Protective effects of inhaled antioxidants against air pollution-induced pathological responses

Abstract

As the public health burden of air pollution continues to increase, new strategies to mitigate harmful health effects are needed. Dietary antioxidants have previously been explored to protect against air pollution-induced lung injury producing inconclusive results. Inhaled (pulmonary or nasal) administration of antioxidants presents a more promising approach as it could directly increase antioxidant levels in the airway surface liquid (ASL), providing protection against oxidative damage from air pollution. Several antioxidants have been shown to exhibit antioxidant, anti-inflammatory, and anti-microbial properties in in vitro and in vivo models of air pollution exposure; however, little work has been done to translate these basic research findings into practice. This narrative review summarizes these findings and data from human studies using inhaled antioxidants in response to air pollution, which have produced positive results, indicating further investigation is warranted. In addition to human studies, cell and murine studies should be conducted using more relevant models of exposure such as air–liquid interface (ALI) cultures of primary cells and non-aqueous apical delivery of antioxidants and pollutants. Inhalation of antioxidants shows promise as a protective intervention to prevent air pollution-induced lung injury and exacerbation of existing lung disease. Graphical Abstract

Dietary supplementations to mitigate the cardiopulmonary effects of air pollution toxicity: A systematic review of clinical trials

“…Also, vitamin E administration has been demonstrated to diminish O 3 -induced cell death in fibroblasts and prevent allergen-induced NF E2-related factor 2 (NRF2) inhibition in asthmatic alveolar macrophages. This has led to the hypothesis that getting more antioxidants could help protect against the oxidative damage caused by breathing in polluted air [ 59 – 61 ].…”

Breath of Danger: Unveiling PM2.5’s Stealthy Impact on Cancer Risks

“…Wong et al reported that long-term exposure to PM2.5 was associated with an elevated risk of mortality across all cancer types [hazard ratio (HR)=1. 22 9). Furthermore, PM2.5 has been associated with an increased risk of lung, bladder and colorectal cancer (2).…”

“…Additionally, polyphenols, such as flavonoids found in green tea, vegetables, and fruits, seem to lower the risk of various cancers, including lung, breast, prostate, and gastrointestinal tumors (16). Other compounds like curcumin, vitamin B6, folate, vitamin D, quercetin, sulforaphane, insole-3-carbinol, vitamin C, vitamin E, and Omega-3 polyunsaturated fatty acids have also demonstrated chemo-preventative effects against human cancer (21,22). Hence, adopting a Mediterranean diet that includes fish, legumes, fresh fruits, and vegetables like berries, kale, broccoli, and tomatoes, along with vitamin D3 supplements, is recommended in high air pollution environments.…”

“…Administering antioxidants through inhalation (pulmonary or nasal) offers a promising approach, potentially elevating antioxidant levels in the airway surface liquid to safeguard against oxidative damage caused by air pollution. These compounds are currently being investigated (22).…”

Molecular Mechanisms of N-Acetylcysteine in RSV Infections and Air Pollution-Induced Alterations: A Scoping Review

“…Thus, a combination of the anti-inflammatory, antioxidant, and mucolytic activity is desirable in the treatment of various respiratory diseases, and the clinical use of NAC has been extensively investigated in chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, or cystic fibrosis [ 2 , 16 , 17 , 18 ]. In infectious diseases, NAC has been shown to inhibit the replication of human influenza virus in lung epithelial cells, human immunodeficiency virus (HIV) and RSV and to reduce the production of pro-inflammatory cytokines, including IL-8, CXCL10, CCL5, and IL-6 [ 19 , 20 ].…”