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Published on: August 7, 2017
Air pollution and systemic immune biomarkers in early life: A systematic review
Veronica Carvajal1, Juan Vicente Jorques Molla2, Yana Luo1
1ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
Insights
Air pollution exposure in children may impact their immune systems, but evidence is limited. More research is needed to understand the effects of indoor and ambient air pollution on children's immune biomarkers.
Area of Science:
- Environmental Health
- Immunology
- Pediatrics
Background:
- Children's developing immune systems are vulnerable to air pollution, increasing risks of adverse health outcomes.
- Mechanisms linking air pollution to immune dysregulation in youth remain poorly understood.
- Systematic review of epidemiological evidence on air pollution and immune biomarkers in early life.
Purpose of the Study:
- To systematically review epidemiological evidence on indoor and ambient air pollution effects on systemic immune biomarkers in children (birth to 18 years).
- To identify knowledge gaps regarding air pollution's impact on early-life immunity.
Main Methods:
- Systematic literature search following PRISMA guidelines across PubMed, SCOPUS, and Web of Science up to August 10th, 2024.
- Inclusion/exclusion criteria defined for study retrieval and quality assessment.
- Five independent reviewers conducted the review process.
Main Results:
- Limited evidence suggests prenatal PM2.5 exposure may reduce T-cells (CD3+, CD8+).
- Postnatal PM exposure shows limited association with increased IgE or allergic sensitization.
- Evidence for other exposure-outcome combinations is inadequate due to study limitations and inconsistencies, especially for indoor air pollution (12 studies).
Conclusions:
- Significant need for further research on air pollution's impact on the pediatric immune system.
- Recommendations provided for future studies to elucidate biological pathways and immune responses.
- Prioritizing research on childhood immunity and air pollution is crucial given lifelong health implications and global exposure burdens.
Introduction:
Children's rapid development and immature immune systems place them at a higher risk of adverse health outcomes associated with air pollution exposure. However, the specific mechanisms in which air pollution mediates immune dysregulation in youth are poorly understood. Thus, we aimed to systematically review the available epidemiological evidence surrounding the effects of indoor and ambient air pollution exposure on systemic immune biomarkers in early life (from birth to 18 years old).
Methods:
based on PRISMA guidelines, we developed a systematic search strategy and defined inclusion and exclusion criteria to retrieve publications from PubMed, SCOPUS and Web of Science published up to August 10th, 2024. Quality assessment and evidence evaluation were also performed. Five independent reviewers participated in the process.
Results:
In total, 96 studies were included. We found limited evidence of a causal relationship between prenatal ambient PM2.5 and reduced T-cells (CD3+ and CD8+), as well as between postnatal PM exposure and increased IgE levels or allergic sensitization. For the rest of exposure-outcome combinations we classified the evidence as inadequate, mainly due to the limited number of studies available or the lack of consistency in the results obtained among them. This was particularly the case for indoor air pollution research, for which only 12 studies were available.
Conclusion:
the present systematic review highlights the need for further research on the impacts of air pollution on youth's immune system. We provided recommendations for future studies in order to better understand the early subclinical and clinical effects of air pollution and the underlying biological pathways, and identify the dynamics of the innate and adaptive immune responses to environmental threats. Considering the significance of childhood immunity on health outcomes within all stages of life, and the globally extensive burden of air pollution exposure, further research on this topic should be prioritized.
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