Division of Respirology, University of British Columbia, Vancouver, BC, Canada.
Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.
Curr Allergy Asthma Rep. 2023 Sep;23(9):541-553. doi: 10.1007/s11882-023-01101-1. Epub 2023 Jul 13.
To provide a review of emerging literature describing the impact of diet on the respiratory response to air pollution in asthma.
Asthma phenotyping (observable characteristics) and endotyping (mechanistic pathways) have increased the specificity of diagnostic and treatment pathways and opened the doors to the identification of subphenotypes with enhanced susceptibility to exposures and interventions. Mechanisms underlying the airway immune response to air pollution are still being defined but include oxidative stress, inflammation, and activation of adaptive and innate immune responses, with genetic susceptibility highlighted. Of these, neutrophil recruitment and activation appear prominent; however, understanding neutrophil function in response to pollutant exposures is a research gap. Diet may play a role in asthma pathogenesis and morbidity; therefore, diet modification is a potential target opportunity to protect against pollutant-induced lung injury. In particular, in vivo and in vitro data suggest the potential for diet to modify the inflammatory response in the airways, including impacts on neutrophil recruitment and function. Murine models provide compelling results in regard to the potential for dietary components (including fiber, antioxidants, and omega-3 fatty acids) to buffer against the inflammatory response to air pollution in the lung. Precision lifestyle approaches to asthma management and respiratory protection in the context of air pollution exposures may evolve to include diet, pending the results of further epidemiologic and causal investigation and with neutrophil recruitment and activation as a candidate mechanism.
描述饮食对哮喘患者呼吸道对空气污染反应的影响的新兴文献。
哮喘表型(可观察到的特征)和内型(机制途径)提高了诊断和治疗途径的特异性,并为识别对暴露和干预更敏感的亚表型开辟了道路。空气污染对气道免疫反应的机制仍在定义中,但包括氧化应激、炎症和适应性和先天免疫反应的激活,突出了遗传易感性。在这些机制中,中性粒细胞的募集和激活似乎很突出;然而,了解中性粒细胞对污染物暴露的反应功能是一个研究空白。饮食可能在哮喘发病机制和发病率中起作用;因此,饮食改变是预防污染物引起的肺损伤的潜在目标机会。特别是,体内和体外数据表明,饮食有可能调节气道中的炎症反应,包括对中性粒细胞募集和功能的影响。在肺部对空气污染的炎症反应方面,关于饮食成分(包括纤维、抗氧化剂和欧米伽 3 脂肪酸)的潜在缓冲作用,鼠类模型提供了令人信服的结果。在空气污染暴露的情况下,针对哮喘管理和呼吸道保护的精准生活方式方法可能会发展到包括饮食,这取决于进一步的流行病学和因果关系研究的结果,以及中性粒细胞募集和激活作为候选机制。