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Clinical and inflammatory features of traffic-related diesel exposure in children with asthma
Anne M Fitzpatrick1, Ahmad F Mohammad2, Kaley Desher2
1Department of Pediatrics, Emory University, Atlanta, Georgia; Division of Pulmonary Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia.
Insights
Children with uncontrolled asthma living near busy roads experience more severe symptoms and lung issues due to diesel particulate matter (PM) exposure. This exposure also triggers unique inflammatory responses and oxidative stress, highlighting the need for cleaner air policies.
Area of Science:
- Environmental Health
- Pediatric Asthma Research
- Toxicology
Background:
- Epidemiologic studies link traffic pollutants, like diesel particulate matter (PM), to childhood asthma.
- However, the specific inflammatory mechanisms in children with asthma exposed to diesel PM remain unclear.
Purpose of the Study:
- To assess asthma symptoms, exacerbations, and lung function in children with uncontrolled asthma based on proximity to major roadways.
- To investigate the association between diesel PM exposure and systemic inflammation, T-cell activation/exhaustion markers, and metabolomic profiles.
Main Methods:
- Enrolled 447 children (5-17 years) with uncontrolled asthma.
- Collected data via questionnaires, lung function tests, and blood biomarker analysis.
- Quantified residential proximity to roadways and estimated pollutant exposure using geocoding.
Main Results:
- Children residing closer to high-traffic roads showed greater disadvantage, higher diesel PM exposure, increased emergency visits for exacerbations, and reduced lung function.
- Highest diesel PM exposure correlated with blunted cytokine secretion and T-cell exhaustion markers.
- Metabolomic analysis revealed disturbances in metabolites linked to glutathione formation and oxidative stress in highly exposed children.
Conclusions:
- Diesel PM exposure in children with poorly controlled asthma is linked to adverse clinical outcomes.
- Unique inflammatory patterns and oxidative stress markers are associated with this exposure.
- Findings support ongoing efforts to reduce traffic-related air pollution and promote health equity for children with asthma.
Background:
Epidemiologic studies have revealed associations between traffic-related pollutants such as diesel particulate matter (PM) and asthma outcomes in children, but the inflammatory features associated with diesel PM exposure in children with asthma are not understood.
Objective:
To evaluate symptoms, exacerbations, and lung function measures in children with uncontrolled asthma and their associations with residential proximity to major roadways and to determine associations between diesel PM exposure and systemic inflammatory cytokines, circulating markers of T-cell activation and exhaustion, and metabolomic features using biomarker studies.
Methods:
Children 5 to 17 years of age with physician-diagnosed, uncontrolled asthma despite treatment with an asthma controller medication completed a research visit involving questionnaires, lung function testing, and venipuncture for biomarker studies. Geocoding was performed to quantify residential proximity to major roadways and pollutant exposure.
Results:
A total of 447 children with uncontrolled asthma were enrolled. Children living closer to highly trafficked roadways were more disadvantaged and had more exposure to diesel PM, more exacerbations prompting an emergency department visit, and lower lung function measures. Children with the highest diesel PM exposure, compared with children with the lowest diesel PM exposure, also had blunted cytokine secretion and evidence of T-cell exhaustion, including disturbances in several metabolites associated with glutathione formation and oxidative stress.
Conclusion:
Traffic-related diesel PM exposure in children with poorly controlled asthma is associated with poorer clinical outcomes and unique patterns of inflammation and oxidative stress. These findings argue for continued mitigation efforts to improve traffic-related air quality and health equity in children with asthma.
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