Low-level ozone has both respiratory and systemic effects in African American adolescents with asthma despite asthma controller therapy

Hernández, Michelle; Dhingra, Radhika; Burbank, Allison J.; Todorich, Krista; Loughlin, Ceila E.; Frye, Marcia; Duncan, Kelly; Robinette, Carole; Mills, Katherine; Devlin, Robert B.; Peden, David B.; Díaz-Sánchez, David

doi:10.1016/j.jaci.2018.08.003

Cited by 23 publications

(25 citation statements)

References 6 publications

(6 reference statements)

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“…Interestingly, we identified that no usage of an indoor air purifier during exposure to high levels of outdoor air pollution was associated with moderate/severe asthma when mild intermittent asthma was considered as a reference. Air pollution is known to affect respiratory health, including asthma, with increases in hospitalization 30. In a previous study, the use of high-efficiency particulate air (HEPA) filters decreased the frequency of unscheduled clinic visits due to asthma exacerbation in children 31.…”

Section: Discussionmentioning

confidence: 98%

Associated Factors for Asthma Severity in Korean Children: A Korean Childhood Asthma Study

Lee

Song

Kim

et al. 2020

Allergy Asthma Immunol Res

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PurposeChildhood asthma has a considerable social impact and economic burden, especially in severe asthma. This study aimed to identify the proportion of childhood asthma severity and to evaluate associated factors for greater asthma severity.MethodsThis study was performed on 667 children aged 5–15 years with asthma from the nationwide 19 hospitals in the Korean childhood Asthma Study (KAS). Asthma was classified as mild intermittent, mild persistent, and moderate/severe persistent groups according to the National Asthma Education and Prevention Program recommendations. Multinomial logistic regression models were used to identify the associated factors for greater asthma severity.ResultsMild persistent asthma was most prevalent (39.0%), followed by mild intermittent (37.6%), moderate persistent (22.8%), and severe persistent asthma (0.6%). Onset later than 6 years of age (adjusted odds ratio [aOR], 1.69 for mild persistent asthma; aOR, 1.92 for moderate/severe persistent asthma) tended to increase asthma severity. Exposure to environmental tobacco smoke (aOR, 1.53 for mild persistent asthma; aOR, 1.85 for moderate/severe persistent asthma), and current dog ownership with sensitization to dog dander (aOR, 5.86 for mild persistent asthma; aOR, 6.90 for moderate/severe persistent asthma) showed increasing trends with greater asthma severity. Lower maternal education levels (aOR, 2.32) and no usage of an air purifier in exposure to high levels of outdoor air pollution (aOR, 1.76) were associated with moderate/severe persistent asthma.ConclusionsModification of identified environmental factors associated with greater asthma severity might help better control childhood asthma, thereby reducing the disease burden due to childhood asthma.

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Section: Discussionmentioning

confidence: 98%

Associated Factors for Asthma Severity in Korean Children: A Korean Childhood Asthma Study

Lee

Song

Kim

et al. 2020

Allergy Asthma Immunol Res

View full text Add to dashboard Cite

show abstract

“…Children who live near major roadways and exposed to traffic-related air pollution have increased susceptibility to asthma. A recent study has shown that exposure to air ozone levels at sub-NAAQS thresholds is associated with pulmonary and systemic changes in African American adolescents with asthma [64]. In general, the burden of air pollution related asthma is associated with a lower socioeconomic status, and is thus a health equity issue [65].…”

Section: Air Pollutionmentioning

confidence: 99%

Epidemiology and risk factors for asthma

Kuruvilla

Vanijcharoenkarn

Shih

et al. 2019

Respiratory Medicine

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“…Ground‐level ozone, one of the dominant air pollutants, is a reactive oxidant gas that can affect lung immunity and exacerbate symptoms in patients with lung disease (Hernandez et al. ). Numerous studies have shown that there is a link between short‐term ozone exposure and the incidence of asthma, idiopathic pulmonary fibrosis, and COPD, as well as dose‐dependent declines in spirometric measurements of lung function and increases in airway resistance, indicating that ozone is a potent toxicant for the respiratory system (Tager et al.…”

Section: Introductionmentioning

confidence: 99%

“…In patients with lung disease, particularly women, exposure to air pollutants has been associated with higher exacerbation and hospitalization rates and increased morbidity and mortality (Guarnieri and Balmes 2014;Kurt et al 2016). Groundlevel ozone, one of the dominant air pollutants, is a reactive oxidant gas that can affect lung immunity and exacerbate symptoms in patients with lung disease (Hernandez et al 2018). Numerous studies have shown that there is a link between short-term ozone exposure and the incidence of asthma, idiopathic pulmonary fibrosis, and COPD, as well as dose-dependent declines in spirometric measurements of lung function and increases in airway resistance, indicating that ozone is a potent toxicant for the respiratory system (Tager et al 2005;Ciencewicki et al 2008;Fernandez et al 2015;Ses e et al 2018).…”

Section: Introductionmentioning

confidence: 99%

Modulation of the lung inflammatory response to ozone by the estrous cycle

et al. 2019

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Emerging evidence suggests that sex differences exist in the control of lung innate immunity; however, the specific roles of sex hormones in the inflammatory response, and the mechanisms involved are unclear. Here, we investigated whether fluctuations in circulating hormone levels occurring in the mouse estrous cycle could affect the inflammatory response to air pollution exposure. For this, we exposed female mice (C57 BL /6J, 8 weeks old) at different phases of the estrous cycle to 2 ppm of ozone or filtered air ( FA ) for 3 h. Following exposure, we collected lung tissue and bronchoalveolar lavage fluid ( BAL ), and performed lung function measurements to evaluate inflammatory responses and respiratory mechanics. We found a differential inflammatory response to ozone in females exposed in the luteal phase (metestrus, diestrus) versus the follicular phase (proestrus, estrus). Females exposed to ozone in the follicular phase had significantly higher expression of inflammatory genes, including Ccl2, Cxcl2, Ccl20, and Il6, compared to females exposed in the luteal phase ( P < 0.05), and displayed differential activation of regulatory pathways. Exposure to ozone in the follicular phase also resulted in higher BAL neutrophilia, lipocalin levels, and airway resistance than exposure in the luteal phase ( P < 0.05). Together, these results show that the effects of ozone exposure in the female lung are affected by the estrous cycle phase, and potentially hormonal status. Future studies investigating air pollution effects and inflammation in women should consider the menstrual cycle phase and/or circulating hormone levels.

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Low-level ozone has both respiratory and systemic effects in African American adolescents with asthma despite asthma controller therapy

Cited by 23 publications

References 6 publications

Associated Factors for Asthma Severity in Korean Children: A Korean Childhood Asthma Study

Associated Factors for Asthma Severity in Korean Children: A Korean Childhood Asthma Study

Epidemiology and risk factors for asthma

Modulation of the lung inflammatory response to ozone by the estrous cycle

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