Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA.
Department of Biology, Miami Dade College Wolfson Campus, Miami, FL, USA.
Indoor Air. 2016 Oct;26(5):734-42. doi: 10.1111/ina.12264. Epub 2015 Dec 14.
Indoor air pollution has been linked to adverse chronic obstructive pulmonary disease (COPD) health, but specific causative agents have not yet been identified. We evaluated the role of indoor endotoxin exposure upon respiratory health in former smokers with COPD. Eighty-four adults with moderate to severe COPD were followed longitudinally and indoor air and dust samples collected at baseline, 3 and 6 months. Respiratory outcomes were repeatedly assessed at each time point. The associations between endotoxin exposure in air and settled dust and health outcomes were explored using generalizing estimating equations in multivariate models accounting for confounders. Dust endotoxin concentrations in the main living area were highest in spring and lowest in fall, while airborne endotoxins remained steady across seasons. Airborne and dust endotoxin concentrations were weakly correlated with one another (rs = +0.24, P = 0.005). Endotoxin concentrations were not significantly associated with respiratory symptoms, rescue medication use, quality of life, or severe exacerbations. In vitro whole-blood assays of the pro-inflammatory capacity of PM10 filters with and without endotoxin depletion demonstrated that the endotoxin component of indoor air pollution was not the primary trigger for interleukin-1β release. Our findings support that endotoxin is not the major driver in the adverse effects of indoor PM upon COPD morbidity.
室内空气污染与慢性阻塞性肺疾病（COPD）的不良健康状况有关，但尚未确定具体的致病因素。我们评估了室内内毒素暴露对 COPD 既往吸烟者呼吸健康的影响。84 名中重度 COPD 成年人进行了纵向随访，并在基线、3 个月和 6 个月时采集室内空气和灰尘样本。在每个时间点都反复评估了呼吸结果。使用广义估计方程在多变量模型中，考虑了混杂因素，探讨了空气中和沉降灰尘中的内毒素暴露与健康结果之间的关系。主要生活区域的灰尘内毒素浓度在春季最高，秋季最低，而空气中的内毒素浓度在整个季节保持稳定。空气中和灰尘中的内毒素浓度彼此弱相关（rs = +0.24，P = 0.005）。内毒素浓度与呼吸道症状、急救药物使用、生活质量或严重恶化均无显著相关性。对含有和不含有内毒素耗尽的 PM10 过滤器的全血体外炎症能力进行检测，结果表明室内空气污染中的内毒素成分不是白细胞介素-1β释放的主要触发因素。我们的研究结果表明，内毒素不是室内 PM 对 COPD 发病率的不良影响的主要驱动因素。
