Air pollution and biomarkers of systemic inflammation and tissue repair in COPD patients

• Published in: The European respiratory journal Vol. 44; no. 3; pp. 603 - 613
• Main Authors: DADVAND, Payam, NIEUWENHUIJSEN, Mark J, FERRER, Antoni, FERRER, Jaume, RODRIGUEZ-ROISIN, Robert, SAULEDA, Jaume, GUERRA, Stefano, ANTO, Josep M, GARCIA-AYMERICH, Judith, AGUSTI, Alvar, DE BATLLE, Jordi, BENET, Marta, BEELEN, Rob, CIRACH, Marta, MARTINEZ, David, HOEK, Gerard, BASAGANA, Xavier
• Format: Journal Article
• Language: English
• Published: Leeds Maney 01-09-2014
• Subjects: Aged; Air Movements; Air Pollutants - analysis; Air Pollution - analysis; Biological and medical sciences; Biomarkers - analysis; C-Reactive Protein - metabolism; Chronic obstructive pulmonary disease, asthma; Cohort Studies; Environment. Living conditions; Female; Fibrinogen - metabolism; Forced Expiratory Volume; Hepatocyte Growth Factor - metabolism; Humans; Inflammation - blood; Inflammation - etiology; Interleukin-6 - blood; Interleukin-8 - blood; Male; Medical sciences; Middle Aged; Nitrogen Dioxide - analysis; Obesity - complications; Particulate Matter - analysis; Pneumology; Public health. Hygiene; Public health. Hygiene-occupational medicine; Pulmonary Disease, Chronic Obstructive - chemically induced; Pulmonary Disease, Chronic Obstructive - physiopathology; Research Design; Smoking - adverse effects; Tumor Necrosis Factor-alpha - blood; MED, Spain, Cataluna, Barcelona; Human; Lung disease; Corrective surgery; Respiratory disease; Biological marker; Patient; Inflammation; Tissue; Chronic; Health and environment; Treatment; Bronchus disease; Air pollution; Chronic obstructive pulmonary disease; Obstructive pulmonary disease; Repair; Public health
• ISSN: 0903-1936; 1399-3003
• DOI: 10.1183/09031936.00168813

The origin(s) of systemic inflammation in patients with chronic obstructive pulmonary disease (COPD) is unclear. We investigated the impact of exposure to ambient air pollution on systemic biomarkers of inflammation (C-reactive protein (CRP), tumour necrosis factor-α, interleukin (IL)-6, IL-8 and fibrinogen) and tissue repair (hepatocyte growth factor (HGF)) in 242 clinically stable COPD patients (mean age 67.8 years and forced expiratory volume in 1 s 71.3% predicted) in Barcelona, Spain, in 2004-2006. A spatiotemporal exposure assessment framework was applied to predict ambient nitrogen dioxide (NO2) and levels of particles with a 50% cut-off aerodynamic diameter of 2.5 μm (PM2.5) at each participant's home address during 10 periods of 24 h (lags 1-10) and 1 year prior to the blood sampling date. We used linear regression models to estimate associations between biomarkers and exposure levels. An interquartile range (IQR) increase in NO2 exposure in lag 5 was associated with 51%, 10% and 9% increases in CRP, fibrinogen and HGF levels respectively. We also observed 12% and 8% increases in IL-8 associated with an IQR increase in NO2 exposure in lag 3 and over the year before sampling, respectively. These increases were larger in former smokers. The results for PM2.5 were not conclusive. These results show that exposure to ambient NO2 increases systemic inflammation in COPD patients, especially in former smokers.