title: Increased risk of cardiovascular disease in premenopausal female ragpickers of Eastern India: involvement of inflammation, oxidative stress, and platelet hyperactivity.
abstract: Millions of poor people in the developing world still thrive on ragpicking. In the present study, we have examined whether ragpicking is associated with increased risk of cardiovascular disease. For this, we have enrolled 112 premenopausal female ragpickers (median age 30 years) and 98 age-matched housemaids as control from Kolkata, Eastern India. Venous blood was drawn for routine hematology; flow cytometry was used to measure generation of reactive oxygen species (ROS) by leukocytes, surface expression of CD62P (P-selectin) in platelets and CD11b in leukocytes. Collagen-induced platelet aggregation was evaluated by aggregometer, and erythrocytic superoxide dismutase (SOD) was measured by spectrophotometry. Soluble P-selectin (sP-sel) and CD40L (sCD40L), neutrophil-activating protein-2 (NAP-2), platelet and plasma serotonin, oxidized low-density lipoprotein (oxLDL), and anticardiolipin antibodies (aCL) in plasma were measured by ELISA. Compared with control, the ragpickers had significantly higher prevalence of hypertension and prehypertension, and hypertension was positively associated with ragpicking. The ragpickers also had higher levels of inflammation (elevated NAP-2), oxidative stress (elevated ROS generation with depleted SOD) with oxLDL, platelet activation and aggregability, soluble CD40 ligand, with altered serotonin level (rose in plasma but depleted in platelet). A greater percentage of ragpickers had elevated serum level of aCL of the IgG and IgM isotypes than the controls. The results suggest that the occupation of ragpicking increases the risk of cardiovascular diseases in premenopausal women of Eastern India via inflammation, oxidative stress, platelet hyperactivity, and hypertension.
authors.affiliation: Department of Experimental Hematology, Chittaranjan National Cancer Institute, 37, S. P. Mukherjee Road, Kolkata, 700 026, India. nandankumar.mondal@louisville.edu.|Department of Cardiovascular and Thoracic Surgery, Cardiovascular Innovation Institute, University of Louisville School of Medicine, 302 E. Muhammad Ali Blvd, Louisville, KY, 40202, USA. nandankumar.mondal@louisville.edu.
authors.forename: Nandan Kumar
authors.initials: NK
authors.lastname: Mondal
authors.affiliation: Department of Experimental Hematology, Chittaranjan National Cancer Institute, 37, S. P. Mukherjee Road, Kolkata, 700 026, India.
authors.forename: Sanghita
authors.initials: S
authors.lastname: Roychoudhury
authors.affiliation: Department of Experimental Hematology, Chittaranjan National Cancer Institute, 37, S. P. Mukherjee Road, Kolkata, 700 026, India.
authors.forename: Sayali
authors.initials: S
authors.lastname: Mukherjee
authors.affiliation: Department of Experimental Hematology, Chittaranjan National Cancer Institute, 37, S. P. Mukherjee Road, Kolkata, 700 026, India.
authors.forename: Shabana
authors.initials: S
authors.lastname: Siddique
authors.affiliation: Department of Experimental Hematology, Chittaranjan National Cancer Institute, 37, S. P. Mukherjee Road, Kolkata, 700 026, India.
authors.forename: Madhuchanda
authors.initials: M
authors.lastname: Banerjee
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Cardiovascular Innovation Institute, University of Louisville School of Medicine, 302 E. Muhammad Ali Blvd, Louisville, KY, 40202, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Slaughter
authors.affiliation: Department of Experimental Hematology, Chittaranjan National Cancer Institute, 37, S. P. Mukherjee Road, Kolkata, 700 026, India.
authors.forename: Twisha
authors.initials: T
authors.lastname: Lahiri
authors.affiliation: Department of Experimental Hematology, Chittaranjan National Cancer Institute, 37, S. P. Mukherjee Road, Kolkata, 700 026, India.
authors.forename: Manas Ranjan
authors.initials: MR
authors.lastname: Ray
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007249:Inflammation / Q000097:blood / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects*; D018384:Oxidative Stress; D015539:Platelet Activation; D012307:Risk Factors
keywords: Cardiovascular health; Hypertension; India; Oxidative stress; Platelet function; Ragpickers