title: Chronic exposure to biomass fuel smoke and markers of endothelial inflammation.
abstract: Indoor smoke exposure may affect cardiovascular disease (CVD) risk via lung-mediated inflammation, oxidative stress, and endothelial inflammation. We sought to explore the association between indoor smoke exposure from burning biomass fuels and a selected group of markers for endothelial inflammation. We compared serum concentrations of amyloid A protein, E-selectin, soluble intercellular adhesion molecule 1 (ICAM-1) and VCAM-1, von Willebrand factor (vWF), and high-sensitivity C-reactive protein (hs-CRP) in 228 biomass-exposed vs. 228 non-exposed participants living in Puno, Peru. Average age was 56 years (s.d. = 13), average BMI was 26.5 kg/m(2) (s.d. = 4.4), 48% were male, 59.4% completed high school, and 2% reported a physician diagnosis of CVD. In unadjusted analysis, serum levels of soluble ICAM-1 (330 vs. 302 ng/ml; P < 0.001), soluble VCAM-1 (403 vs. 362 ng/ml; P < 0.001), and E-selectin (54.2 vs. 52.7 ng/ml; P = 0.05) were increased in biomass-exposed vs. non-exposed participants, respectively, whereas serum levels of vWF (1148 vs. 1311 mU/ml; P < 0.001) and hs-CRP (2.56 vs. 3.12 mg/l; P < 0.001) were decreased, respectively. In adjusted analyses, chronic exposure to biomass fuels remained positively associated with serum levels of soluble ICAM-1 (P = 0.03) and VCAM-1 (P = 0.05) and E-selectin (P = 0.05), and remained negatively associated with serum levels of vWF (P = 0.02) and hs-CRP (P < 0.001). Daily exposure to biomass fuel smoke was associated with important differences in specific biomarkers of endothelial inflammation and may help explain accelerated atherosclerosis among those who are chronically exposed.
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Caravedo
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: P M
authors.initials: PM
authors.lastname: Herrera
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: N
authors.initials: N
authors.lastname: Mongilardi
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: A
authors.initials: A
authors.lastname: de Ferrari
authors.affiliation: Cardiovascular Division, Cardiovascular Imaging and Clinical Research Core Laboratory, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: V G
authors.initials: VG
authors.lastname: Davila-Roman
authors.affiliation: Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: R H
authors.initials: RH
authors.lastname: Gilman
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Wise
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: C H
authors.initials: CH
authors.lastname: Miele
authors.affiliation: CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.|Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: J J
authors.identifier: 0000-0002-4738-5468
authors.initials: JJ
authors.lastname: Miranda
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA. wcheckl1@jhmi.edu.|Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. wcheckl1@jhmi.edu.|CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru. wcheckl1@jhmi.edu.
authors.forename: W
authors.initials: W
authors.lastname: Checkley
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects*; D056804:Biofuels / Q000633:toxicity*; D015415:Biomarkers / Q000097:blood; D018533:Biomass; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000209:etiology; D016022:Case-Control Studies; D019040:E-Selectin / Q000097:blood; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010568:Peru; D012307:Risk Factors; D000685:Serum Amyloid A Protein / Q000032:analysis; D012906:Smoke / Q000009:adverse effects*; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D014841:von Willebrand Factor / Q000032:analysis
chemical_list: D056804:Biofuels; D015415:Biomarkers; D019040:E-Selectin; C546936:SELE protein, human; D000685:Serum Amyloid A Protein; D012906:Smoke; D019010:Vascular Cell Adhesion Molecule-1; D014841:von Willebrand Factor; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein
keywords: Biomass fuel exposure; Cardiovascular disease; Endothelial inflammation biomarkers; Epidemiology; Household air pollution; Rural communities