Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, Michigan, USA.
Department of Medicine, Duke University, Durham, North Carolina, USA.
Environ Health Perspect. 2020 Nov;128(11):117009. doi: 10.1289/EHP7255. Epub 2020 Nov 30.
Epidemiological studies support the hypothesis that diabetes alters pulmonary responses to air pollutants like ozone (). The mechanism(s) underlying these associations and potential links among diabetes, , and lung inflammation and remodeling are currently unknown.
The goal was to determine whether pulmonary responses to repetitive ozone exposures are exacerbated in murine strains that are hyperglycemic and insulin resistant.
Normoglycemic and insulin-sensitive C57BL/6J mice; hyperglycemic, but mildly insulin-resistant, KK mice; and hyperglycemic and markedly insulin-resistant KKAy mice were used for ozone exposure studies. All animals were exposed to filtered air (FA) or repetitive ozone ( , 4 h/d, for 13 consecutive weekdays). Tissue analysis was performed 24 h following the final exposure. This analysis included bronchoalveolar lavage (BAL) for cell and fluid analysis, and tissue for pathology, immunohistology, mRNA, and hydroxyproline.
Following repetitive exposure, higher bronchoalveolar lavage fluid inflammatory cells were observed in all mice (), with a notable influx of neutrophils and eosinophils in KK and KKAy mice. Although the lungs of -exposed C57BL/6J and KK mice had minimal centriacinar histological changes without fibrosis, the lungs of -exposed KKAy mice contained marked epithelial hyperplasia in proximal alveolar ducts and adjacent alveoli with associated centriacinar fibrosis. Fibrosis in -exposed KKAy lungs was confirmed with immunohistochemistry, tissue hydroxyproline content, and tissue mRNA expression of fibrosis-associated genes (, , and ). Immunofluorescence staining and confocal microscopy revealed alterations in the structure and composition of the airway and alveolar epithelium in regions of fibrosis.
Our results demonstrate that in diabetic animal strains repetitive ambient ozone exposure led to early and exaggerated pulmonary inflammation and remodeling. Changes in distal and interstitial airspaces and the activation of Th2 inflammatory and profibrotic pathways in experimental animals provide a preliminary, mechanistic framework to support the emerging epidemiological associations among air pollution, diabetes, and lung disease. https://doi.org/10.1289/EHP7255.
流行病学研究支持这样一种假说,即糖尿病会改变肺部对臭氧等空气污染物的反应()。这些关联的机制以及糖尿病、、肺炎症和重塑之间的潜在联系目前尚不清楚。
本研究旨在确定重复性臭氧暴露是否会加重高血糖和胰岛素抵抗的鼠种的肺部反应。
使用血糖正常且胰岛素敏感的 C57BL/6J 小鼠;高血糖但胰岛素轻度抵抗的 KK 小鼠;以及高血糖且胰岛素抵抗明显的 KKAy 小鼠进行臭氧暴露研究。所有动物均暴露于过滤空气(FA)或重复臭氧(,4 h/d,连续 13 个工作日)中。最后一次暴露后 24 小时进行组织分析。该分析包括支气管肺泡灌洗(BAL)以进行细胞和液体分析,以及组织的病理学、免疫组织化学、mRNA 和羟脯氨酸分析。
在重复接触后,所有小鼠的支气管肺泡灌洗液中炎症细胞均增加(),KK 和 KKAy 小鼠中可见中性粒细胞和嗜酸性粒细胞明显增多。虽然暴露于臭氧的 C57BL/6J 和 KK 小鼠的肺部仅有微小的中心性小叶状组织学变化而无纤维化,但暴露于臭氧的 KKAy 小鼠的近端肺泡导管和相邻肺泡中可见明显的上皮细胞增生,并伴有中心性小叶纤维化。暴露于臭氧的 KKAy 肺部的纤维化通过免疫组织化学、组织羟脯氨酸含量和纤维化相关基因(、、)的组织 mRNA 表达得到证实。免疫荧光染色和共聚焦显微镜显示,纤维化区域的气道和肺泡上皮的结构和组成发生改变。
我们的研究结果表明,在糖尿病动物模型中,重复的环境臭氧暴露会导致早期和过度的肺部炎症和重塑。远端和间质气腔的变化以及实验动物中 Th2 炎症和促纤维化途径的激活为空气污染、糖尿病和肺部疾病之间的新兴流行病学关联提供了初步的机制框架。