Ozone Is Associated With an Increased Risk of Respiratory Exacerbations in Patients With Cystic Fibrosis

Farhat, Sylvia Costa Lima; Almeida, Marina Buarque de; Silva-Filho, Luiz Vicente R. F. da; Farhat, Juliana; Rodrigues, Joaquim Carlos; Braga, Alfésio Luı́s Ferreira

doi:10.1378/chest.12-2414

Cited by 50 publications

(33 citation statements)

References 42 publications

(36 reference statements)

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“…Barometric pressure was found to positively correlate with both O 3 1-h and O 3 8-h in this study, while, in opposition to former research, temperature was negatively associated with ozone concentration [28]. This might be because the months with high temperature were accompanied with high humidity (the rainy season from May to August in Shenzhen), which can influence ultraviolet radiation and thus slow down the formation of ozone.…”

Section: Discussioncontrasting

confidence: 98%

Spatiotemporal Patterns of Ozone and Cardiovascular and Respiratory Disease Mortalities Due to Ozone in Shenzhen

et al. 2017

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Abstract:In order to explore the temporal-spatial patterns and possible health effects of ozone in Shenzhen, daily concentrations of ozone and the daily mortality caused by cardiovascular and respiratory diseases were collected. Using Geographic Information System (GIS) and SPSS, the spatial and temporal patterns of ozone in Shenzhen were illustrated. Using a generalized additive model (GAM), the associations between ozone and cardiovascular and respiratory diseases causing mortality were analyzed, adjusted for meteorological factors and other major air pollutants including fine particulate matter (PM 2.5 ), nitrogen dioxide (NO 2 ) and carbon monoxide (CO), and stratified by lag, age, and gender. The results showed that, during 2013, ozone was the second main air pollutant in Shenzhen apart from PM 2.5 , with average daily concentrations of 95.9 µg/m 3 and 76.8 µg/m 3 for the ozone 1-h mean and the daily ozone 8-h maximum concentration, respectively. The daily level of ozone had a higher concentration from September to October, and relatively low concentration from May to June. Obviously, a higher concentration was found in central parts of Shenzhen with the largest population, indicating higher risks. The excess risk (ER) percentage of the cardio-respiratory mortality rate showed a clearly accumulative effect at L03, with the highest ER percentage of 1.08 (0.88-1.27) per 10 µg/m 3 increase in the ozone 8-h maximum concentration for all the population. Males were found to be more sensitive to ozone compared with females, and the elderly were more susceptible to ozone exposure than younger people.

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Section: Discussioncontrasting

confidence: 98%

Spatiotemporal Patterns of Ozone and Cardiovascular and Respiratory Disease Mortalities Due to Ozone in Shenzhen

et al. 2017

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“…Over the last 20 years, exposure to fossil fuel combustion has attracted significant medical interest. Many studies have demonstrated that current levels of air pollutants contribute to cardiovascular and respiratory morbidity and mortality in adults and children (2,3,(12)(13)(14). We have analyzed air pollutant measurements in the Sao Paulo metropolitan area over the last 30 years, and observed that pollutant levels recorded at each station were highly correlated with one another.…”

Section: Discussionmentioning

confidence: 94%

“…In this regard, this is a major public health hazard in large cities (2)(3)(4), and children and adolescents are susceptible to the effects of air pollution. However, there are few studies evaluating the association between exposure to air pollutants and autoimmune diseases in this population (4,5), and to our knowledge no study has assessed the influence of air pollutants on the disease activity of juvenile-onset systemic lupus erythematosus (SLE) patients.…”

Section: Introductionmentioning

confidence: 99%

Exposure to Air Pollutants and Disease Activity in Juvenile‐Onset Systemic Lupus Erythematosus Patients

Fernandes

Silva

Braga

et al. 2015

Arthritis Care & Research

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Objective. To investigate the association between exposure to air pollutants in the Sao Paulo metropolitan area and disease activity in juvenile-onset systemic lupus erythematosus (SLE) patients. Methods. A longitudinal panel study based on 409 consecutive visits of juvenile-onset SLE patients living in the Sao Paulo metropolitan area was carried out. Disease activity was evaluated in accordance with the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), and the patients were divided into 2 groups: those with SLEDAI scores £8 and those with SLEDAI scores >8. Daily concentrations of inhaled particulate matter (PM 10 ), sulfur dioxide, nitrogen dioxide (NO 2 ), ozone, and carbon monoxide (CO) were evaluated on the 21 days preceding the medical visits. A generalized estimation equation model was used to assess the impact of these measurements on SLEDAI-2K scores, considering the fixed effects for repetitive measurements. The models were adjusted for erythrocyte sedimentation rate, corticosteroid use (daily and cumulative doses), antimalarial use, the use of immunosuppressive agents, the presence of infection 20 days preceding the medical appointment, and the minimum temperature and relative humidity outdoors. Results. PM 10 , NO 2 , and CO were risk factors for juvenile-onset SLE disease activity (SLEDAI-2K score >8) approximately 2 weeks after exposure. A 13.4 mg/m 3 increase in the PM 10 moving average (from lag 12 to lag 15) was associated with a 34% increase (95% confidence interval 7.0-68.0) in the risk of a SLEDAI-2K score >8. Conclusion. This is the first study to show that exposure to inhaled pollutants may increase the risk of disease activity in children with juvenile-onset SLE in a large urban center.

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“…Dysregulated AA metabolism has also been shown during CF exacerbations and periods of poor growth, but it has not been linked to SHSe in children with CF 10 11. Although longitudinal studies have shed light on clinical,10 12–14 microbiological15 and environmental16 factors that impact long-term lung disease, modifiable factors such as SHSe and their interaction with immunological, microbiological or AA signalling in infants and young children with CF are relatively unknown.…”

Section: Introductionmentioning

confidence: 99%

Secondhand smoke alters arachidonic acid metabolism and inflammation in infants and children with cystic fibrosis

Kopp

Thompson

Kim

et al. 2019

Thorax

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BackgroundMechanisms that facilitate early infection and inflammation in cystic fibrosis (CF) are unclear. We previously demonstrated that children with CF and parental-reported secondhand smoke exposure (SHSe) have increased susceptibility to bacterial infections. SHSe hinders arachidonic acid (AA) metabolites that mediate immune function in patients without CF, and may influence CF immune dysfunction. We aimed to define SHSe’s impact on inflammation mediators and infection in children with CF.MethodsSeventy-seven children with CF <10 years of age (35 infants <1 year; 42 children 1–10 years) were enrolled and hair nicotine concentrations measured as an objective surrogate of SHSe. AA signalling by serum and macrophage lipidomics, inflammation using blood transcriptional profiles and in vitro macrophage responses to bacterial infection after SHSe were assessed.ResultsHair nicotine concentrations were elevated in 63% of patients. Of the AA metabolites measured by plasma lipidomics, prostaglandin D2 (PGD2) concentrations were decreased in children with CF exposed to SHSe, and associated with more frequent hospitalisations (p=0.007) and worsened weight z scores (p=0.008). Children with CF exposed to SHSe demonstrated decreased expression of the prostaglandin genes PTGES3 and PTGR2 and overexpression of inflammatory pathways. These findings were confirmed using an in vitro model, where SHSe was associated with a dose-dependent decrease in PGD2 and increased methicillin-resistant Staphylococcus aureus survival in human CF macrophages.ConclusionsInfants and young children with CF and SHSe have altered AA metabolism and dysregulated inflammatory gene expression resulting in impaired bacterial clearance. Our findings identified potential therapeutic targets to halt early disease progression associated with SHSe in the young population with CF.

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Ozone Is Associated With an Increased Risk of Respiratory Exacerbations in Patients With Cystic Fibrosis

Abstract: This study demonstrates that exposure to short-term air pollution in a large urban center increases the risk of a pulmonary exacerbation in patients with CF.

Cited by 50 publications

References 42 publications

Spatiotemporal Patterns of Ozone and Cardiovascular and Respiratory Disease Mortalities Due to Ozone in Shenzhen

Spatiotemporal Patterns of Ozone and Cardiovascular and Respiratory Disease Mortalities Due to Ozone in Shenzhen

Exposure to Air Pollutants and Disease Activity in Juvenile‐Onset Systemic Lupus Erythematosus Patients

Secondhand smoke alters arachidonic acid metabolism and inflammation in infants and children with cystic fibrosis

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