Cardiovascular effects of airborne particulate matter: A review of rodent model studies

Secondhand smoke exposure can increase the risk of first ischemic stroke: A 10.7-year prospective cohort study in China

INTRODUCTION

Passive smoking is considered a major public health issue in China. Prospective evidence regarding the link between secondhand smoke (SHS) and ischemic stroke in China is scarce.

METHODS

The China Kadoorie Biobank (CKB) study in Liuzhou City recruited 50,174 participants during 2004-2008. Of these 30,456 never-smokers were included in our study. The median follow-up period was 10.7 years. The incidence of ischemic stroke was obtained through the China Disease Surveillance Points (DSP) system and the Health Insurance (HI) database. Cox proportional risk models were used to evaluate the association between SHS exposure and ischemic stroke.

RESULTS

During 320,678 person-years of follow-up, there were 2059 patients with ischemic stroke observed and the incidence of ischemic stroke was 6.42 per thousand person-years. Participants exposed to SHS daily faced a 21 % higher risk of ischemic stroke (HR = 1.21, 95 %CI: 1.09-1.34) compared to those exposed to SHS less than once a week. Subgroup analyses revealed that daily SHS exposure was linked to heightened risk of ischemic stroke among women, non-employed, and non-weekly tea drinkers.

CONCLUSIONS

Daily SHS exposure was associated with higher risks of ischemic stroke. Proactive tobacco control strategies are necessary to decrease the risk of ischemic stroke in never smokers.

Oxidative stress and neurotoxicity induced by exposure to settleable atmospheric particulate matter in bullfrog tadpoles, Aquarana catesbeiana, (Shaw, 1802)

Bullfrog tadpoles, Aquarana catesbeiana, were exposed to settleable particulate matter (SePM), (1 g L-1, 96 h) and their organs were collected for analysis of metal/metalloid, oxidative stress and neurotoxicity in liver, muscle, kidney and brain. The SePM water of the exposed groups contained 18 of the 28 metals/metalloids detected in ambient particulate matter (APM). Fe56 and Al were those that presented the highest concentrations, Cr, Mn, Pb and Cu increased from 10 to 20 times and Ti, V, Sr, Rb, Cd, Sn and Ni increased from 1 to 3 times compared to the control. Bioaccumulation of metals/metalloids in the exposure water varied significantly between organs, with the muscle and liver showing the highest concentrations of metals, followed by the brain. Lipoperoxidation and malondialdehyde increased only in muscle, while carbonyl proteins increased only in the liver and brain. Regarding nitric oxide synthase, there was an increase in the liver and brain in the group exposed to SePM. Catalase activity decreased in the liver and muscle, while the activity of glutathione peroxidase, increased in the liver and kidney and decreased in muscle. Glutathione S-transferase, which is mainly responsible for detoxification, increased in the liver and decreased in muscle and the kidney. Cholinesterase activity increased only in the muscle. The results indicate oxidative stress, due to oxidation catalyzed by metals, components of SePM. Thus, the results contribute to the understanding that SePM has a deleterious effect on the aquatic environment, negatively affecting bullfrog tadpoles, in different ways and levels in relation to the analyzed organs.

Global association between air pollution and COVID-19 mortality: A systematic review and meta-analysis

BACKGROUND

The COVID-19 pandemic presents unprecedented challenge for global public health systems and exacerbates existing health disparities. Epidemiological evidence suggested a potential linkage between particulate and gaseous pollutants and COVID-19 mortality. We aimed to summarize the overall risk of COVID-19 mortality associated with ambient air pollutants over the short- and long-term.

METHODS

For the systematic review and meta-analysis, we searched five databases for studies evaluating the risk of COVID-19 mortality from exposure to air pollution. Inclusion of articles was assessed independently on the basis of research topic and availability of effect estimates. The risk estimates (relative risk) for each pollutant were pooled with a random-effect model. Potential heterogeneity was explored by subgroup analysis. Funnel plots and trim-and-fill methods were employed to assess and adjust for publication bias.

FINDINGS

The systematic review retrieved 2059 records, and finally included 43 original studies. PM2.5 (RR: 1.71, 95 % CI: 1.40-2.08, per 10 μg/m3 increase), NO2 (RR: 1.33, 1.07-1.65, per 10 ppb increase) and O3 (RR: 1.61, 1.00-2.57, per 10 ppb increase) were positively associated with COVID-19 mortality for long-term exposures. Accordingly, a higher risk of COVID-19 mortality was associated with PM2.5 (1.05, 1.02-1.08), PM10 (1.05, 1.01-1.08), and NO2 (1.40, 1.04-1.90) for short-term exposures. There was some heterogeneity across subgroups of income level and geographical areas.

CONCLUSION

Both long-term and short-term exposures to ambient air pollution may increase the risk of COVID-19 mortality. Future studies utilizing individual-level information on demographics, exposures, outcome ascertainment and confounders are warranted to improve the accuracy of estimates.

Association between ambient air pollution exposure in pregnant women with antiphospholipid syndrome in Nanjing, China

Antenatal exposure to air pollutants is thought to be associated with a variety of maternal blood markers as well as adverse birth outcomes. However, the dysgenic influence of air pollutants on the antiphospholipid syndrome (APS) in mothers and their pregnancy outcomes remains unclear. In the current study, 371 mother-infant pairs (189 healthy: 182 APS) from Nanjing Maternal and Child Health Hospital as well as air pollutants concentration from their living environment were used to investigate correlations between air pollution with maternal blood indicators and fetal birth weight in the groups of APS and healthy mothers. Generalized linear model was used to evaluate the contributions of air pollutant exposure during pregnancy to the blood indicators variation. The relationships between birth weight with specific air pollutant and blood index were analyzed using ridge regression. Results showed that APS fetal birth weight was significantly impacted by air pollutant exposure during pregnancy, in particular, the birth weight decreased significantly along with increasing fine particulate matter 2.5 (PM2.5) and fine particulate matter 10 (PM10) exposure concentrations throughout pregnancy. In contrast, birth weight increased significantly with sulfur dioxide (SO2) exposure. In addition, APS-related blood indicators comprised of platelet distribution width (PDW), total bilirubin (TBIL), mean platelet volume (MPV), platelet-larger cell ratio (P_LCR), homocysteine (HCY), alkaline phosphatase (ALP), direct bilirubin (DBIL), basophilic granulocyte (BAS), platelet thrombocytocrit (PCT), preprandial glucose levels (OGTT0), monocytes (MON), and monocytes ratio (MON_ratio) were also strongly related with prenatal exposure to PM2.5 and PM10, in which PDW levels showed most strongly negative impaction on fetal birth weight. Together, we showed that prenatal exposure to air pollutant (PM2.5 and PM10) may exacerbate the poor birth outcomes of low birth weight by impacting APS maternal blood indicators especially for PDW.

Co-exposure to particulate matter and humidity increases blood pressure in hypertensive mice via the TRPV4-cPLA2-COX2 pathway

Epidemiological studies have demonstrated that particulate matter (PM) can induce or exacerbate hypertension. High relative humidity has been associated with elevated blood pressure in certain regions. However, the coupling effect of humidity and PM on elevated blood pressure and the underlying mechanisms remain unknown. Herein, we aimed to explore the effects of exposure to PM and/or high relative humidity on hypertension, as well as elucidate underlying mechanisms. Male C57/BL6 mice were intraperitoneally administered N^G-nitro-L-arginine methyl ester (L-NAME) to establish a hypertensive mouse model. The hypertensive mice were exposed to PM (0.15 mg/kg/day) and/or different relative humidities (45/90%) for eight weeks. Histopathological changes, systolic blood pressure (SBP), endothelial-derived contracting factors (thromboxane B₂ [TXB₂], Prostaglandin F2α [PGF_2α], endothelin-1 [ET-1], and angiotensin II [Ang II]), and relaxing factors (prostaglandin I₂ [PGI₂] and nitric oxide [NO]) were measured to assess the effects of PM exposure and humidity on hypertension in mice. Levels of transient receptor potential vanilloid 4 (TRPV4), cytosolic phospholipase A₂ (cPLA₂), and cyclooxygenase 2 (COX2) were measured to explore their potential mechanisms. Herein, exposure to 90% relative humidity or PM alone had a slight but insignificant effect on hypertension. However, pathological changes and elevated blood pressure were markedly exacerbated following exposure to PM and 90% relative humidity. Levels of PGF_2α, TXB₂, and ET-1 were significantly increased, whereas the PGI₂ level was substantially decreased. HC-067047-mediated blockade of TRPV4 suppressed TRPV4, cPLA₂, and COX2 expression and effectively alleviated the increased blood pressure induced by exposure to PM and 90% relative humidity. These results indicate that 90% relative humidity and PM can activate the TRPV4-cPLA₂-COX2 ion channel in the aorta, altering the endothelial-derived contracting and relaxing factors and enhancing blood pressure in hypertensive mice.

CARD9 deficiency improves the recovery of limb ischemia in mice with ambient fine particulate matter exposure

Background

Exposure to fine particulate matter (PM) is a significant risk for cardiovascular diseases largely due to increased reactive oxygen species (ROS) production and inflammation. Caspase recruitment domain (CARD)9 is critically involved in innate immunity and inflammation. The present study was designed to test the hypothesis that CARD9 signaling is critically involved in PM exposure-induced oxidative stress and impaired recovery of limb ischemia.

Methods and results

Critical limb ischemia (CLI) was created in male wildtype C57BL/6 and age matched CARD9 deficient mice with or without PM (average diameter 2.8 μm) exposure. Mice received intranasal PM exposure for 1 month prior to creation of CLI and continued for the duration of the experiment. Blood flow and mechanical function were evaluated in vivo at baseline and days 3, 7, 14, and 21 post CLI. PM exposure significantly increased ROS production, macrophage infiltration, and CARD9 protein expression in ischemic limbs of C57BL/6 mice in association with decreased recovery of blood flow and mechanical function. CARD9 deficiency effectively prevented PM exposure-induced ROS production and macrophage infiltration and preserved the recovery of ischemic limb with increased capillary density. CARD9 deficiency also significantly attenuated PM exposure-induced increase of circulating CD11b⁺/F4/80⁺ macrophages.

Conclusion

The data indicate that CARD9 signaling plays an important role in PM exposure-induced ROS production and impaired limb recovery following ischemia in mice.

The pathophysiological and molecular mechanisms of atmospheric PM2.5 affecting cardiovascular health: A review

BACKGROUND

Exposure to ambient fine particulate matter (PM2.5, with aerodynamic diameter less than 2.5 µm) is a leading environmental risk factor for global cardiovascular health concern.

OBJECTIVE

To provide a roadmap for those new to this field, we reviewed the new insights into the pathophysiological and cellular/molecular mechanisms of PM2.5 responsible for cardiovascular health.

MAIN FINDINGS

PM2.5 is able to disrupt multiple physiological barriers integrity and translocate into the systemic circulation and get access to a range of secondary target organs. An ever-growing body of epidemiological and controlled exposure studies has evidenced a causal relationship between PM2.5 exposure and cardiovascular morbidity and mortality. A variety of cellular and molecular biology mechanisms responsible for the detrimental cardiovascular outcomes attributable to PM2.5 exposure have been described, including metabolic activation, oxidative stress, genotoxicity, inflammation, dysregulation of Ca2+ signaling, disturbance of autophagy, and induction of apoptosis, by which PM2.5 exposure impacts the functions and fates of multiple target cells in cardiovascular system or related organs and further alters a series of pathophysiological processes, such as cardiac autonomic nervous system imbalance, increasing blood pressure, metabolic disorder, accelerated atherosclerosis and plaque vulnerability, platelet aggregation and thrombosis, and disruption in cardiac structure and function, ultimately leading to cardiovascular events and death. Therein, oxidative stress and inflammation were suggested to play pivotal roles in those pathophysiological processes.

CONCLUSION

Those biology mechanisms have deepen insights into the etiology, course, prevention and treatment of this public health concern, although the underlying mechanisms have not yet been entirely clarified.

Phenotypic and Metabolomic Characterization of 3D Lung Cell Cultures Exposed to Airborne Particulate Matter from Three Air Quality Network Stations in Catalonia

Air pollution constitutes an environmental problem that it is known to cause many serious adverse effects on the cardiovascular and respiratory systems. The chemical characterization of particulate matter (PM) is key for a better understanding of the associations between chemistry and toxicological effects. In this work, the chemical composition and biological effects of fifteen PM₁₀ air filter samples from three air quality stations in Catalonia with contrasting air quality backgrounds were investigated. Three-dimensional (3D) lung cancer cell cultures were exposed to these sample extracts, and cytotoxicity, reactive oxygen species (ROS) induction, metabolomics, and lipidomics were explored. The factor analysis method Multivariate Curve Resolution-Alternating Least-Squares (MCR-ALS) was employed for an integrated interpretation of the associations between chemical composition and biological effects, which could be related to urban traffic emission, biomass burning smoke, and secondary aerosols. In this pilot study, a novel strategy combining new approach methodologies and chemometrics provided new insights into the biomolecular changes in lung cells associated with different sources of air pollution. This approach can be applied in further research on air pollution toxicity to improve our understanding of the causality between chemistry and its effects.

Understanding the pathogenesis of occupational coal and silica dust-associated lung disease

Workers in the mining and construction industries are at increased risk of respiratory and other diseases as a result of being exposed to harmful levels of airborne particulate matter (PM) for extended periods of time. While clear links have been established between PM exposure and the development of occupational lung disease, the mechanisms are still poorly understood. A greater understanding of how exposures to different levels and types of PM encountered in mining and construction workplaces affect pathophysiological processes in the airways and lungs and result in different forms of occupational lung disease is urgently required. Such information is needed to inform safe exposure limits and monitoring guidelines for different types of PM and development of biomarkers for earlier disease diagnosis. Suspended particles with a 50% cut-off aerodynamic diameter of 10 µm and 2.5 µm are considered biologically active owing to their ability to bypass the upper respiratory tract's defences and penetrate deep into the lung parenchyma, where they induce potentially irreversible damage, impair lung function and reduce the quality of life. Here we review the current understanding of occupational respiratory diseases, including coal worker pneumoconiosis and silicosis, and how PM exposure may affect pathophysiological responses in the airways and lungs. We also highlight the use of experimental models for better understanding these mechanisms of pathogenesis. We outline the urgency for revised dust control strategies, and the need for evidence-based identification of safe level exposures using clinical and experimental studies to better protect workers' health.

Amine-modified nanoplastics promote the procoagulant activation of isolated human red blood cells and thrombus formation in rats

Background

Microplastics (MPs) and nanoplastics (NPs) formed from decomposed plastic are increasing environmental threats. Although MPs and NPs exposed through various routes enter the systemic circulation, the potential toxicity of those is largely unknown. We investigated whether polystyrene NPs (PS-NPs) promote the coagulation activity of red blood cells (RBCs).

Results

We tested several types of PS-NPs using human RBCs and found that amine-modified 100 nm PS-NPs were the most potent. We measured the uptake of PS-NPs using flow cytometry and confocal microscopy. Electron microscopy revealed morphological changes of RBCs by PS-NPs. PS-NPs induced the externalization of phosphatidylserine, generation of microvesicles in RBCs, and perturbations in the intracellular microenvironment. PS-NPs increased the activity of scramblases responsible for phospholipid translocation in RBCs. PS-NPs modulated the functional interaction to adjacent tissues and coagulation cascade, enhancing RBC adhesion and thrombin generation. Our observations in human RBCs were consistent with those in isolated rat RBCs, showing no inter-species differences. In rat venous thrombosis models, the intravenous administration of PS-NPs enhanced thrombus formation.

Conclusion

Amine-modified PS-NPs induce the prothrombotic activation of RBCs causing thrombus formation. We believe that our study will contribute to understanding the potential toxicity of amine-modified polystyrene particles in blood cells and cardiovascular systems.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12989-022-00500-y.

Effects of air pollution on human health - Mechanistic evidence suggested by in vitro and in vivo modelling

Airborne particulate matter (PM) comprises both solid and liquid particles, including carbon, sulphates, nitrate, and toxic heavy metals, which can induce oxidative stress and inflammation after inhalation. These changes occur both in the lung and systemically, due to the ability of the small-sized PM (i.e. diameters ≤2.5 μm, PM_2.5) to enter and circulate in the bloodstream. As such, in 2016, airborne PM caused ∼4.2 million premature deaths worldwide. Acute exposure to high levels of airborne PM (eg. during wildfires) can exacerbate pre-existing illnesses leading to hospitalisation, such as in those with asthma and coronary heart disease. Prolonged exposure to PM can increase the risk of non-communicable chronic diseases affecting the brain, lung, heart, liver, and kidney, although the latter is less well studied. Given the breadth of potential disease, it is critical to understand the mechanisms underlying airborne PM exposure-induced disorders. Establishing aetiology in humans is difficult, therefore, in-vitro and in-vivo studies can provide mechanistic insights. We describe acute health effects (e.g. exacerbations of asthma) and long term health effects such as the induction of chronic inflammatory lung disease, and effects outside the lung (e.g. liver and renal change). We will focus on oxidative stress and inflammation as this is the common mechanism of PM-induced disease, which may be used to develop effective treatments to mitigate the adverse health effect of PM exposure.

Particulate matter and Alzheimer's disease: an intimate connection

The environmental role in disease progression has been appreciated for decades; however, understanding how airborne toxicant exposure can affect organs beyond the lungs is an underappreciated area of scientific inquiry. Particulate matter (PM) includes various gases, liquids, and particles in suspension and is produced by industrial activities such as fossil fuel combustion and natural events including wildfires and volcanic eruptions. Although agencies have attempted to reduce acceptable airborne particulate levels, with urbanization and population growth, these policies have been only moderately effective in mitigating disease progression. A growing area of research is focused on the role of PM exposure in the progression of Alzheimer's disease (AD). This review will summarize the knowns and unknowns of this expanding field.

Suppression of NADPH oxidase 4 inhibits PM2.5-induced cardiac fibrosis through ROS-P38 MAPK pathway

Fine particulate matter (PM_2.5) has been consistently linked to cardiovascular diseases, and cardiac fibrosis plays a crucial role in the occurrence and development of heart diseases. It is reported that NOX4-dependent redox signaling are responsible for TGFβ-mediated profibrotic responses. The current study was designed to explore the possible mechanisms of cardiac fibrosis by PM_2.5 both in vitro and in vivo. Female C57BL/6 mice received PM_2.5 (3 mg/kg b.w.) exposure with/without NOX4 inhibitor (apocynin, 25 mg/kg b.w.) or ROS scavenger (NALC, 50 mg/kg b.w.), every other day, for 4 weeks. H9C2 cells were incubated with PM_2.5 (3 μg/mL) with/without 5 mM NALC, TGFβ inhibitor (SB431542, 10 μM), or siRNA-NOX4 for 24 h. The results demonstrated that PM_2.5 induced evident collagen deposition and elevated expression of fibrosis biomarkers (Col1a1 & Col3a1). Significant systemic inflammatory response and cardiac oxidative stress were triggered by PM_2.5. PM_2.5 increased the protein expression of TGFβ1, NOX4, and P38 MAPK. Notably, the increased effects of PM_2.5 could be suppressed by SB431542, siRNA-NOX4 in vitro or apocynin in vivo, and NALC. The reverse verification experiments further supported the involvement of the TGFβ/NOX4/ROS/P38 MAPK signaling pathway in the myocardial fibrosis induced by PM_2.5. In summary, the current study provided evidence that PM_2.5 challenge led to cardiac fibrosis through oxidative stress, systemic inflammation, and subsequent TGFβ/NOX4/ROS/P38 MAPK pathway and may offer new therapeutic targets in cardiac fibrosis.

Indirect mediators of systemic health outcomes following nanoparticle inhalation exposure

The growing field of nanoscience has shed light on the wide diversity of natural and anthropogenic sources of nano-scale particulates, raising concern as to their impacts on human health. Inhalation is the most robust route of entry, with nanoparticles (NPs) evading mucociliary clearance and depositing deep into the alveolar region. Yet, impacts from inhaled NPs are evident far outside the lung, particularly on the cardiovascular system and highly vascularized organs like the brain. Peripheral effects are partly explained by the translocation of some NPs from the lung into the circulation; however, other NPs largely confined to the lung are still accompanied by systemic outcomes. Omic research has only just begun to inform on the complex myriad of molecules released from the lung to the blood as byproducts of pulmonary pathology. These indirect mediators are diverse in their molecular make-up and activity in the periphery. The present review examines systemic outcomes attributed to pulmonary NP exposure and what is known about indirect pathological mediators released from the lung into the circulation. Further focus was directed to outcomes in the brain, a highly vascularized region susceptible to acute and longer-term outcomes. Findings here support the need for big-data toxicological studies to understand what drives these health outcomes and better predict, circumvent, and treat the potential health impacts arising from NP exposure scenarios.

Comparison of the Toxic Effects of Pristine and Photocatalytically Used TiO2 Nanoparticles in Mice

TiO₂ nanoparticles used in the photocatalytic degradation of pollutants in water treatment processes undergo physiochemical changes; therefore, their toxicological effects may be potentially different from those of the pristine nanoparticles. This study compared the toxic effects of exposure to pristine and photocatalytically used TiO₂ nanoparticles in mice. To obtain used TiO₂, the nanoparticles were used for photocatalytic degradation of a model pollutant under UV irradiation several times. Two groups of mice were exposed to pristine (PT group) and photocatalytically used TiO₂ (UT group) at three different concentrations (5-20 mg/m³) using whole-body exposure chambers (2 h/day, 5 days/weeks, 4 weeks). Exposure to both pristine and used TiO₂ increased the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphate (ALP), lactate dehydrogenase (LDH), C-reactive protein (CRP), and creatine kinase (CK-MB) significantly. Both exposed groups showed higher levels of WBC, lymphocytes, platelets, hematocrits, hemoglobin, and mean corpuscular volume (MCV) and lower levels of RBC and mean corpuscular hemoglobin concentration (MCHC) in a concentration-dependent manner. In all analyses, there were small non-significant differences between the PT and UT groups. More pathological changes were observed in the lung, kidney, and brain of the UT group, while the PT group showed more pathological effects in the liver and heart. The histological observations indicated that damage was mostly in the form of vascular endothelial injury. These two types of TiO₂ may activate different pathways to promote adverse effects. Further studies are required to evaluate and distinguish the mechanisms through which pristine and used TiO₂ induce toxicity.

PM2.5 causes vascular hyperreactivity through the upregulation of the thromboxane A2 receptor and activation of MAPK pathways

Airborne fine particulate matter (PM_2.5) is a major cardiovascular disease environmental risk factor. However, the underlying mechanism of action is not fully understood. Thromboxane is widely known as an important vasoconstrictor substance that binds to G-protein-coupled receptors (GPCR) in arteries and is involved in various cardiovascular diseases. This study examined the effect of PM_2.5 on thromboxane A₂ receptor (TP) in the mesenteric arteries and the underlying intracellular signal mechanisms (by focusing on the mitogen-activated protein kinase (MAPK) pathway). Rat mesenteric artery segments were exposed to PM_2.5 in the presence of MAPK pathway inhibitors. The contractile reactivity of mesenteric arteries was analyzed using wire myography. The mRNA and protein expression of TP receptor and MAPK pathway molecules were detected by real-time PCR and Western blot. Mesenteric artery receptor localization was assessed by immunohistochemistry. The results showed that TP receptor-mediated maximum contraction response was achieved after exposing arteries to 1.0 μg/mL PM_2.5 for 16 h (Emax: 228 ± 16% of K⁺). Moreover, inhibitor U0126 (ERK1/2 inhibitor), SB203580 (p38 inhibitor), and SP600125 (JNK inhibitor) depressed the increased TP receptor-mediated contractile responses (reduced rage were 17.9 ~ 59.6%). These inhibitors also decreased the increased mRNA expression and protein of the TP receptor induced by PM_2.5 (reduced by more than 50% and 46%, respectively). The immunoreactivity of increased TP receptor expression was primarily localized in the cytoplasm. In addition, phosphorylation quantitative analysis showed that in the presence of MAPK inhibitors, the PM_2.5-induced phosphorylation of ERK1/2, p38, and JNK protein increased by more than 30.0 ~ 130.3%. These results suggest that PM_2.5 upregulates the TP receptor of rat mesenteric arteries through activation of the ERK1/2, p38, and JNK MAPK pathways.

Short-term associations between particulate matter air pollution and hospital admissions through the emergency room for urinary system disease in Beijing, China: A time-series study

Evidence on the relationship between particulate matter air pollution and urinary system disease (UD) is scarce. This study aims to evaluate the associations between short-term exposures to PM_2.5 and PM₁₀ and risk of daily UD inpatient hospital admissions through the emergency room (ER-admissions) in Beijing. We obtained 41,203 weekday UD ER-admissions for secondary and tertiary hospitals in all 16 districts in Beijing during 2013-2018 from the Beijing Municipal Health Commission Information Center and obtained district-level air pollution concentrations based on 35 fixed monitoring stations in Beijing. We conducted a two-stage time-series analysis, with district-specific generalized linear models for each of Beijing's 16 districts, followed by random effects meta-analysis to obtain pooled risk estimates. We evaluated lagged and cumulative associations up to 30 days. In single-pollutant models, for both PM_2.5 and PM₁₀, cumulative exposure averaged over the day of admission and the previous 10 days (lag 0-10 days) showed the strongest association, with per interquartile range increases of PM_2.5 or PM₁₀ concentrations associated with a 7.5 % (95 % confidence interval [CI]: 3.0 %-12.2 %) or 6.0 % (95 % CI: 1.1 %-11.2 %) increased risk of daily UD hospital admissions, respectively. The risk estimates were robust to adjustment for co-pollutants and to a variety of sensitivity analyses. However, due to the strong correlation between PM_2.5 and PM₁₀ concentrations, we were unable to disentangle the respective relationships between these two exposures and UD risk. In this study, we found that short-term exposures to PM_2.5 and PM₁₀ are risk factors for UD morbidity and that cumulative exposure to PM pollution over a period of one to two weeks (i.e., 11 days) could be more important for UD risk than transient exposure during each of the respective single days.

The cardiovascular effects of air pollution: Prevention and reversal by pharmacological agents

Air pollution is associated with staggering levels of cardiovascular morbidity and mortality. Airborne particulate matter (PM), in particular, has been associated with a wide range of detrimental cardiovascular effects, including impaired vascular function, raised blood pressure, alterations in cardiac rhythm, blood clotting disorders, coronary artery disease, and stroke. Considerable headway has been made in elucidating the biological processes underlying these associations, revealing a labyrinth of multiple interacting mechanistic pathways. Several studies have used pharmacological agents to prevent or reverse the cardiovascular effects of PM; an approach that not only has the advantages of elucidating mechanisms, but also potentially revealing therapeutic agents that could benefit individuals that are especially susceptible to the effects of air pollution. This review gathers investigations with pharmacological agents, offering insight into the biology of how PM, and other air pollutants, may cause cardiovascular morbidity.

Key Characteristics of Cardiovascular Toxicants

BACKGROUND

The concept of chemical agents having properties that confer potential hazard called key characteristics (KCs) was first developed to identify carcinogenic hazards. Identification of KCs of cardiovascular (CV) toxicants could facilitate the systematic assessment of CV hazards and understanding of assay and data gaps associated with current approaches.

OBJECTIVES

We sought to develop a consensus-based synthesis of scientific evidence on the KCs of chemical and nonchemical agents known to cause CV toxicity along with methods to measure them.

METHODS

An expert working group was convened to discuss mechanisms associated with CV toxicity.

RESULTS

The group identified 12 KCs of CV toxicants, defined as exogenous agents that adversely interfere with function of the CV system. The KCs were organized into those primarily affecting cardiac tissue (numbers 1-4 below), the vascular system (5-7), or both (8-12), as follows: 1) impairs regulation of cardiac excitability, 2) impairs cardiac contractility and relaxation, 3) induces cardiomyocyte injury and death, 4) induces proliferation of valve stroma, 5) impacts endothelial and vascular function, 6) alters hemostasis, 7) causes dyslipidemia, 8) impairs mitochondrial function, 9) modifies autonomic nervous system activity, 10) induces oxidative stress, 11) causes inflammation, and 12) alters hormone signaling.

DISCUSSION

These 12 KCs can be used to help identify pharmaceuticals and environmental pollutants as CV toxicants, as well as to better understand the mechanistic underpinnings of their toxicity. For example, evidence exists that fine particulate matter [PM ≤2.5μm in aerodynamic diameter (PM2.5)] air pollution, arsenic, anthracycline drugs, and other exogenous chemicals possess one or more of the described KCs. In conclusion, the KCs could be used to identify potential CV toxicants and to define a set of test methods to evaluate CV toxicity in a more comprehensive and standardized manner than current approaches. https://doi.org/10.1289/EHP9321.

Air Pollution and COVID-19: A Possible Dangerous Synergy for Male Fertility

Several studies indicate that semen quality has strongly declined in the last decades worldwide. Air pollution represents a significant co-factor with the COVID-19 impact and has negative effects on the male reproductive system, through pro-oxidant, inflammatory and immune-dysregulating mechanisms. It has recently been reported that chronic exposure to PM2.5 causes overexpression of the alveolar ACE2 receptor, the entry route of SARS-CoV-2 into the organism shared by the lungs and testis where expression is highest in the body. In the testis, the ACE2/Ang-(1-7)/MasR pathway plays an important role in the regulation of spermatogenesis and an indirect mechanism of testicular damage could be due to the blockade of the ACE2 receptor by SARS-CoV-2. This prevents the conversion of specific angiotensins, and their excess causes inflammation with the overproduction of cytokines. PM2.5-induced overexpression of the alveolar ACE2 receptor, in turn, could increase local viral load in patients exposed to pollutants, producing ACE2 receptor depletion and compromising host defenses. By presenting an overall view of epidemiological data and molecular mechanisms, this manuscript aims to interpret the possible synergistic effects of both air pollution and COVID-19 on male reproductive function, warning that the spread of SARS-CoV-2 in the fertile years may represent a significant threat to global reproductive health. All of this should be of great concern, especially for men of the age of maximum reproductive capacity, and an important topic of debate for policy makers. Altered environmental conditions, together with the direct and indirect short- and long-term effects of viral infection could cause a worsening of semen quality with important consequences for male fertility, especially in those areas with higher environmental impact.

Particulate Matter, an Intrauterine Toxin Affecting Foetal Development and Beyond

Air pollution is the 9th cause of the overall disease burden globally. The solid component in the polluted air, particulate matters (PMs) with a diameter of 2.5 μm or smaller (PM_2.5) possess a significant health risk to several organ systems. PM_2.5 has also been shown to cross the blood–placental barrier and circulate in foetal blood. Therefore, it is considered an intrauterine environmental toxin. Exposure to PM_2.5 during the perinatal period, when the foetus is particularly susceptible to developmental defects, has been shown to reduce birth weight and cause preterm birth, with an increase in adult disease susceptibility in the offspring. However, few studies have thoroughly studied the health outcome of foetuses due to intrauterine exposure and the underlying mechanisms. This perspective summarises currently available evidence, which suggests that intrauterine exposure to PM_2.5 promotes oxidative stress and inflammation in a similar manner as occurs in response to direct PM exposure. Oxidative stress and inflammation are likely to be the common mechanisms underlying the dysfunction of multiple systems, offering potential targets for preventative strategies in pregnant mothers for an optimal foetal outcome.

The Protective Effects of Shengmai Formula Against Myocardial Injury Induced by Ultrafine Particulate Matter Exposure and Myocardial Ischemia are Mediated by the PI3K/AKT/p38 MAPK/Nrf2 Pathway

Background and Purpose: Ultrafine particulate matter (UFPM) induces oxidative stress (OS) and is considered to be a risk factor of myocardial ischemia (MI). Shengmai formula (SMF) is a traditional Chinese medicine with antioxidant properties and has been used to treat cardiovascular diseases for a long time. The aim of this study was to explore the protective role of SMF and the mechanism by which it prevents myocardial injury in UFPM-exposed rats with MI. Methods: An MI rat model was established. Animals were randomly divided into five groups: sham, UFPM + MI, SMF (1.08 mg/kg⋅d) + UFPM + MI, SMF (2.16 mg/kg⋅d) + UFPM + MI, and SMF (4.32 mg/kg⋅d) + UFPM + MI. SMF or saline was administrated 7 days before UFPM instillation (100 μg/kg), followed by 24 h of ischemia. Physiological and biochemical parameters were measured, and histopathological examinations were conducted to evaluate myocardial damage. We also explored the potential mechanism of the protective role of SMF using a system pharmacology approach and an in vitro myoblast cell model with small molecule inhibitors. Results: UFPM produced myocardial injuries on myocardial infarct size; serum levels of LDH, CK-MB, and cardiac troponin; and OS responses in the rats with MI. Pretreatment with SMF significantly attenuated these damages via reversing the biomarkers. SMF also improved histopathology induced by UFPM and significantly altered the PI3K/AKT/MAPK and OS signaling pathways. The expression patterns of Cat, Gstk1, and Cyba in the UFPM model group were reversed in the SMF-treated group. In in vitro studies, SMF attenuated UFPM-induced reactive oxygen species production, mitochondrial damage, and OS responses. The PI3K/AKT/p38 MAPK/Nrf2 pathway was significantly changed in the SMF group compared with that in the UFPM group, whereas opposite results were obtained for pathway inhibition. Conclusion: These findings indicate that SMF prevents OS responses and exerts beneficial effects against myocardial injury induced by UFPM + MI in rats. Furthermore, the PI3K/AKT/p38 MAPK/Nrf2 signaling pathway might be involved in the protective effects of SMF.

Double trouble: combined cardiovascular effects of particulate matter exposure and coronavirus disease 2019

The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly grown into a pandemic. According to initial reports, the lungs were thought to be the primary target, but recent case studies have shown its reach can extend to other organs including the heart and blood vessels. The severity of cardiac complications of COVID-19 depends on multiple underlying factors, with air pollutant exposure being one of them, as reported by several recent studies. Airborne particulate matter (PM) attracts heightened attention due to its implication in various diseases, especially respiratory and cardiovascular diseases. Inhaled PM not only carries microorganisms inside the body but also elicits local and systemic inflammatory responses resulting in altering the host’s immunity and increasing susceptibility to infection. Previous and recent studies have documented that PM acts as a ‘carrier’ for the virus and aids in spreading viral infections. This review presents the mechanisms and effects of viral entry and how pollution can potentially modulate pathophysiological processes in the heart. We aimed to concisely summarize studies examining cardiovascular outcomes in COVID-19 patients and postulate on how PM can influence these outcomes. We have also reviewed evidence on the use of renin–angiotensin system inhibitors, namely angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, in patients with COVID-19. The interplay of pollution and SARS-CoV-2 is essential to understanding the effects of accentuated cardiovascular effects of COVID-19 and deserves in-depth experimental investigations.

Atmospheric particle-bound polycyclic aromatic hydrocarbons, n-alkanes, hopanes, steranes and trace metals: PM2.5 source identification, individual and cumulative multi-pathway lifetime cancer risk assessment in the urban environment

The occurrence of atmospheric fine particles (PM_2.5)-associated polycyclic aromatic hydrocarbons (PAHs), trace metals and organic molecular markers was investigated by conducting an intensive sampling campaign at the Eastern Mediterranean urban area of Nicosia (Cyprus). Sixty-two 24-hr PM_2.5 samples were collected and analyzed for fifty parent and alkylated PAHs, twenty-five long chain n-alkanes, seventeen hopanes and twelve steranes used for source apportionment. The same number and kind of samples were analyzed to determine twenty-eight trace metals. Emphasis was given to investigate the air levels of the scarcely monitored although highly carcinogenic PAHs such as dibenzopyrenes, dibenzoanthracenes, 7H-benzo[c]fluorene and 5-methyl-chrysene, not included in the USEPA's sixteen PAH priority list (USEPA-16). UNMIX receptor model was applied to apportion the sources of atmospheric emissions of the determined organic compounds and trace metals and evaluate their daily contributions to the corresponding PM_2.5 associated concentrations. For comparison purposes, principal component analysis with multiple linear regression (PCA/MLR) was also applied and its results are reported. The UNMIX receptor model, compared to PCA/MLR, offered a more precise source profile and more reliable daily mass source distributions by eliminating negative contributions. The individual and cumulative multi-pathway lifetime cancer risk (posed via inhalation, ingestion and dermal contact) by exposure to PM_2.5-associated USEPA-16 listed and non-listed PAHs and selected airborne trace metals (As, Cd, Co, Ni, and Pb) were assessed. To estimate the contribution of each emission source to the total cancer risk, multiple linear regression analysis was performed, using as independent variables the daily source mass contributions and as dependent variables the respective cancer risk units. The estimated total cumulative cancer risk comprising all toxic PAHs, besides those included in the priority list, and metals was higher than the USEPA's threshold by a factor of eight, denoting a potential risk for long-term exposure of a population in the urban environment.

How do low wind speeds and high levels of air pollution support the spread of COVID-19?

The pandemic of coronavirus disease 2019 (COVID-19) is generating a high number of infected individuals and deaths. One of the current questions is how climatological factors and environmental pollution can affect the diffusion of COVID-19 in human society. This study endeavours to explain the relation between wind speed, air pollution and the diffusion of COVID-19 to provide insights to constrain and/or prevent future pandemics and epidemics. The statistical analysis here focuses on case study of Italy and reveals two main findings: 1) cities with high wind speed have lower numbers of COVID-19 related infected individuals; 2) cities located in hinterland zones (mostly those bordering large urban conurbations) with little wind speed and frequently high levels of air pollution had higher numbers of COVID-19 related infected individuals. Results here suggest that high concentrations of air pollutants, associated with low wind speeds, may promote a longer permanence of viral particles in polluted air of cities, thus favouring an indirect means of diffusion of the novel coronavirus (SARS-CoV-2), in addition to the direct diffusion with human-to-human transmission dynamics.

Asymmetric link between environmental pollution and COVID-19 in the top ten affected states of US: A novel estimations from quantile-on-quantile approach

This study draws the link between COVID-19 and air pollution (ground ozone O₃) from February 29, 2020 to July 10, 2020 in the top 10 affected States of the US. Utilizing quantile-on-quantile (QQ) estimation technique, we examine in what manner the quantiles of COVID-19 affect the quantiles of air pollution and vice versa. The primary findings confirm overall dependence between COVID-19 and air pollution. Empirical results exhibit a strong negative effect of COVID-19 on air pollution in New York, Texas, Illinois, Massachusetts, and Pennsylvania; especially at medium to higher quantiles, while New Jersey, Illinois, Arizona, and Georgia show strong negative effect mainly at lower quantiles. Contrarily, COVID-19 positively affects air pollution in Pennsylvania at extreme lower quantiles. On the other side, air pollution predominantly caused to increase in the intensity of COVID-19 cases across all states except lower quantiles of Massachusetts, and extreme higher quantiles of Arizona and New Jersey, where this effect becomes less pronounced or negative. Concludingly, a rare positive fallout of COVID-19 is reducing environmental pressure, while higher environmental pollution causes to increase the vulnerability of COVID-19 cases. These findings imply that air pollution is at the heart of chronic diseases, therefore the state government should consider these asymmetric channels and introduce appropriate policy measures to reset and control atmospheric emissions.

Real-time monitoring of toxic components from fine dust air pollutant samples by utilizing spark-induced plasma spectroscopy

A growing modern-day concern is fine dust air pollution that contains heavy metals and ammonium ions (NH₄⁺) from industrial and agricultural waste sources, respectively. In the current study, the development of an innovative and effective technique for real-time, quantitative monitoring of toxic fine dust components using plasma emission spectroscopy is presented as a complement to emergency preparedness plans aimed at reducing dust pollution. A novel spark-induced plasma spectroscopic (SIPS) device that can control the frequency and magnitude of plasma was developed for the toxic pollutants in this work. SIPS utilizes an electrical discharge from a high voltage at a low current to produce plasma when the applied voltage is higher than the ambient voltage surrounding the electrodes. The detection limit of this setup was enhanced by a factor of 4.3 over laser-induced plasma spectroscopy (LIPS). This compact sensing device was used in combination with a new quantitative analytical method to measure the concentration of heavy metals and ammonia molecules in fine dust air pollution. By integrating the time-resolved plasma emission signals that were based on the plasma continuum decay time of each element, quantitative measurements of the minute changes in composition of 0.1 μg/m³ were conducted. The findings of this study could inspire future research on the use of SIPS for monitoring airborne fine dust pollutants with better sensitivity in real-time via a new quantitative analytical method.

Commercial exchanges instead of air pollution as possible origin of COVID-19 initial diffusion phase in Italy: More efforts are necessary to address interdisciplinary research

This communication aims to advocate a more coordinate activity mainly between medical and environmental scientists to clarify some confusing information related to airborne diffusion mechanisms of COVID-19. In this frame it is suggested that parameters other than environmental pollution (accounting for pollution-to-human transmission mechanisms), as for example parameters involving commercial exchanges (accounting for human-to-human transmission mechanisms), should be considered to better justify the difference in the initial diffusion of virus in Italy.

Pathogenic Role of Air Pollution Particulate Matter in Cardiometabolic Disease: Evidence from Mice and Humans

Significance: Air pollution is a considerable global threat to human health that dramatically increases the risk for cardiovascular pathologies, such as atherosclerosis, myocardial infarction, and stroke. An estimated 4.2 million cases of premature deaths worldwide are attributable to outdoor air pollution. Among multiple other components, airborne particulate matter (PM) has been identified as the major bioactive constituent in polluted air. While PM-related illness was historically thought to be confined to diseases of the respiratory system, overwhelming clinical and experimental data have now established that acute and chronic exposure to PM causes a systemic inflammatory and oxidative stress response that promotes cardiovascular disease. Recent Advances: A large body of evidence has identified an impairment of redox metabolism and the generation of oxidatively modified lipids and proteins in the lung as initial tissue response to PM. In addition, the pathogenicity of PM is mediated by an inflammatory response that involves PM uptake by tissue-resident immune cells, the activation of proinflammatory pathways in various cell types and organs, and the release of proinflammatory cytokines as locally produced tissue response signals that have the ability to affect organ function in a remote manner. Critical Issues: In the present review, we summarize and discuss the functional participation of PM in cardiovascular pathologies and its risk factors with an emphasis on how oxidative stress, inflammation, and immunity interact and synergize as a response to PM. Future Directions: The impact of PM constituents, doses, and novel anti-inflammatory therapies against PM-related illness is also discussed.

Carcinogenic risks and chemical composition of particulate matter recovered by two methods: wet and dry extraction

Wet and dry extraction methods are two main methods used in toxicological in vitro and in vivo studies to recover particulate matter (PM) from filter papers. The aim of this study was to extract PM by wet and dry extraction methods and compare the elemental content and carcinogenic risks of extracts. PM₁₀ samples were collected using fiberglass filters and a high-volume air sampler. For wet extraction, the method involved agitation in water, sonication in water bath, and agitation again. For dry extraction, the filters were sonicated and the PM was recovered using sweeping by a brush. Elemental composition of extracts was determined by inductively coupled plasma-optical emission spectrometry (ICP-OES). Excess lifetime cancer risks (ELCR) of As, Cd, Cr, Ni, and Pb in extracts were estimated. The average recovery efficiency (%) of dry and wet extraction methods were 36.8% and 58.5%, respectively. The average elemental concentration that resulted from dry and wet methods was calculated to be 2.27 and 1.26 μg/m³, respectively. The total ELCR of all heavy metals in both methods exceeds the 1 × 10^-6 limit. However, the total ELCR of heavy metals that resulted from the dry method was higher than that from the wet method. In conclusion, the dry method showed to be more effective to recover a representative extract from the filter. This can ultimately lead to a realistic and robust response in toxicological studies. However, a toxicological comparison between the extracts of these two methods is required.