Acute effects of air pollution on pulmonary function, airway inflammation, and oxidative stress in asthmatic children

Ling Liu, Raymond Poon, Li Chen, Anna-Maria Frescura, Paolo Montuschi, Giovanni Ciabattoni, Amanda Wheeler, Robert Dales, Ling Liu, Raymond Poon, Li Chen, Anna-Maria Frescura, Paolo Montuschi, Giovanni Ciabattoni, Amanda Wheeler, Robert Dales

Abstract

Background: Air pollution is associated with respiratory symptoms, lung function decrements, and hospitalizations. However, there is little information about the influence of air pollution on lung injury.

Objective: In this study we investigated acute effects of air pollution on pulmonary function and airway oxidative stress and inflammation in asthmatic children.

Methods: We studied 182 children with asthma, 9-14 years of age, for 4 weeks. Daily ambient concentrations of sulfur dioxide, nitrogen dioxide, ozone, and particulate matter < or = 2.5 microm in aerodynamic diameter (PM(2.5)) were monitored from two stations. Once a week we measured spirometry and fractional exhaled nitric oxide (FeNO), and determined thiobarbituric acid reactive substances (TBARS) and 8-isoprostane--two oxidative stress markers--and interleukin-6 (IL-6) in breath condensate. We tested associations using mixed-effects regression models, adjusting for confounding variables.

Results: Interquartile-range increases in 3-day average SO2 (5.4 ppb), NO2 (6.8 ppb), and PM(2.5) (5.4 microg/m3) were associated with decreases in forced expiratory flow between 25% and 75% of forced vital capacity, with changes being -3.1% [95% confidence interval (CI), -5.8 to -0.3], -2.8% (95% CI, -4.8 to -0.8), and -3.0% (95% CI, -4.7 to -1.2), respectively. SO2, NO2, and PM(2.5) were associated with increases in TBARS, with changes being 36.2% (95% CI, 15.7 to 57.2), 21.8% (95% CI, 8.2 to 36.0), and 24.8% (95% CI, 10.8 to 39.4), respectively. Risk estimates appear to be larger in children not taking corticosteroids than in children taking corticosteroids. O3 (5.3 ppb) was not associated with health end points. FeNO, 8-isoprostane, and IL-6 were not associated with air pollutants.

Conclusion: Air pollution may increase airway oxidative stress and decrease small airway function of asthmatic children. Inhaled corticosteroids may reduce oxidative stress and improve airway function.

Keywords: air pollution; asthma; children; exhaled breath condensate; inflammation; oxidative stress; pulmonary function.

Figures

Figure 1
Figure 1
Map of Windsor, Ontario, Canada.
Figure 2
Figure 2
Percent changes and 95% confidence intervals in FEV1 (A), FEF25–75%(B), FeNO (C), and breath TBARS (D) of asthmatic children taking or not taking ICS during the study period, in association with an interquartile-range increase in a pollutant. Sixty-eight asthmatic children took (Yes), and 114 children did not take (No) ICS. Pollutant concentrations were averaged over 3 days including the same day and 2 days before the clinical testing was done. Models were adjusted for testing period, daily temperature, relative humidity, and use of SABA.
Figure 3
Figure 3
Percent changes and 95% confidence intervals in FEV1 (A), FEF25–75%(B), FeNO (C), and breath TBARS (D) of asthmatic children, in association with an interquartile-range increase in a pollutant, in one- and two-pollutant models. Pollutant concentrations were averaged over 3 days including the same day and 2 days before the clinical testing was done. Models were adjusted for testing period, daily temperature, relative humidity, and use of SABA and ICS.

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Source: PubMed

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