Abstract
Air pollution is known to increase the risk of pneumonia. However, the effects of air pollution on the pleural effusion of patients with pneumonia are unclear. The objective of this study was to investigate alterations in inflammatory–immune biomarkers by air pollution in patients with pneumonia by analyzing their pleural effusion. Patients who had undergone thoracentesis to drain their pleural effusion in a hospital were recruited for this study. Patients with pneumonia and those with congestive heart failure respectively served as the case and control groups. We observed that an increase of 1 ppb in one-year NO2 was associated with a decrease of 0.105 ng/mL in cluster of differentiation 62 (CD62) (95% confidence interval (CI) = −0.085, −0.004, p < 0.05) in the pleural effusion. Furthermore, we observed that an increase in one−year 1 ppb of NO2 was associated with a decrease of 0.026 ng/mL in molybdenum (Mo) (95% CI = −0.138, −0.020, p < 0.05). An increase in one-year 1 ppb of SO2 was associated with a decrease of 0.531 ng/mL in zinc (95% CI = −0.164, −0.006, p < 0.05). Also, an increase in one-year 1 ppb of O3 was associated with a decrease of 0.025 ng/mL in Mo (95% CI = −0.372, −0.053, p < 0.05). In conclusion, air pollution exposure, especially gaseous pollution, may be associated with the regulation of immune responses and changes in metal levels in the pleural effusion of pneumonia patients.
Highlights
Pneumonia is reported to be one of the leading causes of childhood deaths worldwide, accounting for about 1.3 million deaths among children under five years old annually in 2010 and 2011 [1].Recent reports highlighted that there are many risk factors that may increase the risk of pneumonia onset
Sixty-three subjects with pneumonia and 27 subjects with congestive heart failure (CHF) were enrolled in the present study (Table 1)
There were no significant differences in numbers of current smokers or alcohol consumers between the pneumonia and CHF groups
Summary
Pneumonia is reported to be one of the leading causes of childhood deaths worldwide, accounting for about 1.3 million deaths among children under five years old annually in 2010 and 2011 [1].Recent reports highlighted that there are many risk factors that may increase the risk of pneumonia onset. For example, is recognized as being one of the risk factors for pneumonia [2]. Results of a meta-analysis showed an association between air pollution (including particulate and gaseous pollutants) and hospitalizations of children due to pneumonia [5]. Immunosuppression was reported to be one important mechanism that occurs due to air pollution [6]. Pleural effusion results from different diseases such as pneumonia and congestive heart failure (CHF). In patients with CHF, pleural effusion occurs as a result of increased interstitial fluid in the lungs, which is due to elevated pulmonary capillary pressure. Proteins or metals in pleural effusions can be objectively and quantitatively measured and evaluated as biomarkers of normal or pathological biological processes and exposure to environmental factors
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