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Shi C, Zhu J, Liu G, Du Z, Hao Y. Time series analysis of the interaction between ambient temperature and air pollution on hospitalizations for AECOPD in Ganzhou, China. Sci Rep 2024; 14:17106. [PMID: 39048614 PMCID: PMC11269578 DOI: 10.1038/s41598-024-67617-2] [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: 05/21/2024] [Accepted: 07/13/2024] [Indexed: 07/27/2024] Open
Abstract
This study aimed to investigate the univariate and bivariate effects of ambient temperature and air pollutants on 57,251 inpatients with AECOPD (Acute Exacerbation of Chronic Obstructive Pulmonary Disease) in Ganzhou from January 1, 2016, to December 31, 2019. We categorized the daily mean temperature and air pollutant variables based on the exposure-response curve of the Distributed Lag Non-Linear Model. Poisson regression model was used for interaction and stratification analysis. The Relative Excess Risk due to Interaction (RERI) with 95% confidence intervals (95% CI) between daily mean temperature (Tmean) and air pollutants including NO2, PM2.5, and PM10 were - 0.428 (95% CI - 0.637, - 0.218), -- 0.227 (95% CI - 0.293, - 0.161), and - 0.119 (95% CI - 0.159, - 0.079). Further stratification analysis showed the relative risk (RR) (95% CI) of high NO2 (> 33 μg/m3) at low Tmean (≤ 28 °C) was 1.119 (95% CI 1.096, 1.142). Low temperatures with high PM10 in men and high PM2.5 in women were associated with a higher risk of AECOPD hospitalization. The results indicate a higher risk of hospitalization for AECOPD when there is with high concentrations of air pollution at low temperatures.
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Affiliation(s)
- Chenyang Shi
- Department of Health Statistics, School of Public Health and Health Management, Gannan Medical University, Ganzhou, 341000, Jiangxi, China
| | - Jinyun Zhu
- Health Commission of Ganzhou Municipality, Ganzhou, 341000, Jiangxi, China
| | - Guoliang Liu
- School of Medical Information Engineering, Gannan Medical University, Ganzhou, 341000, Jiangxi, China
| | - Zhicheng Du
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.
| | - Yanbin Hao
- Department of Health Statistics, School of Public Health and Health Management, Gannan Medical University, Ganzhou, 341000, Jiangxi, China.
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Niu Y, Niu H, Meng X, Zhu Y, Ren X, He R, Wu H, Yu T, Zhang Y, Kan H, Chen R, Yang T, Wang C. Associations Between Air Pollution and the Onset of Acute Exacerbations of COPD: A Time-Stratified Case-Crossover Study in China. Chest 2024:S0012-3692(24)00745-1. [PMID: 38906462 DOI: 10.1016/j.chest.2024.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Associations between air pollution and the acute exacerbations (AEs) of COPD have been established primarily in time-series studies in which exposure and case data were at the aggregate level, limiting the identification of susceptible populations. RESEARCH QUESTION Are air pollutants associated with the onset of AEs of COPD in China? Who is more susceptible to the effects of air pollutants? STUDY DESIGN AND METHODS Data regarding AEs of COPD were obtained from the Acute Exacerbation of Chronic Obstructive Pulmonary Disease Registry study, and air pollution data were assigned to individuals based on their residential address. We adopted a time-stratified case-crossover study design combined with conditional logistic regression models to estimate the associations between six air pollutants and AEs of COPD. Stratified analyses were performed by individual characteristics, disease severity, COPD types, and the season of exacerbations. RESULTS A total of 5,746 patients were included. At a 2-day lag, for each interquartile range increase in fine particulate matter (PM2.5) and inhalable particulate matter (PM10) concentrations, ORs for AEs of COPD were 1.054 (95% CI, 1.012-1.097) and 1.050 (95% CI, 1.009-1.092), respectively. The associations were more pronounced in participants who were younger than 65 years, had experienced at least one severe AE of COPD in the past year, received a diagnosis of COPD between 20 and 50 years of age, and experienced AEs of COPD in the cool seasons. By contrast, significant associations for nitrogen dioxide, sulfur dioxide, and carbon monoxide lost significance when excluding patients collected before 2020 or with larger distance from the monitoring station, and no significant association was observed for ozone. INTERPRETATION This study provides robust evidence that short-term exposure to PM2.5 and PM10 was associated with higher odds of AEs of COPD onset. Individuals who are young, have severe COPD, or whose first diagnosis of COPD was made when they were between 20 and 50 years of age and experience an exacerbation during the cooler seasons may be particularly susceptible. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT2657525; URL: www. CLINICALTRIALS gov.
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Affiliation(s)
- Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Hongtao Niu
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yixiang Zhu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xiaoxia Ren
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Ruoxi He
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Hunan, China
| | - Hanna Wu
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Tao Yu
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yushi Zhang
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Ting Yang
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Chen Wang
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Mah J, Ritchie AI, Finney LJ. Selected updates on chronic obstructive pulmonary disease. Curr Opin Pulm Med 2024; 30:136-140. [PMID: 38099447 DOI: 10.1097/mcp.0000000000001042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
PURPOSE OF REVIEW Chronic obstructive pulmonary disease (COPD) is preventable disease and yet it remains the third greatest cause of death worldwide. This review focuses on recent updates in COPD research which have had an impact on our understanding of the epidemiology and pathophysiology of COPD. RECENT FINDINGS Epidemiological studies of COPD have moved towards trying to understand the global impact of COPD particularly in low- and middle-income countries where disease prevalence continues to increase. In addition, we are beginning to uncover the impact of air pollution on COPD development with recent work showing a relationship between air pollution and COPD exacerbations. Advances in understanding early origins and early development of COPD have the potential to intervene earlier in the disease course to prevent disease progression. Although biomarkers such as peripheral blood eosinophilia have led to trials of biologic agents in COPD suggesting we may be entering an exciting new biologic era in COPD. SUMMARY Recent advances suggest there may be a relationship between air pollution and COPD exacerbations. This requires further research to influence environmental policy. New clinical trials of biologics targeting TH2 inflammation in COPD suggest that targeted treatments with biologics may be a possibility COPD.
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Affiliation(s)
- Jordina Mah
- National Heart and Lung Institute, Imperial College London, London
| | - Andrew I Ritchie
- National Heart and Lung Institute, Imperial College London, London
- Early Clinical Development, Respiratory and Immunology, Clinical, BioPharmaceuticals R&D, AstraZeneca, Cambridge
| | - Lydia J Finney
- National Heart and Lung Institute, Imperial College London, London
- Imperial College Healthcare NHS Trust, UK
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Meng Q, Wang J, Cui J, Li B, Wu S, Yun J, Aschner M, Wang C, Zhang L, Li X, Chen R. Prediction of COPD acute exacerbation in response to air pollution using exosomal circRNA profile and Machine learning. ENVIRONMENT INTERNATIONAL 2022; 168:107469. [PMID: 36041244 PMCID: PMC9939562 DOI: 10.1016/j.envint.2022.107469] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/19/2022] [Accepted: 08/10/2022] [Indexed: 05/11/2023]
Abstract
Ambient fine particulate matter (PM2.5) is linked to an increased risk of chronic obstructive pulmonary disease (COPD) exacerbations, which significantly increase the risk of mortality in COPD patients. Identifying the subtype of COPD patients who are sensitive to environmental aggressions is necessary. Using in vitro and in vivo PM2.5 exposure models, we demonstrate that exosomal hsa_circ_0005045 is upregulated by PM2.5 and binds to the protein cargo peroxiredoxin2, which functionally aggravates hallmarks of COPD by recruiting neutrophil elastase and triggering in situ release of tumor necrosis factor (TNF)-α by inflammatory cells. The biological function of hsa_circ_0005045 associated with aggravation of COPD is validated using exosome-transplantation and conditional circRNA-knockdown murine models. By sorting the major components of PM2.5, we find that PM2.5-bound heavy metals, which are distinguishable from the components of cigarette smoke, trigger the elevation of exosomal hsa_circ_0005045. Finally, using machine learning models in a cohort with 327 COPD patients, the PM2.5 exposure-sensitive COPD patients are characterized by relatively high hsa_circ_0005045 expression, non-smoking, and group C (mMRC 0-1 (or CAT < 10) and ≥ 2 exacerbations (or ≥ 1 exacerbation leading to hospital admission) in the past year). Thus, our results suggest that environmental reduction in PM2.5 emission provides a targeted approach to protecting non-smoking COPD patients against air pollution-related disease exacerbation.
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Affiliation(s)
- Qingtao Meng
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, PR China
| | - Jiajia Wang
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, PR China
| | - Jian Cui
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, 87, Ding Jia Qiao Road, Nanjing 210009, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Bin Li
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, PR China
| | - Shenshen Wu
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, PR China
| | - Jun Yun
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Forchheimer 209, 1300 Morris Park Avenue, Bronx, NY 10461, USA
| | - Chengshuo Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China; Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China
| | - Luo Zhang
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, 100005, China; Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing China; Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100005, China.
| | - Xiaobo Li
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, PR China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China.
| | - Rui Chen
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, PR China; School of Public Health, Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, PR China; Institute for Chemical Carcinogenesis, Guangzhou Medical University, Guangzhou 511436, PR China.
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