title: A Longitudinal Study of Association between Heavy Metals and Itchy Eyes, Coughing in Chronic Cough Patients: Related with Non-Immunoglobulin E Mediated Mechanism.
abstract: The association between heavy metals exposure and respiratory diseases or allergic sensitization showing high serum immunoglobulin E (IgE) has been suggested. However, previous findings have been inconsistent and the mechanisms responsible remain unclear. We evaluated heavy metal exposure and its association with coughing, itchy eyes in chronic cough patients with different IgE levels. Ninety outpatients in Kanazawa University Hospital were recruited between January-June 2011. Subjects whose total IgE measured by radioimmunosorbent test were asked to record their daily symptoms. We collected daily total suspended particles (TSP) from which concentrations of calcium (Ca), cadmium (Cd), chromium (Cr), iron (Fe), manganese (Mn), nickel (Ni), and lead (Pb) were determined then divided into high and low level groups. Generalized estimating equations were applied to compute the relationship between concentrations of these metals and symptoms. All metals at high levels were significantly associated with itchy eyes compared with low levels, with exception of Ca, the six others were significant in patients with IgE < 250 IU/mL. Cd, Fe, Mn had association with coughing (odds ratio-OR (95% confidence interval-CI): 1.13 (1.03, 1.24), 1.22 (1.05, 1.42), and 1.13 (1.01, 1.27), respectively), this relationship remained significant for Cd (OR (95% CI): 1.14 (1.03, 1.27)) and Mn (OR (95% CI): 1.15 (1.00, 1.31)) in patients with lower IgE. Our findings demonstrate the relationship between aerial heavy metals and itchy eyes, coughing in chronic cough patients, suggesting these symptoms may be due to a non-IgE mediated mechanism.
authors.affiliation: Department of Environmental Health and Preventive Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan. toi_fs@yahoo.com.
authors.forename: Thao Thi Thu
authors.initials: TT
authors.lastname: Nguyen
authors.affiliation: Department of Hygiene, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan. tomotomo@med.kanazawa-u.ac.jp.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Higashi
authors.affiliation: Department of Environmental Health and Preventive Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan. ykamba@med.kanazawa-u.ac.jp.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kambayashi
authors.affiliation: Department of Environmental Health and Preventive Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan. enolany@yahoo.com.
authors.forename: Enoch Olando
authors.initials: EO
authors.lastname: Anyenda
authors.affiliation: Environment Preservation Center, Kanazawa University, Kakuma-machi, Kanazawa 920-1192, Japan. mitigami@t.kanazawa-u.ac.jp.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Michigami
authors.affiliation: Respiratory Medicine, Cellular Transplantation Biology, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan. hara0728@gmail.com.
authors.forename: Johsuke
authors.initials: J
authors.lastname: Hara
authors.affiliation: Respiratory Medicine, Cellular Transplantation Biology, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan. fujimura@nanao.hosp.go.jp.|Respiratory Medicine, National Hospital Organization Nanao Hospital, 3-1 Mattou-machi Yabe, Nanao, Ishikawa 926-8531, Japan. fujimura@nanao.hosp.go.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Fujimura
authors.affiliation: Department of Environmental Health and Preventive Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan. t-hiromasa@med.kanazawa-u.ac.jp.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Tsujiguchi
authors.affiliation: Department of Environmental Health and Preventive Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan. m-ymzk16@stu.kanazawa-u.ac.jp.
authors.forename: Masami
authors.initials: M
authors.lastname: Kitaoka
authors.affiliation: Department of Environmental Health and Preventive Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan. heros@stu.kanazawa-u.ac.jp.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Asakura
authors.affiliation: Department of Environmental Health and Preventive Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan. hori_d@mbr.nifty.com.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hori
authors.affiliation: Department of Environmental Health and Preventive Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan. hibino@staff.kanazawa-u.ac.jp.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Hibino
authors.affiliation: Third Department of Internal Medicine, Fukui University School of Medicine, Eiheiji, Fukui 910-1193, Japan. konosita@u-fukui.ac.jp.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Konoshita
authors.affiliation: Department of Environmental Health and Preventive Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan. hiro-n@po.incl.ne.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D000368:Aged; D002104:Cadmium / Q000009:adverse effects / Q000097:blood; D002118:Calcium / Q000009:adverse effects / Q000097:blood; D002857:Chromium / Q000009:adverse effects / Q000097:blood; D002908:Chronic Disease; D003371:Cough / Q000209:etiology*; D005128:Eye Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood* / Q000502:physiology*; D007501:Iron / Q000009:adverse effects / Q000097:blood; D007564:Japan; D007854:Lead / Q000009:adverse effects / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008345:Manganese / Q000009:adverse effects / Q000097:blood; D019216:Metals, Heavy / Q000009:adverse effects*; D008875:Middle Aged; D009532:Nickel / Q000009:adverse effects / Q000097:blood; D011537:Pruritus / Q000209:etiology*
chemical_list: D019216:Metals, Heavy; D002104:Cadmium; D002857:Chromium; D007854:Lead; D007073:Immunoglobulin E; D008345:Manganese; D009532:Nickel; D007501:Iron; D002118:Calcium
keywords: chronic cough; coughing; heavy metals; itchy eyes; total serum IgE level