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La exposición personal al dióxido de nitrógeno (NO2) y la gravedad del asma inducida por virus en niños

A J Chauhan¹, Hazel M Inskip, Catherine H Linaker

¹Respiratory, Cell, and Molecular Biology Research Division, University of Southampton, Southampton, UK. anoop.chauhan@porthosp.nhs.uk <anoop.chauhan@porthosp.nhs.uk>

Lancet (London, England)

|June 13, 2003

Resumen

La alta exposición al dióxido de nitrógeno (NO2) antes de una infección viral empeora las exacerbaciones del asma en los niños. Incluso los niveles dentro de los estándares de calidad del aire aumentan la gravedad de los síntomas y reducen la función pulmonar.

Área de la Ciencia:

Salud Ambiental Salud del medio ambiente.
Medicina Respiratoria Pediátrica para niños y niñas.
Toxicología de la contaminación atmosférica.

Sus antecedentes:

El dióxido de nitrógeno (NO2) es un contaminante común del aire relacionado con problemas respiratorios.
Las infecciones virales son los principales desencadenantes de las exacerbaciones del asma en los niños.
El impacto específico de la exposición al NO2 en la gravedad del asma inducida por virus requiere más investigación.

Objetivo del estudio:

Determinar la relación entre la exposición al dióxido de nitrógeno (NO2) y la gravedad de las exacerbaciones de asma infantil.
Evaluar si la exposición al NO2 influye en la gravedad del asma durante infecciones virales respiratorias comprobadas.

Principales métodos:

Una cohorte de 114 niños (8-11 años) con asma monitoreó los síntomas diarios, el flujo expiratorio máximo (PEF) y la exposición personal al NO2 semanalmente durante 13 meses.
Las aspiraciones nasales se recogieron durante los episodios de enfermedades del tracto respiratorio superior y se probaron para virus comunes utilizando RT-PCR.
Las ecuaciones de estimación generalizadas analizaron la asociación entre tertiles de exposición al NO2 (baja, media, alta) y la gravedad de la exacerbación del asma después de la infección.

Principales resultados:

Se detectaron virus en el 78% de los episodios de infección; las medianas de NO2 fueron de 5, 10 y 21 μg/m3 para tertiles bajos, medios y altos.
Se observaron aumentos significativos en las puntuaciones de los síntomas del tracto respiratorio inferior en los tertiles NO2 (p=0,05 para todos los virus, p=0,01 para el RSV).
La exposición alta a NO2 se relacionó con una reducción de la PEF de >12 L/min para las exacerbaciones inducidas por picornavirus (p=0,04) en comparación con una exposición baja.

Conclusiones:

La alta exposición al dióxido de nitrógeno (NO2), incluso dentro de los estándares actuales de calidad del aire, que precede a una infección viral se asocia con un aumento de la gravedad de la exacerbación del asma en los niños.
Esto sugiere que el NO2 actúa como un potenciador de las infecciones virales respiratorias, lo que lleva a resultados de asma más graves.

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