick LM, Garrick MD. Lung injury after ozone exposure is iron dependent. Am J Physiol Lung Cell Mol Physiol 2006; 292:L134-43. [PMID: 16905637 DOI: 10.1152/ajplung.00534.2005] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
We tested the hypothesis that oxidative stress and biological effect after ozone (O3) exposure are dependent on changes in iron homeostasis. After O3 exposure, healthy volunteers demonstrated increased lavage concentrations of iron, transferrin, lactoferrin, and ferritin. In normal rats, alterations of iron metabolism after O3 exposure were immediate and preceded the inflammatory influx. To test for participation of this disruption in iron homeostasis in lung injury following O3 inhalation, we exposed Belgrade rats, which are functionally deficient in divalent metal transporter 1 (DMT1) as a means of iron uptake, and controls to O3. Iron homeostasis was disrupted to a greater extent and the extent of injury was greater in Belgrade rats than in control rats. Nonheme iron and ferritin concentrations were higher in human bronchial epithelial (HBE) cells exposed to O3 than in HBE cells exposed to filtered air. Aldehyde generation and IL-8 release by the HBE cells was also elevated following O3 exposure. Human embryonic kidney (HEK 293) cells with elevated expression of a DMT1 construct were exposed to filtered air and O3. With exposure to O3, elevated DMT1 expression diminished oxidative stress (i.e., aldehyde generation) and IL-8 release. We conclude that iron participates critically in the oxidative stress and biological effects after O3 exposure.
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Affiliation(s)
- Andrew J Ghio
- Human Studies Division, National Health and Environmental Effects Research Laboratory, Office of Research and Development, US Environmental Protection Agency, 104 Mason Farm Rd., Chapel Hill, NC 27599-7315, USA.
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16
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Sánchez-Carrillo CI, Cerón-Mireles P, Rojas-Martínez MR, Mendoza-Alvarado L, Olaiz-Fernández G, Borja-Aburto VH. Surveillance of acute health effects of air pollution in Mexico City. Epidemiology 2003; 14:536-44. [PMID: 14501268 DOI: 10.1097/01.ede.0000081801.90352.bf] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND A unique, active, timely, low-cost surveillance system for the metropolitan area of Mexico City was established in the mid-1990s. METHODS The system obtained upper and lower respiratory tract symptoms and eye symptoms from daily interviews for a systematic sample of the general nonhospitalized population living within a 2-km radius of air pollution monitors during 1996-1997. RESULTS Ozone increments (10 ppb) were associated with upper respiratory symptoms (odds ratio [OR] = 1.003; 95% confidence interval [CI] = 1.002-1.004) and ocular symptoms indicators (OR = 1.005; CI = 1.004-1.007), and with a higher risk of lower respiratory symptoms indicator among nonsmokers (OR = 1.003; CI = 1.002-1.005). Increases in relative humidity reduced the risk of increments of sulfur dioxide on the 3 acute health indicators. Association of PM10 with health indicators varied among the 5 regions. During emergency episodes, symptoms increased sharply when ozone reached 281 ppb, a finding that resulted in a change in the ozone criteria for emergency declaration from 294 to 281 ppb. CONCLUSIONS This system has been low cost, timely, and useful for local decision making.
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Abstract
Ozone (O3) is an air pollutant produced by sunlight-driven reactions involving the oxides of nitrogen and volatile organic compounds. The population of many large metropolitan areas in the US is exposed to high levels of O3, particularly in the summer months. Individuals exposed to O3 levels in human experiments at higher than common ambient levels develop reversible reductions in lung function often associated with symptoms, such as airway hyperreactivity and lung inflammation. Animal models have helped characterize potential mechanisms of lung injury from O3 exposure. Defining the adverse effects of chronic exposure to ambient levels of O3 on lung function and disease have been challenging, in part due to the presence of co-pollutants, such as particulate matter. The US Environmental Protection Agency's 1997 revised standard for O3 (0.08 ppm averaged over 8 hours) is designed to provide better protection to susceptible individuals. The revised standard is being implemented following the failure of court challenges.
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Affiliation(s)
- Nevin Uysal
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin and Zablocki Veterans Affairs Medical Center, Milwaukee, 53295, USA.
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18
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Xu H, Hoet PHM, Nemery B. In vitro toxicity assessment of polyvinyl chloride particles and comparison of six cellular systems. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2002; 65:1141-1159. [PMID: 12167213 DOI: 10.1080/152873902760125372] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Occupational exposure to polyvinyl chloride (PVC) dust has been occasionally associated with lung disease. Our aim was to evaluate the in vitro toxicity of various types of PVC particles in relevant cell culture systems. Six samples from the normal industrial suspension process (PVC-S) and eight samples from the emulsion process (PVC-E) were studied. Cytotoxicity was assessed, using the MTT assay, after 20 h of incubation in A549 cells and in primary cultures of alveolar macrophages (AM) and type II pneumocytes (TII) obtained from rats (r-AM, r-TII) or from human surgical specimens (h-AM, h-TII). Hemolysis was assessed after 2 h of incubation with human erythrocytes (h-RBC). A positive control (crystalline SiO(2), Min-U-Sil) and relevant additives of these PVC particles were tested concurrently. No toxicity of PVC-S particles could be established up to 5 mg/ml in the hemolysis test and 2.5 mg/ml in the MTT assay. In contrast, 4 out of 8 PVC-E particles induced significant toxicity, with EC50 values ranging from 0.7 to 3.7 mg/ml in the hemolysis test and from 0.2 to 1.2 mg/ml in primary cells. The most toxic particles were those that contained the additives with the highest in vitro cytotoxicity. There was a good correlation between EC50 values obtained in relevant bioassays. The sensitivity order of the cell systems was A549 < h-RBC approximately h-TII < or = h-AM < r-TII < or = r-AM for the particles. In conclusion, PVC-E particles produced a moderate in vitro toxicity for primary rat and human pulmonary cells, probably because of the residual presence of additives.
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Affiliation(s)
- Haiyan Xu
- Laboratory of Pneumology, Lung Toxicology, Katholieke Universiteit Leuven, Herestraat 49, B-3000 Leuven, Belgium
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Karen Z. Voter, John C. Whitin, Alf. OZONE EXPOSURE AND THE PRODUCTION OF REACTIVE OXYGEN SPECIES BY BRONCHOALVEOLAR CELLS IN HUMANS. Inhal Toxicol 2001. [DOI: 10.1080/08958370117715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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20
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Avissar NE, Reed CK, Cox C, Frampton MW, Finkelstein JN. Ozone, but not nitrogen dioxide, exposure decreases glutathione peroxidases in epithelial lining fluid of human lung. Am J Respir Crit Care Med 2000; 162:1342-7. [PMID: 11029342 DOI: 10.1164/ajrccm.162.4.9912041] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Antioxidants, such as glutathione peroxidases (GPxs), in epithelial lining fluid (ELF) protect against health effects of oxidant pollutants, which includes O(3) or NO(2). We hypothesized that GPxs concentration in ELF is responsive to O(3) or NO(2) exposure. Subjects underwent two 4-h exposures to O(3) (0.22 ppm) and one to air. In another experiment, subjects underwent 3-h exposures to air and NO(2) (0.6 and 1.5 ppm). Bronchoalveolar lavage (BAL) was performed immediately or 18 h after O(3) exposure and 3.5 h after each NO(2) exposure. GPx activity and extracellular GPx (eGPx) protein concentrations were determined in ELF, and their relationships to markers of lung function, inflammation, and epithelial permeability were examined. Although the total amounts were not changed, basal (air) GPx activity (223.6 +/- 24.4 mU/ml), basal eGPx protein concentration (2.62 +/- 0.25 microg/ml), and basal ELF dilution factor (152.3 +/- 8.4) decreased 40% immediately after O(3) exposure and remained 30% decreased 18 h after exposure (p = 0.0001). No effect of NO(2) exposure on GPxs concentration was detected. There was an inverse correlation between baseline ELF eGPx protein concentration and the change in PMN 18 h after O(3) exposure (p = 0.04). Thus, O(3), a strong oxidant, decreases both GPx activity and eGPx protein in ELF, whereas NO(2), a weaker oxidant, does not. eGPx in ELF may protect against O(3)-induced airway inflammation.
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Affiliation(s)
- N E Avissar
- Departments of Surgery, Pediatrics, Biostatistics, Medicine, and Environmental Medicine, University of Rochester, School of Medicine and Dentistry, Rochester, New York, USA.
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21
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Blomberg A. Airway inflammatory and antioxidant responses to oxidative and particulate air pollutants - experimental exposure studies in humans. Clin Exp Allergy 2000; 30:310-7. [PMID: 10691887 DOI: 10.1046/j.1365-2222.2000.00814.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- A Blomberg
- Department of Respiratory Medicine and Allergy, University Hospital, Umeå, Sweden.
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Cassino C, Ito K, Bader I, Ciotoli C, Thurston G, Reibman J. Cigarette smoking and ozone-associated emergency department use for asthma by adults in New York City. Am J Respir Crit Care Med 1999; 159:1773-9. [PMID: 10351917 DOI: 10.1164/ajrccm.159.6.9809042] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The association between ambient ozone (O3) and hospital use for asthma in children and adults is well documented. The question remains of whether there are susceptible subpopulations of asthmatic individuals who are particularly vulnerable to high O3 levels. Because tobacco use was prevalent in our cohort of inner-city adult asthmatic individuals (n = 1,216) in New York City (NYC), we investigated whether cigarette smoking was an effect modifier for asthma morbidity. We examined the relationship between personal tobacco use and O3-associated emergency department (ED) use for asthma in public hospitals in NYC. Three subpopulations were defined: never smokers (0 pack-yr), heavy smokers (>/= 13 pack-yr) and light smokers (< 13 pack-yr). Time-series regression analysis of ED use for asthma and daily O3 levels was done while controlling for temperature, seasonal/long-term trends, and day-of-week effects. Heavy smokers displayed an increased relative risk (RR) of ED visits for asthma in response to increases in 2-d lagged O3 levels (RR per 50 ppb O3 = 1.72; 95% confidence interval: 1.13 to 2.62). Logistic regression analysis confirmed that heavy cigarette use was a predictor of ED use for asthma following days with high O3 levels. Although adverse health effects of ambient O3 have also been documented in asthma populations not using cigarettes (e.g., children), our results suggest that in adult asthmatic individuals, heavy personal tobacco use may be an effect modifier for O3-associated morbidity.
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Affiliation(s)
- C Cassino
- Department of Medicine and Nelson Institute of Environmental Medicine, New York University Medical Center, New York, NY, USA
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Frampton MW, Pryor WA, Cueto R, Cox C, Morrow PE, Utell MJ. Ozone exposure increases aldehydes in epithelial lining fluid in human lung. Am J Respir Crit Care Med 1999; 159:1134-7. [PMID: 10194157 DOI: 10.1164/ajrccm.159.4.9807057] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We hypothesized that exposure of healthy humans to ozone causes both ozonation and peroxidation of lipids in lung epithelial lining fluid. Twelve smokers and 15 nonsmokers (eight lung function "responders" and seven "nonresponders") were exposed once to air and twice to 0. 22 ppm ozone for 4 h with exercise in an environmental chamber, with each exposure separated by at least 3 wk. Bronchoalveolar lavage (BAL) was performed immediately after one ozone exposure and 18 h after the other ozone exposure. BAL fluid was analyzed for the aldehyde products of ozonation and lipid peroxidation, nonanal (C9) and hexanal (C6), as well as total protein, albumin, and immunoglobulin M as markers of changes in epithelial permeability. Ozone exposure resulted in a significant early increase in C9 (p = 0. 0001), with no statistically significant relationship between increases in C9 and lung function changes, airway inflammation, or changes in epithelial permeability. Increases in C6 levels were not statistically significant (p = 0.16). Both C9 and C6 levels returned to baseline by 18 h after exposure. These studies confirm that exposure to ozone with exercise, at concentrations relevant to urban outdoor air, results in ozonation of lipids in the airway epithelial lining fluid of humans.
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Affiliation(s)
- M W Frampton
- University of Rochester School of Medicine, Rochester, New York; and Biodynamics Institute, Louisiana State University, Baton Rouge, Louisiana, USA
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van Klaveren RJ, Nemery B. Role of reactive oxygen species in occupational and environmental obstructive pulmonary diseases. Curr Opin Pulm Med 1999; 5:118-23. [PMID: 10813262 DOI: 10.1097/00063198-199903000-00007] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Free radicals and their metabolites, also called reactive oxygen species (ROS), have been implicated in the pathogenesis of many diseases. Because of its continuous exposure to toxic pollutants in the ambient air, such as cigarette smoke, air pollution, and mineral dusts, the lung is very vulnerable to ROS-induced injury. In this review, the role of ROS in the pathogenesis of obstructive lung diseases is reviewed. A central theme in this review is the pivotal role of transition metals such as iron, vanadium, and nickel in ROS-induced cell damage, not only in exposure to mineral dusts but also in cigarette smoke and air pollution.
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Affiliation(s)
- R J van Klaveren
- Department of Pulmonology, University Hospital Antwerp, Leuven, Belgium
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25
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Torres A, Utell MJ, Morow PE, Voter KZ, Whitin JC, Cox C, Looney RJ, Speers DM, Tsai Y, Frampton MW. Airway inflammation in smokers and nonsmokers with varying responsiveness to ozone. Am J Respir Crit Care Med 1997; 156:728-36. [PMID: 9309986 DOI: 10.1164/ajrccm.156.3.9601054] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Exposure to ozone causes symptoms, changes in lung function, and airway inflammation. We studied whether individuals who differ in lung-function responsiveness to ozone, or in smoking status, also differ in susceptibility to airway inflammation. Healthy subjects were selected on the basis of responsiveness to a classifying exposure to 0.22 ppm ozone for 4 h with exercise (responders, with a decrease in FEV1 > 15%; and non-responders, with a decrease in FEV1 < 5%). Three groups were studied: nonsmoker-nonresponders (n = 12), nonsmoker-responders (n = 13), and smokers (n = 13, 11 nonresponders and two responders). Each subject underwent two exposures to ozone and one to air, separated by at least 3 wk; bronchoalveolar and nasal lavages were performed on three occasions: immediately (early) and 18 h (late) after ozone exposure, and either early or late after air exposure. Recovery of polymorphonuclear leukocytes (PMN) increased progressively in all groups, and by up to 6-fold late after ozone exposure. Interleukin-6 (IL-6) and IL-8 increased early (by up to 10-fold and up to 2-fold, respectively), and correlated with the late increase in PMN. Lymphocytes, mast cells, and eosinophils also increased late after exposure. We conclude that ozone-induced airway inflammation is independent of smoking status or airway responsiveness to ozone.
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Affiliation(s)
- A Torres
- Department of Medicine, University of Rochester School of Medicine, New York 14642-8692, USA
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