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He LX, Deng K, Wang J, Zhang X, Wang L, Zhang HP, Xie M, Chen ZH, Zhang J, Chen-Yu Hsu A, Zhang L, Oliver BG, Wark PAB, Qin L, Gao P, Wan HJ, Liu D, Luo FM, Li WM, Wang G, Gibson PG. Clinical Subtypes of Neutrophilic Asthma: A Cluster Analysis From Australasian Severe Asthma Network. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:686-698.e8. [PMID: 37778630 DOI: 10.1016/j.jaip.2023.09.023] [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: 07/14/2022] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Clinical heterogeneity may exist within asthma subtypes defined by inflammatory markers. However, the heterogeneity of neutrophilic asthma (NA) remains largely unexplored. OBJECTIVE To explore potential clusters and the stability of NA. METHODS Participants with NA from the Australasian Severe Asthma Network underwent a multidimensional assessment. They were then asked to participate in a 12-month longitudinal cohort study. We explored potential clusters using a hierarchical cluster analysis and validated the differential future risk of asthma exacerbations in the identified clusters. A decision tree analysis was developed to predict cluster assignments. Finally, the stability of prespecified clusters was examined within 1 month. RESULTS Three clusters were identified in 149 patients with NA. Cluster 1 (n = 99; 66.4%) was characterized by female-predominant nonsmokers with well-controlled NA, cluster 2 (n = 16; 10.7%) by individuals with comorbid anxiety/depressive symptoms with poorly controlled NA, and cluster 3 by older male smokers with late-onset NA. Cluster 2 had a greater proportion of participants with severe exacerbations (P = .005), hospitalization (P = .010), and unscheduled visits (P = .013) and a higher number of emergency room visits (P = .039) than that of the other two clusters. The decision tree assigned 92.6% of participants correctly. Most participants (87.5%; n = 7) in cluster 2 had a stable NA phenotype, whereas participants of clusters 1 and 3 had variable phenotypes. CONCLUSIONS We identified three clinical clusters of NA, in which cluster 2 represents an uncontrolled and stable NA subtype with an elevated risk of exacerbations. These findings have clinical implications for the management of NA.
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Affiliation(s)
- Li Xiu He
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China; Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China
| | - Ke Deng
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China
| | - Ji Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China
| | - Xin Zhang
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China; Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Wang
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China; Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Ping Zhang
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China; Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Min Xie
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Zhi Hong Chen
- Shanghai Institute of Respiratory Disease, Respiratory Division of Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jie Zhang
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Jilin University, Changchun, Jilin, China
| | - Alan Chen-Yu Hsu
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | - Li Zhang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China; Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Brian G Oliver
- School of Life Sciences, University of Technology Sydney, Ultimo, New South Wales, Australia; Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Peter A B Wark
- Priority Research Center for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia
| | - Ling Qin
- Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Peng Gao
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Jilin University, Changchun, Jilin, China
| | - Hua Jing Wan
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China
| | - Dan Liu
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China; Respiratory Microbiome Laboratory, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China
| | - Feng Ming Luo
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China
| | - Wei Min Li
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China; Respiratory Microbiome Laboratory, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China.
| | - Gang Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China.
| | - Peter Gerard Gibson
- Priority Research Center for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia; National Health and Medical Research Council Center for Excellence in Severe Asthma, Newcastle, New South Wales, Australia
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Morton L, Paton C, Braakhuis A. The Effects of Polyphenol Supplementation on BDNF, Cytokines and Cognition in Trained Male Cyclists following Acute Ozone Exposure during High-Intensity Cycling. Nutrients 2024; 16:233. [PMID: 38257125 PMCID: PMC10819340 DOI: 10.3390/nu16020233] [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: 11/28/2023] [Revised: 01/02/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
The neurotoxic effects of ozone exposure are related to neuroinflammation and increases in reactive oxygen species (ROS). This study aimed to assess inflammation, Brain-Derived Neurotrophic Factor (BDNF), and cognition in healthy male cyclists following polyphenol supplementation and exercise in an ozone-polluted environment. Ten male cyclists initially completed a maximal incremental test and maximal effort 4 km time trial in ambient air. Cyclists then completed two trials in an ozone-polluted environment (0.25 ppm) following 7 days of supplementation with either polyphenol (POLY) or placebo (PL). Experimental trials consisted of a three-stage submaximal test followed by a 4 km time trial. Blood samples were drawn pre- and post-exercise, and analyzed for BDNF, interleukin 6 (IL-6), interleukin 10 (IL-10) and tumor necrosis factor (TNF-α). The Stroop test and serial subtraction task were performed before ozone exposure and again after the 4 km TT. Serum BDNF increased post-exercise (p < 0.0001), and positive differences were observed post-exercise in the ozone POLY group relative to PL (p = 0.013). Plasma IL-6 increased post-exercise (p = 0.0015), and TNF-α increased post-ozone exposure (p = 0.0018). There were no differences in Stroop or serial subtraction tasks pre- or post-exercise. Exercise increases BDNF in ozone.
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Affiliation(s)
- Lillian Morton
- Department of Nutrition, Faculty of Medical & Health Science, The University of Auckland, Auckland 1023, New Zealand;
| | - Carl Paton
- School of Health and Sport Science, The Eastern Institute of Technology, Napier 4142, New Zealand;
| | - Andrea Braakhuis
- Department of Nutrition, Faculty of Medical & Health Science, The University of Auckland, Auckland 1023, New Zealand;
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Morton LC, Paton CD, Merry T, Braakhuis AJ. Effects of 7-day polyphenol powder supplementation on cycling performance and lung function in an ozone-polluted environment. Eur J Appl Physiol 2024; 124:343-352. [PMID: 37517068 PMCID: PMC10786979 DOI: 10.1007/s00421-023-05287-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/08/2023] [Indexed: 08/01/2023]
Abstract
PURPOSE Polluted environments can adversely affect lung function and exercise performance. Evidence suggests that some nutrient supplements may offset pollution's detrimental effects. This study examined the effect of polyphenol supplementation on lung function and exercise performance in an ozone-polluted environment. METHODS Ten male cyclists (mean ± SD: age, 43.8 ± 12.4 years; height, 177.8 ± 7.1 cm; weight, 76.03 ± 7.88 kg; VO2max 4.12 ± 0.72 L min-1) initially completed a baseline maximal incremental test and maximal effort 4 km time trial in ambient air. Thereafter cyclists completed two trials in an ozone-polluted environment (0.25 ppm) following seven days of supplementation with either polyphenol (PB) or placebo (PL). Experimental trials consisted of a three-stage submaximal test (50%, 60% and 70% incremental peak power) followed by a 4 km time trial. Lung function was measured pre- and post-exercise via spirometry and adverse respiratory symptoms with a Likert scale. RESULTS Ozone exposure significantly reduced (p < 0.05) lung function relative to ambient air. There were no significant differences (p > 0.05) in measured variables across the three submaximal intensities. There was a small (d = 0.31) non-significant difference (p = 0.09) in 4 km performance in PB (406.43 ± 50.29 s) vs. PL (426.20 ± 75.06 s). Oxygen consumption during the time trial was greater in PB (3.49 ± 0.71 L min-1) vs PL (3.32 ± 0.71 L min-1, p = 0.01, d = 0.24). Cough severity (SOC) was lower (p = 0.03) with PB relative to PL. CONCLUSION PB supplementation may provide small benefits to performance and reduce cough symptoms during high-intensity exercise in ozone-polluted environments.
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Affiliation(s)
- Lillian C Morton
- Department of Nutrition, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand.
| | - Carl D Paton
- School of Health and Sport Science, The Eastern Institute of Technology, Napier, New Zealand
| | - Troy Merry
- Department of Nutrition, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Andrea J Braakhuis
- Department of Nutrition, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
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4
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Mazumder MHH, Gandhi J, Majumder N, Wang L, Cumming RI, Stradtman S, Velayutham M, Hathaway QA, Shannahan J, Hu G, Nurkiewicz TR, Tighe RM, Kelley EE, Hussain S. Lung-gut axis of microbiome alterations following co-exposure to ultrafine carbon black and ozone. Part Fibre Toxicol 2023; 20:15. [PMID: 37085867 PMCID: PMC10122302 DOI: 10.1186/s12989-023-00528-8] [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: 01/26/2023] [Accepted: 04/17/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Microbial dysbiosis is a potential mediator of air pollution-induced adverse outcomes. However, a systemic comparison of the lung and gut microbiome alterations and lung-gut axis following air pollution exposure is scant. In this study, we exposed male C57BL/6J mice to inhaled air, CB (10 mg/m3), O3 (2 ppm) or CB + O3 mixture for 3 h/day for either one day or four consecutive days and were euthanized 24 h post last exposure. The lung and gut microbiome were quantified by 16 s sequencing. RESULTS Multiple CB + O3 exposures induced an increase in the lung inflammatory cells (neutrophils, eosinophils and B lymphocytes), reduced absolute bacterial load in the lungs and increased load in the gut. CB + O3 exposure was more potent as it decreased lung microbiome alpha diversity just after a single exposure. CB + O3 co-exposure uniquely increased Clostridiaceae and Prevotellaceae in the lungs. Serum short chain fatty acids (SCFA) (acetate and propionate) were increased significantly only after CB + O3 co-exposure. A significant increase in SCFA producing bacterial families (Ruminococcaceae, Lachnospiraceae, and Eubacterium) were also observed in the gut after multiple exposures. Co-exposure induced significant alterations in the gut derived metabolite receptors/mediator (Gcg, Glp-1r, Cck) mRNA expression. Oxidative stress related mRNA expression in lungs, and oxidant levels in the BALF, serum and gut significantly increased after CB + O3 exposures. CONCLUSION Our study confirms distinct gut and lung microbiome alterations after CB + O3 inhalation co-exposure and indicate a potential homeostatic shift in the gut microbiome to counter deleterious impacts of environmental exposures on metabolic system.
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Affiliation(s)
- Md Habibul Hasan Mazumder
- Department of Physiology, Pharmacology, and Toxicology, Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
- Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
| | - Jasleen Gandhi
- Department of Microbiology, School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
| | - Nairrita Majumder
- Department of Physiology, Pharmacology, and Toxicology, Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
- Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
| | - Lei Wang
- Department of Microbiology, School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
| | - Robert Ian Cumming
- Department of Medicine, Duke University Medical Center, Durham, NC, 2927, USA
| | - Sydney Stradtman
- School of Health Sciences, Purdue University, West Lafayette, IN, 47907, USA
| | - Murugesan Velayutham
- Department of Physiology, Pharmacology, and Toxicology, Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
- Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
- Department of Biochemistry and Molecular Medicine, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Quincy A Hathaway
- Heart and Vascular Institute, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Jonathan Shannahan
- School of Health Sciences, Purdue University, West Lafayette, IN, 47907, USA
| | - Gangqing Hu
- Department of Microbiology, School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
| | - Timothy R Nurkiewicz
- Department of Physiology, Pharmacology, and Toxicology, Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
- Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
| | - Robert M Tighe
- Department of Medicine, Duke University Medical Center, Durham, NC, 2927, USA
| | - Eric E Kelley
- Department of Physiology, Pharmacology, and Toxicology, Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
- Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
| | - Salik Hussain
- Department of Physiology, Pharmacology, and Toxicology, Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, Morgantown, WV, 26506, USA.
- Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, Morgantown, WV, 26506, USA.
- Department of Microbiology, School of Medicine, West Virginia University, Morgantown, WV, 26506, USA.
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Long E, Schwartz C, Carlsten C. Controlled human exposure to diesel exhaust: a method for understanding health effects of traffic-related air pollution. Part Fibre Toxicol 2022; 19:15. [PMID: 35216599 PMCID: PMC8876178 DOI: 10.1186/s12989-022-00454-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 02/03/2022] [Indexed: 12/17/2022] Open
Abstract
Diesel exhaust (DE) is a major component of air pollution in urban centers. Controlled human exposure (CHE) experiments are commonly used to investigate the acute effects of DE inhalation specifically and also as a paradigm for investigating responses to traffic-related air pollution (TRAP) more generally. Given the critical role this model plays in our understanding of TRAP’s health effects mechanistically and in support of associated policy and regulation, we review the methodology of CHE to DE (CHE–DE) in detail to distill critical elements so that the results of these studies can be understood in context. From 104 eligible publications, we identified 79 CHE–DE studies and extracted information on DE generation, exposure session characteristics, pollutant and particulate composition of exposures, and participant demographics. Virtually all studies had a crossover design, and most studies involved a single DE exposure per participant. Exposure sessions were typically 1 or 2 h in duration, with participants alternating between exercise and rest. Most CHE–DE targeted a PM concentration of 300 μg/m3. There was a wide range in commonly measured co-pollutants including nitrogen oxides, carbon monoxide, and total organic compounds. Reporting of detailed parameters of aerosol composition, including particle diameter, was inconsistent between studies, and older studies from a given lab were often cited in lieu of repeating measurements for new experiments. There was a male predominance in participants, and over half of studies involved healthy participants only. Other populations studied include those with asthma, atopy, or metabolic syndrome. Standardization in reporting exposure conditions, potentially using current versions of engines with modern emissions control technology, will allow for more valid comparisons between studies of CHE–DE, while recognizing that diesel engines in much of the world remain old and heterogeneous. Inclusion of female participants as well as populations more susceptible to TRAP will broaden the applicability of results from CHE–DE studies.
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Affiliation(s)
- Erin Long
- Faculty of Medicine, University of British Columbia, 317 - 2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Carley Schwartz
- Department of Medicine, Division of Respiratory Medicine, University of British Columbia, 2775 Laurel Street 7th Floor, Vancouver, BC, V5Z 1M9, Canada
| | - Christopher Carlsten
- Department of Medicine, Division of Respiratory Medicine, University of British Columbia, 2775 Laurel Street 7th Floor, Vancouver, BC, V5Z 1M9, Canada.
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6
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Long E, Carlsten C. Controlled human exposure to diesel exhaust: results illuminate health effects of traffic-related air pollution and inform future directions. Part Fibre Toxicol 2022; 19:11. [PMID: 35139881 PMCID: PMC8827176 DOI: 10.1186/s12989-022-00450-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/31/2022] [Indexed: 12/03/2022] Open
Abstract
Air pollution is an issue of increasing interest due to its globally relevant impacts on morbidity and mortality. Controlled human exposure (CHE) studies are often employed to investigate the impacts of pollution on human health, with diesel exhaust (DE) commonly used as a surrogate of traffic related air pollution (TRAP). This paper will review the results derived from 104 publications of CHE to DE (CHE-DE) with respect to health outcomes. CHE-DE studies have provided mechanistic evidence supporting TRAP’s detrimental effects on related to the cardiovascular system (e.g., vasomotor dysfunction, inhibition of fibrinolysis, and impaired cardiac function) and respiratory system (e.g., airway inflammation, increased airway responsiveness, and clinical symptoms of asthma). Oxidative stress is thought to be the primary mechanism of TRAP-induced effects and has been supported by several CHE-DE studies. A historical limitation of some air pollution research is consideration of TRAP (or its components) in isolation, limiting insight into the interactions between TRAP and other environmental factors often encountered in tandem. CHE-DE studies can help to shed light on complex conditions, and several have included co-exposure to common elements such as allergens, ozone, and activity level. The ability of filters to mitigate the adverse effects of DE, by limiting exposure to the particulate fraction of polluted aerosols, has also been examined. While various biomarkers of DE exposure have been evaluated in CHE-DE studies, a definitive such endpoint has yet to be identified. In spite of the above advantages, this paradigm for TRAP is constrained to acute exposures and can only be indirectly applied to chronic exposures, despite the critical real-world impact of living long-term with TRAP. Those with significant medical conditions are often excluded from CHE-DE studies and so results derived from healthy individuals may not apply to more susceptible populations whose further study is needed to avoid potentially misleading conclusions. In spite of limitations, the contributions of CHE-DE studies have greatly advanced current understanding of the health impacts associated with TRAP exposure, especially regarding mechanisms therein, with important implications for regulation and policy.
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Affiliation(s)
- Erin Long
- Faculty of Medicine, University of British Columbia, 317 - 2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Christopher Carlsten
- Division of Respiratory Medicine, Department of Medicine, University of British Columbia, 2775 Laurel Street 7th Floor, Vancouver, BC, V5Z 1M9, Canada.
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7
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Majumder N, Goldsmith WT, Kodali VK, Velayutham M, Friend SA, Khramtsov VV, Nurkiewicz TR, Erdely A, Zeidler-Erdely PC, Castranova V, Harkema JR, Kelley EE, Hussain S. Oxidant-induced epithelial alarmin pathway mediates lung inflammation and functional decline following ultrafine carbon and ozone inhalation co-exposure. Redox Biol 2021; 46:102092. [PMID: 34418598 PMCID: PMC8385153 DOI: 10.1016/j.redox.2021.102092] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 11/29/2022] Open
Abstract
Environmental inhalation exposures are inherently mixed (gases and particles), yet regulations are still based on single toxicant exposures. While the impacts of individual components of environmental pollution have received substantial attention, the impact of inhalation co-exposures is poorly understood. Here, we mechanistically investigated pulmonary inflammation and lung function decline after inhalation co-exposure and individual exposures to ozone (O3) and ultrafine carbon black (CB). Environmentally/occupationally relevant lung deposition levels in mice were achieved after inhalation of stable aerosols with similar aerodynamic and mass median distributions. X-ray photoemission spectroscopy detected increased surface oxygen contents on particles in co-exposure aerosols. Compared with individual exposures, co-exposure aerosols produced greater acellular and cellular oxidants detected by electron paramagnetic resonance (EPR) spectroscopy, and in vivo immune-spin trapping (IST), as well as synergistically increased lavage neutrophils, lavage proteins and inflammation related gene/protein expression. Co-exposure induced a significantly greater respiratory function decline compared to individual exposure. A synthetic catalase-superoxide dismutase mimetic (EUK-134) significantly blunted lung inflammation and respiratory function decline confirming the role of oxidant imbalance. We identified a significant induction of epithelial alarmin (thymic stromal lymphopoietin-TSLP)-dependent interleukin-13 pathway after co-exposure, associated with increased mucin and interferon gene expression. We provided evidence of interactive outcomes after air pollution constituent co-exposure and identified a key mechanistic pathway that can potentially explain epidemiological observation of lung function decline after an acute peak of air pollution. Developing and studying the co-exposure scenario in a standardized and controlled fashion will enable a better mechanistic understanding of how environmental exposures result in adverse outcomes. Interaction with O3 mediates free radical production on the surface of carbon black (CB) particles. Oxidants mediate co-exposure (CB + O3)-induced lung function decline. EUK-134 (a synthetic superoxide-catalase mimetic) abrogates CB + O3-induced lung inflammation. CB + O3 co-exposure induces greater lung inflammation than individual exposures. Epithelial alarmin (TSLP) contributes significantly to the CB + O3 toxicity.
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Affiliation(s)
- Nairrita Majumder
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA; Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA
| | - William T Goldsmith
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA; Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA
| | - Vamsi K Kodali
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA; Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA; National Institute for Occupational Safety and Health, USA
| | | | - Sherri A Friend
- Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA; National Institute for Occupational Safety and Health, USA
| | - Valery V Khramtsov
- Department of Biochemistry, School of Medicine, West Virginia University, USA
| | - Timothy R Nurkiewicz
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA; Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA
| | - Aaron Erdely
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA; Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA; National Institute for Occupational Safety and Health, USA
| | - Patti C Zeidler-Erdely
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA; Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA; National Institute for Occupational Safety and Health, USA
| | - Vince Castranova
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA
| | - Jack R Harkema
- Department of Pathobiology and Diagnostic Investigation, School of Veterinary Medicine, Michigan State University, USA
| | - Eric E Kelley
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA; Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA
| | - Salik Hussain
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA; Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA.
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8
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Crisford H, Sapey E, Rogers GB, Taylor S, Nagakumar P, Lokwani R, Simpson JL. Neutrophils in asthma: the good, the bad and the bacteria. Thorax 2021; 76:thoraxjnl-2020-215986. [PMID: 33632765 PMCID: PMC8311087 DOI: 10.1136/thoraxjnl-2020-215986] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 12/30/2022]
Abstract
Airway inflammation plays a key role in asthma pathogenesis but is heterogeneous in nature. There has been significant scientific discovery with regard to type 2-driven, eosinophil-dominated asthma, with effective therapies ranging from inhaled corticosteroids to novel biologics. However, studies suggest that approximately 1 in 5 adults with asthma have an increased proportion of neutrophils in their airways. These patients tend to be older, have potentially pathogenic airway bacteria and do not respond well to classical therapies. Currently, there are no specific therapeutic options for these patients, such as neutrophil-targeting biologics.Neutrophils comprise 70% of the total circulatory white cells and play a critical defence role during inflammatory and infective challenges. This makes them a problematic target for therapeutics. Furthermore, neutrophil functions change with age, with reduced microbial killing, increased reactive oxygen species release and reduced production of extracellular traps with advancing age. Therefore, different therapeutic strategies may be required for different age groups of patients.The pathogenesis of neutrophil-dominated airway inflammation in adults with asthma may reflect a counterproductive response to the defective neutrophil microbial killing seen with age, resulting in bystander damage to host airway cells and subsequent mucus hypersecretion and airway remodelling. However, in children with asthma, neutrophils are less associated with adverse features of disease, and it is possible that in children, neutrophils are less pathogenic.In this review, we explore the mechanisms of neutrophil recruitment, changes in cellular function across the life course and the implications this may have for asthma management now and in the future. We also describe the prevalence of neutrophilic asthma globally, with a focus on First Nations people of Australia, New Zealand and North America.
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Affiliation(s)
- Helena Crisford
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Elizabeth Sapey
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Geraint B Rogers
- SAHMRI Microbiome Research Laboratory, Flinders University College of Medicine and Public Health, Adelaide, South Australia, Australia
- Microbiome and Host Health, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Steven Taylor
- SAHMRI Microbiome Research Laboratory, Flinders University College of Medicine and Public Health, Adelaide, South Australia, Australia
- Microbiome and Host Health, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Prasad Nagakumar
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- Respiratory Medicine, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Ravi Lokwani
- Faculty of Health and Medicine, Priority Research Centre for Healthy Lungs, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Jodie L Simpson
- Faculty of Health and Medicine, Priority Research Centre for Healthy Lungs, The University of Newcastle, Callaghan, New South Wales, Australia
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9
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Ghio AJ, Gonzalez DH, Paulson SE, Soukup JM, Dailey LA, Madden MC, Mahler B, Elmore SA, Schladweiler MC, Kodavanti UP. Ozone Reacts With Carbon Black to Produce a Fulvic Acid-Like Substance and Increase an Inflammatory Effect. Toxicol Pathol 2020; 48:887-898. [PMID: 32975498 DOI: 10.1177/0192623320961017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Exposure to ambient ozone has been associated with increased human mortality. Ozone exposure can introduce oxygen-containing functional groups in particulate matter (PM) effecting a greater capacity of the particle for metal complexation and inflammatory effect. We tested the postulate that (1) a fulvic acid-like substance can be produced through a reaction of a carbonaceous particle with high concentrations of ozone and (2) such a fulvic acid-like substance included in the PM can initiate inflammatory effects following exposure of respiratory epithelial (BEAS-2B) cells and an animal model (male Wistar Kyoto rats). Carbon black (CB) was exposed for 72 hours to either filtered air (CB-Air) or approximately 100 ppm ozone (CB-O3). Carbon black exposure to high levels of ozone produced water-soluble, fluorescent organic material. Iron import by BEAS-2B cells at 4 and 24 hours was not induced by incubations with CB-Air but was increased following coexposures of CB-O3 with ferric ammonium citrate. In contrast to CB-Air, exposure of BEAS-2B cells and rats to CB-O3 for 24 hours increased expression of pro-inflammatory cytokines and lung injury, respectively. It is concluded that inflammatory effects of carbonaceous particles on cells can potentially result from (1) an inclusion of a fulvic acid-like substance after reaction with ozone and (2) changes in iron homeostasis following such exposure.
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Affiliation(s)
- Andrew J Ghio
- 138030US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - David H Gonzalez
- Atmospheric and Oceanic Sciences, 8783University of California at Los Angeles, Los Angeles, CA, USA
| | - Suzanne E Paulson
- Atmospheric and Oceanic Sciences, 8783University of California at Los Angeles, Los Angeles, CA, USA
| | - Joleen M Soukup
- 138030US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Lisa A Dailey
- 138030US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Michael C Madden
- 138030US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Beth Mahler
- Experimental Pathology Laboratories, Inc., Research Triangle Park, NC, USA
| | - Susan A Elmore
- National Toxicology Program, 6857National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | | | - Urmila P Kodavanti
- 138030US Environmental Protection Agency, Research Triangle Park, NC, USA
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10
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Ghio AJ, Soukup JM, Dailey LA, Madden MC. Air pollutants disrupt iron homeostasis to impact oxidant generation, biological effects, and tissue injury. Free Radic Biol Med 2020; 151:38-55. [PMID: 32092410 PMCID: PMC8274387 DOI: 10.1016/j.freeradbiomed.2020.02.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/27/2020] [Accepted: 02/10/2020] [Indexed: 02/07/2023]
Abstract
Air pollutants cause changes in iron homeostasis through: 1) a capacity of the pollutant, or a metabolite(s), to complex/chelate iron from pivotal sites in the cell or 2) an ability of the pollutant to displace iron from pivotal sites in the cell. Through either pathway of disruption in iron homeostasis, metal previously employed in essential cell processes is sequestered after air pollutant exposure. An absolute or functional cell iron deficiency results. If enough iron is lost or is otherwise not available within the cell, cell death ensues. However, prior to death, exposed cells will attempt to reverse the loss of requisite metal. This response of the cell includes increased expression of metal importers (e.g. divalent metal transporter 1). Oxidant generation after exposure to air pollutants includes superoxide production which functions in ferrireduction necessary for cell iron import. Activation of kinases and phosphatases and transcription factors and increased release of pro-inflammatory mediators also result from a cell iron deficiency, absolute or functional, after exposure to air pollutants. Finally, air pollutant exposure culminates in the development of inflammation and fibrosis which is a tissue response to the iron deficiency challenging cell survival. Following the response of increased expression of importers and ferrireduction, activation of kinases and phosphatases and transcription factors, release of pro-inflammatory mediators, and inflammation and fibrosis, cell iron is altered, and a new metal homeostasis is established. This new metal homeostasis includes increased total iron concentrations in cells with metal now at levels sufficient to meet requirements for continued function.
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Affiliation(s)
- Andrew J Ghio
- From the National Health and Environmental Effects Research Laboratory, Environmental Protection Agency, Chapel Hill, NC, USA.
| | - Joleen M Soukup
- From the National Health and Environmental Effects Research Laboratory, Environmental Protection Agency, Chapel Hill, NC, USA
| | - Lisa A Dailey
- From the National Health and Environmental Effects Research Laboratory, Environmental Protection Agency, Chapel Hill, NC, USA
| | - Michael C Madden
- From the National Health and Environmental Effects Research Laboratory, Environmental Protection Agency, Chapel Hill, NC, USA
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11
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Jantzen K, Jensen A, Kermanizadeh A, Elholm G, Sigsgaard T, Møller P, Roursgaard M, Loft S. Inhalation of House Dust and Ozone Alters Systemic Levels of Endothelial Progenitor Cells, Oxidative Stress, and Inflammation in Elderly Subjects. Toxicol Sci 2019; 163:353-363. [PMID: 29767793 DOI: 10.1093/toxsci/kfy027] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Ambient air pollution including ozone and especially particulate matter represents important causes of cardiovascular disease. However, there is limited knowledge on indoor air dust with respect to this risk and the potential interactions between dust and ozone. Here, we exposed 23 healthy elderly subjects for 5.5 h, to either clean air, house dust at 275 µg/m3 (diameter < 2.5 µm), ozone at 100 ppb or combined house dust and ozone in a double-blinded randomized cross-over study. The combined house dust and ozone exposure was associated with a 48% (95% CI 24%-65%) decrease as compared with the clean air exposure, in CD34+KDR+ late endothelial progenitor cells (EPCs) per leukocyte in the blood shortly after exposure, whereas none of the single exposures resulted in a significant effect. The combined exposure also increased reactive oxygen species production capacity in granulocytes and monocytes as well as an up-regulation of interleukin-8 mRNA levels in leukocytes. Ozone alone reduced the gene expression of tumor necrosis factor and C-C motif chemokine ligand 2, while dust alone showed no effects. The combined exposure to house dust and ozone also reduced levels of oxidized purines in DNA consistent with concomitant up-regulation of mRNA of the repair enzyme 8-oxoguanine DNA glycosylase. The reduction in late EPCs can be an indicator of cardiovascular risk caused by the combination of pulmonary oxidative stress induced by ozone and the inflammatory potential of the house dust. These data were corroborated with in vitro findings from exposed human macrophages and endothelial cells.
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Affiliation(s)
- Kim Jantzen
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 1014 Copenhagen, Denmark
| | - Annie Jensen
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 1014 Copenhagen, Denmark
| | - Ali Kermanizadeh
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 1014 Copenhagen, Denmark
| | - Grethe Elholm
- Section of Environment, Occupation and Health, Department of Public Health, Aarhus University, 8000 Aarhus, Denmark
| | - Torben Sigsgaard
- Section of Environment, Occupation and Health, Department of Public Health, Aarhus University, 8000 Aarhus, Denmark
| | - Peter Møller
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 1014 Copenhagen, Denmark
| | - Martin Roursgaard
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 1014 Copenhagen, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 1014 Copenhagen, Denmark
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12
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Li P, Wang J, Wang X, Ding Q, Bai X, Zhang Y, Su D, Zhang W, Zhang W, Tang B. In situ visualization of ozone in the brains of mice with depression phenotypes by using a new near-infrared fluorescence probe. Chem Sci 2019; 10:2805-2810. [PMID: 30997001 PMCID: PMC6425856 DOI: 10.1039/c8sc04891f] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 01/12/2019] [Indexed: 01/21/2023] Open
Abstract
Ozone (O3), one of the reactive oxygen species (ROS), is deeply involved in diseases including depression. However, the lack of appropriate in situ detection methods suitable for the complex biological context of brain impedes uncovering the exact relationship between depression and changes in the O3 level. Therefore, we developed a near-infrared (NIR) fluorescent probe (ACy7) for the direct visualization of O3 in mice brains. The specific cycloaddition reaction between O3 and the terminal double bond of the butenyl group extends the conjugation of the "pre-" heptamethine cyanine system, which emits NIR fluorescence of heptamethine cyanine. This makes the ACy7 specific, highly sensitive and able to deeply penetrate tissue. Using ACy7, we found that under glutamate stimulation, the O3 content in PC12 cells was significantly higher than that in control cells. By imaging analysis on the brains of mice, we revealed for the first time that the levels of O3 in mice with depression phenotypes were markedly higher than that in control mice. Intriguingly, experimental results unravelled that excess O3 promoted high expression of the pro-inflammatory cytokine interleukin-8 (IL-8), which ultimately induced depression phenotypes. Our work demonstrates the pivotal role of elevated O3 in depression and provides a fresh entry point for exploring oxidative stress contributing to depression.
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Affiliation(s)
- Ping Li
- College of Chemistry, Chemical Engineering and Materials Science , Key Laboratory of Molecular and Nano Probes , Ministry of Education , Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong , Institutes of Biomedical Sciences , Shandong Normal University , Jinan 250014 , People's Republic of China .
| | - Jijuan Wang
- College of Chemistry, Chemical Engineering and Materials Science , Key Laboratory of Molecular and Nano Probes , Ministry of Education , Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong , Institutes of Biomedical Sciences , Shandong Normal University , Jinan 250014 , People's Republic of China .
| | - Xin Wang
- College of Chemistry, Chemical Engineering and Materials Science , Key Laboratory of Molecular and Nano Probes , Ministry of Education , Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong , Institutes of Biomedical Sciences , Shandong Normal University , Jinan 250014 , People's Republic of China .
| | - Qi Ding
- College of Chemistry, Chemical Engineering and Materials Science , Key Laboratory of Molecular and Nano Probes , Ministry of Education , Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong , Institutes of Biomedical Sciences , Shandong Normal University , Jinan 250014 , People's Republic of China .
| | - Xiaoyi Bai
- College of Chemistry, Chemical Engineering and Materials Science , Key Laboratory of Molecular and Nano Probes , Ministry of Education , Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong , Institutes of Biomedical Sciences , Shandong Normal University , Jinan 250014 , People's Republic of China .
| | - Yandi Zhang
- College of Chemistry, Chemical Engineering and Materials Science , Key Laboratory of Molecular and Nano Probes , Ministry of Education , Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong , Institutes of Biomedical Sciences , Shandong Normal University , Jinan 250014 , People's Republic of China .
| | - Di Su
- College of Chemistry, Chemical Engineering and Materials Science , Key Laboratory of Molecular and Nano Probes , Ministry of Education , Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong , Institutes of Biomedical Sciences , Shandong Normal University , Jinan 250014 , People's Republic of China .
| | - Wei Zhang
- College of Chemistry, Chemical Engineering and Materials Science , Key Laboratory of Molecular and Nano Probes , Ministry of Education , Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong , Institutes of Biomedical Sciences , Shandong Normal University , Jinan 250014 , People's Republic of China .
| | - Wen Zhang
- College of Chemistry, Chemical Engineering and Materials Science , Key Laboratory of Molecular and Nano Probes , Ministry of Education , Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong , Institutes of Biomedical Sciences , Shandong Normal University , Jinan 250014 , People's Republic of China .
| | - Bo Tang
- College of Chemistry, Chemical Engineering and Materials Science , Key Laboratory of Molecular and Nano Probes , Ministry of Education , Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong , Institutes of Biomedical Sciences , Shandong Normal University , Jinan 250014 , People's Republic of China .
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13
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Ghio AJ, Soukup JM, Madden MC. The toxicology of air pollution predicts its epidemiology. Inhal Toxicol 2018; 30:327-334. [PMID: 30516398 DOI: 10.1080/08958378.2018.1530316] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The epidemiologic investigation has successively delineated associations of air pollution exposure with non-malignant and malignant lung disease, cardiovascular disease, cerebrovascular disease, pregnancy outcomes, perinatal effects and other extra-pulmonary disease including diabetes. Defining these relationships between air pollution exposure and human health closely parallels results of an earlier epidemiologic investigation into cigarette smoking and environmental tobacco smoke (ETS), two other particle-related exposures. Humic-like substances (HULIS) have been identified as a chemical component common to cigarette smoke and air pollution particles. Toxicology studies provide evidence that a disruption of iron homeostasis with sequestration of host metal by HULIS is a fundamental mechanistic pathway through which biological effects are initiated by cigarette smoke and air pollution particles. As a result of a common chemical component and a shared mechanistic pathway, it should be possible to extrapolate from the epidemiology of cigarette smoking and ETS to predict associations of air pollution exposure with human disease, which are currently unrecognized. Accordingly, it is anticipated that the forthcoming epidemiologic investigation will demonstrate relationships of air pollution with COPD causation, peripheral vascular disease, hypertension, renal disease, digestive disease, loss of bone mass/risk of fractures, dental disease, eye disease, fertility problems, and extrapulmonary malignancies.
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Affiliation(s)
- Andrew J Ghio
- a The National Health and Environmental Effects Research Laboratory , Environmental Protection Agency , Chapel Hill , NC , USA
| | - Joleen M Soukup
- a The National Health and Environmental Effects Research Laboratory , Environmental Protection Agency , Chapel Hill , NC , USA
| | - Michael C Madden
- a The National Health and Environmental Effects Research Laboratory , Environmental Protection Agency , Chapel Hill , NC , USA
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14
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Ozone augments interleukin-8 production induced by ambient particulate matter. Genes Environ 2018; 40:14. [PMID: 30026883 PMCID: PMC6050665 DOI: 10.1186/s41021-018-0102-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 06/28/2018] [Indexed: 01/05/2023] Open
Abstract
Background Experimental and controlled human exposure studies have demonstrated additive effects of ambient particulate matter and ozone on health. A few epidemiological studies have suggested that ambient particulate matter components are important for the combined effects of ambient particulate matter and ozone on health. However, few studies have examined whether ozone changes the effects of ambient particulate matter on pro-inflammatory cytokine production. In this study, the influence of ozone on pro-inflammatory cytokine production in response to ambient particulate matter was evaluated. Results Ambient particulate matter smaller than 1 μm was collected and the suspension of this particulate matter was bubbled through 0.12 ppm and 0.24 ppm ozone. THP1 cells were stimulated by the solution containing the particulate matter with and without bubbling through ozone at 1 μg/mL. The interleukin-8 concentrations in the supernatants of THP1 cells stimulated by collected particulate matter dissolved in solution were 108.3 ± 24.7 pg/mL without ozone exposure, 165.0 ± 26.1 pg/mL for 0.12 ppm ozone bubbling for 1 min, 175.1 ± 33.1 pg/mL for 0.12 ppm for 5 min, 183.3 ± 17.8 pg/mL for 0.12 ppm for 15 min, 167.8 ± 35.9 pg/mL for 0.24 ppm for 1 min, 209.2 ± 8.4 pg/mL for 0.24 ppm for 5 min, and 209.3 ± 14.3 pg/mL for 0.24 ppm for 15 min. Ozone significantly increased interleukin-8 concentrations compared to those for particulate matter dissolved in solution without ozone exposure and the solvent only (8.2 ± 0.9 pg/mL) in an ozone concentration-dependent manner. Collected particulate matter in solutions with or without bubbling through ozone had no effect on interleukin-6 production. The antioxidant N-acetyl-L-cysteine significantly inhibited the increases in interleukin-8 induced by solutions with particulate matter, regardless of ozone exposure. The reactive oxygen species concentration in solutions with collected particulate matter was not associated with ozone bubbling. Conclusion Ozone may augment the production of interleukin-8 in response to ambient particulate matter by a mechanism unrelated to reactive oxygen species. These results support the epidemiological evidence for combined effects of ambient particulate matter and ozone on human health.
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15
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Hansbro PM, Kim RY, Starkey MR, Donovan C, Dua K, Mayall JR, Liu G, Hansbro NG, Simpson JL, Wood LG, Hirota JA, Knight DA, Foster PS, Horvat JC. Mechanisms and treatments for severe, steroid-resistant allergic airway disease and asthma. Immunol Rev 2018; 278:41-62. [PMID: 28658552 DOI: 10.1111/imr.12543] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Severe, steroid-resistant asthma is clinically and economically important since affected individuals do not respond to mainstay corticosteroid treatments for asthma. Patients with this disease experience more frequent exacerbations of asthma, are more likely to be hospitalized, and have a poorer quality of life. Effective therapies are urgently required, however, their development has been hampered by a lack of understanding of the pathological processes that underpin disease. A major obstacle to understanding the processes that drive severe, steroid-resistant asthma is that the several endotypes of the disease have been described that are characterized by different inflammatory and immunological phenotypes. This heterogeneity makes pinpointing processes that drive disease difficult in humans. Clinical studies strongly associate specific respiratory infections with severe, steroid-resistant asthma. In this review, we discuss key findings from our studies where we describe the development of representative experimental models to improve our understanding of the links between infection and severe, steroid-resistant forms of this disease. We also discuss their use in elucidating the mechanisms, and their potential for developing effective therapeutic strategies, for severe, steroid-resistant asthma. Finally, we highlight how the immune mechanisms and therapeutic targets we have identified may be applicable to obesity-or pollution-associated asthma.
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Affiliation(s)
- Philip M Hansbro
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Richard Y Kim
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Malcolm R Starkey
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Chantal Donovan
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Kamal Dua
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Jemma R Mayall
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Gang Liu
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Nicole G Hansbro
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Jodie L Simpson
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Lisa G Wood
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Jeremy A Hirota
- James Hogg Research Centre, University of British Columbia, Vancouver, BC, Canada
| | - Darryl A Knight
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Paul S Foster
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
| | - Jay C Horvat
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, NSW, Australia
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16
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Zhang X, Staimer N, Gillen DL, Tjoa T, Schauer JJ, Shafer MM, Hasheminassab S, Pakbin P, Vaziri ND, Sioutas C, Delfino RJ. Associations of oxidative stress and inflammatory biomarkers with chemically-characterized air pollutant exposures in an elderly cohort. ENVIRONMENTAL RESEARCH 2016; 150:306-319. [PMID: 27336235 PMCID: PMC5003670 DOI: 10.1016/j.envres.2016.06.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 05/18/2016] [Accepted: 06/10/2016] [Indexed: 05/12/2023]
Abstract
BACKGROUND Exposure to air pollution has been associated with cardiorespiratory morbidity and mortality. However, the chemical constituents and pollution sources underlying these associations remain unclear. METHOD We conducted a cohort panel study involving 97 elderly subjects living in the Los Angeles metropolitan area. Airway and circulating biomarkers of oxidative stress and inflammation were measured weekly over 12 weeks and included, exhaled breath condensate malondialdehyde (EBC MDA), fractional exhaled nitric oxide (FeNO), plasma oxidized low-density lipoprotein (oxLDL), and plasma interleukin-6 (IL-6). Exposures included 7-day personal nitrogen oxides (NOx), daily criteria-pollutant data, five-day average particulate matter (PM) measured in three size-fractions and characterized by chemical components including transition metals, and in vitro PM oxidative potential (dithiothreitol and macrophage reactive oxygen species). Associations between biomarkers and pollutants were assessed using linear mixed effects regression models. RESULTS We found significant positive associations of airway oxidative stress and inflammation with traffic-related air pollutants, ultrafine particles and transition metals. Positive but nonsignificant associations were observed with PM oxidative potential. The strongest associations were observed among PM variables in the ultrafine range (PM <0.18µm). It was estimated that an interquartile increase in 5-day average ultrafine polycyclic aromatic hydrocarbons was associated with a 6.3% (95% CI: 1.1%, 11.6%) increase in EBC MDA and 6.7% (95% CI: 3.4%, 10.2%) increase in FeNO. In addition, positive but nonsignificant associations were observed between oxLDL and traffic-related pollutants, ultrafine particles and transition metals while plasma IL-6 was positively associated with 1-day average traffic-related pollutants. CONCLUSION Our results suggest that exposure to pollutants with high oxidative potential (traffic-related pollutants, ultrafine particles, and transition metals) may lead to increased airway oxidative stress and inflammation in elderly adults. This observation was less clear with circulating biomarkers.
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Affiliation(s)
- Xian Zhang
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA
| | - Norbert Staimer
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA
| | - Daniel L Gillen
- Department of Statistics, School of Information and Computer Sciences, University of California, Irvine, CA, USA
| | - Tomas Tjoa
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA
| | - James J Schauer
- University of Wisconsin-Madison, Environmental Chemistry and Technology Program, Madison, WI, USA
| | - Martin M Shafer
- University of Wisconsin-Madison, Environmental Chemistry and Technology Program, Madison, WI, USA
| | - Sina Hasheminassab
- Department of Civil and Environmental Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Payam Pakbin
- Department of Civil and Environmental Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Nosratola D Vaziri
- Division of Nephrology and Hypertension, Department of Medicine, School of Medicine, University of California, Irvine, CA, USA
| | - Constantinos Sioutas
- Department of Civil and Environmental Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Ralph J Delfino
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA.
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17
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Stiegel MA, Pleil JD, Sobus JR, Madden MC. Inflammatory Cytokines and White Blood Cell Counts Response to Environmental Levels of Diesel Exhaust and Ozone Inhalation Exposures. PLoS One 2016; 11:e0152458. [PMID: 27058360 PMCID: PMC4825980 DOI: 10.1371/journal.pone.0152458] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 03/15/2016] [Indexed: 12/21/2022] Open
Abstract
Epidemiological observations of urban inhalation exposures to diesel exhaust (DE) and ozone (O3) have shown pre-clinical cardiopulmonary responses in humans. Identifying the key biological mechanisms that initiate these health bioindicators is difficult due to variability in environmental exposure in time and from person to person. Previously, environmentally controlled human exposure chambers have been used to study DE and O3 dose-response patterns separately, but investigation of co-exposures has not been performed under controlled conditions. Because a mixture is a more realistic exposure scenario for the general public, in this study we investigate the relationships of urban levels of urban-level DE exposure (300 μg/m3), O3 (0.3 ppm), DE + O3 co-exposure, and innate immune system responses. Fifteen healthy human volunteers were studied for changes in ten inflammatory cytokines (interleukins 1β, 2, 4, 5, 8, 10, 12p70 and 13, IFN-γ, and TNF-α) and counts of three white blood cell types (lymphocytes, monocytes, and neutrophils) following controlled exposures to DE, O3, and DE+O3. The results show subtle cytokines responses to the diesel-only and ozone-only exposures, and that a more complex (possibly synergistic) relationship exists in the combination of these two exposures with suppression of IL-5, IL-12p70, IFN-γ, and TNF-α that persists up to 22-hours for IFN-γ and TNF-α. The white blood cell differential counts showed significant monocyte and lymphocyte decreases and neutrophil increases following the DE + O3 exposure; lymphocytes and neutrophils changes also persist for at least 22-hours. Because human studies must be conducted under strict safety protocols at environmental levels, these effects are subtle and are generally only seen with detailed statistical analysis. This study indicates that the observed associations between environmental exposures and cardiopulmonary effects are possibly mediated by inflammatory response mechanisms.
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Affiliation(s)
- Matthew A. Stiegel
- Duke University Medical Center, Department of Occupational and Environmental Safety, Division of Occupational Hygiene and Safety, Durham, North Carolina, United States of America
| | - Joachim D. Pleil
- United States Environmental Protection Agency, National Exposure Research Lab, Human Exposure and Atmospheric Sciences Division, Research Triangle Park, North Carolina, United States of America
| | - Jon R. Sobus
- United States Environmental Protection Agency, National Exposure Research Lab, Human Exposure and Atmospheric Sciences Division, Research Triangle Park, North Carolina, United States of America
| | - Michael C. Madden
- United States Environmental Protection Agency, National Health and Environmental Effects Research Lab, Environmental Public Health Division, Chapel Hill, North Carolina, United States of America
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Diosmin downregulates the expression of T cell receptors, pro-inflammatory cytokines and NF-κB activation against LPS-induced acute lung injury in mice. Pharmacol Res 2015; 102:1-11. [DOI: 10.1016/j.phrs.2015.09.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 09/04/2015] [Accepted: 09/06/2015] [Indexed: 12/22/2022]
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Al-Harbi NO, Imam F, Nadeem A, Al-Harbi MM, Korashy HM, Sayed-Ahmed MM, Hafez MM, Al-Shabanah OA, Nagi MN, Bahashwan S. Riboflavin attenuates lipopolysaccharide-induced lung injury in rats. Toxicol Mech Methods 2015; 25:417-23. [PMID: 26360969 DOI: 10.3109/15376516.2015.1045662] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Riboflavin (vitamin B2) is an easily absorbed micronutrient with a key role in maintaining health in humans and animals. It is the central component of the cofactors flavin adenine dinucleotide (FAD) and flavin mononucleotide (FMN) and is therefore required by all flavoproteins. Riboflavin also works as an antioxidant by scavenging free radicals. The present study was designed to evaluate the effects of riboflavin against acute lungs injury induced by the administration of a single intranasal dose (20 μg/rat) of lipopolysaccharides (LPS) in experimental rats. Administration of LPS resulted in marked increase in malondialdehyde (MDA) level (p < 0.01) and MPO activity (p < 0.001), whereas marked decrease in glutathione (GSH) content (p < 0.001), glutathione reductase (GR) (p < 0.001) and glutathione peroxidase (p < 0.01) activity. These changes were significantly (p < 0.001) improved by treatment with riboflavin in a dose-dependent manner (30 and 100 mg/kg, respectively). Riboflavin (100 mg/kg, p.o.) showed similar protective effects as dexamethasone (1 mg/kg, p.o.). Administration of LPS showed marked cellular changes including interstitial edema, hemorrhage, infiltration of PMNs, etc., which were reversed by riboflavin administration. Histopathological examinations showed normal morphological structures of lungs tissue in the control group. These biochemical and histopathological examination were appended with iNOS and CAT gene expression. The iNOS mRNA expression was increased significantly (p < 0.001) and levels of CAT mRNA expression was decreased significantly (p < 0.001) in the animals exposed to LPS, while treatment with riboflavin significantly (p < 0.01) improved expression of both gene. In conclusion, the present study clearly demonstrated that riboflavin caused a protective effect against LPS-induced ALI. These results suggest that riboflavin may be used to protect against toxic effect of LPS in lungs.
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Affiliation(s)
- Naif O Al-Harbi
- a Department of Pharmacology and Toxicology , College of Pharmacy, King Saud University , Riyadh , KSA and
| | - Faisal Imam
- a Department of Pharmacology and Toxicology , College of Pharmacy, King Saud University , Riyadh , KSA and
| | - Ahmed Nadeem
- a Department of Pharmacology and Toxicology , College of Pharmacy, King Saud University , Riyadh , KSA and
| | - Mohammed M Al-Harbi
- a Department of Pharmacology and Toxicology , College of Pharmacy, King Saud University , Riyadh , KSA and
| | - Hesham M Korashy
- a Department of Pharmacology and Toxicology , College of Pharmacy, King Saud University , Riyadh , KSA and
| | - Mohammed M Sayed-Ahmed
- a Department of Pharmacology and Toxicology , College of Pharmacy, King Saud University , Riyadh , KSA and
| | - Mohamed M Hafez
- a Department of Pharmacology and Toxicology , College of Pharmacy, King Saud University , Riyadh , KSA and
| | - Othman A Al-Shabanah
- a Department of Pharmacology and Toxicology , College of Pharmacy, King Saud University , Riyadh , KSA and
| | - Mahmoud N Nagi
- a Department of Pharmacology and Toxicology , College of Pharmacy, King Saud University , Riyadh , KSA and
| | - Saleh Bahashwan
- b Department of Pharmacology and Toxicology , College of Pharmacy, Taibah University , Medina , KSA
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Wang G, Zhao J, Jiang R, Song W. Rat lung response to ozone and fine particulate matter (PM2.5) exposures. ENVIRONMENTAL TOXICOLOGY 2015; 30:343-356. [PMID: 24136897 DOI: 10.1002/tox.21912] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 09/16/2013] [Accepted: 09/20/2013] [Indexed: 05/28/2023]
Abstract
Exposure to different ambient pollutants maybe more toxic to lung than exposure to a single pollutant. In this study, we discussed the inflammation and oxidative stress responses of rat lung caused by ozone and PM2.5 versus that of rats exposed to saline, ozone, or single PM2.5 . Wistar rats inhaled 0.8 ppm ozone or air for 4 h and then placed in air for 3 h following intratracheal instillation with 0, 0.2 (low dose), 0.8 (medium dose), 3.2 (high dose) mg/rat PM2.5 dissolved in sterile saline (0.25 mL/rat), repeated twice per week for 3 weeks, the cumulative doses of PM2.5 in animals were 1.2, 4.8, and 19.2 mg. Rats were sacrificed 24 h after the last (sixth) exposure. The collected bronchoalveolar lavage fluid (BALF) was analyzed for inflammatory cells and cytokines. Lung tissues were processed for light microscopic and transmission electron microscopic (TEM) examinations. Results showed that total cell number in BALF of PM2.5 -exposed groups were higher than control (p < 0.05). PM2.5 instillation caused dose-trend increase in tumor necrosis factor alpha (TNF-α), interleukin-6, lactate dehydrogenase, and total protein of BALF. Exposure to ozone alone only caused TNF-α significant change in above-mentioned indicators of lung injury. On the other hand, ozone could enhance PM2.5-induced inflammatory changes and pathological characters in rat lungs. SOD and GSH-Px activities in lung were reduced in PM2.5-exposed rats with and without prior ozone exposure compared to control. To determine whether the PM2.5 and ozone affect endothelium system, iNOS, eNOS, and ICAM-1 mRNA levels in lung were analyzed by real-time PCR. These data demonstrated that inflammation and oxidative stress were involved in toxicology mechanisms of PM2.5 in rat lung and ozone potentiated these effects induced by PM2.5. These results have implications for understanding the pulmonary effects induced by ozone and PM2.5.
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Affiliation(s)
- Guanghe Wang
- Department of Hygienic Toxicology, College of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, 150081, China; Department of Environmental Health, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032, China
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21
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Madden MC, Stevens T, Case M, Schmitt M, Diaz-Sanchez D, Bassett M, Montilla TS, Berntsen J, Devlin RB. Diesel exhaust modulates ozone-induced lung function decrements in healthy human volunteers. Part Fibre Toxicol 2014; 11:37. [PMID: 25178924 PMCID: PMC4354281 DOI: 10.1186/s12989-014-0037-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 08/05/2014] [Indexed: 01/22/2023] Open
Abstract
The potential effects of combinations of dilute whole diesel exhaust (DE) and ozone (O₃), each a common component of ambient airborne pollutant mixtures, on lung function were examined. Healthy young human volunteers were exposed for 2 hr to pollutants while exercising (~50 L/min) intermittently on two consecutive days. Day 1 exposures were either to filtered air, DE (300 μg/m³), O₃ (0.300 ppm), or the combination of both pollutants. On Day 2 all exposures were to O₃ (0.300 ppm), and Day 3 served as a followup observation day. Lung function was assessed by spirometry just prior to, immediately after, and up to 4 hr post-exposure on each exposure day. Functional pulmonary responses to the pollutants were also characterized based on stratification by glutathione S-transferase mu 1 (GSTM1) genotype. On Day 1, exposure to air or DE did not change FEV1 or FVC in the subject population (n = 15). The co-exposure to O₃ and DE decreased FEV1 (17.6%) to a greater extent than O₃ alone (9.9%). To test for synergistic exposure effects, i.e., in a greater than additive fashion, FEV1 changes post individual O₃ and DE exposures were summed together and compared to the combined DE and O₃ exposure; the p value was 0.057. On Day 2, subjects who received DE exposure on Day 1 had a larger FEV1 decrement (14.7%) immediately after the O₃ exposure than the individuals' matched response following a Day 1 air exposure (10.9%). GSTM1 genotype did not affect the magnitude of lung function changes in a significant fashion. These data suggest that altered respiratory responses to the combination of O₃ and DE exposure can be observed showing a greater than additive manner. In addition, O₃-induced lung function decrements are greater with a prior exposure to DE compared to a prior exposure to filtered air. Based on the joint occurrence of these pollutants in the ambient environment, the potential exists for interactions in more than an additive fashion affecting lung physiological processes.
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Affiliation(s)
- Michael C Madden
- EPHD, NHEERL, US EPA, Research Triangle Park, Chapel Hill, NC, 27711, USA.
- U.S EPA Human Studies Facility, 104 Mason Farm Road, Chapel Hill, NC, 27599-7315, USA.
| | - Tina Stevens
- EPHD, NHEERL, US EPA, Research Triangle Park, Chapel Hill, NC, 27711, USA.
- Currently ORISE, Research Triangle Park, Chapel Hill, NC, 27711, USA.
| | - Martin Case
- EPHD, NHEERL, US EPA, Research Triangle Park, Chapel Hill, NC, 27711, USA.
| | - Michael Schmitt
- EPHD, NHEERL, US EPA, Research Triangle Park, Chapel Hill, NC, 27711, USA.
| | - David Diaz-Sanchez
- EPHD, NHEERL, US EPA, Research Triangle Park, Chapel Hill, NC, 27711, USA.
| | - Maryann Bassett
- EPHD, NHEERL, US EPA, Research Triangle Park, Chapel Hill, NC, 27711, USA.
| | - Tracey S Montilla
- EPHD, NHEERL, US EPA, Research Triangle Park, Chapel Hill, NC, 27711, USA.
| | | | - Robert B Devlin
- EPHD, NHEERL, US EPA, Research Triangle Park, Chapel Hill, NC, 27711, USA.
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Wagner JG, Birmingham NP, Jackson-Humbles D, Jiang Q, Harkema JR, Peden DB. Supplementation with γ-tocopherol attenuates endotoxin-induced airway neutrophil and mucous cell responses in rats. Free Radic Biol Med 2014; 68:101-9. [PMID: 24333275 PMCID: PMC3961823 DOI: 10.1016/j.freeradbiomed.2013.11.024] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 11/13/2013] [Accepted: 11/25/2013] [Indexed: 12/31/2022]
Abstract
Neutrophil-mediated tissue injury is a shared pathogenesis of both chronic pulmonary diseases and acute responses to pathogens, allergens, and airborne pollutants. Interventions to minimize toxic effects of neutrophil-derived oxidants and proteases are usually limited to corticosteroids, which can have adverse side effects. We used a rodent model of endotoxin-induced lung injury to test the hypothesis that the dietary supplement γ-tocopherol (γT), a natural form of vitamin E with antioxidant and novel anti-inflammatory properties, will protect from adverse nasal and pulmonary inflammatory responses induced by endotoxin (lipopolysaccharide; LPS). Male Fisher F344 rats were intranasally (i.n.) instilled with LPS for 2 consecutive days. Beginning 2 days before i.n. LPS, the rats were gavaged daily with 30mg/kg γT. Twenty-four hours after the last i.n. LPS, bronchoalveolar lavage fluid (BALF) was collected, and pulmonary and nasal tissues were analyzed for gene expression and morphometric analyses of neutrophils and intraepithelial mucosubstances (IM). LPS caused increased BALF total cells (70% increase), neutrophils (300%), protein (35%), PGE2 (500%), and secreted mucins (75%). Robust increases in neutrophils and IM were detected in conducting airways. Pulmonary expression of MUC5AC, MIP-2, CINC-1, and MCP-1 was elevated three- to eightfold by LPS. Treatment with γT inhibited LPS-induced increases in BALF total cells, neutrophils, protein, PGE2, and secreted mucins, as well as IM and tissue neutrophil influx. Furthermore γT induced the expression of the regulatory cytokines IL-10 and IFN-γ while decreasing MUC5AC, MIP-2, CINC-1, and MCP-1. These data demonstrate novel therapeutic effects of the dietary vitamin E γT promoting anti-inflammatory pathways to protect from neutrophil-mediated lung injury.
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Affiliation(s)
- James G Wagner
- Center for Integrative Toxicology, Michigan State University, East Lansing, MI 48824, USA; Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, MI 48824, USA.
| | - Neil P Birmingham
- Center for Integrative Toxicology, Michigan State University, East Lansing, MI 48824, USA
| | - Daven Jackson-Humbles
- Center for Integrative Toxicology, Michigan State University, East Lansing, MI 48824, USA; Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, MI 48824, USA
| | - Qing Jiang
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA
| | - Jack R Harkema
- Center for Integrative Toxicology, Michigan State University, East Lansing, MI 48824, USA; Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, MI 48824, USA
| | - David B Peden
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina, Chapel Hill, NC 27599, USA
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23
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Ground level ozone (O3) associated with radon (222Rn) and particulate matter (PM) concentrations in Bucharest metropolitan area and adverse health effects. J Radioanal Nucl Chem 2014. [DOI: 10.1007/s10967-014-3041-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kim KH, Jahan SA, Kabir E. A review on human health perspective of air pollution with respect to allergies and asthma. ENVIRONMENT INTERNATIONAL 2013; 59:41-52. [PMID: 23770580 DOI: 10.1016/j.envint.2013.05.007] [Citation(s) in RCA: 183] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 05/10/2013] [Accepted: 05/11/2013] [Indexed: 05/27/2023]
Abstract
The increase in cases of asthma and allergies has become an important health issue throughout the globe. Although these ailments were not common diseases a few short decades ago, they are now affecting a large part of the population in many regions. Exposure to environmental (both outdoor and indoor) pollutants may partially account for the prevalence of such diseases. In this review, we provide a multidisciplinary review based on the most up-to-date survey of literature regarding various types of airborne pollutants and their associations with asthma-allergies. The major pollutants in this respect include both chemical (nitrogen dioxide, ozone, sulfur dioxide, particulate matter, and volatile organic compounds) and biophysical parameters (dust mites, pet allergens, and mold). The analysis was extended further to describe the development of these afflictions in the human body and the subsequent impact on health. This publication is organized to offer an overview on the current state of research regarding the significance of air pollution and its linkage with allergy and asthma.
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Affiliation(s)
- Ki-Hyun Kim
- Department of Environment & Energy, Sejong University, Seoul 143-747, Republic of Korea.
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25
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Barath S, Langrish JP, Lundbäck M, Bosson JA, Goudie C, Newby DE, Sandström T, Mills NL, Blomberg A. Short-term exposure to ozone does not impair vascular function or affect heart rate variability in healthy young men. Toxicol Sci 2013; 135:292-9. [PMID: 23872581 PMCID: PMC3807622 DOI: 10.1093/toxsci/kft157] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Air pollution exposure is associated with cardiovascular morbidity and mortality, yet the role of individual pollutants remains unclear. In particular, there is uncertainty regarding the acute effect of ozone exposure on cardiovascular disease. In these studies, we aimed to determine the effect of ozone exposure on vascular function, fibrinolysis, and the autonomic regulation of the heart. Thirty-six healthy men were exposed to ozone (300 ppb) and filtered air for 75min on two occasions in randomized double-blind crossover studies. Bilateral forearm blood flow (FBF) was measured using forearm venous occlusion plethysmography before and during intra-arterial infusions of vasodilators 2–4 and 6–8h after each exposure. Heart rhythm and heart rate variability (HRV) were monitored during and 24h after exposure. Compared with filtered air, ozone exposure did not alter heart rate, blood pressure, or resting FBF at either 2 or 6h. There was a dose-dependent increase in FBF with all vasodilators that was similar after both exposures at 2–4h. Ozone exposure did not impair vasomotor or fibrinolytic function at 6–8h but rather increased vasodilatation to acetylcholine (p = .015) and sodium nitroprusside (p = .005). Ozone did not affect measures of HRV during or after the exposure. Our findings do not support a direct rapid effect of ozone on vascular function or cardiac autonomic control although we cannot exclude an effect of chronic exposure or an interaction between ozone and alternative air pollutants that may be responsible for the adverse cardiovascular health effects attributed to ozone.
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Affiliation(s)
- Stefan Barath
- * Department of Public Health and Clinical Medicine, Division of Medicine/Respiratory Medicine, Umeå University, Umeå, Sweden
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Abstract
The increased risk of morbidity and mortality among adults and children with pre-existing cardiovascular or respiratory illness from emission-derived particulate matter (PM) is well documented. However, the detrimental effects of PM inhalation on the exercising, healthy population is still in question. This review will focus on the acute and chronic responses to PM inhalation during exercise and how PM exposure influences exercise performance. The smaller ultrafine PM (<0.01 μm aerodynamic diameter) appears to have the most severe health consequences compared with the larger coarse PM (2.5 < PM <10 μm aerodynamic diameter). While the response to PM inhalation may affect those with a pre-existing condition, the healthy population is not immune to the effects of PM inhalation, especially during exercise. This population, including the competitive athlete, is susceptible to pulmonary inflammation, decreased lung function (both acute and chronic in nature), the increased risk of asthma, vascular endothelial dysfunction, mild elevations in pulmonary artery pressure and diminished exercise performance. PM exposure is usually associated with vehicular traffic, but other sources of PM, including small engines from lawn and garden equipment, cigarette smoke, wood smoke and cooking, may also impair health and performance. The physiological effects of PM are dependent on the source of PM, various environmental factors, physical attributes and nature of exercise. There are a number of measures an athlete can take to reduce exposure to PM, as well as the deleterious effects that result from the inevitable exposure to PM. Considering the acute and chronic physiological responses to PM inhalation, individuals living and exercising in urban areas in close proximity to major roadways should consider ambient air pollution levels (in particular, PM and ozone) prior to engaging in vigorous exercise, and those exposed to PM through other sources may need to make lifestyle alterations to avoid the deleterious effects of PM inhalation. Although it is clear that PM exposure is detrimental to healthy individuals engaging in exercise, further research is necessary to better understand the role of PM on athlete health and performance, as well as measures that can attenuate the harmful effects of PM.
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Patel MM, Chillrud SN, Deepti KC, Ross JM, Kinney PL. Traffic-related air pollutants and exhaled markers of airway inflammation and oxidative stress in New York City adolescents. ENVIRONMENTAL RESEARCH 2013; 121:71-78. [PMID: 23177171 PMCID: PMC3577992 DOI: 10.1016/j.envres.2012.10.012] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 10/25/2012] [Accepted: 10/29/2012] [Indexed: 05/20/2023]
Abstract
Exposures to ambient diesel exhaust particles have been associated with respiratory symptoms and asthma exacerbations in children; however, epidemiologic evidence linking short-term exposure to ambient diesel exhaust particles with airway inflammation is limited. We conducted a panel study with asthmatic and nonasthmatic adolescents to characterize associations between ambient diesel exhaust particle exposures and exhaled biological markers of airway inflammation and oxidative stress. Over four weeks, exhaled breath condensate was collected twice a week from 18 asthmatics and 18 nonasthmatics (ages 14-19 years) attending two New York City schools and analyzed for pH and 8-isoprostane as indicators of airway inflammation and oxidative stress, respectively. Air concentrations of black carbon, a diesel exhaust particle indicator, were measured outside schools. Air measurements of nitrogen dioxide, ozone, and fine particulate matter were obtained for the closest central monitoring sites. Relationships between ambient pollutants and exhaled biomarkers were characterized using mixed effects models. Among all subjects, increases in 1- to 5-day averages of black carbon were associated with decreases in exhaled breath condensate pH, indicating increased airway inflammation, and increases in 8-isoprostane, indicating increased oxidative stress. Increases in 1- to 5-day averages of nitrogen dioxide were associated with increases in 8-isoprostane. Ozone and fine particulate matter were inconsistently associated with exhaled biomarkers. Associations did not differ between asthmatics and nonasthmatics. The findings indicate that short-term exposure to traffic-related air pollutants may increase airway inflammation and/or oxidative stress in urban youth and provide mechanistic support for associations documented between traffic-related pollutant exposures and respiratory morbidity.
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Affiliation(s)
- Molini M. Patel
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W. 168 St, New York, NY, 10032, U.S.A
| | - Steven N. Chillrud
- Lamont-Doherty Earth Observatory, Columbia University, Comer Building, Rm 201, Palisades, NY, 10964, U.S.A
| | - KC Deepti
- West Harlem Environmental Action, Inc., 271 West 125 Street, Suite 308, New York, NY, 10027, U.S.A
| | - James M. Ross
- Lamont-Doherty Earth Observatory, Columbia University, Comer Building, Rm 201, Palisades, NY, 10964, U.S.A
| | - Patrick L. Kinney
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W. 168 St, New York, NY, 10032, U.S.A
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28
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Effects of diesel exhaust particles on primary cultured healthy human conjunctival epithelium. Ann Allergy Asthma Immunol 2012; 110:39-43. [PMID: 23244657 DOI: 10.1016/j.anai.2012.10.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 10/11/2012] [Accepted: 10/23/2012] [Indexed: 11/20/2022]
Abstract
BACKGROUND Air pollution from road traffic is a serious public health problem. Epidemiologic studies have demonstrated adverse health effects associated with environmental pollution. Diesel exhaust is a major contributor to ambient particulate matter air pollution. We studied the effects of exposure to diesel exhaust particles on allergic conjunctivitis using cultured conjunctival epithelial cells obtained from healthy people. OBJECTIVE To identify the factors involved in the human conjunctival epithelial response to diesel exhaust in vitro. METHODS Healthy individuals underwent conjunctival biopsy, and the samples were incubated on conjunctival epithelial sheets. We investigated the effects of exposure to diesel exhaust using GeneChip arrays. The adhesion molecules and cytokines showing increased expression on GeneChip arrays were verified by real-time reverse transcription polymerase chain reaction and enzyme-linked immunosorbent assay. RESULTS The GeneChip array showed increased expression of adhesion molecules, cytokines, chemokines, and growth factors after exposure to diesel exhaust. Real-time reverse transcription polymerase chain reaction and enzyme-linked immunosorbent assay confirmed that the expression of intercellular adhesion molecule 1 and interleukin 6, in particular, were significantly upregulated. CONCLUSION Our experimental data confirm that exposure to diesel exhaust particles increases inflammatory factor expression in human conjunctiva and thereby contributes to allergic conjunctival responses.
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Cornell AG, Chillrud SN, Mellins RB, Acosta LM, Miller RL, Quinn JW, Yan B, Divjan A, Olmedo OE, Lopez-Pintado S, Kinney PL, Perera FP, Jacobson JS, Goldstein IF, Rundle AG, Perzanowski MS. Domestic airborne black carbon and exhaled nitric oxide in children in NYC. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2012; 22:258-66. [PMID: 22377682 PMCID: PMC3685864 DOI: 10.1038/jes.2012.3] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Accepted: 09/23/2011] [Indexed: 05/21/2023]
Abstract
Differential exposure to combustion by-products and allergens may partially explain the marked disparity in asthma prevalence (3-18%) among New York City neighborhoods. Subclinical changes in airway inflammation can be measured by fractional exhaled nitric oxide (FeNO). FeNO could be used to test independent effects of these environmental exposures on airway inflammation. Seven- and eight-year-old children from neighborhoods with lower (range 3-9%, n=119) and higher (range 11-18%, n=121) asthma prevalence participated in an asthma case-control study. During home visits, FeNO was measured, and samples of bed dust (allergens) and air (black carbon; BC) were collected. Neighborhood built-environment characteristics were assessed for the 500 m surrounding participants' homes. Airborne BC concentrations in homes correlated with neighborhood asthma prevalence (P<0.001) and neighborhood densities of truck routes (P<0.001) and buildings burning residual oil (P<0.001). FeNO concentrations were higher among asthmatics with than in those without frequent wheeze (≥4 times/year) (P=0.002). FeNO concentrations correlated with domestic BC among children without seroatopy (P=0.012) and with dust mite allergen among children with seroatopy (P=0.020). The association between airborne BC in homes and both neighborhood asthma prevalence and FeNO suggest that further public health interventions on truck emissions standards and residual oil use are warranted.
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Affiliation(s)
- Alexandra G. Cornell
- Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY
| | - Steven N. Chillrud
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY
- Columbia Center for Children’s Environmental Health, Columbia University, New York, NY
| | - Robert B. Mellins
- Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY
| | - Luis M. Acosta
- Columbia Center for Children’s Environmental Health, Columbia University, New York, NY
| | - Rachel L. Miller
- Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY
- Columbia Center for Children’s Environmental Health, Columbia University, New York, NY
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY
- Division of Pulmonary, Allergy, Critical Care Medicine, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY
| | - James W. Quinn
- Institute for Social and Economic Research and Policy, Columbia University, New York, NY
| | - Beizhan Yan
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY
| | - Adnan Divjan
- Columbia Center for Children’s Environmental Health, Columbia University, New York, NY
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Omar E. Olmedo
- Columbia Center for Children’s Environmental Health, Columbia University, New York, NY
| | - Sara Lopez-Pintado
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY
| | - Patrick L. Kinney
- Columbia Center for Children’s Environmental Health, Columbia University, New York, NY
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Frederica P. Perera
- Columbia Center for Children’s Environmental Health, Columbia University, New York, NY
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Judith S. Jacobson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Inge F. Goldstein
- Columbia Center for Children’s Environmental Health, Columbia University, New York, NY
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Andrew G. Rundle
- Columbia Center for Children’s Environmental Health, Columbia University, New York, NY
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Matthew S. Perzanowski
- Columbia Center for Children’s Environmental Health, Columbia University, New York, NY
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY
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Association between proximity to major roads and sputum cell counts. Can Respir J 2012; 18:13-8. [PMID: 21369545 DOI: 10.1155/2011/920734] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Air pollution caused by motor vehicle emissions has been associated with exacerbations of obstructive airway diseases; however, the nature of the resulting bronchitis has not been quantified. OBJECTIVE To examine whether proximity to major roads or highways is associated with an increase in sputum neutrophils or eosinophils, and to evaluate the effect of proximity to roads on spirometry and exacerbations in patients with asthma. METHODS A retrospective study of 485 sputum cell counts from patients attending a tertiary chest clinic in Hamilton, Ontario, identified eosinophilic or neutrophilic bronchitis. Patients' residences were geocoded to the street network of Hamilton using geographic information system software. Associations among bronchitis, lung function, and proximity to major roads and highways were examined using multinomial logistic and multivariate linear regression analyses adjusted for patient age, smoking status and corticosteroid medications. RESULTS Patients living within 1000 m of highways showed an increased risk of bronchitis (OR 3.8 [95% CI 1.0 to 13.7]; P<0.05), particularly neutrophilic bronchitis (OR 4.7 [95% CI 1.2 to 18.7]; P<0.05) as well as an increased risk of an asthma diagnosis (OR 1.9 [95% CI 1.0 to 3.4]; P<0.05). Patients living within 300 m of a major road were at increased risk for an asthma exacerbation (OR 1.9 [95% CI 1.5 to 15.5]; P<0.01) and lower lung function, particularly in women (P=0.036). CONCLUSION In patients with airway diseases, living close to a highway or major road was associated with neutrophilic bronchitis, an increased risk of asthma diagnosis, asthma exacerbations and lower lung function.
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Abstract
PURPOSE OF REVIEW Epidemiologic investigation has associated traffic-related air pollution with adverse human health outcomes. The capacity of diesel exhaust particles (DEPs), a major emission source air pollution particle, to initiate an airway inflammation has subsequently been investigated. We review the recent controlled human exposures to diesel exhaust and DEPs, and summarize the investigations into the associations between this emission source air pollution particle and airway inflammation. RECENT FINDINGS Using bronchoalveolar lavage, bronchial biopsies, and sputum collection, studies have demonstrated inflammation in the airways of healthy individuals after exposure to diesel exhaust and DEPs. This inflammation has included neutrophils, eosinophils, mast cells, and lymphocytes. Elevated expression and concentrations of inflammatory mediators have similarly been observed in the respiratory tract after diesel exhaust and DEP exposure. An increased sensitivity of asthmatic individuals to the proinflammatory effects of DEPs has not been confirmed. SUMMARY Inflammation after diesel exhaust and DEP exposure is evident at higher concentrations only; there appears to be a threshold dose for DEPs approximating 300 μg/m. The lack of a biological response to DEPs at lower concentrations may reflect a contribution of gaseous constituents or interactions between DEPs and gaseous air pollutants to the human inflammatory response and function loss.
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Que LG, Stiles JV, Sundy JS, Foster WM. Pulmonary function, bronchial reactivity, and epithelial permeability are response phenotypes to ozone and develop differentially in healthy humans. J Appl Physiol (1985) 2011; 111:679-87. [PMID: 21700892 DOI: 10.1152/japplphysiol.00337.2011] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Effect of laboratory exposure to O₃ (220 ppb) and filtered air (FA) on respiratory physiology were evaluated at two time points (acute and 1 day postexposure) in healthy cohort (n = 138, 18-35 yr, 40% women) comprised mainly of Caucasian (60%) and African American (33.3%) subjects. Randomized exposures had a crossover design and durations of 2.25 h that included rest and treadmill walking. Airway responsiveness (AHR) to methacholine (Mch) and permeability of respiratory epithelium (EI) to hydrophilic radiomarker ((99m)Tc-DTPA, MW = 492), were measured at 1-day postexposure. O₃ significantly affected FEV₁ and FVC indices acutely with mean decrements from pre-exposure values on the order of 7.7 to 8.8% and 1.8 to 2.3% at 1-day post. Acute FEV₁ and FVC decreases were most robust in African American male subjects. At 1-day post, O₃ induced significant changes in AHR (slope of Mch dose response curve) and EI (Tc(99m)-DTPA clearance half-time). Based on conventional thresholds of response and dichotomous classification of subjects as responders and nonresponders, sensitivity to O₃ was shown to be nonuniform. Acute decrements ≥ 15% in FEV₁, a doubling of Mch slope, or ≥ 15% increase in EI developed in 20.3%, 23.1%, and 25.9%, respectively, of subjects evaluated. Results demonstrate a diffuse sensitivity to O₃ and physiological responses, either acutely (decreases in FEV₁) or 1 day post (development of AHR or change in EI) occur differentially in healthy young adults. Random overlap among subjects classified as responsive for respective FEV₁, AHR, and EI endpoints suggests these are separate and independent phenotypes of O₃ exposure.
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Affiliation(s)
- Loretta G Que
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
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Spira-Cohen A, Chen LC, Kendall M, Lall R, Thurston GD. Personal exposures to traffic-related air pollution and acute respiratory health among Bronx schoolchildren with asthma. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:559-65. [PMID: 21216722 PMCID: PMC3080941 DOI: 10.1289/ehp.1002653] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Accepted: 01/07/2011] [Indexed: 05/04/2023]
Abstract
BACKGROUND Previous studies have reported relationships between adverse respiratory health outcomes and residential proximity to traffic pollution, but have not shown this at a personal exposure level. OBJECTIVE We compared, among inner-city children with asthma, the associations of adverse asthma outcome incidences with increased personal exposure to particulate matter mass ≤ 2.5 μm in aerodynamic diameter (PM(2.5)) air pollution versus the diesel-related carbonaceous fraction of PM2.5. METHODS Daily 24-hr personal samples of PM(2.5), including the elemental carbon (EC) fraction, were collected for 40 fifth-grade children with asthma at four South Bronx schools (10 children per school) during approximately 1 month each. Spirometry and symptom scores were recorded several times daily during weekdays. RESULTS We found elevated same-day relative risks of wheeze [1.45; 95% confidence interval (CI), 1.03-2.04)], shortness of breath (1.41; 95% CI, 1.01-1.99), and total symptoms (1.30; 95% CI, 1.04-1.62) with an increase in personal EC, but not with personal PM(2.5) mass. We found increased risk of cough, wheeze, and total symptoms with increased 1-day lag and 2-day average personal and school-site EC. We found no significant associations with school-site PM(2.5) mass or sulfur. The EC effect estimate was robust to addition of gaseous pollutants. CONCLUSION Adverse health associations were strongest with personal measures of EC exposure, suggesting that the diesel "soot" fraction of PM(2.5) is most responsible for pollution-related asthma exacerbations among children living near roadways. Studies that rely on exposure to PM mass may underestimate PM health impacts.
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Affiliation(s)
- Ariel Spira-Cohen
- Nelson Institute of Environmental Medicine, New York University School of Medicine, Tuxedo, New York, USA
| | - Lung Chi Chen
- Nelson Institute of Environmental Medicine, New York University School of Medicine, Tuxedo, New York, USA
| | - Michaela Kendall
- European Centre for Environment and Human Health, Peninsula College of Medicine and Dentistry, University of Exeter, The Knowledge Spa, Truro, Cornwall, United Kingdom
| | - Ramona Lall
- Nelson Institute of Environmental Medicine, New York University School of Medicine, Tuxedo, New York, USA
| | - George D. Thurston
- Nelson Institute of Environmental Medicine, New York University School of Medicine, Tuxedo, New York, USA
- Address correspondence to G.D. Thurston, Nelson Institute of Environmental Medicine, NYU School of Medicine, 57 Old Forge Rd., Tuxedo, NY 10987-5007 USA. Telephone: (845) 731-3564. Fax: (845) 351-5472. E-mail:
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Kodavanti UP, Thomas R, Ledbetter AD, Schladweiler MC, Shannahan JH, Wallenborn JG, Lund AK, Campen MJ, Butler EO, Gottipolu RR, Nyska A, Richards JE, Andrews D, Jaskot RH, McKee J, Kotha SR, Patel RB, Parinandi NL. Vascular and cardiac impairments in rats inhaling ozone and diesel exhaust particles. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:312-8. [PMID: 20980218 PMCID: PMC3059992 DOI: 10.1289/ehp.1002386] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 10/27/2010] [Indexed: 05/24/2023]
Abstract
BACKGROUND Mechanisms of cardiovascular injuries from exposure to gas and particulate air pollutants are unknown. OBJECTIVE We sought to determine whether episodic exposure of rats to ozone or diesel exhaust particles (DEP) causes differential cardiovascular impairments that are exacerbated by ozone plus DEP. METHODS AND RESULTS Male Wistar Kyoto rats (10-12 weeks of age) were exposed to air, ozone (0.4 ppm), DEP (2.1 mg/m(3)), or ozone (0.38 ppm) + DEP (2.2 mg/m(3)) for 5 hr/day, 1 day/week for 16 weeks, or to air, ozone (0.51 or 1.0 ppm), or DEP (1.9 mg/m(3)) for 5 hr/day for 2 days. At the end of each exposure period, we examined pulmonary and cardiovascular biomarkers of injury. In the 16-week study, we observed mild pulmonary pathology in the ozone, DEP, and ozone + DEP exposure groups, a slight decrease in circulating lymphocytes in the ozone and DEP groups, and decreased platelets in the DEP group. After 16 weeks of exposure, mRNA biomarkers of oxidative stress (hemeoxygenase-1), thrombosis (tissue factor, plasminogen activator inhibitor-1, tissue plasminogen activator, and von Willebrand factor), vasoconstriction (endothelin-1, endothelin receptors A and B, endothelial NO synthase) and proteolysis [matrix metalloprotease (MMP)-2, MMP-3, and tissue inhibitor of matrix metalloprotease-2] were increased by DEP and/or ozone in the aorta, but not in the heart. Aortic LOX-1 (lectin-like oxidized low-density lipoprotein receptor-1) mRNA and protein increased after ozone exposure, and LOX-1 protein increased after exposure to ozone + DEP. RAGE (receptor for advanced glycation end products) mRNA increased in the ozone + DEP group. Exposure to ozone or DEP depleted cardiac mitochondrial phospholipid fatty acids (DEP > ozone). The combined effect of ozone and DEP exposure was less pronounced than exposure to either pollutant alone. Exposure to ozone or DEP for 2 days (acute) caused mild changes in the aorta. CONCLUSIONS In animals exposed to ozone or DEP alone for 16 weeks, we observed elevated biomarkers of vascular impairments in the aorta, with the loss of phospholipid fatty acids in myocardial mitochondria. We conclude that there is a possible role of oxidized lipids and protein through LOX-1 and/or RAGE signaling.
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Affiliation(s)
- Urmila P Kodavanti
- Environmental Public Health Division, National Health and Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27709, USA.
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Hesterberg TW, Long CM, Lapin CA, Hamade AK, Valberg PA. Diesel exhaust particulate (DEP) and nanoparticle exposures: what do DEP human clinical studies tell us about potential human health hazards of nanoparticles? Inhal Toxicol 2010; 22:679-94. [PMID: 20462394 DOI: 10.3109/08958371003758823] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Engineered nanoparticles (ENPs) are increasingly tested in cellular and laboratory-animal experiments for hazard potential, but there is a lack of health effects data for humans exposed to ENPs. However, human data for another source of nanoparticle (NP) exposure are available, notably for the NPs contained in diesel exhaust particulate (DEP). Studies of human volunteers exposed to diesel exhaust (DE) in research settings report DEP-NP number concentrations (i.e., >10(6) particles/cm(3)) that exceed number concentrations reported for worst-case exposure conditions for workers manufacturing and handling ENPs. Recent human DE exposure studies, using sensitive physiological instrumentation and well-characterized exposure concentrations and durations, suggest that elevated DE exposures from pre-2007 engines may trigger short-term changes in, for example, lung and systemic inflammation, thrombogenesis, vascular function, and brain activity. Considerable uncertainty remains both as to which DE constituents underlie the observed responses (i.e., DEP NPs, DEP mass, DE gases), and as to the implications of the observed short-term changes for the development of disease. Even so, these DE human clinical data do not give evidence of a unique toxicity for NPs as compared to other small particles. Of course, physicochemical properties of toxicological relevance may differ between DEP NPs and other NPs, yet overall, the DE human clinical data do not support the idea that elevated levels of NPs per se (at least in the DEP context) must be acutely toxic by virtue of their nano-sized nature alone.
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Wallace J, Nair P, Kanaroglou P. Atmospheric remote sensing to detect effects of temperature inversions on sputum cell counts in airway diseases. ENVIRONMENTAL RESEARCH 2010; 110:624-632. [PMID: 20704033 DOI: 10.1016/j.envres.2010.05.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Temperature inversions result in the accumulation of air pollution, often to levels exceeding air quality criteria. The respiratory response may be detectable in sputum cell counts. This study investigates the effect of boundary layer temperature inversions on sputum cell counts. Total and differential cell counts of neutrophils, eosinophils, macrophages and lymphocytes were quantified in sputum samples of patients attending an outpatient clinic. Temperature inversions were identified using data from the Atmospheric Infrared Sounder, an atmospheric sensor on the Aqua spacecraft which was launched in 2002 by the National Aeronautics and Space Administration. On inversion days, a statistically significant increase in the percent of cells that were neutrophils was observed in stable patients. There was also a statistically significant increase in the percent of cells that were macrophages, in exacerbated patients. Multivariate linear regression models were used to assess the relationship between temperature inversions and cell counts, controlling patients' age, smoking status, medications and meteorological variables of temperature and humidity. The analyses indicate that, in the stable and exacerbated groups, percent neutrophils and macrophages increased by 12.6% and 2.5%, respectively, on inversion days. These results suggest that temperature inversions need consideration as an exacerbating factor in bronchitis and obstructive airway disease. The effects of air pollutants, nitrogen dioxide, carbon monoxide, fine particulate matter and ozone, were investigated. We identified no significant associations with any pollutant. However, we found that monthly averages of total cell counts were strongly correlated with monthly nitrogen dioxide concentrations, an association not previously identified in the literature.
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Affiliation(s)
- Julie Wallace
- School of Geography and Earth Sciences, McMaster University, 1280 Main Street West, Hamilton, Ontario,
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Farraj AK, Boykin E, Ledbetter A, Andrews D, Gavett SH. Increased lung resistance after diesel particulate and ozone co-exposure not associated with enhanced lung inflammation in allergic mice. Inhal Toxicol 2010; 22:33-41. [PMID: 20017592 DOI: 10.3109/08958370902862434] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Exposure to diesel exhaust particulate matter (DEP) exacerbates asthma. Likewise, similar effects have been reported with exposure to the oxidizing air pollutant ozone (O(3)). Since levels of both pollutants in ambient air tend to be simultaneously elevated, we investigated the possible synergistic effect of these agents on the exacerbation of allergic airways disease in mice. Male BALB/c mice were sensitized ip with ovalbumin (Ova) or vehicle only, then exposed once per week for 4 wk via nose-only inhalation (4 h) to the PM(2.5) fraction of DEP (2 mg/m(3)), O(3) (0.5 ppm), DEP and O(3), or filtered air, and then challenged with aerosolized ovalbumin. Ova sensitization in air-exposed mice enhanced pulmonary inflammatory cell infiltration, several indicators of injury in the lung (lactate dehydrogenase, albumin and total protein), and lung resistance (R(L)) and elastance (E(L)) in response to methacholine (MCh) aerosol challenge. DEP exposure did not enhance the Ova-induced increase in pulmonary cell infiltration, indicators of injury, or R(L) and E(L). O(3) exposure enhanced the Ova-induced increase in inflammatory cell infiltration and N-acetylglucosaminidase (NAG) in the lung, but had no effect on R(L) or E(L). DEP co-exposure significantly attenuated the O(3)-induced increase in cell infiltration and indicators of injury; co-exposure had no effect on E(L) relative to air-exposed Ova-sensitized mice. However, only DEP-O(3) co-exposure significantly increased the Ova-induced increase in R(L). Thus, O(3) and DEP co-exposure exacerbated airways hyperresponsiveness, a response that was not associated with parallel increases in pulmonary inflammation and one that may be mediated by a unique mechanism.
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Affiliation(s)
- Aimen K Farraj
- Experimental Toxicology Division, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, USA.
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Imboden M, Schwartz J, Schindler C, Curjuric I, Berger W, Liu SL, Russi EW, Ackermann-Liebrich U, Rochat T, Probst-Hensch NM. Decreased PM10 exposure attenuates age-related lung function decline: genetic variants in p53, p21, and CCND1 modify this effect. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:1420-7. [PMID: 19750108 PMCID: PMC2737020 DOI: 10.1289/ehp.0800430] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2008] [Accepted: 05/26/2009] [Indexed: 05/05/2023]
Abstract
BACKGROUND Decreasing exposure to airborne particulates was previously associated with reduced age-related decline in lung function. However, whether the benefit from improved air quality depends on genetic background is not known. Recent evidence points to the involvement of the genes p53 and p21 and of the cell cycle control gene cyclin D1 (CCND1) in the response of bronchial cells to air pollution. OBJECTIVE We determined in 4,326 participants of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA) whether four single-nucleotide polymorphisms in three genes [CCND1 (rs9344 [P242P], rs667515), p53 (rs1042522 [R72P]), and p21 (rs1801270 [S31R])] modified the previously observed attenuation of the decline in the forced expiratory flow between 25% and 75% of the forced vital capacity (FEF(25-75)) associated with improved air quality. METHODS Subjects of the prospective population-based SAPALDIA cohort were assessed in 1991 and 2002 by spirometry, questionnaires, and biological sample collection for genotyping. We assigned spatially resolved concentrations of particulate matter with aerodynamic diameter < or = 10 microm (PM(10)) to each participant's residential history 12 months before the baseline and follow-up assessments. RESULTS The effect of diminishing PM(10) exposure on FEF(25-75) decline appeared to be modified by p53 R72P, CCND1 P242P, and CCND1 rs667515. For example, a 10-microg/m(3) decline in average PM(10) exposure over an 11-year period attenuated the average annual decline in FEF(25-75) by 21.33 mL/year (95% confidence interval, 10.57-32.08) among participants homozygous for the CCND1 (P242P) GG genotype, by 13.72 mL/year (5.38-22.06) among GA genotypes, and by 6.00 mL/year (-4.54 to 16.54) among AA genotypes. CONCLUSIONS Our results suggest that cell cycle control genes may modify the degree to which improved air quality may benefit respiratory function in adults.
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Affiliation(s)
- Medea Imboden
- Department of Chronic Disease Epidemiology, Institute of Social and Preventive Medicine and
- Institute of Medical Genetics, University of Zurich, Zurich, Switzerland
| | - Joel Schwartz
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachussetts, USA
| | - Christian Schindler
- Institute of Social and Preventive Medicine, University of Basel, Basel, Switzerland
| | - Ivan Curjuric
- Department of Chronic Disease Epidemiology, Institute of Social and Preventive Medicine and
- Institute of Social and Preventive Medicine, University of Basel, Basel, Switzerland
| | - Wolfgang Berger
- Institute of Medical Genetics, University of Zurich, Zurich, Switzerland
| | - Sally L.J. Liu
- Institute of Social and Preventive Medicine, University of Basel, Basel, Switzerland
| | - Erich W. Russi
- Department of Pneumology, University Hospital Zurich, Zurich, Switzerland
| | | | - Thierry Rochat
- Division of Pulmonary Medicine, University Hospitals Geneva, Geneva, Switzerland
| | - Nicole M. Probst-Hensch
- Department of Chronic Disease Epidemiology, Institute of Social and Preventive Medicine and
- Address correspondence to N.M. Probst-Hensch, Department of Chronic Disease Epidemiology, Institute of Social and Preventive Medicine, Sumatrastrasse 30, CH-8006 Zurich, Switzerland. Telephone: 41-44-634-53-73. Fax: 41-44-634-40-09. E-mail:
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Spraggins JM, Lloyd JA, Johnston MV, Laskin J, Ridge DP. Fragmentation mechanisms of oxidized peptides elucidated by SID, RRKM modeling, and molecular dynamics. JOURNAL OF THE AMERICAN SOCIETY FOR MASS SPECTROMETRY 2009; 20:1579-1592. [PMID: 19560936 DOI: 10.1016/j.jasms.2009.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2008] [Revised: 03/06/2009] [Accepted: 04/20/2009] [Indexed: 05/28/2023]
Abstract
The gas-phase fragmentation reactions of singly charged angiotensin II (AngII, DR(+)VYIHPF) and the ozonolysis products AngII+O (DR(+)VY*IHPF), AngII+3O (DR(+)VYIH*PF), and AngII+4O (DR(+)VY*IH*PF) were studied using SID FT-ICR mass spectrometry, RRKM modeling, and molecular dynamics. Oxidation of Tyr (AngII+O) leads to a low-energy charge-remote selective fragmentation channel resulting in the b(4)+O fragment ion. Modification of His (AngII+3O and AngII+4O) leads to a series of new selective dissociation channels. For AngII+3O and AngII+4O, the formation of [MH+3O](+)-45 and [MH+3O](+)-71 are driven by charge-remote processes while it is suggested that b(5) and [MH+3O](+)-88 fragments are a result of charge-directed reactions. Energy-resolved SID experiments and RRKM modeling provide threshold energies and activation entropies for the lowest energy fragmentation channel for each of the parent ions. Fragmentation of the ozonolysis products was found to be controlled by entropic effects. Mechanisms are proposed for each of the new dissociation pathways based on the energies and entropies of activation and parent ion conformations sampled using molecular dynamics.
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Affiliation(s)
- Jeffrey M Spraggins
- Department of Chemistry and Biochemistry, University of Delaware, Newark, Delaware, USA
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Volckens J, Dailey L, Walters G, Devlin RB. Direct particle-to-cell deposition of coarse ambient particulate matter increases the production of inflammatory mediators from cultured human airway epithelial cells. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2009; 43:4595-4599. [PMID: 19603682 PMCID: PMC2902165 DOI: 10.1021/es900698a] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Exposure of cultured cells to particulate matter air pollution is usually accomplished by collecting particles on a solid matrix, extracting the particles from the matrix, suspending them in liquid, and applying the suspension to cells grown on plastic and submerged in medium. The objective of this work was to develop a more physiologically and environmentally relevant model of air pollutant deposition on cultures of human primary airway epithelial cells. We hypothesize that the toxicology of inhaled particulate matter depends strongly on both the particulate dispersion state and the mode of delivery to cells. Our exposure system employs a combination of unipolar charging and electrostatic force to deposit particles directly from the air onto cells grown at an air-liquid interface in a heated, humidified exposure chamber. Normal human bronchial epithelial cells exposed to concentrated, coarse ambient particulate matter in this system expressed increased levels of inflammatory biomarkers at 1 h following exposure and relative to controls exposed to particle-free air. More importantly, these effects are seen at particulate loadings that are 1-2 orders of magnitude lower than levels applied using traditional in vitro systems.
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Affiliation(s)
- John Volckens
- Department of Environmental and Radiological Health Sciences, 1681 Campus Delivery, Colorado State University, Fort Collins, Colorado 80523, USA.
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Hernández-Cadena L, Holguin F, Barraza-Villarreal A, Del Río-Navarro BE, Sienra-Monge JJ, Romieu I. Increased levels of outdoor air pollutants are associated with reduced bronchodilation in children with asthma. Chest 2009; 136:1529-1536. [PMID: 19318670 DOI: 10.1378/chest.08-1463] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Increased outdoor air pollution levels are associated with more frequent use of rescue inhalers in subjects with asthma. However, it is unknown whether this phenomenon is explained by an air pollution-mediated increase in respiratory symptom severity or whether air pollutants decrease the efficacy of short-acting beta-agonists (SABAs). METHODS We examined the relationship between the percentage change in FEV(1) after SABA use with outdoor air pollution exposure in 85 children with asthma who were 7 to 12 years of age. Outdoor air pollution exposure was determined by measuring nitrogen dioxide (NO(2)), ozone (O(3)), and fine particulate matter (ie, particulate matter with an aerodynamic diameter < 2.5 microm [PM(2.5)]) levels. These measurements were obtained from the Mexico City Automated Monitoring Network from network sites located within a 5-km radius of each child's home and school. RESULTS We found that a same-day interquartile increase of 10 parts per billion (ppb) in NO(2) concentration was associated with a reduced response of FEV(1) to SABA therapy (-15%; 95% CI, -29 to -0.5). This association was also significant when considering NO(2) levels in each of the preceding 3 days. An interquartile O(3) increase (16 ppb) in the preceding fifth day was associated with a reduced response to SABA (-11%; 95% CI, -23 to -1); an interquartile PM(2.5) increase (14 microg/m(3)) was not associated with any significant reductions in the response to SABA therapy. These associations were not observed in children receiving therapy with inhaled corticosteroids. CONCLUSIONS Our results suggest that recent exposure to NO(2) and possibly O(3) may reduce the response to SABAs in producing bronchodilation in children with asthma. The association between NO(2) and FEV(1) response to SABA administration may have important implications in understanding how outdoor air pollution levels relate to asthma control.
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Affiliation(s)
| | - Fernando Holguin
- Department of Pulmonary, Allergy and Critical Care, University of Pittsburgh Medical Center, Pittsburgh, PA.
| | | | | | - Juan J Sienra-Monge
- Department of Asthma and Allergy, Hospital Infantil de México, Mexico City, Mexico
| | - Isabelle Romieu
- Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
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Outdoor air pollution: impact on chronic obstructive pulmonary disease patients. Curr Opin Pulm Med 2009; 15:150-7. [DOI: 10.1097/mcp.0b013e32832185ee] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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