Jo Yong Suk, Song Jin Woo
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Tuberc Respir Dis (Seoul). 2025 Jan;88(1):45-55. doi: 10.4046/trd.2024.0116. Epub 2024 Nov 14.
This review article explores the multifaceted relationship between air pollution and interstitial lung diseases (ILDs), particularly focusing on idiopathic pulmonary fibrosis, the most severe form of fibrotic ILD. Air pollutants are mainly composed of particulate matter, ozone (O3), nitrogen dioxide (NO2), carbon monoxide (CO), and sulfur dioxide (SO2). They are recognized as risk factors for several respiratory diseases. However, their specific effects on ILDs and related mechanisms have not been thoroughly studied yet. Emerging evidence suggests that air pollutants may contribute to the development and acute exacerbation of ILDs. Longitudinal studies have indicated that air pollution can adversely affect the prognosis of disease by decreasing lung function and increasing mortality. Lots of in vitro, in vivo , and epidemiologic studies have proposed possible mechanisms linking ILDs to air pollution, including inflammation and oxidative stress induced by exposure to air pollutants, which may induce mitochondrial dysfunction, promote cellular senescence, and disrupt normal epithelial repair processes. Despite these findings, effective interventions to mitigate effects of air pollution on ILD are not well established yet. This review emphasizes the urgent need to address air pollution as a key environmental risk factor for ILDs and calls for further studies to clarify its effects and develop preventive and therapeutic strategies.
这篇综述文章探讨了空气污染与间质性肺疾病(ILDs)之间的多方面关系,尤其聚焦于特发性肺纤维化,这是纤维化ILDs中最严重的一种形式。空气污染物主要由颗粒物、臭氧(O3)、二氧化氮(NO2)、一氧化碳(CO)和二氧化硫(SO2)组成。它们被认为是多种呼吸道疾病的风险因素。然而,它们对ILDs的具体影响及相关机制尚未得到充分研究。新出现的证据表明,空气污染物可能促使ILDs发生发展及急性加重。纵向研究表明,空气污染可通过降低肺功能和增加死亡率对疾病预后产生不利影响。大量的体外、体内及流行病学研究提出了将ILDs与空气污染联系起来的可能机制,包括接触空气污染物引起的炎症和氧化应激,这可能诱导线粒体功能障碍、促进细胞衰老并扰乱正常的上皮修复过程。尽管有这些发现,但减轻空气污染对ILDs影响的有效干预措施尚未确立。本综述强调迫切需要将空气污染作为ILDs的关键环境风险因素加以应对,并呼吁进一步开展研究以阐明其影响并制定预防和治疗策略。