空气污染暴露组学中导致 COPD 患者 TNFα 水平升高的危险因素。

Risk factors in air pollution exposome contributing to higher levels of TNFα in COPD patients.

机构信息

BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China; Hebei Technology Innovation Center of Human Settlement in Green Building, Shenzhen Institute of Building Research Co., Ltd., Xiongan 071700, China.

BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China.

出版信息

Environ Int. 2022 Jan 15;159:107034. doi: 10.1016/j.envint.2021.107034. Epub 2021 Dec 11.

DOI:10.1016/j.envint.2021.107034

PMID:34906887

Abstract

BACKGROUND

Air pollutants are found associated with various health effects in chronic obstructive pulmonary patients. Given the complicate chemical components of air pollutants, it is not clear which components are the main risk factors for these health effects.

OBJECTIVES

Based on the COPD in Beijing (COPDB) study and exposome concept, we examined comprehensively the air pollution components to screen out high-risk factors for systemic inflammation of COPD patients.

METHODS

Concentrations of PM with aerodynamic diameter ≤ 2.5 μm (PM), ultrafine and accumulated-mode particles (UFPs and Acc), PM-contained carbonaceous components/elements/water soluble ions, gaseous pollutants, temperature, and relative humidity (RH) were continuously monitored around participants. Urinary polycyclic aromatic hydrocarbons (PAHs) and cotinine, and serum tumor necrosis factor α (TNFα) were measured from 53 COPD and 82 non-COPD participants. Lifestyle variables were recorded using follow-up questionnaire. Linear mixed effects (LME) models were used to assess the associations of TNFα differences with exposure to air pollutants, meteorological variations, and lifestyle.

RESULTS

In COPD patients, the associations of TNFα differences with exposure to ozone, Cd, UFPs, Acc, 2-hydroxydibenzofuran, temperature and RH parameters, and several elements in PM were significant in certain time-windows. For example, per interquartile range (IQR) increase in average ozone concentration 14 d before visits was associated with 17.3% (95% confidence interval: 6.8%, 27.7%) TNFα difference. Associations between ozone, Cd, UFPs, Acc, the maximum value of RH, and 2-hydroxydibenzofuran exposure and TNFα differences remained robust in two-pollutant models, and contributed to 19.0%, 10.5%, 2.2%, 1.6%, 2.1%, and 1.5% TNFα differences, respectively. Among the high-risk factors for COPD patients, the responses to UFPs, Acc, and 2-hydroxydibenzofuran were not robust in non-COPD participants.

DISCUSSION

Ozone, Cd, UFPs, Acc, PAHs exposure and RH variation were high-risk factors of systemic inflammation for COPD patients, and the profile of high-risk factors were different from those in general population.

摘要

背景

空气污染物与慢性阻塞性肺疾病患者的各种健康影响有关。鉴于空气污染物的复杂化学成分，尚不清楚哪些成分是这些健康影响的主要危险因素。

目的

基于北京慢性阻塞性肺疾病（COPD）研究和暴露组学概念，我们全面检查了空气污染物成分，以筛选出 COPD 患者全身炎症的高危因素。

方法

连续监测了 53 名 COPD 患者和 82 名非 COPD 患者周围环境中空气动力学直径≤2.5μm 的颗粒物（PM）、超细颗粒和累积模式颗粒（UFPs 和 Acc）、含碳成分/元素/水溶性离子的 PM、气态污染物、温度和相对湿度（RH）。从 53 名 COPD 患者和 82 名非 COPD 患者中测量了尿多环芳烃（PAHs）和可替宁以及血清肿瘤坏死因子-α（TNFα）。使用随访问卷记录生活方式变量。使用线性混合效应（LME）模型评估 TNFα 差异与暴露于空气污染物、气象变化和生活方式之间的关联。

结果

在 COPD 患者中，在某些时间窗口内，TNFα 差异与暴露于臭氧、镉、UFPs、Acc、2-羟基二苯并呋喃、温度和 RH 参数以及 PM 中的几种元素之间存在显著关联。例如，就诊前 14 天平均臭氧浓度每增加一个四分位间距（IQR），与 TNFα 差异增加 17.3%（95%置信区间：6.8%，27.7%）相关。臭氧、镉、UFPs、Acc、RH 值最大值和 2-羟基二苯并呋喃暴露与 TNFα 差异之间的关联在双污染物模型中仍然稳健，分别导致 TNFα 差异增加 19.0%、10.5%、2.2%、1.6%、2.1%和 1.5%。在 COPD 患者的高危因素中，UFPs、Acc 和 2-羟基二苯并呋喃的反应在非 COPD 患者中并不稳健。