颗粒物空气污染物与心血管疾病:干预策略。

Particulate matter air pollutants and cardiovascular disease: Strategies for intervention.

机构信息

Louisiana State University School of Veterinary Medicine, Department of Comparative Biomedical Sciences, Skip Bertman Drive, Baton Rouge, Louisiana 70803, United States of America.

Louisiana State University School of Veterinary Medicine, Department of Comparative Biomedical Sciences, Skip Bertman Drive, Baton Rouge, Louisiana 70803, United States of America.

出版信息

Pharmacol Ther. 2021 Jul;223:107890. doi: 10.1016/j.pharmthera.2021.107890. Epub 2021 May 14.

Abstract

Air pollution is consistently linked with elevations in cardiovascular disease (CVD) and CVD-related mortality. Particulate matter (PM) is a critical factor in air pollution-associated CVD. PM forms in the air during the combustion of fuels as solid particles and liquid droplets and the sources of airborne PM range from dust and dirt to soot and smoke. The health impacts of PM inhalation are well documented. In the US, where CVD is already the leading cause of death, it is estimated that PM (PM < 2.5 μm in size) is responsible for nearly 200,000 premature deaths annually. Despite the public health data, definitive mechanisms underlying PM-associated CVD are elusive. However, evidence to-date implicates mechanisms involving oxidative stress, inflammation, metabolic dysfunction and dyslipidemia, contributing to vascular dysfunction and atherosclerosis, along with autonomic dysfunction and hypertension. For the benefit of susceptible individuals and individuals who live in areas where PM levels exceed the National Ambient Air Quality Standard, interventional strategies for mitigating PM-associated CVD are necessary. This review will highlight current state of knowledge with respect to mechanisms for PM-dependent CVD. Based upon these mechanisms, strategies for intervention will be outlined. Citing data from animal models and human subjects, these highlighted strategies include: 1) antioxidants, such as vitamins E and C, carnosine, sulforaphane and resveratrol, to reduce oxidative stress and systemic inflammation; 2) omega-3 fatty acids, to inhibit inflammation and autonomic dysfunction; 3) statins, to decrease cholesterol accumulation and inflammation; 4) melatonin, to regulate the immune-pineal axis and 5) metformin, to address PM-associated metabolic dysfunction. Each of these will be discussed with respect to its potential role in limiting PM-associated CVD.

摘要

空气污染与心血管疾病(CVD)和 CVD 相关死亡率的升高密切相关。颗粒物(PM)是与空气污染相关的 CVD 的关键因素。PM 在燃料燃烧过程中作为固体颗粒和液滴形成于空气中,空气中的 PM 来源从灰尘和污垢到烟尘和烟雾不等。PM 吸入对健康的影响已有充分记录。在美国,CVD 已经是主要的死亡原因,据估计,PM(尺寸小于 2.5μm 的 PM)每年导致近 20 万人过早死亡。尽管有公共卫生数据,但 PM 相关 CVD 的明确机制仍难以捉摸。然而,迄今为止的证据表明,涉及氧化应激、炎症、代谢功能障碍和血脂异常的机制,导致血管功能障碍和动脉粥样硬化,以及自主神经功能障碍和高血压。为了保护易感人群和生活在 PM 水平超过国家环境空气质量标准的地区的人群,有必要采取干预策略来减轻 PM 相关 CVD。本综述将重点介绍 PM 依赖性 CVD 的机制的现有知识状态。基于这些机制,将概述干预策略。引用来自动物模型和人类受试者的数据,这些突出的策略包括:1)抗氧化剂,如维生素 E 和 C、肌肽、萝卜硫素和白藜芦醇,以减少氧化应激和全身炎症;2)ω-3 脂肪酸,抑制炎症和自主神经功能障碍;3)他汀类药物,减少胆固醇积累和炎症;4)褪黑素,调节免疫松果体轴;5)二甲双胍,解决 PM 相关代谢功能障碍。将分别讨论这些策略在限制 PM 相关 CVD 方面的潜在作用。

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