State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Global Health Institute, Nicholas School of the Environment, Duke University, Durham, North Carolina.
Clin Exp Allergy. 2019 Mar;49(3):366-377. doi: 10.1111/cea.13308. Epub 2019 Jan 14.
The pathogenesis and pathophysiology of eosinophilia-related chronic cough such as non-asthmatic eosinophilic bronchitis and cough variant asthma are still not clear.
This study is to examine the potential role of traffic-related air pollution (TRAP) in eosinophilic inflammation and cough responses.
Non-sensitized guinea-pigs were exposed to TRAP in an urban traffic tunnel or kept in a filtered air environment for 7 or 14 days. Reflexive cough was measured using citric acid and allyl isothiocyanate (AITC) challenges, respectively. Spontaneous cough counting was determined using audio recording and a waveform analysis. Airway inflammation was evaluated using differential cells in bronchoalveolar lavage fluid (BALF) and lung histopathology. To further elucidate the relationship between airway inflammation and cough hypersensitivity, a subgroup of those exposed for 14 days received a dexamethasone treatment.
Compared to reflexive cough count (mean (95% confidence interval) in 10 minutes) provoked by the AITC challenge for the unexposed animals (3.1 (1.7-4.5)), those were increased significantly following both the 7-day (12.0 (6.8-17.2), P < 0.01) and the 14-day (12.0 (6.4-17.6), P < 0.01) TRAP exposure. The effect provoked by the citric acid challenge was more profound following the 14-day exposure (26.0 (19.5-32.5) vs 3.8 (1.5-6.0) for the control, P < 0.001). TRAP exposures enhanced spontaneous cough events, caused a significant increase of eosinophils and neutrophils in BALF and resulted in a dramatic eosinophilic infiltration in submucosal layer of trachea and bronchus, which can be inhibited significantly by dexamethasone treatment.
CONCLUSIONS & CLINICAL RELEVANCE: TRAP exposures induced cough hypersensitivity and non-allergic eosinophilic inflammation of airways in guinea-pigs. This study highlights the potential mechanisms of eosinophilia-related chronic cough that can be induced by traffic-related air pollution.
嗜酸性粒细胞相关慢性咳嗽(如非哮喘性嗜酸性支气管炎和咳嗽变异性哮喘)的发病机制和病理生理学仍不清楚。
本研究旨在探讨交通相关空气污染(TRAP)在嗜酸性粒细胞炎症和咳嗽反应中的潜在作用。
非致敏豚鼠在城市交通隧道中或在过滤空气环境中暴露于 TRAP 7 或 14 天。分别使用柠檬酸和丙烯基异硫氰酸酯(AITC)挑战测量反射性咳嗽。使用音频记录和波形分析确定自发性咳嗽计数。通过支气管肺泡灌洗液(BALF)和肺组织病理学评估气道炎症。为了进一步阐明气道炎症与咳嗽高敏性之间的关系,接受 14 天暴露的亚组接受了地塞米松治疗。
与未暴露动物的 AITC 挑战引起的反射性咳嗽计数(10 分钟内的平均值(95%置信区间))相比,暴露于 TRAP 7 天(12.0(6.8-17.2),P<0.01)和 14 天(12.0(6.4-17.6),P<0.01)后的反射性咳嗽计数均显著增加。柠檬酸挑战引起的作用在 14 天暴露后更为明显(26.0(19.5-32.5)与对照相比为 3.8(1.5-6.0),P<0.001)。TRAP 暴露增强了自发性咳嗽事件,导致 BALF 中的嗜酸性粒细胞和中性粒细胞显著增加,并导致气管和支气管粘膜下层发生剧烈的嗜酸性粒细胞浸润,这可以被地塞米松治疗显著抑制。
TRAP 暴露导致豚鼠气道咳嗽高敏性和非过敏性嗜酸性粒细胞炎症。本研究强调了交通相关空气污染可能引起的与嗜酸性粒细胞相关的慢性咳嗽的潜在机制。