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1.
Lancet Planet Health ; 5(9): e588-e598, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34508680

RESUMO

BACKGROUND: The prevalence of landscape fires has increased, particularly in low-income and middle-income countries (LMICs). We aimed to assess the impact of exposure to landscape fire smoke (LFS) on the health of children. METHODS: We conducted a sibling-matched case-control study and selected 552 155 children (aged <18 years) from Demographic and Health Surveys in 55 LMICs from 2000 to 2014. Each deceased child was matched with their sibling(s). The exposure indicators were fire-sourced PM2·5 and dry-matter emissions. We associated these exposure indicators with child mortality using conditional regressions, and derived an exposure-response function using a non-linear model. Based on the association, we quantified the global burden of fire-attributable child deaths in LMICs from 2000 to 2014. FINDINGS: Each 1 µg/m3 increment of fire-sourced PM2·5 was associated with a 2·31% (95% CI 1·50-3·13) increased risk of child mortality. The association was robust to different models. The exposure-response function was superlinear and suggested per-unit exposure to larger fires was more toxic. Based on our non-linear exposure-response function, we estimated that between 2000 and 2014, the five countries with the largest number of child deaths associated with fire-sourced PM2·5 were Nigeria (164 000 [126 000 to 209 000] annual deaths), Democratic Republic of the Congo (126 000 [95% CI 114 000 to 139 000] annual deaths), India (65 900 [-22 200 to 147 000] annual deaths), Uganda (30 200 [24 500 to 36 300] annual deaths), and Indonesia (28 900 [19 100 to 38 400]). INTERPRETATION: Exposure to landscape fire smoke contributes substantially to the global burden of child mortality. FUNDING: National Natural Science Foundation of China, Ministry of Science and Technology of China, Peking University, UK National Institute for Health Research Health Protection Research Unit, Leverhulme Center for Wildfires, Environment and Society, and National Environment Research Council National Capability funding to National Centre for Earth Observation and Energy Foundation.

2.
Ecotoxicol Environ Saf ; 225: 112780, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34537587

RESUMO

Growing evidence supports that air pollution exposure has become a risk factor of type II diabetes mellitus through the induction of insulin resistance (IR), but the presented findings did not provide a consistent relationship between air pollution exposure and IR in the temporal scale and the magnitude. Reported associated with IR and air pollution exposure, branched-chain amino acids (BCAAs) in blood might modify the association between air pollution exposure and IR. We took advantage of an existing panel study on elderly people who were healthy or with pre-diabetes. Amino acids were analyzed from the serum samples using a UPLC-QQQ-MS, and the homeostasis model assessment of insulin resistance (HOMA-IR) values were calculated to represent the levels of IR in each visit. Exposures to PM2.5, NO2, SO2, CO, O3, and black carbon (BC) were estimated using data from a monitoring station. Linear mixed-effects models were applied to estimate the associations between the air pollution and HOMA-IR, as well as the modifying effects of BCAAs. We found significantly higher concentrations of BCAAs in the pre-diabetic subjects than healthy ones. The concentrations of BCAAs were all significantly associated with HOMA-IR. For subjects with high-level BCAAs, HOMA-IR was positively associated with an IQR increase in PM2.5, NO2, BC, and CO at lag day 2 and in PM2.5, SO2, NO2, BC, and CO at lag day 7. While for subjects with low-level BCAAs, there was no significant association observed at any lag day except for CO at lag day 5. The study provided evidence that circulating BCAAs may modify the relationship between air pollution exposure and the level of insulin resistance in humans.


Assuntos
Poluentes Atmosféricos , Diabetes Mellitus Tipo 2 , Resistência à Insulina , Idoso , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Aminoácidos de Cadeia Ramificada , Diabetes Mellitus Tipo 2/induzido quimicamente , Exposição Ambiental/análise , Humanos
3.
Cancer Med ; 10(19): 6744-6761, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34472719

RESUMO

BACKGROUND: Anthracycline-based chemotherapy (ABC) is one of the standard therapies against breast cancer. However, few guidelines are currently available to optimize the use of ABC. Therefore, the present analysis aimed at determining the profile and treatment patterns of ABC and the association of clinicopathological characteristics with ABC selection. METHODS: We retrospectively analyzed the data of a nation-wide multicenter epidemiological study, which collected the medical records of breast cancer patients receiving chemotherapy in different settings from seven geographic regions in China (NCT03047889). RESULTS: In total, 3393 patients were included, with 2917 treated with ABC. Among them, 553 (89.8%), 2165 (81.7%), and 814 (25.7%) were subjected to ABC as neoadjuvant, adjuvant, and advanced chemotherapy, respectively. The most frequently used regimens were anthracycline-taxane-based combinations for neo- and adjuvant chemotherapy, along with taxanes and oral fluorouracils for the palliative stages. In the overall cohort, patients aged < 40 or 40-65 (p < 0.001), in premenopause (p < 0.001), without comorbidities (p = 0.016), with invasive ductal carcinoma (p= 0.001), high lymph node involvement (p < 0.001), in the pTNM stage II, III, or IV versus stage I (p < 0.001), subjected to mastectomy (p < 0.001) or subjected to sentinel lymph node biopsy combined with axillary lymph node dissection (p = 0.044), or with a decreased disease-free survival (p < 0.001) were more likely to be recommended to ABC. CONCLUSION: Taken together, ABC remained the mainstay of breast cancer treatment, especially in neo and adjuvant therapy. ABC was mainly used as a combination therapy, and the correlation between influencing factors and ABC choice varied during different settings, indicating the preference and different perspectives of medication considered by medical oncologists regarding the use ABC in China.

4.
Environ Pollut ; 290: 118008, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34479157

RESUMO

Individuals with metabolic disorders exhibit enhanced susceptibility to the cardiovascular health effects of particulate air pollution, but the underlying mechanisms are not yet understood. We aim to assess whether changes in proinflammatory lipid signals are associated with fine particulate matter (PM2.5) exposure in individuals with and without prediabetes. A longitudinal panel study was conducted in Beijing, China, and included 120 participants followed up over 589 clinical visits from August 2013 to February 2015. We measured 12 lipids derived from arachidonic acid pathways in blood samples of the participants via targeted lipidomic analyses. Ambient PM2.5 concentrations were continuously monitored at a station for associations with the lipids. Among the 120 participants, 110 (mean [SD] age at recruitment, 56.5 [4.2] years; 31 prediabetics) who visited the clinic at least twice over the follow-up period were assigned exposure values of the outdoor residential PM2.5 concentrations during the 1-14 days preceding each clinical visit. With an interquartile range increase in the 1-day-lag PM2.5 exposure (64.0 µg/m3), the prediabetic group had consistently greater increases in the concentration of arachidonate metabolites derived from the cytochrome P450 (CYP450) pathway (5,6-DHET, 15.8% [95% CI, 3.5-29.7%]; 8,9-DHET, 9.7% [95% CI, 0.6-19.6%]; 11,12-DHET, 8.3% [95% CI, 1.9-15.1%]; 14,15-DHET, 7.4% [95% CI, 0.9-14.4%]; and 20-HETE, 8.9% [95% CI, 1.0-17.5%]), compared with the healthy group. Among CYP450-derived lipids, 14,15-DHET and 20-HETE significantly mediated 8% and 8% of the PM2.5-associated increase in white blood cells, 10% and 13% of that in neutrophils, and 20% and 23% of that in monocytes, respectively, in the prediabetic group. In conclusion, proinflammatory lipid signals from CYP450 pathways triggered the health effects of particulate air pollution in individuals with prediabetes, suggesting that targeting lipid metabolism has therapeutic potential to attenuate or prevent the cardiovascular effects of air pollution in susceptible populations.

5.
Environ Sci Technol ; 55(15): 10589-10596, 2021 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-34297563

RESUMO

Fine particulate matter (PM2.5) can promote chronic diseases through the fundamental mechanism of inflammation; however, systemic information is lacking on the inflammatory PM2.5 components. To decipher organic components from personal PM2.5 exposure that were associated with respiratory and circulatory inflammatory responses in older adults, we developed an exposomic approach using trace amounts of particles and applied it on 424 personal PM2.5 samples collected in a panel study in Beijing. Applying an integrated multivariate and univariate untargeted strategy, a total of 267 organic compounds were filtered and then chemically identified according to their association with exhaled nitric oxide (eNO)/interleukin (IL)-6 or serum IL-1ß/IL-6, with monocyclic and polycyclic aromatic compounds (i.e., MACs and PACs) as the representatives. Indoor-derived species with medium volatility including MACs were mainly associated with systemic inflammation, while low-volatile ambient components that originate from combustion sources, such as PACs, were mostly associated with airway inflammation. Following ambient component exposure, we found an inverted U-shaped relationship on change of eNO with insulin resistance, suggesting a higher risk of cardiopulmonary dysfunction for individuals with homeostatic model assessment for insulin resistance (HOMA-IR) levels > 2.3. Overall, this study provided a practical untargeted strategy for the systemic investigation of PM2.5 components and proposed source-specific inflammatory effects.


Assuntos
Poluentes Atmosféricos , Idoso , Poluentes Atmosféricos/análise , Pequim , Humanos , Inflamação , Compostos Orgânicos , Material Particulado/análise
6.
Crit Rev Oncol Hematol ; 163: 103376, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34087346

RESUMO

Dermatological toxicity is the most common immune-related adverse events (irAEs) following immune checkpoint inhibitors (ICIs). A better understanding of this side effect enables early recognition, diagnosis and management in clinical practice. We did a systematic review and meta-analysis of literature published on ClinicalTrials.gov, Pubmed, Embase, and Cochrane Library to assess the differences in cutaneous irAEs among ICIs, the effect from dosage and combined treatment on the incidence, and the predictive values for prognosis. A total of 46 eligible RCTs involving 28,569 patients were included. This study indicates that cutaneous irAEs are dose-independent and agent-specific immune reactions with the highest risk observed in CTLA-4 blockade and might not a surrogate prognostic indicator.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Inibidores de Checkpoint Imunológico , Humanos , Prognóstico
7.
Biomed Res Int ; 2021: 6650107, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34124255

RESUMO

Objective: To better understand the immune-related heterogeneity of tumor microenvironment (TME) and establish a prognostic model for breast cancer in clinical practice. Methods: For the 2620 breast cancer cases obtained from The Cancer Genome Atlas and the Molecular Taxonomy of Breast Cancer International Consortium, the CIBERSORT algorithm was performed to identify the immunological pattern, which underwent consensus clustering to curate TME subtypes, and biological profiles were explored by enrichment analysis. Random forest analysis, least absolute shrinkage, and selection operator analysis, in addition to uni- and multivariate COX regression analyses, were successively employed to precisely select the significant genes with prediction values for the introduction of the prognostic model. Results: Three TME subtypes with distinct molecular and clinical features were identified by an unsupervised clustering approach, of which the molecular heterogeneity could be the result of cell cycle dysfunction and the variation of cytotoxic T lymphocyte activity. A total of 15 significant genes were proposed to construct the prognostic immune-related score system, and a predictive model was established in combination with clinicopathological characteristics for the survival of breast cancer patients. For immunological signatures, proactivity of CD8 T lymphocytes and hyperangiogenesis could be attributed to heterogeneous survival profiles. Conclusions: We developed and validated a prognostic model based on immune-related signatures for breast cancer. This promising model is justified for validation and optimized in future clinical practice.


Assuntos
Neoplasias da Mama , Ciclo Celular , Bases de Dados Genéticas , Ativação Linfocitária/genética , Linfócitos T Citotóxicos/imunologia , Microambiente Tumoral , Neoplasias da Mama/genética , Neoplasias da Mama/imunologia , Neoplasias da Mama/mortalidade , Ciclo Celular/genética , Ciclo Celular/imunologia , Intervalo Livre de Doença , Feminino , Humanos , Taxa de Sobrevida , Microambiente Tumoral/genética , Microambiente Tumoral/imunologia
8.
Sci China Life Sci ; 2021 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-34008166

RESUMO

Susceptibility of patients with chronic obstructive pulmonary disease (COPD) to cardiovascular autonomic dysfunction associated with exposure to metals in ambient fine particles (PM2.5, particulate matter with aerodynamic diameter ≤2.5 µm) remains poorly evidenced. Based on the COPDB (COPD in Beijing) panel study, we aimed to compare the associations of heart rate (HR, an indicator of cardiovascular autonomic function) and exposure to metals in PM2.5 between 53 patients with COPD and 82 healthy controls by using linear mixed-effects models. In all participants, the HR levels were significantly associated with interquartile range increases in the average concentrations of Cr, Zn, and Pb, but the strength of the associations differed by exposure time (from 1.4% for an average 9 days (d) Cr exposure to 3.5% for an average 9 d Zn exposure). HR was positively associated with the average concentrations of PM2.5 and certain metals only in patients with COPD. Associations between HR and exposure to PM2.5, K, Cr, Mn, Ni, Cu, Zn, As, and Se in patients with COPD significantly differed from those in health controls. Furthermore, association between HR and Cr exposure was robust in COPD patients. In conclusion, our findings indicate that COPD could exacerbate difference in HR following exposure to metals in PM2.5.

9.
Nat Commun ; 12(1): 3205, 2021 05 28.
Artigo em Inglês | MEDLINE | ID: mdl-34050160

RESUMO

Interactions between climate change and anthropogenic activities result in increasing numbers of open fires, which have been shown to harm maternal health. However, few studies have examined the association between open fire and pregnancy loss. We conduct a self-comparison case-control study including 24,876 mothers from South Asia, the region with the heaviest pregnancy-loss burden in the world. Exposure is assessed using a chemical transport model as the concentrations of fire-sourced PM2.5 (i.e., fire PM2.5). The adjusted odds ratio (OR) of pregnancy loss for a 1-µg/m3 increment in averaged concentration of fire PM2.5 during pregnancy is estimated as 1.051 (95% confidence intervals [CI]: 1.035, 1.067). Because fire PM2.5 is more strongly linked with pregnancy loss than non-fire PM2.5 (OR: 1.014; 95% CI: 1.011, 1.016), it contributes to a non-neglectable fraction (13%) of PM2.5-associated pregnancy loss. Here, we show maternal health is threaten by gestational exposure to fire smoke in South Asia.


Assuntos
Aborto Espontâneo/epidemiologia , Poluentes Atmosféricos/efeitos adversos , Incêndios , Exposição Materna/efeitos adversos , Fumaça/efeitos adversos , Aborto Espontâneo/etiologia , Adulto , Poluição do Ar/efeitos adversos , Poluição do Ar/estatística & dados numéricos , Ásia/epidemiologia , Estudos de Casos e Controles , Monitoramento Ambiental/estatística & dados numéricos , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Exposição Materna/estatística & dados numéricos , Saúde Materna/estatística & dados numéricos , Gravidez , Fatores de Risco , Imagens de Satélites/estatística & dados numéricos , Adulto Jovem
10.
Sci Total Environ ; 788: 147760, 2021 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-34020092

RESUMO

BACKGROUND: The underlying mechanism on the susceptibility of chronic obstructive pulmonary disease (COPD) patients to air pollution has yet to be clarified. OBJECTIVES: Based on the COPD in Beijing (COPDB) study, we examined whether lung dysfunction contributed to pollutant-associated systemic inflammation in COPD patients. METHODS: Proinflammatory biomarkers including interleukin-8 (IL-8) and tumor necrosis factor α (TNFα) were measured in serum samples collected from 53 COPD and 82 healthy participants. Concentrations of particulate matter with aerodynamic diameter ≤ 2.5 µm (PM2.5), carbonaceous components in PM2.5, and PM size distribution were continuously monitored. Linear mixed effects models were used to examine the associations of biomarker differences with particle exposure, between COPD and healthy participants, and across subgroups with different levels of lung dysfunction. RESULTS: COPD patients showed higher differences in IL-8 and TNFα levels associated with exposure to measured pollutants, comparing to healthy controls. In advanced analysis, particle-associated differences in IL-8 and TNFα levels were higher in participants with poorer lung ventilation and diffusion capacity, and higher ratio of residual volume. For example, an interquartile range increase in average PM2.5 concentration 2 weeks before visits was associated with a 15.7% difference in IL-8 level in participants with the lowest ratio of measured value to predicted value of forced expiratory volume in 1 s (FEV1%pred) (65.2%), and the association decreased monotonically with increasing FEV1%pred. Associations between differences in TNFα level and average ultrafine particle concentration 1 week before visits increased gradually with increasing ratio of measured value to predicted value of residual volume/total lung capacity. CONCLUSIONS: COPD patients, especially those with poorer lung function, are more susceptible to systemic inflammation associated with fine particle exposure.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Doença Pulmonar Obstrutiva Crônica , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/análise , Pequim/epidemiologia , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Humanos , Inflamação/induzido quimicamente , Pulmão , Material Particulado/análise , Material Particulado/toxicidade , Doença Pulmonar Obstrutiva Crônica/epidemiologia
11.
J Hazard Mater ; 416: 125790, 2021 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-33862484

RESUMO

Ambient air pollution is a major risk factor for the prevalence and exacerbation of chronic obstructive pulmonary disease (COPD). Based on the COPDB (COPD in Beijing) panel study, whole-blood transcriptomes were repeatedly measured in 48 COPD patients and 62 healthy participants. Ambient mass concentrations of fine particulate matter (PM2.5), temperature, and relative humidity were continuously monitored at a monitoring station. The linear mixed-effects models were applied to estimate the associations between logarithmically transformed transcript levels and 1-day (d), 7-d, and 14-d average concentrations of PM2.5 before the start of follow-up visits. MetaCore™ was used to conduct the pathway enrichment analyses. Exposure to 1-, 7-, and 14-d average concentrations of PM2.5 was significantly associated with the transcriptome responses in both groups. The top 10, top 100, and top 1000 PM2.5-associated transcripts differed greatly between the two groups. Among COPD patients, role of alpha-6/beta-4 integrins in carcinoma progression, Notch signaling in breast cancer, and ubiquinone metabolism were the most significantly enriched PM2.5-associated biological pathways in the three time windows, respectively. In healthy participants, pro-opiomelanocortin processing was the most significant PM2.5-associated biological pathway in all three time windows. Our findings provide novel insights into the adverse health effects of air pollution exposure.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Doença Pulmonar Obstrutiva Crônica , Adulto , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/análise , Poluição do Ar/estatística & dados numéricos , Pequim/epidemiologia , Exposição Ambiental/análise , Exposição Ambiental/estatística & dados numéricos , Humanos , Material Particulado/análise , Material Particulado/toxicidade , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/genética , Transcriptoma
13.
Sci Rep ; 11(1): 8694, 2021 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-33888748

RESUMO

Social and mental stressors associated with the pandemic of a novel infectious disease, e.g., COVID-19 or SARS may promote long-term effects on child development. However, reports aimed at identifying the relationship between pandemics and child health are limited. A retrospective study was conducted to associate the SARS pandemic in 2003 with development milestones or physical examinations among longitudinal measurements of 14,647 children. Experiencing SARS during childhood was associated with delayed milestones, with hazard ratios of 3.17 (95% confidence intervals CI: 2.71, 3.70), 3.98 (3.50, 4.53), 4.96 (4.48, 5.49), or 5.57 (5.00, 6.20) for walking independently, saying a complete sentence, counting 0-10, and undressing him/herself for urination, respectively. These results suggest relevant impacts from COVID-19 on child development should be investigated.


Assuntos
COVID-19/psicologia , Desenvolvimento Infantil , Síndrome Respiratória Aguda Grave/psicologia , Criança , Pré-Escolar , China , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos
14.
BMC Cancer ; 21(1): 341, 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33789616

RESUMO

BACKGROUND: To evaluate the efficacy and safety of recombinant human serum albumin /granulocyte colony-stimulating factor (rHSA/G-CSF) in breast cancer following receipt of cytotoxic agents. METHODS: The phase 1b trial assessed the pharmacokinetics, pharmacodynamics, and safety of dose-escalation, ranging from rHSA/G-CSF 1800 µg, 2100 µg, and 2400 µg. Randomized controlled phase 2b trial was further conducted to ensure the comparative efficacy and safety of rHSA/G-CSF 2400 µg and rhG-CSF 5 µg/kg. In multicenter, randomized, open-label, parallel, phase 2 study, participants treated with anthracycline-containing chemotherapy were assigned in a ratio 1:1:1 to receive double delivery of rHSA/G-CSF 1200 µg, 1500 µg, and continuous rhG-CSF 5 µg/kg. RESULTS: Between December 16, 2014, to July 23, 2018, a total of 320 patients were enrolled, including 25 individuals in phase 1b trial, 80 patients in phase 2b trial, and 215 participants in phase 2 study. The mean duration of agranulocytosis during the first chemotherapeutic intermission was observed as 1.14 ± 1.35 days in rHSA/G-CSF 1500 µg, which was comparable with that of 1.07 ± 0.97 days obtained in rhG-CSF control (P = 0.71). Safety profiles were assessed to be acceptable ranging from rHSA/G-CSF 1800 µg to 2400 µg, while the double delivery of HSA/G-CSF 2400 µg failed to meet the noninferiority in comparison with rhG-CSF. CONCLUSION: The prospective randomized controlled trials demonstrated that rHSA/G-CSF was efficacious and well-tolerated with an approachable frequency and expense of application for prophylactic management of agranulocytosis. The double delivery of rHSA/G-CSF 1500 µg in comparisons with paralleling G-CSF preparations is warranted in the phase 3 trial. TRIAL REGISTRATION: ClinicalTrials.gov identifiers: NCT02465801 (11/17/2014), NCT03246009 (08/08/2017), NCT03251768 (08/07/2017).


Assuntos
Antraciclinas/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Fator Estimulador de Colônias de Granulócitos/metabolismo , Albumina Sérica/metabolismo , Feminino , Humanos , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto
16.
Environ Int ; 151: 106454, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33676285

RESUMO

BACKGROUND: Although epidemiological studies on the effect of chronic fine particulate matter (PM2.5) exposure on lipid disorders have been conducted, it is unclear if improved air quality is associated with beneficial changes in the blood lipid profile. In China, clean air actions introduced in 2013 have rapidly reduced the concentration of ambient PM2.5. METHODS: We conducted a change-by-change study, based on two waves (2011 and 2015) of a national survey of the same 5111 Chinese adults before and after implementation of the clean air actions. Long-term PM2.5 exposure was assessed using a state-of-the-art estimator at the city level. Based on the within-individual differences between the two waves, we associated PM2.5 changes with the variations of four lipid biomarkers-triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)-using a mixed-effects regression model. The robustness and homogeneity of the association were tested via sensitivity analyses. RESULTS: For each 10 µg/m3 reduction in PM2.5, LDL-C, and TC decreased by 2.71 (95% confidence interval [CI] 0.10-5.32) and 4.16 (95% CI 1.24-7.08)mg/dL, respectively. There was no significant association with HDL-C or TG. The results were robust among models adjusted for different covariates. PM2.5 was a significant risk factor for dyslipidemia with an adjusted relative risk of 1.21 (95% CI 1.09-1.34). The association between PM2.5 and LDL-C was stronger in the elderly or adults who did not take medications. CONCLUSIONS: The results suggest that PM2.5 exert a cardiotoxic effect by increasing the risk of lipid disorders. Improvement of air quality could prevent dyslipidemia by reducing LDL-C and TC levels. Clean air policies should be implemented as public health measures in countries with aging societies, especially developing ones with a high air pollution burden.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Adulto , Idoso , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , China , Cidades , Exposição Ambiental/análise , Humanos , Lipídeos , Material Particulado/análise
17.
Ann Am Thorac Soc ; 18(2): 247-256, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32810417

RESUMO

Rationale: Lung function impairment is reportedly associated with elevated exposure to ambient fine particles (particulate matter ≤2.5 µm in aerodynamic diameter [PM2.5]). However, whether improvement of air quality prevents respiratory diseases is unclear.Objectives: To examine whether the policy-driven reduction in PM2.5 concentration after 2013 was associated with improved lung function among Chinese adults.Methods: We compared the longitudinal measurements of peak expiratory flow (PEF) before (2011) and after (2013 and 2015) China's clean air actions. Long-term exposure to ambient pollution was assessed using a state-of-the-art estimator of historical PM2.5 concentration, and its association with PEF was examined using a linear mixed-effects model. The robustness and homogeneity of the association were examined via sensitivity analyses.Results: We analyzed 35,055 repeated measurements from 13,959 adults. Mean of age at survey was 60.5 years (standard deviation = 9.7 yr). Compared with the reference in 2011, after the policy was implemented, the mean PEF was elevated by 9.19 (6.79-11.59) L/min and 36.64 (33.53-39.75) L/min in 2013 and 2015, respectively. According to the regression results, each 10-µg/m3 reduction of PM2.5 was associated with a 14.95 (12.62-17.28) L/min improvement of PEF. The significance of the association was not affected by adjustments for covariates, inclusion criteria, or the approach to control for the effects of age. Adults of lower socioeconomic status (e.g., those with an educational level of below middle school or rural residents) were more susceptible to the adverse effects of PM2.5 on PEF.Conclusions: We found a robust association between a reduction in PM2.5 and an increase in PEF among Chinese adults. The findings suggest that mitigation of air pollution can promote respiratory health.

18.
Int J Cancer ; 148(3): 692-701, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-32700765

RESUMO

Although receptor status including estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) of the primary breast tumors was related to the prognosis of breast cancer patients, little information is yet available on whether patient management and survival are impacted by receptor conversion in breast cancer metastases. Using data from the nation-wide multicenter clinical epidemiology study of advanced breast cancer in China (NCT03047889), we report the situation of retesting ER, PR and HER2 status for breast cancer metastases and evaluate the patient management and prognostic value of receptor conversion. In total, 3295 patients were analyzed and 1583 (48.0%) patients retesting receptor status for metastasis. Discordance in one or more receptors between the primary and the metastatic biopsy was found in 37.7% of women. Patients who remained hormone receptor (HR) positive in their metastases had similar progression-free survival of first-line and second-line treatment compared to patients with HR conversion (P > .05). In multivariate analysis, patients who showed ER conversion from negative to positive had longer disease-free survival (DFS) than patients who remained negative in their metastases (hazard ratio, 2.05; 95% confidence interval [CI], 1.45-2.90; P < .001). Patients with PR remained positive and had longer DFS than patients with PR conversion from negative to positive (hazard ratio, 0.56; 95% CI, 0.38-0.83; P = .004). Patients with PR conversion have shorter overall survival than patients with PR remained positive or negative (P = .016 and P = .041, respectively). Our findings showed that the receptors' conversions were common in metastatic breast cancer, and the conversion impacted the survival.


Assuntos
Neoplasias da Mama/mortalidade , Receptor ErbB-2/metabolismo , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Neoplasias da Mama/metabolismo , Intervalo Livre de Doença , Estudos Epidemiológicos , Feminino , Humanos , Análise Multivariada , Metástase Neoplásica , Prognóstico , Estudos Retrospectivos
19.
Sci Total Environ ; 766: 142639, 2021 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-33069482

RESUMO

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. There is no clear evidence of whether COPD patients are more susceptible to respiratory inflammation associated with short-term exposure to air pollutants than those without COPD. OBJECTIVES: This study directly compared air pollutant-associated respiratory inflammation between COPD patients and healthy controls. METHODS: This study is based on the COPDB panel study (COPD in Beijing). Fractional exhaled nitric oxide (FeNO) was repeatedly measured in 53 COPD patients and 82 healthy controls at up to four clinical visits. Concentrations of carbon monoxide (CO), nitrogen monoxide, nitrogen dioxide (NO2), sulfur dioxide (SO2), fine particulate matter (PM2.5), black carbon (BC), ultrafine particles (UFPs), and accumulated-mode particles (Acc) were monitored continuously at a fixed-site monitoring station. Linear mixed-effects models were used to compare the associations between ln-transformed FeNO and average 1-23 h concentrations of air pollutants before the clinical visits. RESULTS: FeNO was positively associated with interquartile range (IQR) increases in average concentrations of CO, NO2, SO2, BC, UFPs, and Acc in all participants, with the strongest associations in different time-windows (range from 6.6% for average 1 h NO2 exposure to 32.1% for average 7 h SO2 exposure). Associations between FeNO and average 13-23 h PM2.5 exposure differed significantly according to COPD status. Increases in FeNO associated with average 1-2 h NO exposure were significant in COPD patients (range 8.9-10.2%), while the associations were nonsignificant in healthy controls. Associations between FeNO and average 1-23 h CO and SO2 exposure tended to be higher in COPD patients than in healthy controls, although the differences were not significant. UFPs-associated respiratory inflammation was robust in both subgroups. CONCLUSIONS: COPD patients are more susceptible to respiratory inflammation following PM2.5, NO, CO, and SO2 exposure than individuals without COPD.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Doença Pulmonar Obstrutiva Crônica , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Pequim/epidemiologia , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Humanos , Inflamação/induzido quimicamente , Inflamação/epidemiologia , Material Particulado/efeitos adversos , Material Particulado/análise , Doença Pulmonar Obstrutiva Crônica/epidemiologia
20.
Faraday Discuss ; 226: 569-583, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33295898

RESUMO

Measurement of ambient fine particulate matter (PM2.5) is often used as a proxy of personal exposure in epidemiological studies. However, the difference between personal and ambient exposure, and whether it biases the estimates of health effects remain unknown. Based on an epidemiological study (AIRLESS) and simultaneously launched intensive monitoring campaigns (APHH), we quantified and compared the personal and ambient exposure to PM2.5 and the related health impact among residents in Beijing, China. In total, 123 urban and 128 peri-urban non-smoking participants were recruited from two well-established cohorts in Beijing. During winter 2016 and summer 2017, each participant was instructed to carry a validated personal air monitor (PAM) to measure PM2.5 concentration at high spatiotemporal resolution for seven consecutive days in each season. Multiple inflammatory biomarkers were measured, including exhaled NO, blood monocytes counts and C-reactive protein. Linear mixed-effect models were used for the associations between exposure and health outcomes with adjustment for confounders. The average level of daily personal exposure to PM2.5 was consistently lower than using corresponding ambient concentration, and the difference is greater during the winter. The personal to ambient (P/A) ratio of exposure to PM2.5 exhibited an exponentially declining trend, and showed larger variations when ambient PM2.5 levels < 25 µg m-3. Personal exposure to PM2.5 was significantly associated with the increase in respiratory and systemic inflammatory biomarkers; however, the associations were weaker or became insignificant when ambient concentrations were used. Exposure to ambient PM2.5 might not be a good proxy to estimate the health effect of exposure to personal PM2.5.

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