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1.
G Ital Nefrol ; 41(2)2024 Apr 29.
Article in English | MEDLINE | ID: mdl-38695229

ABSTRACT

Background. Neonatal high blood pressure has been diagnosed more frequently in recent years, and its impact extends to adulthood. However, the knowledge gaps on associated factors, diagnosis, and treatment are challenging for medical personnel. The incidence of this condition varies depending on neonatal conditions. Patients in the Newborn Unit are at increased risk of developing high blood pressure. The persistence of this condition beyond the neonatal stage increases the risk of cardiovascular disease and chronic kidney disease in childhood and adulthood. Methodology. A case-control study was carried out. It included hospitalized patients with neonatal hypertension as cases. Three controls were randomly selected for each case and matched by gestational age. The variables were analyzed based on their nature. Multivariate analysis was performed using a multivariate conditional regression model to identify variables associated with the outcome. Finally, the model was adjusted for possible confounders. Results. 37 cases were obtained and matched with 111 controls. In the univariate analysis, heart disease (OR 2.86; 95% CI 1.22-6.71), kidney disease (OR 7.24; 95% CI 1.92-28.28), bronchopulmonary dysplasia (OR 6.62; 95% CI 1.42-50.82) and major surgical procedures (OR 3.71; 95% CI 1.64-8.39) had an association with neonatal arterial hypertension. Only the latter maintained this finding in the multivariate analysis (adjusted OR 2.88; 95% CI 1.14-7.30). A significant association of two or more comorbidities with neonatal arterial hypertension was also found (OR 3.81; 95% CI 1.53-9.49). Conclusions. The study analyzed the factors related to high blood pressure in hospitalized neonates, finding relevant associations in the said population. The importance of meticulous neonatal care and monitoring of risk factors such as birth weight and major surgeries is highlighted.


Subject(s)
Hypertension , Humans , Case-Control Studies , Infant, Newborn , Hypertension/epidemiology , Hypertension/complications , Female , Male , Risk Factors , Bronchopulmonary Dysplasia/epidemiology , Bronchopulmonary Dysplasia/complications , Heart Diseases/epidemiology , Heart Diseases/complications , Heart Diseases/etiology
2.
Annu Rev Med ; 75: 277-292, 2024 Jan 29.
Article in English | MEDLINE | ID: mdl-37738508

ABSTRACT

We review current knowledge on the trends and drivers of global wildfire activity, advances in the measurement of wildfire smoke exposure, and evidence on the health effects of this exposure. We describe methodological issues in estimating the causal effects of wildfire smoke exposures on health and quantify their importance, emphasizing the role of nonlinear and lagged effects. We conduct a systematic review and meta-analysis of the health effects of wildfire smoke exposure, finding positive impacts on all-cause mortality and respiratory hospitalizations but less consistent evidence on cardiovascular morbidity. We conclude by highlighting priority areas for future research, including leveraging recently developed spatially and temporally resolved wildfire-specific ambient air pollution data to improve estimates of the health effects of wildfire smoke exposure.


Subject(s)
Air Pollution , Wildfires , Humans , Air Pollution/adverse effects , Air Pollution/analysis , Environmental Exposure/adverse effects , Hospitalization , Smoke/adverse effects , Smoke/analysis
3.
G Ital Nefrol ; 40(5)2023 Oct 26.
Article in English | MEDLINE | ID: mdl-38010247

ABSTRACT

Autosomal dominant tubulointerstitial kidney disease (ADTKD) is a low-prevalence pathology mainly associated with pathogenic variants of the UMOD gene. It is characterized by the progressive deterioration of renal function, associated with hyperuricemia and accompanied by a family history of gout or hyperuricemia. Often, clinical variability and a lack of molecular testing results in diagnostic failure to determine the ADTKD-UMOD association. Case presentation: We describe the case of a 14-year-old male who presented to the nephrology service with hyperuricemia, renal ultrasonographic changes, and progression to chronic kidney disease in 4 years. He had a family history of hyperuricemia. A probable genetic disease with an autosomal dominant inheritance pattern was considered, confirmed by the presence of a probably pathogenic variant of the UMOD gene, not previously reported in the literature. Conclusion: The investigation of this case led to the identification of a new variant in the UMOD gene, broadening the spectrum of known variants for ADTKD-UMOD. In addition, in this case, a comprehensive anamnesis, that takes into account family history, was the key point to carry out genetic tests that confirmed the diagnosis suspicion. Directed Genetic tests are currently an essential diagnostic tool and should be performed as long as they are available and there is an indication to perform them.


Subject(s)
Gout , Hyperuricemia , Polycystic Kidney Diseases , Male , Humans , Adolescent , Uromodulin , Gout/genetics , Genetic Testing/methods , Polycystic Kidney Diseases/genetics , Mutation
5.
Semin Perinatol ; 47(8): 151838, 2023 12.
Article in English | MEDLINE | ID: mdl-37858459

ABSTRACT

Increased fossil fuel usage and extreme climate change events have led to global increases in greenhouse gases and particulate matter with 99% of the world's population now breathing polluted air that exceeds the World Health Organization's recommended limits. Pregnant women and neonates with exposure to high levels of air pollutants are at increased risk of adverse health outcomes such as maternal hypertensive disorders, postpartum depression, placental abruption, low birth weight, preterm birth, infant mortality, and adverse lung and respiratory effects. While the exact mechanism by which air pollution exerts adverse health effects is unknown, oxidative stress as well as epigenetic and immune mechanisms are thought to play roles. Comprehensive, global efforts are urgently required to tackle the health challenges posed by air pollution through policies and action for reducing air pollution as well as finding ways to protect the health of vulnerable populations in the face of increasing air pollution.


Subject(s)
Air Pollutants , Air Pollution , Premature Birth , Infant , Female , Infant, Newborn , Pregnancy , Humans , Premature Birth/epidemiology , Placenta , Air Pollution/adverse effects , Air Pollution/analysis , Air Pollutants/toxicity , Air Pollutants/analysis , Particulate Matter/adverse effects , Particulate Matter/analysis , Pregnancy Outcome/epidemiology
6.
Rev. cienc. salud (Bogotá) ; 21(3): [1-24], 20230901.
Article in Spanish | LILACS | ID: biblio-1512799

ABSTRACT

Antecedentes: la enfermedad de Fabry (Ef) es una enfermedad rara ligada a X secundaria al depósito lisosomal de glicoesfingolípidos, debido a la deficiencia de la enzima alfa galactosidasa A (α-Gal A). A pesar de su baja frecuencia, es una condición que afecta la calidad de vida de los pacientes y disminuye su esperanza de vida. Objetivo: generar recomendaciones informadas para el diagnóstico y tratamiento de pacientes pediátricos (menores de 18 años) con Ef. Material y Métodos: revisión de literatura en bases de datos y literatura gris a partir de 2010, incluyendo guías de práctica clínica, revisiones sistemáticas y estudios primarios. La calidad de evidencia se evaluó de acuerdo con el tipo. Las recomendaciones se sometieron a consenso de expertos a través de metodología Delphi modificada. El acuerdo se definió a partir del 80 %. Resultados: A partir del análisis de la evidencia recolectada se formularon un total de 45 recomendaciones para tamización, diagnóstico y tratamiento de paciente pediátrico con Ef. El panel revisor estuvo conformado por once expertos en el tema. Las recomendaciones fueron aprobadas con puntuaciones entre 82.3 % y 100 %. Conclusiones: las recomendaciones resultantes del consenso de expertos permitirán la toma de decisiones clínicas y estandarización de la práctica en la atención de pacientes pediátricos con Ef en el país y la región. El diagnóstico temprano y oportuno garantiza una disminución del impacto en la calidad de vida de los pacientes y sus familiares


Background: Fabry disease (fD) is a rare X-linked disease characterized by the accumulation of glyco- sphingolipids in lysosomes due to the deficiency in the production of alpha-galactosidase A (α-Gal A) enzyme. Despite its low frequency, this disease has a serious impact on the life expectancy and quality. Objective: To make evidence-based recommendations for the diagnosis and treatment of fD in pediatric patients (<18 years of age). Materials and Methods: A study of databases and gray literature was conducted in 2010, including clinical practice guidelines, systematic reviews, and primary research. The type of evidence was used to determine the quality of evidence. The recommendations were submitted to an expert consensus using the modified Delphi process. The agreement was set at 80%. Conclusions: The recommendations emerging from this expert consensus will enable the standardization of care provision for pediatric patients with fD in Colombia and Latin America and clinical decision-making for disease management. Notably, making an early diagnosis ensures a reduction in the impact of this disease on the quality of life of patients and their families


Fundamento: a doença de Fabry (Df) é uma rara doença ligada ao cromossomo X secundária à deposi- ção lisossômica de glicoesfingolipídeos devido à deficiência da enzima alfa galactosidase A (α-Gal A). Apesar de sua baixa frequência, é uma condição que afeta a qualidade de vida dos pacientes e diminui sua expectativa de vida. Objetivo: gerar recomendações baseadas em evidências para o diagnóstico e tratamento de pacientes pediátricos (com menos de 8 anos de idade) com Df. Materais e Métodos: foi realizada uma revisão da literatura em bases de dados e literatura cinza a partir de 2010, incluindo diretrizes de prática clínica, revisões sistemáticas e estudos primários. A qualidade da evidência foi avaliada de acordo com o tipo de evidência. As recomendações foram submetidas ao consenso de especialistas usando a metodologia Delphi modificada. A concordância foi definida a partir de 80%. Resultados: com base na análise das evidências coletadas, foram formuladas um total de 45 recomendações para triagem, diagnóstico e tratamento de pacientes pediátricos com doença de Fabry. O painel de revisão foi composto por onze especialistas no assunto. As recomendações foram aprovadas com pontuações entre 82,3% e 100%. Conclusões: as recomendações resultantes do consenso de especialistas permitirão a tomada de decisão clínica e a padronização da prática no cuidado de pacientes pediátricos com Df em nível nacional e regional; o diagnóstico precoce e oportuno garante a redução do impacto na qualidade de vida dos pacientes e seus familiares.


Subject(s)
Humans
7.
Microorganisms ; 11(8)2023 Aug 02.
Article in English | MEDLINE | ID: mdl-37630555

ABSTRACT

Bacteremia has been associated with severity in some infections; however, its impact on the prognosis of urinary tract infections (UTIs) is still disputed. Our goal is to determine the risk factors for bacteremia and its clinical impact on hospitalized patients with complicated community-acquired urinary tract infections. We conducted a prospective observational study of patients admitted to the hospital with complicated community-acquired UTIs. Clinical variables and outcomes of patients with and without bacteremia were compared, and multivariate analysis was performed to identify risk factors for bacteremia and mortality. Of 279 patients with complicated community-acquired UTIs, 37.6% had positive blood cultures. Risk factors for bacteremia by multivariate analysis were temperature ≥ 38 °C (p = 0.006, OR 1.3 (95% CI 1.1-1.7)) and procalcitonin ≥ 0.5 ng/mL (p = 0.005, OR 8.5 (95% CI 2.2-39.4)). In-hospital and 30-day mortality were 9% and 13.6%, respectively. Quick SOFA (p = 0.030, OR 5.4 (95% CI 1.2-24.9)) and Barthel Index <40% (p = 0.020, OR 4.8 (95% CI 1.3-18.2)) were associated with 30-day mortality by multivariate analysis. However, bacteremia was not associated with 30-day mortality (p = 0.154, OR 2.7 (95% CI 0.7-10.3)). Our study found that febrile community-acquired UTIs and elevated procalcitonin were risk factors for bacteremia. The outcomes in patients with bacteremia were slightly worse, but without significant differences in mortality.

8.
Article in English | MEDLINE | ID: mdl-37539354

ABSTRACT

Background: Given the increasing prevalence of wildfires worldwide, understanding the effects of wildfire air pollutants on human health-particularly in specific immunologic pathways-is crucial. Exposure to air pollutants is associated with cardiorespiratory disease; however, immune and epithelial barrier alterations require further investigation. Objective: We sought to determine the impact of wildfire smoke exposure on the immune system and epithelial barriers by using proteomics and immune cell phenotyping. Methods: A San Francisco Bay area cohort (n = 15; age 30 ± 10 years) provided blood samples before (October 2019 to March 2020; air quality index = 37) and during (August 2020; air quality index = 80) a major wildfire. Exposure samples were collected 11 days (range, 10-12 days) after continuous exposure to wildfire smoke. We determined alterations in 506 proteins, including zonulin family peptide (ZFP); immune cell phenotypes by cytometry by time of flight (CyTOF); and their interrelationship using a correlation matrix. Results: Targeted proteomic analyses (n = 15) revealed a decrease of spondin-2 and an increase of granzymes A, B, and H, killer cell immunoglobulin-like receptor 3DL1, IL-16, nibrin, poly(ADP-ribose) polymerase 1, C1q TNF-related protein, fibroblast growth factor 19, and von Willebrand factor after 11 days' average continuous exposure to smoke from a large wildfire (P < .05). We also observed a large correlation cluster between immune regulation pathways (IL-16, granzymes A, B, and H, and killer cell immunoglobulin-like receptor 3DL1), DNA repair [poly(ADP-ribose) 1, nibrin], and natural killer cells. We did not observe changes in ZFP levels suggesting a change in epithelial barriers. However, ZFP was associated with immune cell phenotypes (naive CD4+, TH2 cells). Conclusion: We observed functional changes in critical immune cells and their proteins during wildfire smoke exposure. Future studies in larger cohorts or in firefighters exposed to wildfire smoke should further assess immune changes and intervention targets.

9.
Health Promot Pract ; 24(4): 597-602, 2023 07.
Article in English | MEDLINE | ID: mdl-37408459

ABSTRACT

Our climate emergency is changing health promotion practice, and we need to increase our efforts. In the 20 years since our journal was published, we have witnessed the pressing challenges incurred by human-caused threats to planetary health. These threats are most profound in communities that are already unjustly under threat from structural factors such as poverty, toxic exposures, and inequitable allocation of resources for promoting their health. Those least responsible for contributing to this emergency, including all living environments in harm's way, will unjustly experience the greatest burdens. This commentary calls for health promotion practice to engage in system change and action in the struggle for climate justice by adopting a planetary health perspective. There must be a just transition from extractive to regenerative economies and actions. We describe our own journey as researchers and health practitioners toward this call for action. We propose a series of system change actions in social, environmental, political, health systems, and health profession education within the scope and responsibility of health promotion practice.


Subject(s)
Environmental Justice , Health Promotion , Humans , Social Justice
10.
J Environ Manage ; 341: 117908, 2023 Sep 01.
Article in English | MEDLINE | ID: mdl-37182403

ABSTRACT

Wildfires are increasingly impacting the environment and human health. Among the top 20 California wildfires, those in 2020-2021 burned more acres than the last century combined. Lack of an adequate early warning system impacts the health and safety of vulnerable populations disproportionately and widens the inequality gap. In this project, a multi-modal wildfire prediction and early warning system has been developed based on a novel spatio-temporal machine learning architecture. A comprehensive wildfire database with over 37 million data points was created, including the historical wildfires, environmental and meteorological sensor data from the Environmental Protection Agency, and geological data. The data was augmented into 2.53 km × 2.53 km square grids to overcome the sensor network coverage limitations. Leading and trailing indicators for the wildfires are proposed, classified, and tested. The leading indicators are correlated to the risks of wildfire conception, whereas the trailing indicators are correlated to the byproducts of the wildfires. Additionally, geological data was incorporated to provide additional information for better assessment on wildfire risks and propagation. Next, a novel U-Convolutional Long Short-Term Memory (ULSTM) neural network was developed to extract key spatial and temporal features of the dataset, specifically to address the spatial nature of the location of the wildfire and time-progression temporal nature of the wildfire evolution. Through iterative improvements and optimization, the final ULSTM network architecture, trained with data from 2012 to 2017, achieved >97% accuracy for predicting wildfires in 2018, as compared to ∼76% using traditional Convolutional Neural Network (CNN) techniques. The final model was applied to conduct a retrospective study for the 2018-2022 wildfire seasons, and successfully predicted 85.7% of wildfires >300 K acres in size. This technique could enable fire departments to anticipate and prevent wildfires before they strike and provide early warnings for at-risk individuals for better preparation, thereby saving lives, protecting the environment, and avoiding economic damages.


Subject(s)
Wildfires , Humans , Retrospective Studies , Machine Learning , Neural Networks, Computer , Seasons
11.
Semin Immunol ; 67: 101765, 2023 05.
Article in English | MEDLINE | ID: mdl-37105834

ABSTRACT

Climate change is considered the greatest threat to global health. Greenhouse gases as well as global surface temperatures have increased causing more frequent and intense heat and cold waves, wildfires, floods, drought, altered rainfall patterns, hurricanes, thunderstorms, air pollution, and windstorms. These extreme weather events have direct and indirect effects on the immune system, leading to allergic disease due to exposure to pollen, molds, and other environmental pollutants. In this review, we will focus on immune mechanisms associated with allergy and asthma-related health risks induced by climate change events. We will review current understanding of the molecular and cellular mechanisms by which the changing environment mediates these effects.


Subject(s)
Air Pollution , Asthma , Climate Change , Hypersensitivity , Asthma/immunology , Hypersensitivity/immunology , Immune System , Disasters , Humans , Animals
13.
Environ Pollut ; 315: 120442, 2022 Dec 15.
Article in English | MEDLINE | ID: mdl-36272609

ABSTRACT

Microplastics are plastic particles <5 mm in diameter. Since the 1950s, there has been an exponential increase in the production of plastics. As of 2015, it is estimated that approximately 6300 million metric tons of plastic waste had been generated of which 79% has accumulated in landfills or the natural environment. Further, it is estimated that if current trends continue, roughly 12,000 million metric tons of plastic waste will accumulate by 2050. Plastics and microplastics are now found ubiquitously-in the air, water, and soil. Microplastics are small enough to enter the tissues of plants and animals and have been detected in human lungs, stools, placentas, and blood. Their presence in human tissues and the food chain is a cause for concern. While direct clinical evidence or epidemiological studies on the adverse effects of microplastic on human health are lacking, in vitro cellular and tissue studies and in vivo animal studies suggest potential adverse effects. With the ever-increasing presence of plastic waste in our environment, it is critical to understand their effects on our environment and on human health. The use of plastic additives, many of which have known toxic effects are also of concern. This review provides a brief overview of microplastics and the extent of the microplastic problem. There have been a few inroads in regulating plastics but currently these are insufficient to adequately mitigate plastic pollution. We also review recent advances in microplastic testing methodologies, which should support management and regulation of plastic wastes. Significant efforts to reduce, reuse, and recycle plastics are needed at the individual, community, national, and international levels to meet the challenge. In particular, significant reductions in plastic production must occur to curb the impacts of plastic on human and worldwide health, given the fact that plastic is not truly recyclable.


Subject(s)
Microplastics , Water Pollutants, Chemical , Humans , Animals , Plastics , Environmental Pollution , Recycling , Soil , Water Pollutants, Chemical/analysis , Environmental Monitoring
14.
Biosensors (Basel) ; 12(10)2022 Oct 13.
Article in English | MEDLINE | ID: mdl-36291006

ABSTRACT

In the quest for effective gas sensors for breath analysis, magnetoelastic resonance-based gas sensors (MEGSs) are remarkable candidates. Thanks to their intrinsic contactless operation, they can be used as non-invasive and portable devices. However, traditional monitoring techniques are bound to slow detection, which hinders their application to fast bio-related reactions. Here we present a method for real-time monitoring of the resonance frequency, with a proof of concept for real-time monitoring of gaseous biomarkers based on resonance frequency. This method was validated with a MEGS based on a Metglass 2826 MB microribbon with a polyvinylpyrrolidone (PVP) nanofiber electrospun functionalization. The device provided a low-noise (RMS = 1.7 Hz), fast (<2 min), and highly reproducible response to humidity (Δf = 46−182 Hz for 17−95% RH), ammonia (Δf = 112 Hz for 40 ppm), and acetone (Δf = 44 Hz for 40 ppm). These analytes are highly important in biomedical applications, particularly ammonia and acetone, which are biomarkers related to diseases such as diabetes. Furthermore, the capability of distinguishing between breath and regular air was demonstrated with real breath measurements. The sensor also exhibited strong resistance to benzene, a common gaseous interferent in breath analysis.


Subject(s)
Acetone , Ammonia , Acetone/analysis , Ammonia/analysis , Benzene , Povidone , Gases , Biomarkers/analysis
15.
NPJ Aging ; 8(1): 8, 2022 Jun 27.
Article in English | MEDLINE | ID: mdl-35927269

ABSTRACT

Skeletal muscle adapts to different exercise training modalities with age; however, the impact of both variables at the systemic and tissue levels is not fully understood. Here, adult and old C57BL/6 male mice were assigned to one of three groups: sedentary, daily high-intensity intermittent training (HIIT), or moderate intensity continuous training (MICT) for 4 weeks, compatible with the older group's exercise capacity. Improvements in body composition, fasting blood glucose, and muscle strength were mostly observed in the MICT old group, while effects of HIIT training in adult and old animals was less clear. Skeletal muscle exhibited structural and functional adaptations to exercise training, as revealed by electron microscopy, OXPHOS assays, respirometry, and muscle protein biomarkers. Transcriptomics analysis of gastrocnemius muscle combined with liver and serum metabolomics unveiled an age-dependent metabolic remodeling in response to exercise training. These results support a tailored exercise prescription approach aimed at improving health and ameliorating age-associated loss of muscle strength and function in the elderly.

16.
Antioxidants (Basel) ; 11(4)2022 Apr 08.
Article in English | MEDLINE | ID: mdl-35453428

ABSTRACT

The quantification of mitochondrial respiratory chain (MRC) enzymatic activities is essential for diagnosis of a wide range of mitochondrial diseases, ranging from inherited defects to secondary dysfunctions. MRC lesion is frequently linked to extended cell damage through the generation of proton leak or oxidative stress, threatening organ viability and patient health. However, the intrinsic challenge of a methodological setup and the high variability in measuring MRC enzymatic activities represents a major obstacle for comparative analysis amongst institutions. To improve experimental and statistical robustness, seven Spanish centers with extensive experience in mitochondrial research and diagnosis joined to standardize common protocols for spectrophotometric MRC enzymatic measurements using minimum amounts of sample. Herein, we present the detailed protocols, reference ranges, tips and troubleshooting methods for experimental and analytical setups in different sample preparations and tissues that will allow an international standardization of common protocols for the diagnosis of MRC defects. Methodological standardization is a crucial step to obtain comparable reference ranges and international standards for laboratory assays to set the path for further diagnosis and research in the field of mitochondrial diseases.

17.
J Mech Behav Biomed Mater ; 131: 105232, 2022 07.
Article in English | MEDLINE | ID: mdl-35439667

ABSTRACT

OBJECTIVES: To evaluate biocorrosion and eccentric occlusal loading interplay in marginal quality of cervical restorations. METHODS: Cervical wedge-shaped cavities were prepared in extracted premolars and restored with a composite. Premolars underwent either an erosive challenge (E: 1% citric acid/10 min), eccentric occlusal loading (EOL: 150 N/2.5 Hz/106 cycles), E before EOL (E + EOL), E intermediate to EOL (EOL/E/EOL), E after EOL (EOL + E), or no E or EOL (C: control). Marginal quality was analyzed based on a series of Optical Coherence Tomography images. Each of the margins was assigned a gap score (0, 1, 2, or 3) and measurement (µm). For each margin, scores data were analyzed with Kruskall Wallis and Dunn tests, and µm data, with Kruskall Wallis. Overall and for each group, the different margins were compared using Wilcoxon signed-rank test, and the correlation between scores and µm, Spearman's correlation coefficient (α = 0.05). RESULTS: E and EOL, even if associated, did not influence enamel marginal quality. EOL/E/EOL impaired dentin/cementum marginal quality only in the case of scores and compared to E. E + EOL, EOL + E or EOL and even C, without differences between each other, did not influence results differently from E or EOL/E/EOL. Margins in dentin/cementum always showed lengthier gaps. Except for C, E and EOL + E cervical margin, there was a strong positive correlation between scores and µm. CONCLUSIONS: Eccentric occlusal loading and/or biocorrosion cannot be assumed as causes of marginal failure of cervical restorations in wedge-shaped cavities. A relevant concern may still be the establishment of adhesive interfaces in dentin/cementum. CLINICAL SIGNIFICANCE: Although non-carious cervical lesions are strongly being recognized multifactorial and their respective restorations not always behave as expected, biocorrosion and eccentric occlusal loading interplay cannot serve as an explanation for marginal gaps they often present.


Subject(s)
Adhesives , Composite Resins , Bicuspid , Dental Restoration, Permanent , Resin Cements
18.
Clin Epigenetics ; 14(1): 40, 2022 03 14.
Article in English | MEDLINE | ID: mdl-35287715

ABSTRACT

BACKGROUND: Ambient air pollutant (AAP) exposure is associated with adverse pregnancy outcomes, such as preeclampsia, preterm labor, and low birth weight. Previous studies have shown methylation of immune genes associate with exposure to air pollutants in pregnant women, but the cell-mediated response in the context of typical pregnancy cell alterations has not been investigated. Pregnancy causes attenuation in cell-mediated immunity with alterations in the Th1/Th2/Th17/Treg environment, contributing to maternal susceptibility. We recruited women (n = 186) who were 20 weeks pregnant from Fresno, CA, an area with chronically elevated AAP levels. Associations of average pollution concentration estimates for 1 week, 1 month, 3 months, and 6 months prior to blood draw were associated with Th cell subset (Th1, Th2, Th17, and Treg) percentages and methylation of CpG sites (IL4, IL10, IFNγ, and FoxP3). Linear regression models were adjusted for weight, age, season, race, and asthma, using a Q value as the false-discovery-rate-adjusted p-value across all genes. RESULTS: Short-term and mid-term AAP exposures to fine particulate matter (PM2.5), nitrogen dioxide (NO2) carbon monoxide (CO), and polycyclic aromatic hydrocarbons (PAH456) were associated with percentages of immune cells. A decrease in Th1 cell percentage was negatively associated with PM2.5 (1 mo/3 mo: Q < 0.05), NO2 (1 mo/3 mo/6 mo: Q < 0.05), and PAH456 (1 week/1 mo/3 mo: Q < 0.05). Th2 cell percentages were negatively associated with PM2.5 (1 week/1 mo/3 mo/6 mo: Q < 0.06), and NO2 (1 week/1 mo/3 mo/6 mo: Q < 0.06). Th17 cell percentage was negatively associated with NO2 (3 mo/6 mo: Q < 0.01), CO (1 week/1 mo: Q < 0.1), PM2.5 (3 mo/6 mo: Q < 0.05), and PAH456 (1 mo/3 mo/6 mo: Q < 0.08). Methylation of the IL10 gene was positively associated with CO (1 week/1 mo/3 mo: Q < 0.01), NO2 (1 mo/3 mo/6 mo: Q < 0.08), PAH456 (1 week/1 mo/3 mo: Q < 0.01), and PM2.5 (3 mo: Q = 0.06) while IL4 gene methylation was positively associated with concentrations of CO (1 week/1 mo/3 mo/6 mo: Q < 0.09). Also, IFNγ gene methylation was positively associated with CO (1 week/1 mo/3 mo: Q < 0.05) and PAH456 (1 week/1 mo/3 mo: Q < 0.06). CONCLUSION: Exposure to several AAPs was negatively associated with T-helper subsets involved in pro-inflammatory and anti-inflammatory responses during pregnancy. Methylation of IL4, IL10, and IFNγ genes with pollution exposure confirms previous research. These results offer insights into the detrimental effects of air pollution during pregnancy, the demand for more epigenetic studies, and mitigation strategies to decrease pollution exposure during pregnancy.


Subject(s)
Air Pollutants , Environmental Pollutants , Air Pollutants/adverse effects , DNA Methylation , Environmental Exposure/adverse effects , Female , Humans , Infant, Newborn , Interferon-gamma/genetics , Interleukin-10/genetics , Interleukin-4/genetics , Nitrogen Dioxide/adverse effects , Nitrogen Dioxide/analysis , Particulate Matter/adverse effects , Particulate Matter/analysis , Pregnancy , Pregnancy Outcome
19.
Allergy ; 77(5): 1389-1407, 2022 05.
Article in English | MEDLINE | ID: mdl-35073410

ABSTRACT

There is increasing understanding, globally, that climate change and increased pollution will have a profound and mostly harmful effect on human health. This review brings together international experts to describe both the direct (such as heat waves) and indirect (such as vector-borne disease incidence) health impacts of climate change. These impacts vary depending on vulnerability (i.e., existing diseases) and the international, economic, political, and environmental context. This unique review also expands on these issues to address a third category of potential longer-term impacts on global health: famine, population dislocation, and environmental justice and education. This scholarly resource explores these issues fully, linking them to global health in urban and rural settings in developed and developing countries. The review finishes with a practical discussion of action that health professionals around the world in our field can yet take.


Subject(s)
Climate Change , Global Health , Environmental Pollution , Humans
20.
Trends Cardiovasc Med ; 32(8): 487-498, 2022 11.
Article in English | MEDLINE | ID: mdl-34619335

ABSTRACT

Air pollution is a rapidly growing major health concern around the world. Atmospheric particulate matter that has a diameter of less than 2.5 µm (PM2.5) refers to an air pollutant composed of particles and chemical compounds that originate from various sources. While epidemiological studies have established the association between PM2.5 exposure and cardiovascular diseases, the precise cellular and molecular mechanisms by which PM2.5 promotes cardiovascular complications are yet to be fully elucidated. In this review, we summarize the various sources of PM2.5, its components, and the concentrations of ambient PM2.5 in various settings. We discuss the experimental findings to date that evaluate the potential adverse effects of PM2.5 on cardiovascular homeostasis and function, and the possible therapeutic options that may alleviate PM2.5-driven cardiovascular damage.


Subject(s)
Air Pollutants , Air Pollution , Humans , Particulate Matter/adverse effects , Particulate Matter/analysis , Environmental Exposure/adverse effects , Air Pollution/adverse effects , Air Pollutants/adverse effects , Homeostasis
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