Carvajal Veronica, Jorques Molla Juan Vicente, Luo Yana, Zhao Yu, Moncunill Gemma, Gascon Mireia
ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain.
Environ Res. 2025 Mar 15;269:120838. doi: 10.1016/j.envres.2025.120838. Epub 2025 Jan 18.
Children's rapid development and immature immune systems place them at a higher risk of adverse health outcomes associated with air pollution exposure. However, the specific mechanisms in which air pollution mediates immune dysregulation in youth are poorly understood. Thus, we aimed to systematically review the available epidemiological evidence surrounding the effects of indoor and ambient air pollution exposure on systemic immune biomarkers in early life (from birth to 18 years old).
based on PRISMA guidelines, we developed a systematic search strategy and defined inclusion and exclusion criteria to retrieve publications from PubMed, SCOPUS and Web of Science published up to August 10th, 2024. Quality assessment and evidence evaluation were also performed. Five independent reviewers participated in the process.
In total, 96 studies were included. We found limited evidence of a causal relationship between prenatal ambient PM and reduced T-cells (CD3 and CD8), as well as between postnatal PM exposure and increased IgE levels or allergic sensitization. For the rest of exposure-outcome combinations we classified the evidence as inadequate, mainly due to the limited number of studies available or the lack of consistency in the results obtained among them. This was particularly the case for indoor air pollution research, for which only 12 studies were available.
the present systematic review highlights the need for further research on the impacts of air pollution on youth's immune system. We provided recommendations for future studies in order to better understand the early subclinical and clinical effects of air pollution and the underlying biological pathways, and identify the dynamics of the innate and adaptive immune responses to environmental threats. Considering the significance of childhood immunity on health outcomes within all stages of life, and the globally extensive burden of air pollution exposure, further research on this topic should be prioritized.
儿童的快速发育和未成熟的免疫系统使他们面临与空气污染暴露相关的不良健康后果的更高风险。然而，空气污染介导青少年免疫失调的具体机制尚不清楚。因此，我们旨在系统地综述有关室内和室外空气污染暴露对生命早期（从出生到18岁）全身免疫生物标志物影响的现有流行病学证据。
基于PRISMA指南，我们制定了系统的检索策略，并定义了纳入和排除标准，以检索截至2024年8月10日在PubMed、SCOPUS和Web of Science上发表的文献。还进行了质量评估和证据评价。五名独立评审员参与了这一过程。
总共纳入了96项研究。我们发现，产前室外细颗粒物与T细胞减少（CD3和CD8）之间以及产后细颗粒物暴露与IgE水平升高或过敏致敏之间存在因果关系的证据有限。对于其余的暴露-结果组合，我们将证据分类为不充分，主要是由于可用研究数量有限或它们之间获得的结果缺乏一致性。室内空气污染研究尤其如此，仅有12项研究。
本系统综述强调了进一步研究空气污染对青少年免疫系统影响的必要性。我们为未来的研究提供了建议，以便更好地理解空气污染的早期亚临床和临床影响以及潜在的生物学途径，并确定先天和适应性免疫反应对环境威胁的动态变化。考虑到儿童免疫对生命各阶段健康结果的重要性以及全球范围内空气污染暴露的广泛负担，应优先对这一主题进行进一步研究。
