Less air pollution leads to rapid reduction of airway inflammation and improved airway function in asthmatic children.
OBJECTIVE
Air pollution can promote airway inflammation, posing significant health risks for children with chronic respiratory problems. However, it is unknown whether this process is reversible, so that limiting pollution will benefit these children. We measured the short-term response of allergic asthmatic children exposed to a real-life reduction in outdoor air pollution by using noninvasive biomarkers of airway inflammation and function.


METHODS
Thirty-seven untreated allergic children with mild persistent asthma were recruited from a highly polluted urban environment and relocated to a less polluted rural environment. Air pollution, pollen counts, and meteorological conditions were carefully monitored at both sites. Nasal eosinophils, fractional exhaled nitric oxide, peak expiratory flow, and urinary leukotriene E(4) were measured first in the urban environment and then again 7 days after relocation to the rural environment.


RESULTS
One week after relocation to the rural environment, we measured, on average, a fourfold decrease in nasal eosinophils and significant decrease in fractional exhaled nitric oxide. We also noted an improvement in lower airway function, reflected by highly significant increase in peak expiratory flow. In contrast, mean urinary leukotriene E(4) concentration remained unchanged after 1 week of exposure to the rural environment.


CONCLUSIONS
Better air quality is associated with a rapid reduction of airway inflammation in allergic asthmatic children. Nasal eosinophils and fractional exhaled nitric oxide are sensitive indicators of this effect, and their rapid decline is paralleled by improved airway function measured by peak expiratory flow. Leukotriene synthesis has a more variable response to environmental modifications.
Renzetti
Gabriele
G
West Virginia University School of Medicine, Department of Pediatrics, Robert C. Byrd Health Sciences Center, 1 Medical Center Dr, PO Box 9214, Morgantown, WV 26506-9214, USA. gpiedimonte@hsc.wvu.edu
Silvestre
Gaetano
G
D'Amario
Claudio
C
Bottini
Egidio
E
Gloria-Bottini
Fulvia
F
Bottini
Nunzio
N
Auais
Alexander
A
Perez
Miriam K
MK
Piedimonte
Giovanni
G
D000397:Air Pollution / Q000517:prevention & control*; D001249:Asthma / Q000276:immunology / Q000517:prevention & control*; D001991:Bronchitis / Q000276:immunology / Q000517:prevention & control*; D002648:Child; D002980:Climate; D004804:Eosinophils; D005260:Female; D006801:Humans; D007558:Italy; D007958:Leukocyte Count; D008176:Lung Volume Measurements; D008297:Male; D009297:Nasal Mucosa / Q000276:immunology; D010366:Peak Expiratory Flow Rate; D012130:Respiratory Hypersensitivity / Q000150:complications / Q000276:immunology; D012424:Rural Population; D016896:Treatment Outcome; D014505:Urban Population