Université Grenoble Alpes, CNRS UMR 5309, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France.
INSERM U1209, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France.
Eur Respir J. 2017 Jan 18;49(1). doi: 10.1183/13993003.00206-2016. Print 2017 Jan.
An irreversible loss in lung function limits the long-term success in lung transplantation. We evaluated the role of chronic exposure to ambient air pollution on lung function levels in lung transplant recipients (LTRs).The lung function of 520 LTRs from the Cohort in Lung Transplantation (COLT) study was measured every 6 months. The levels of air pollutants (nitrogen dioxide (NO), particulate matter with an aerodynamic cut-off diameter of x µm (PM) and ozone (O)) at the patients' home address were averaged in the 12 months before each spirometry test. The effects of air pollutants on forced expiratory volume in 1 s (FEV) and forced vital capacity (FVC) in % predicted were estimated using mixed linear regressions. We assessed the effect modification of macrolide antibiotics in this relationship.Increased 12-month levels of pollutants were associated with lower levels of FVC % pred (-2.56%, 95% CI -3.86--1.25 for 5 µg·m of PM; -0.75%, 95% CI -1.38--0.12 for 2 µg·m of PM and -2.58%, 95% CI -4.63--0.53 for 10 µg·m of NO). In patients not taking macrolides, the deleterious association between PM and FVC tended to be stronger and PM was associated with lower FEVOur study suggests a deleterious effect of chronic exposure to air pollutants on lung function levels in LTRs, which might be modified with macrolides.
肺功能的不可逆转损失限制了肺移植的长期成功。我们评估了慢性暴露于环境空气污染对肺移植受者（LTR）肺功能水平的影响。COLT 研究中的 520 名 LTR 的肺功能每 6 个月测量一次。在每次肺活量检查前的 12 个月内，平均计算患者家庭地址处的空气污染物（二氧化氮（NO）、空气动力学截止直径为 x µm（PM）的颗粒物和臭氧（O））水平。使用混合线性回归估计空气污染物对 1 秒用力呼气量（FEV）和用力肺活量（FVC）占预计值的百分比的影响。我们评估了大环内酯类抗生素在这种关系中的效应修饰作用。12 个月污染物水平升高与 FVC % pred 水平降低相关（PM 5 µg·m 时为-2.56%，95%CI -3.86--1.25；PM 2 µg·m 时为-0.75%，95%CI -1.38--0.12；PM 10 µg·m 时为-2.58%，95%CI -4.63--0.53）。在未服用大环内酯类药物的患者中，PM 与 FVC 之间的有害关联似乎更强，且 PM 与较低的 FEV 相关。本研究提示慢性暴露于空气污染物对 LTR 肺功能水平具有有害影响，大环内酯类药物可能会对此产生修饰作用。
