A review of experimental studies on diesel exhaust particles and nasal epithelium alterations.

The aim of the present review is to summarize biological events in nasal epithelium after short-term exposure to diesel exhaust particles (DEP). Therefore human, animal, and in vitro studies carried out since 1987 are reviewed. Short-term exposure results included qualitative alterations characterized by immediate nasal hyperresponsiveness, antioxidant responses, marked epithelial inflammation, and a specific humoral response. In addition, studies on combined DEP/allergen challenge reported that, besides their intrinsic deleterious properties, DEP produced adjuvant-like effects on the immediate and late-phase response to allergen challenge, since they are able to mimic effects occurring after allergen challenge. DEP act deeply in nasal epithelium by (1) directing cytokine gene expression toward a Th2 profile, (2) enhancing local antigen-specific immunoglobulin E (IgE) production, and (3) driving in vivo isotype switch to IgE. Furthermore, DEP can induce in allergic subjects sensitization to a neoallergen, sensitization that did not occur with exposure to the neoantigen alone. Particulate pollutants such as DEP, encountered in urban areas, are therefore thought to be contributing causal factors to the exaggerated sensitization to allergens in subjects with appropriate genetic predisposition, sensitization that they might not otherwise have experienced. These findings add weight to the hypothesis that DEP are involved in the increased prevalence of airway allergic diseases.