title: Nitric oxide and proinflammatory cytokines in nasal lavage fluid associated with symptoms and exposure to moldy building microbes.
abstract: Epidemiological data indicate that living or working in a moldy building is associated with increased risk of respiratory symptoms and disease related to inflammatory reactions, but biochemical evidence linking cause and effect is still scarce. The staff working in a mold-contaminated school, and a reference group without such exposure, were studied. Nasal lavage was performed and health data were collected with a questionnaire at the end of the spring term, after a 2.5-mo summer vacation, and at the end of the fall term. Here we show that concentrations of tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), and nitric oxide (NO) in nasal lavage fluid were significantly higher in the exposed than in the control subjects at the end of the first exposure period. These inflammatory mediators decreased to reference group concentrations during the period when there was no exposure and the production of NO and IL-6 increased again during the reexposure in the fall term. Reports of cough, phlegm, rhinitis, eye irritation, and fatigue paralleled the changes in the measured inflammatory markers. These results point to an association between inflammatory markers in the nasal lavage fluid, the high prevalence of respiratory symptoms among the occupants, and chronic exposure to molds in the indoor environment.
authors.affiliation: Division of Environmental Health, National Public Health Institute, Kuopio, Finland. Maija-Riitta.Hirvonen@ktl.fi
authors.forename: M R
authors.initials: MR
authors.lastname: Hirvonen
authors.forename: M
authors.initials: M
authors.lastname: Ruotsalainen
authors.forename: M
authors.initials: M
authors.lastname: Roponen
authors.forename: A
authors.initials: A
authors.lastname: Hyvärinen
authors.forename: T
authors.initials: T
authors.lastname: Husman
authors.forename: V M
authors.initials: VM
authors.lastname: Kosma
authors.forename: H
authors.initials: H
authors.lastname: Komulainen
authors.forename: K
authors.initials: K
authors.lastname: Savolainen
authors.forename: A
authors.initials: A
authors.lastname: Nevalainen
mesh_terms: D000328:Adult; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D002452:Cell Count; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis*; D015850:Interleukin-6 / Q000032:analysis*; D008875:Middle Aged; D003904:Mitosporic Fungi; D017817:Nasal Lavage Fluid / Q000737:chemistry* / Q000166:cytology; D009569:Nitric Oxide / Q000032:analysis*; D016273:Occupational Exposure; D012140:Respiratory Tract Diseases / Q000209:etiology* / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
chemical_list: D018836:Inflammation Mediators; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D009569:Nitric Oxide