Dai Lirui, Jiang Shu, Zhou Peizhi
Department of Neurosurgery, West China Hospital of Sichuan University, Sichuan University, Chengdu, Sichuan, China.
Int J Med Sci. 2025 Jul 28;22(14):3565-3580. doi: 10.7150/ijms.115853. eCollection 2025.
Epidemiological studies has investigated the correlation between ambient air pollution and neurosurgical multisystem diseases. Multiple studies have shown that air pollution significantly influences various neurological disorders. Nevertheless, the findings from these studies are inconsistent and contentious, leaving the causal relationships for many conditions unresolved. The study systematically investigates the underlying genetic causal relationships between air pollution and neurosurgical multisystem diseases, as well as to assess the implications of these associations. Genetic instruments for particulate matter (PM) with aerodynamic diameter < 2.5 μm (PM), < 2.5-10 μm (PM), <10 μm (PM), PM absorbance, nitrogen dioxide (NO), nitrogen oxides (NOx) and 30 neurosurgical multi-system diseases were selected. In the European population, a noteworthy causal association was identified between NO and PM exposure and cerebral infarction (IVW: OR = 1.03, 95%CI: 1.011.06). Among African American or Afro-Caribbean individuals, NOx (IVW: OR = 0.63, 95%CI: 0.440.90) and NO (IVW: OR = 0.68, 95%CI: 0.54-0.87) are predisposed to trigger trigeminal neuralgia, while PM is related to 3 neurosurgical diseases, including epilepsy (IVW: OR = 0.89, 95%CI: 0.791.00), subarachnoid hemorrhage (IVW: OR = 0.75, 95%CI: 0.610.91), and diffuse brain injury (IVW: OR = 0.67, 95%CI: 0.470.96). In East Asian populations, a correlation has been observed between PM (IVW: OR = 0.99, 95%CI: 0.981.00) and PM (IVW: OR = 1.00, 95%CI: 1.001.00) exposure and the occurrence of cervical spondylosis. Additionally, there is a genetic susceptibility to pituitary adenoma and craniopharyngioma related to NO (IVW: OR = 1.24, 95%CI: 1.021.52) and PM absorbance (IVW: OR = 0.73, 95%CI: 0.590.90). In South Asian populations, there is a significant genetic susceptibility to the influences of PM (IVW: OR = 0.90, 95%CI: 0.830.97) on stroke incidence. In contrast, for populations in the Greater Middle East, air pollution is predominantly associated with cerebrovascular diseases. For example, PM shows a positive genetic predisposition towards stroke (IVW: OR = 1.02, 95%CI: 1.001.05) and subarachnoid hemorrhage (IVW: OR = 1.06, 95%CI: 1.001.12). This study presents the first genetic evidence establishing a connection between air pollution and neurosurgical multisystem diseases. Our findings emphasize the importance of air quality in the context of these diseases, potentially offering new insights into the underlying mechanisms and informing future clinical research on air pollution-mediated neurosurgical conditions, particularly cerebrovascular and brain functional disorders.
流行病学研究调查了环境空气污染与神经外科多系统疾病之间的相关性。多项研究表明，空气污染会显著影响各种神经系统疾病。然而，这些研究的结果并不一致且存在争议，许多疾病的因果关系尚未得到解决。该研究系统地调查了空气污染与神经外科多系统疾病之间潜在的遗传因果关系，并评估这些关联的影响。选择了空气动力学直径<2.5μm的颗粒物（PM2.5）、<2.5 - 10μm的颗粒物（PM2.5 - 10）、<10μm的颗粒物（PM10）、PM吸光度、二氧化氮（NO2）、氮氧化物（NOx）的遗传工具变量以及30种神经外科多系统疾病。在欧洲人群中，发现NO和PM暴露与脑梗死之间存在显著的因果关联（逆方差加权法：OR = 1.03，95%置信区间：1.011.06）。在非裔美国人或非洲加勒比裔个体中，NOx（逆方差加权法：OR = 0.63，95%置信区间：0.440.90）和NO（逆方差加权法：OR = 0.68，95%置信区间：0.54 - 0.87）易引发三叉神经痛，而PM与3种神经外科疾病有关，包括癫痫（逆方差加权法：OR = 0.89，95%置信区间：0.791.00）、蛛网膜下腔出血（逆方差加权法：OR = 0.75，95%置信区间：0.610.91）和弥漫性脑损伤（逆方差加权法：OR = 0.67，95%置信区间：0.470.96）。在东亚人群中，观察到PM2.5（逆方差加权法：OR = 0.99，95%置信区间：0.981.00）和PM10（逆方差加权法：OR = 1.00，95%置信区间：1.001.00）暴露与颈椎病发生之间存在相关性。此外，垂体腺瘤和颅咽管瘤存在与NO（逆方差加权法：OR = 1.24，95%置信区间：1.021.52）和PM吸光度（逆方差加权法：OR = 0.73，95%置信区间：0.590.90）相关的遗传易感性。在南亚人群中，PM对中风发病率的影响存在显著的遗传易感性（逆方差加权法：OR = 0.90，95%置信区间：0.830.97）。相比之下，对于大中东地区的人群，空气污染主要与脑血管疾病相关。例如，PM对中风（逆方差加权法：OR = 1.02，95%置信区间：1.001.05）和蛛网膜下腔出血（逆方差加权法：OR = 1.06，95%置信区间：1.001.12）显示出正向遗传易感性。本研究提供了首个建立空气污染与神经外科多系统疾病之间联系的遗传证据。我们的研究结果强调了空气质量在这些疾病背景下的重要性，可能为潜在机制提供新的见解，并为未来关于空气污染介导的神经外科疾病，特别是脑血管和脑功能障碍的临床研究提供参考。
