Short-term effects of air pollution: a panel study of blood markers in patients with chronic pulmonary disease
Tóm tắt
Growing evidence indicates that ambient air pollution is associated with exacerbation of chronic diseases like chronic pulmonary disease. A prospective panel study was conducted to investigate short-term changes of blood markers of inflammation and coagulation in response to daily changes in air pollution in Erfurt, Germany. 12 clinical visits were scheduled and blood parameters were measured in 38 male patients with chronic pulmonary disease during winter 2001/2002. Additive mixed models with random patient intercept were applied, adjusting for trend, weekday, and meteorological parameters. Hourly data on ultrafine particles (UFP, 0.01-0.1 μm), accumulation mode particles (ACP, 0.1-1.0 μm), PM10 (particulate matter <10 μm in diameter), elemental (EC) and organic carbon (OC), gaseous pollutants (nitrogen monoxide [NO], nitrogen dioxide [NO2], carbon monoxide [CO], and sulphur dioxide [SO2]) were collected at a central monitoring site and meteorological data were received from an official network. For each person and visit the individual 24-hour average of pollutants immediately preceding the blood withdrawal (lag 0) up to day 5 (lag1-4) and 5-day running means were calculated. Increased levels of fibrinogen were observed for an increase in one interquartile range of UFP, PM10, EC, OC, CO, and NO revealing the strongest effect for lag 3. E-selectin increased in association with ACP and PM10 with a delay of one day. The ACP effect was also seen with the 5-day-mean. The pattern found for D-dimer was inconsistent. Prothrombin fragment 1+2 decreased with lag 4 consistently for all particulate pollutants. Von Willebrand factor antigen (vWF) showed a consistent decrease in association with almost all air pollutants with all lags except for lag 0. No associations were found for C-reactive protein, soluble intercellular adhesion molecule 1, serum amyloid A and factor VII. These results suggest that elevated concentrations of air pollution are associated with changes in some blood markers of inflammation and coagulation in patients with chronic pulmonary disease. The clinical implications of these findings need further investigation.
Tài liệu tham khảo
Mills NL, Donaldson K, Hadoke PW, Boon NA, MacNee W, Cassee FR, Sandstrom T, Blomberg A, Newby DE: Adverse cardiovascular effects of air pollution. Nat Clin Pract Cardiovasc Med 2009, 6: 36–44. 10.1038/ncpcardio1399
Schikowski T, Sugiri D, Ranft U, Gehring U, Heinrich J, Wichmann HE, Kramer U: Does respiratory health contribute to the effects of long-term air pollution exposure on cardiovascular mortality? Respir Res 2007, 8: 20. 10.1186/1465-9921-8-20
Sunyer J, Schwartz J, Tobias A, Macfarlane D, Garcia J, Anto JM: Patients with chronic obstructive pulmonary disease are at increased risk of death associated with urban particle air pollution: a case-crossover analysis. Am J Epidemiol 2000, 151: 50–56.
Garcia-Aymerich J, Tobias A, Anto JM, Sunyer J: Air pollution and mortality in a cohort of patients with chronic obstructive pulmonary disease: a time series analysis. J Epidemiol Community Health 2000, 54: 73–74. 10.1136/jech.54.1.73
Donaldson K, Tran L, Jimenez LA, Duffin R, Newby DE, Mills N, MacNee W, Stone V: Combustion-derived nanoparticles: a review of their toxicology following inhalation exposure. Part Fibre Toxicol 2005, 2: 10. 10.1186/1743-8977-2-10
Ruckerl R, Ibald-Mulli A, Koenig W, Schneider A, Woelke G, Cyrys J, Heinrich J, Marder V, Frampton M, Wichmann HE, Peters A: Air pollution and markers of inflammation and coagulation in patients with coronary heart disease. Am J Respir Crit Care Med 2006, 173: 432–441. 10.1164/rccm.200507-1123OC
Davi G, Basili S, Vieri M, Cipollone F, Santarone S, Alessandri C, Gazzaniga P, Cordova C, Violi F: Enhanced thromboxane biosynthesis in patients with chronic obstructive pulmonary disease. The Chronic Obstructive Bronchitis and Haemostasis Study Group. Am J Respir Crit Care Med 1997, 156: 1794–1799.
Agusti AG, Noguera A, Sauleda J, Sala E, Pons J, Busquets X: Systemic effects of chronic obstructive pulmonary disease. Eur Respir J 2003, 21: 347–360. 10.1183/09031936.03.00405703
Pitz M, Cyrys J, Karg E, Wiedensohler A, Wichmann HE, Heinrich J: Variability of apparent particle density of an urban aerosol. Environmental Science & Technology 2003, 37: 1–10. 10.1021/es034322p
Gabay C, Kushner I: Acute-phase proteins and other systemic responses to inflammation. N Engl J Med 1999, 340: 448–454. 10.1056/NEJM199902113400607
Thomas L: Labor und Diagnose. S. Aufl. TH-Books, Frankfurt/Main; 1998.
Wedzicha JA, Seemungal TA, MacCallum PK, Paul EA, Donaldson GC, Bhowmik A, Jeffries DJ, Meade TW: Acute exacerbations of chronic obstructive pulmonary disease are accompanied by elevations of plasma fibrinogen and serum IL-6 levels. Thromb Haemost 2000, 84: 210–215.
Danesh J, Lewington S, Thompson SG, Lowe GD, Collins R, Kostis JB, Wilson AC, Folsom AR, Wu K, Benderly M, Goldbourt U, Willeit J, Kiechl S, Yarnell JW, Sweetnam PM, Elwood PC, Cushman M, Psaty BM, Tracy RP, Tybjaerg-Hansen A, Haverkate F, de Maat MP, Fowkes FG, Lee AJ, Smith FB, Salomaa V, Harald K, Rasi R, Vahtera E, Jousilahti P, Pekkanen J, D'Agostino R, Kannel WB, Wilson PW, Tofler G, Arocha-Pinango CL, Rodriguez-Larralde A, Nagy E, Mijares M, Espinosa R, Rodriquez-Roa E, Ryder E, Diez-Ewald MP, Campos G, Fernandez V, Torres E, Marchioli R, Valagussa F, Rosengren A, Wilhelmsen L, Lappas G, Eriksson H, Cremer P, Nagel D, Curb JD, Rodriguez B, Yano K, Salonen JT, Nyyssonen K, Tuomainen TP, Hedblad B, Lind P, Loewel H, Koenig W, Meade TW, Cooper JA, De Stavola B, Knottenbelt C, Miller GJ, Cooper JA, Bauer KA, Rosenberg RD, Sato S, Kitamura A, Naito Y, Palosuo T, Ducimetiere P, Amouyel P, Arveiler D, Evans AE, Ferrieres J, Juhan-Vague I, Bingham A, Schulte H, Assmann G, Cantin B, Lamarche B, Despres JP, Dagenais GR, Tunstall-Pedoe H, Woodward M, Ben Shlomo Y, Davey , Smith G, Palmieri V, Yeh JL, Rudnicka A, Ridker P, Rodeghiero F, Tosetto A, Shepherd J, Ford I, Robertson M, Brunner E, Shipley M, Feskens EJ, Kromhout D, Dickinson A, Ireland B, Juzwishin K, Kaptoge S, Lewington S, Memon A, Sarwar N, Walker M, Wheeler J, White I, Wood A: Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis. JAMA 2005, 294: 1799–1809. 10.1001/jama.294.14.1799
Sin DD, Man SF: Why are patients with chronic obstructive pulmonary disease at increased risk of cardiovascular diseases? The potential role of systemic inflammation in chronic obstructive pulmonary disease. Circulation 2003, 107: 1514–1519. 10.1161/01.CIR.0000056767.69054.B3
Schwartz J: Air pollution and blood markers of cardiovascular risk. Environ Health Perspect 2001, 109 Suppl 3: 405–409. 10.2307/3434788
Pekkanen J, Brunner EJ, Anderson HR, Tiittanen P, Atkinson RW: Daily concentrations of air pollution and plasma fibrinogen in London. Occup Environ Med 2000, 57: 818–822. 10.1136/oem.57.12.818
Silkoff PE, Zhang L, Dutton S, Langmack EL, Vedal S, Murphy J, Make B: Winter air pollution and disease parameters in advanced chronic obstructive pulmonary disease panels residing in Denver, Colorado. J Allergy Clin Immunol 2005, 115: 337–344. 10.1016/j.jaci.2004.11.035
Seaton A, Soutar A, Crawford V, Elton R, McNerlan S, Cherrie J, Watt M, Agius R, Stout R: Particulate air pollution and the blood. Thorax 1999, 54: 1027–1032.
Pope CA III, Hansen ML, Long RW, Nielsen KR, Eatough NL, Wilson WE, Eatough DJ: Ambient particulate air pollution, heart rate variability, and blood markers of inflammation in a panel of elderly subjects. Environ Health Perspect 2004, 112: 339–345.
Peters A, Frohlich M, Doring A, Immervoll T, Wichmann HE, Hutchinson WL, Pepys MB, Koenig W: Particulate air pollution is associated with an acute phase response in men; results from the MONICA-Augsburg Study. Eur Heart J 2001, 22: 1198–1204. 10.1053/euhj.2000.2483
Vernooy JH, Kucukaycan M, Jacobs JA, Chavannes NH, Buurman WA, Dentener MA, Wouters EF: Local and systemic inflammation in patients with chronic obstructive pulmonary disease: soluble tumor necrosis factor receptors are increased in sputum. Am J Respir Crit Care Med 2002, 166: 1218–1224. 10.1164/rccm.2202023
Hurst JR, Perera WR, Wilkinson TM, Donaldson GC, Wedzicha JA: Exacerbation of chronic obstructive pulmonary disease: pan-airway and systemic inflammatory indices. Proc Am Thorac Soc 2006, 3: 481–482. 10.1513/pats.200603-059MS
Pietropaoli AP, Frampton MW, Hyde RW, Morrow PE, Oberdorster G, Cox C, Speers DM, Frasier LM, Chalupa DC, Huang LS, Utell MJ: Pulmonary function, diffusing capacity, and inflammation in healthy and asthmatic subjects exposed to ultrafine particles. Inhal Toxicol 2004,16(Suppl 1):59–72. 10.1080/08958370490443079
Donaldson GC, Seemungal TA, Patel IS, Bhowmik A, Wilkinson TM, Hurst JR, MacCallum PK, Wedzicha JA: Airway and systemic inflammation and decline in lung function in patients with COPD. Chest 2005, 128: 1995–2004. 10.1378/chest.128.4.1995
Downs SH, Schindler C, Liu LJ, Keidel D, Bayer-Oglesby L, Brutsche MH, Gerbase MW, Keller R, Kunzli N, Leuenberger P, Probst-Hensch NM, Tschopp JM, Zellweger JP, Rochat T, Schwartz J, Ackermann-Liebrich U: Reduced exposure to PM10 and attenuated age-related decline in lung function. N Engl J Med 2007, 357: 2338–2347. 10.1056/NEJMoa073625
Hwang SJ, Ballantyne CM, Sharrett AR, Smith LC, Davis CE, Gotto AM, Boerwinkle E: Circulating adhesion molecules VCAM-1, ICAM-1, and E-selectin in carotid atherosclerosis and incident coronary heart disease cases - The atherosclerosis risk in communities (ARIC) study. Circulation 1997, 96: 4219–4225.
Bauer KA, Barzegar S, Rosenberg RD: Influence of anticoagulants used for blood collection on plasma prothrombin fragment F1+2 measurements. Thromb Res 1991, 63: 617–628. 10.1016/0049-3848(91)90088-E
Allen GA, Wolberg AS, Oliver JA, Hoffman M, Roberts HR, Monroe DM: Impact of procoagulant concentration on rate, peak and total thrombin generation in a model system. J Thromb Haemost 2004, 2: 402–413. 10.1111/j.1538-7933.2003.00617.x
Monroe DM, Hoffman M: What does it take to make the perfect clot? Arterioscler Thromb Vasc Biol 2006, 26: 41–48. 10.1161/01.ATV.0000193624.28251.83
Mannucci PM: von Willebrand factor: a marker of endothelial damage? Arterioscler Thromb Vasc Biol 1998, 18: 1359–1362.
Sadler JE: Biochemistry and genetics of von Willebrand factor. Annu Rev Biochem 1998, 67: 395–424. 10.1146/annurev.biochem.67.1.395
Whincup PH, Danesh J, Walker M, Lennon L, Thomson A, Appleby P, Rumley A, Lowe GD: von Willebrand factor and coronary heart disease: prospective study and meta-analysis. Eur Heart J 2002, 23: 1764–1770. 10.1053/euhj.2001.3237
Jager A, van Hinsbergh VW, Kostense PJ, Emeis JJ, Yudkin JS, Nijpels G, Dekker JM, Heine RJ, Bouter LM, Stehouwer CD: von Willebrand factor, C-reactive protein, and 5-year mortality in diabetic and nondiabetic subjects: the Hoorn Study. Arterioscler Thromb Vasc Biol 1999, 19: 3071–3078.
Lowe GD, Rumley A: Use of fibrinogen and fibrin D-dimer in prediction of arterial thrombotic events. Thromb Haemost 1999, 82: 667–672.
Ridker PM, Hennekens CH, Cerskus A, Stampfer MJ: Plasma concentration of cross-linked fibrin degradation product (D-dimer) and the risk of future myocardial infarction among apparently healthy men. Circulation 1994, 90: 2236–2240.
Cyrys J, Pitz M, Bischof W, Wichmann HE, Heinrich J: Relationship between indoor and outdoor levels of fine particle mass, particle number concentrations and black smoke under different ventilation conditions. J Expo Anal Environ Epidemiol 2004, 14: 275–283. 10.1038/sj.jea.7500317
Janssen NA, Hoek G, Brunekreef B, Harssema H, Mensink I, Zuidhof A: Personal sampling of particles in adults: relation among personal, indoor, and outdoor air concentrations. Am J Epidemiol 1998, 147: 537–547.
Ebelt ST, Wilson WE, Brauer M: Exposure to ambient and nonambient components of particulate matter: a comparison of health effects. Epidemiology 2005, 16: 396–405. 10.1097/01.ede.0000158918.57071.3e