Patel Molini M, Miller Rachel L
Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University College of Physicians and Surgeons, 630 W. 168th Street, New York, NY 10032, USA.
Curr Opin Pediatr. 2009 Apr;21(2):235-42. doi: 10.1097/mop.0b013e3283267726.
Current levels of air pollution are consistently associated with asthma development and morbidity among children, suggesting that current regulatory policies may be insufficient. This review will describe recent studies that have examined specific emission sources or components of pollutants that may be associated with pediatric asthma and identify subpopulations that may be particularly susceptible to the effects of air pollution exposure.
Important advances include new characterizations of the effects of traffic-related air pollution in urban areas. They also include the application of novel exposure and outcome measures such as pollution estimates derived from land use regression modeling and biological markers of airway inflammation. Additionally, studies have identified host susceptibility characteristics that may modify responses to air pollution exposure, including polymorphisms in oxidative stress genes and epigenetic alterations.
Identifying specific sources and toxic constituents of air pollution and accurately assessing air pollutant-related asthma outcomes are needed to better direct control strategies. Further research is needed to identify additional host factors that confer increased susceptibility to air pollution exposure. Future therapy to reduce the adverse effects of air pollution on respiratory disease will likely depend on targeting susceptible populations for intervention.
当前的空气污染水平一直与儿童哮喘的发生和发病相关,这表明当前的监管政策可能并不充分。本综述将描述近期研究,这些研究探讨了可能与儿童哮喘相关的特定排放源或污染物成分,并确定可能特别易受空气污染暴露影响的亚人群。
重要进展包括对城市地区交通相关空气污染影响的新描述。还包括应用新的暴露和结局测量方法,如从土地利用回归模型得出的污染估计值和气道炎症的生物标志物。此外,研究已经确定了可能改变对空气污染暴露反应的宿主易感性特征,包括氧化应激基因的多态性和表观遗传改变。
为了更好地指导控制策略,需要确定空气污染的具体来源和有毒成分,并准确评估与空气污染物相关的哮喘结局。还需要进一步研究以确定其他使个体对空气污染暴露易感性增加的宿主因素。未来减少空气污染对呼吸系统疾病不利影响的治疗可能取决于针对易感人群进行干预。