Churg A, Brauer M
Department of Pathology and School of Occupational and Environmental Hygiene, The University of British Columbia, Vancouver, Canada.
Ultrastruct Pathol. 2000 Nov-Dec;24(6):353-61. doi: 10.1080/019131200750060014.
Epidemiologic studies linking particulate matter (PM) air pollution and adverse respiratory and cardiovascular effects have focused attention on the interactions of PM and lung cells. Information on the types, numbers, composition, sizes, and distribution of ambient particles in the airways is potentially useful for correlations with pathological and/or physiological changes, but relatively little is known about the extent to which ambient particles actually enter airway epithelial cells and are retained in airway walls and even less information is available about correlations with pathologic changes. Since many ambient particles are colorless and/or well below the level of resolution of light microscopy, definitive evaluation of particle burden in the airway wall requires analytical electron microscopy. Studies from the authors' laboratory suggest that in Vancouver, a city with relatively low PM levels, particle loads in the airway mucosa are nonetheless numerically substantial, typically in the range of 10(7) particles/g dry tissue. In most individuals particle concentrations in the larger airways show a clear increase in concentration with increasing airway generation (smaller airway diameter) as expected from deposition models; however, smoking disrupts this pattern in some subjects. Respiratory bronchioles accumulate particularly high particle loads, typically 25-100 times the concentrations seen in the mainstem bronchus. Similarly high concentrations are found in the large airway carinas, suggesting that these locations are likely sites for particle toxicity. The majority of particles in the airways in Vancouver lungs appear to be crustal in origin, with particular accumulation of silica in the airways compared to the parenchyma. Ultrafine particles, which have been postulated to be important in PM toxicity, are present in small numbers as singlet particles and are largely metals, perhaps representing combustion products, but carbonaceous chain aggregates are rarely found. Mean particle aerodynamic diameters vary from about 0.3 to 0.6 microm in different parts of the airways and, overall, the airways retain PM2.5 rather than PM10, a finding supporting the observation that, in some studies, adverse health effects appear to correlate better with PM2.5 than with PM10 concentrations. Preliminary examination of lungs of subjects from Mexico City, a location with relatively high ambient particle concentrations, indicates that the airway mucosa retains relatively large numbers of carbonaceous chain aggregates of ultrafine particles that appear to be combustion products and that presumably produce the numerous adverse effects documented for such products. Limited published data correlating visible particle load and airway mucus secretion, inflammation, and mural fibrosis suggest that high levels of air pollutant particles can induce chronic fibrotic responses in the airways, a phenomenon that might be linked to chronic airflow obstruction; this observation needs confirmation as well as correlation with specific types of particles.
将颗粒物(PM)空气污染与不良呼吸和心血管影响联系起来的流行病学研究,已将注意力集中在PM与肺细胞的相互作用上。有关气道中环境颗粒物的类型、数量、组成、大小和分布的信息,对于与病理和/或生理变化的相关性可能是有用的,但对于环境颗粒物实际进入气道上皮细胞并保留在气道壁中的程度了解相对较少,而关于与病理变化相关性的信息则更少。由于许多环境颗粒物是无色的和/或远低于光学显微镜的分辨率水平,因此对气道壁中颗粒物负荷的明确评估需要分析电子显微镜。作者实验室的研究表明,在PM水平相对较低的温哥华市,气道黏膜中的颗粒物负荷在数量上仍然很大,通常在10(7)个颗粒/克干组织的范围内。在大多数个体中,较大气道中的颗粒物浓度随着气道分级增加(气道直径变小)而明显增加,这与沉积模型预期的一致;然而,吸烟在一些受试者中破坏了这种模式。呼吸性细支气管积累的颗粒物负荷特别高,通常是主支气管中浓度的25 - 100倍。在大气道隆突处也发现了同样高的浓度,这表明这些部位可能是颗粒物毒性的位点。温哥华肺部气道中的大多数颗粒物似乎起源于地壳物质,与实质相比,气道中二氧化硅有特别的积累。据推测在PM毒性中起重要作用的超细颗粒物,以单个颗粒的形式少量存在,并且主要是金属,可能代表燃烧产物,但很少发现碳质链聚集体。气道不同部位的平均颗粒物空气动力学直径在约0.3至0.6微米之间变化,总体而言,气道保留的是PM2.5而非PM10,这一发现支持了在一些研究中的观察结果,即不良健康影响似乎与PM2.5的相关性比与PM10浓度的相关性更好。对来自环境颗粒物浓度相对较高的墨西哥城受试者的肺部进行的初步检查表明,气道黏膜保留了相对大量的超细颗粒物的碳质链聚集体,这些聚集体似乎是燃烧产物,并且可能产生了针对此类产物记录的众多不良影响。将可见颗粒物负荷与气道黏液分泌、炎症和壁层纤维化相关联的已发表数据有限,这表明高浓度的空气污染物颗粒可诱导气道中的慢性纤维化反应,这一现象可能与慢性气流阻塞有关;这一观察结果需要得到证实以及与特定类型的颗粒物建立相关性。