title: Air pollution and biomarkers of systemic inflammation and tissue repair in COPD patients.
abstract: 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.
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain pdadvand@creal.cat.
authors.forename: Payam
authors.initials: P
authors.lastname: Dadvand
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Nieuwenhuijsen
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Bunyola and Barcelona, Spain Dept of Pneumology, Institut del Tòrax, Hospital Clínic, Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain Fundació Investigació Sanitaria Illes Balears (FISIB), Palma de Mallorca, Spain.
authors.forename: Àlvar
authors.initials: À
authors.lastname: Agustí
authors.affiliation: Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France.
authors.forename: Jordi
authors.initials: J
authors.lastname: de Batlle
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Dept de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Benet
authors.affiliation: Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands.
authors.forename: Rob
authors.initials: R
authors.lastname: Beelen
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Cirach
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Martinez
authors.affiliation: Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands.
authors.forename: Gerard
authors.initials: G
authors.lastname: Hoek
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Basagaña
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Bunyola and Barcelona, Spain Dept de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain Dept of Pneumology, Hospital del Mar - IMIM, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Ferrer
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Bunyola and Barcelona, Spain Dept of Pneumology, Hospital General Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Ferrer
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Bunyola and Barcelona, Spain Dept of Pneumology, Institut del Tòrax, Hospital Clínic, Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Robert
authors.initials: R
authors.lastname: Rodriguez-Roisin
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Bunyola and Barcelona, Spain Dept of Pneumology, Hospital Universitari Son Dureta, Palma de Mallorca, Spain Institut Universitari d'Investigacions en Ciències de la Salut (IUNICS), Palma de Mallorca, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Sauleda
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Dept de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA.
authors.forename: Stefano
authors.initials: S
authors.lastname: Guerra
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Dept de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Antó
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Dept de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain.
authors.forename: Judith
authors.initials: J
authors.lastname: Garcia-Aymerich
mesh_terms: D000368:Aged; D000392:Air Movements; D000393:Air Pollutants / Q000032:analysis*; D000397:Air Pollution / Q000032:analysis*; D015415:Biomarkers / Q000032:analysis*; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005541:Forced Expiratory Volume; D017228:Hepatocyte Growth Factor / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology*; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009585:Nitrogen Dioxide / Q000032:analysis; D009765:Obesity / Q000150:complications; D052638:Particulate Matter / Q000032:analysis; D029424:Pulmonary Disease, Chronic Obstructive / Q000139:chemically induced* / Q000503:physiopathology; D012107:Research Design; D012907:Smoking / Q000009:adverse effects; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D000393:Air Pollutants; D015415:Biomarkers; D015850:Interleukin-6; D016209:Interleukin-8; D052638:Particulate Matter; D014409:Tumor Necrosis Factor-alpha; D017228:Hepatocyte Growth Factor; D005340:Fibrinogen; D002097:C-Reactive Protein; D009585:Nitrogen Dioxide