被动吸烟对大鼠肺组织Clara细胞及CC16的影响

目的 研究被动吸烟不同时间大鼠肺组织Clara细胞及其分泌蛋白CC16的变化,以探讨被动吸烟与肺部慢性炎症性疾病发生的关系.方法 将Wistar雄性大鼠随机分为被动吸烟1、2、3月组和正常对照组,每组10只.进行HE染色,观察实验组大鼠肺组织光镜表现,以透射电镜观察其Clara细胞的超微结构.以RT-PCR法检测各组大鼠肺组织CC16mRNA的表达水平,以免疫组织化学法检测肺组织Clara细胞数量,以酶联免疫吸附法检测支气管肺泡灌洗液(BALF)中CC16含量.结果 被动吸烟3月组大鼠终末细支管上皮Clara细胞超微结构有显著改变;HE染色见肺泡壁变薄,相互融合成肺大泡.随着被动吸烟时间的延长,大鼠肺组织CC16 mRNA的表达、Clara细胞的数量及BALF中CC16的含量逐渐降低.被动吸烟2月和3月组大鼠肺组织CC16 mRNA的表达、Clara细胞的数量及BALF中CC16的含量与正常对照组比较,差异有统计学意义(P均＜0.01).被动吸烟1月组大鼠肺组织CC16 mRNA的表达、Clara细胞的数量及BALF中CC16的含量与对照组比较,差异无统计学意义(P＞0.05).结论 在一定吸烟量条件下,随暴露时间延长,Clara细胞数量及CC16的合成及分泌量减少,这可能与肺部慢性炎症性疾病的发生发展有一定的关系.     

CC16基因多态性与儿童性哮喘相关性研究

哮喘是一种常见的慢性呼吸系统疾病,特点是可逆性气流阻塞和气道高反应性,也是儿童呼吸系统常见病。本文对近年来Clara 细胞分泌蛋白(CC16)的基因38 A/G 多态性与儿童哮喘的相关性研究进行综述。     

高浓度细颗粒物暴露职业人群血清克拉拉细胞蛋白与肺功能相关性研究

目的在高浓度细颗粒物(Fine particulate matter, PM_(2.5))暴露职业人群中,探讨血清克拉拉细胞蛋白(Clara cell protein,CC16)水平与肺功能变化之间的关系。方法选取390名男性焦炉工人作为暴露组,其中低PM_(2.5)组215人、高PM_(2.5)组175人,同地区的对照组工人115名。酶联免疫吸附测定法(ELISA)检测血清中CC16水平,使用便携式电子肺活量计测量研究对象肺功能的改变。结果 3组人群血清CC16水平随PM_(2.5)暴露水平的增加呈下降趋势,且差异具有统计学意义(P=0.019)。研究发现FEV_1/FVC与血清CC16水平之间具有正相关关系(r=0.094,P=0.035)。简单线性回归校正年龄、身高、体重、饮酒和吸烟,亦发现在全人群中FEV_1/FVC随血清CC16降低而降低(P=0.045)。在非吸烟人群中,FEF_(25%～75%)%和FEV_1/FVC与血清CC16水平之间具有正相关关系,但在吸烟人群中,各项肺功能指标与血清CC16水平之间均无线性相关关系。年龄分层后发现,在年龄≤36岁的人群中,FEF_(25%～75%)%、FEV_1%和FEV_1/FVC随血清CC16的降低而降低(P分别为0.032、0.036和0.029),但在年龄 36岁的人群中,并未发现各项肺功能指标与血清CC16显著关联。结论高浓度PM_(2.5)暴露职业人群血清CC16水平与肺功能降低之间存在明显的相关性,血清CC16水平改变可以作为高浓度PM_(2.5)暴露致肺损伤的效应标志物。     

KIM-1、CC16在急性肾/肺损伤中的意义及研究进展

临床上急性肾损伤(acute kidney injury,AKI)与急性肺损伤(acute lung injury,ALI)虽是两个独立组织器官的损伤,但当疾病发展到某种程度或阶段时,两者之间将相互影响甚至互为因果.目前研究发现肾损伤分子-l(kidney injury molecule-1,KIM-1)可作为早期诊断AKI的生物标志物,同时炎症反应相关性指标Clara细胞分泌蛋白(Clara cell secretion protein,CCSP/CC16)在AKI、ALI中均表达异常.因此,在AKI与ALI发病过程中,KIM-1、CC16是否参与二者的生理病理过程,笔者复习近期相关文献综述如下.     

空气污染与慢性阻塞性肺疾病：人群暴露、健康影响和干预策略

空气污染与慢性阻塞性肺疾病(简称慢阻肺)发生发展密切相关, 即使低水平的颗粒物和臭氧污染仍会对慢阻肺患者的心肺功能产生显著的不良影响。近年来, 代谢组学、转录组学等技术的应用为深入阐明空气污染影响慢阻肺患者健康的生物学机制提供了机遇。在未来空气污染与慢阻肺的研究中, 基于个体暴露监测或者内暴露标志物测量的暴露评价方法将有助于建立更加准确的暴露—反应关系。在临床和公共卫生实践中, 积极采取适宜的干预措施降低群体或个体的空气污染物暴露水平, 对于减轻慢阻肺的疾病负担和改善慢阻肺患者的生活质量具有重要意义。     

妊娠妇女空气污染暴露相关生物学标记研究进展

空气污染可以导致呼吸道疾病以及心脑血管疾病。妊娠妇女机体处于一种高代谢状态,对空气污染物比较敏感;胎儿处于生长发育的关键时期,对污染物也更敏感。近年来的研究表明,妊娠妇女暴露于空气污染物与各种不良妊娠结局有关,包括自然流产、胎儿生长受限、早产和低出生体质量等。然而,其潜在机制尚不清楚。目前暴露组学、代谢组学的应用筛选出许多空气污染体内暴露的生物学标记物,如DNA加合物等代谢产物。生物学标记物可以用来反映个体的内暴露水平,相比外暴露的污染物监测更为准确,更能反映机体的暴露水平,从而指导探究空气污染暴露与各种妊娠结局相关的潜在机制。     

妊娠妇女空气污染暴露相关生物学标记研究进展

空气污染可以导致呼吸道疾病以及心脑血管疾病。妊娠妇女机体处于一种高代谢状态,对空气污染物比较敏感;胎儿处于生长发育的关键时期,对污染物也更敏感。近年来的研究表明,妊娠妇女暴露于空气污染物与各种不良妊娠结局有关,包括自然流产、胎儿生长受限、早产和低出生体质量等。然而,其潜在机制尚不清楚。目前暴露组学、代谢组学的应用筛选出许多空气污染体内暴露的生物学标记物,如DNA加合物等代谢产物。生物学标记物可以用来反映个体的内暴露水平,相比外暴露的污染物监测更为准确,更能反映机体的暴露水平,从而指导探究空气污染暴露与各种妊娠结局相关的潜在机制。     

农村地区空气污染人群暴露评价研究

目的了解我国农村欠发达地区空气污染的状况及农村人群对空气污染的实际暴露水平。方法选择安庆市所属两个县18个乡镇的189个家庭,对其室内、外空气污染水平进行环境监测 ,同时对上述家庭中年龄在15～65岁之间的488名调查对象进行入户问卷调查。结果被调查地区存在严重的室内外空气污染 ,污染物以可吸入颗粒物PM10 为主 ,厨房、卧室、庭院、田间分别为(518±27)μg/m3,(340±9)μg/m3,(287±9)μg/m3,(270±10)μg/m3,室内污染水平显著高于室外 (P<0.01) ;SO2 和CO的污染水平较低 (P>0.05)。结合个体暴露时间和环境暴露浓度对个体的综合空气污染暴露进行综合评价的结果显示 ,该地区农村居民冬季对PM10 的实际暴露水平明显高于国家卫生标准 ,而其室内外空气污染主要来源是由于做饭和取暖的燃料燃烧引起。结论该地区农村室内空气污染严重 ,污染物以PM10 为主     

臭氧大气污染与阿尔兹海默症的研究进展

目前阿尔兹海默症(Alzheimer’s disease,AD)的发病机制存在很多假说,AD的患病可能由神经炎症与氧化应激、β淀粉样(amyloid beta,Aβ)肽沉积及Tau蛋白过度磷酸化、基因突变等机制所致。空气污染是国内较严重的问题之一,O3暴露与AD等神经退行性疾病的相关研究已成为研究热点。我们从流行病学和分子机制方面探讨O3空气污染对AD患病的影响,以期为疾病的预防与控制提供参考。     

染矽尘大鼠表面活性蛋白D和克拉拉细胞蛋白表达的变化

目的 探讨染矽尘大鼠肺组织和支气管肺泡灌洗液(BALF)表面活性蛋白-D(SP-D)和克拉拉细胞蛋白(CC16)表达的动态变化.方法 将80只大鼠随机分为对照组、染矽尘组(每组40只),采用气管暴露注入矽尘悬液法建立矽肺动物模型.染尘后在7、14、21、28和60 d时每组分别处死8只大鼠,取肺组织和BALF.免疫组化法检测不同时间点的肺组织SP-D和CC16在肺组织中的表达,并作定量分析;以Western Blot法检测BALF中SP-D和CC16含量,并作定量分析.结果 对照组大鼠肺泡Ⅱ型细胞和Clara细胞胞浆内有少量sP-D表达.染矽尘组染矽尘7d后肺组织SP-D表达明显升高,与对照组的差异有统计学意义(P＜0.01);14 d时达到高峰期,此后开始下降.在对照组细支气管周边的Clara细胞胞浆内CC16高表达,部分细胞核内也可见CC16表达.染矽尘大鼠7d后CC16表达明显减少,与对照组的差异有统计学意义(P＜0.01).随着染矽尘时间的延长,CC16表达逐渐减少,并且呈负相关性(t=-0.967,P＜0.01) 7、28 d染矽尘组BALF中SP-D含量均高于对照组,差异有统计学意义(P＜0.01);且28 d BALF中SP-D含量明显高于7 d染矽尘组,差异有统计学意义(P＜0.01).7、28 d染矽尘组BALF中CC16蛋白含量均低于对照组,差异有统计学意义(P＜0.01);且28 d明显低于7 d染矽尘组,差异有统计学意义(P＜0.01).结论 染矽尘能够导致大鼬市组织和BALF SP-D和CC16蛋白表达改变且与染矽尘时间有一定关系.     

Pulmonary epithelial integrity in children: relationship to ambient ozone exposure and swimming pool attendance

Airway irritants such as ozone are known to impair lung function and induce airway inflammation. Clara cell protein (CC16) is a small anti-inflammatory protein secreted by the nonciliated bronchiolar Clara cells. CC16 in serum has been proposed as a noninvasive and sensitive marker of lung epithelial injury. In this study, we used lung function and serum CC16 concentration to examine the pulmonary responses to ambient O3 exposure and swimming pool attendance. The measurements were made on 57 children 10-11 years of age before and after outdoor exercise for 2 hr. Individual O3 exposure was estimated as the total exposure dose between 0700 hr until the second blood sample was obtained (mean O3 concentration/m3 times symbol hours). The maximal 1-hr value was 118 microg/m3 (59 ppb), and the individual exposure dose ranged between 352 and 914 microg/m3hr. These O3 levels did not cause any significant changes in mean serum CC16 concentrations before or after outdoor exercise, nor was any decrease in lung function detected. However, children who regularly visited chlorinated indoor swimming pools had significantly lower CC16 levels in serum than did nonswimming children both before and after exercise (respectively, 57 +/- 2.4 and 53 +/- 1.7 microg/L vs. 8.2 +/- 2.8 and 8.0 +/- 2.6 microg/L; p < 0.002). These results indicate that repeated exposure to chlorination by-products in the air of indoor swimming pools has adverse effects on the Clara cell function in children. A possible relation between such damage to Clara cells and pulmonary morbidity (e.g., asthma) should be further investigated.     

Asthmatic symptoms among pupils in relation to winter indoor and outdoor air pollution in schools in Taiyuan, China

BACKGROUND: There are few studies on associations between children's respiratory heath and air pollution in schools in China. The industrial development and increased traffic may affect the indoor exposure to air pollutants in school environment. Moreover, there is a need to study respiratory effects of environmental tobacco smoke (ETS) and emissions from new building materials in homes in China. OBJECTIVES: We studied the associations between pupils' asthmatic symptoms and indoor and outdoor air pollution in schools, as well as selected home exposures, in a coal-burning city in north China. METHODS: A questionnaire survey was administered to pupils (11-15 years of age) in 10 schools in urban Taiyuan, collecting data on respiratory health and selected home environmental factors. Indoor and outdoor school air pollutants and climate factors were measured in winter. RESULTS: A total of 1,993 pupils (90.2%) participated; 1.8% had cumulative asthma, 8.4% wheezing, 29.8% had daytime attacks of breathlessness. The indoor average concentrations of sulfur dioxide, nitrogen dioxide, ozone, and formaldehyde by class were 264.8, 39.4, 10.1, and 2.3 microg/m3, respectively. Outdoor levels were two to three times higher. Controlling for possible confounders, either wheeze or daytime or nocturnal attacks of breathlessness were positively associated with SO2, NO2, or formaldehyde. In addition, ETS and new furniture at home were risk factors for wheeze, daytime breathlessness, and respiratory infections. CONCLUSIONS: Indoor chemical air pollutants of mainly outdoor origin could be risk factors for pupils' respiratory symptoms at school, and home exposure to ETS and chemical emissions from new furniture could affect pupils' respiratory health.     

Associations between environmental exposures and serum concentrations of Clara cell protein among elderly men in Oslo, Norway

Cardiopulmonary morbidity and mortality is associated with several environmental exposures. Mechanistically, pathophysiological changes in the cardiopulmonary system may lead to the induction of inflammatory responses.In the present study we explored associations between environmental exposures and serum concentrations of lung Clara cell protein 16 kDa, a biomarker that has recently been used to assess the integrity of the lung epithelium.Serum Clara cell protein concentrations were associated with both number of cigarettes smoked per day and number of pack-years of smoking. There was no evidence of an association between long-term exposure to ambient air pollution, as assessed at each participant's home address, and serum concentrations of CC16. However, short-term variations in both ambient air pollution and temperature were associated with increases in serum Clara cell concentrations. All findings were robust when other factors were adjusted for.These findings suggest that acute environmental exposures may compromise the integrity of the lung epithelium and lead to increased epithelial barrier permeability in the lungs of elderly men.     

Traffic air pollution and other risk factors for respiratory illness in schoolchildren in the niger-delta region of Nigeria

Background: Association of childhood respiratory illness with traffic air pollution has been investigated largely in developed but not in developing countries, where pollution levels are often very high.Objectives: In this study we investigated associations between respiratory health and outdoor and indoor air pollution in schoolchildren 7–14 years of age in low socioeconomic status areas in the Niger Delta.Methods: A cross-sectional survey was carried out among 1,397 schoolchildren. Exposure to home outdoor and indoor air pollution was assessed by self-report questionnaire. School air pollution exposures were assessed using traffic counts, distance of schools to major streets, and particulate matter and carbon monoxide measurements, combined using principal components analysis. Hierarchical logistic regression was used to examine associations with reported respiratory health, adjusting for potential confounders.Results: Traffic disturbance at home (i.e., traffic noise and/or fumes evident inside the home vs. none) was associated with wheeze [odds ratio (OR) = 2.16; 95% confidence interval (CI), 1.28–3.64], night cough (OR = 1.37; 95% CI, 1.03–1.82), phlegm (OR = 1.49; 95% CI, 1.09–2.04), and nose symptoms (OR = 1.40; 95% CI, 1.03–1.90), whereas school exposure to a component variable indicating exposure to fine particles was associated with increased phlegm (OR = 1.38; 95% CI, 1.09–1.75). Nonsignificant positive associations were found between cooking with wood/coal (OR = 2.99; 95% CI, 0.88–10.18) or kerosene (OR = 2.83; 95% CI, 0.85–9.44) and phlegm compared with cooking with gas.Conclusion: Traffic pollution is associated with respiratory symptoms in schoolchildren in a deprived area of western Africa. Associations may have been underestimated because of nondifferential misclassification resulting from limitations in exposure measurement.     

人体对室内外空气污染物的暴露量与潜在剂量的关系

目的：探讨人体对室内外空气污染物的暴露量（exposure)与潜在剂量（potential dose)的关系，方法：分析并对比暴露量与潜在剂量的定义和计算方法，应用方案评价法分别计算个体对室内外空气中甲醛的暴露量与潜在剂量和对CO的暴露量与潜在剂量，二者有时明显相关，有时无相关性。结论：与暴露量相比，潜在剂量应能更好地反映室内外空气中污染物与健康效应的关系。     

Indoor and outdoor air pollution: tobacco smoke, moulds and diseases in infants and children

Although outdoor air pollution first brought the issue of air pollution health effects to public attention, it is now indoor air pollution that likely has the greatest impact on children's health. The World Health Organization estimates that the global burden of disease from indoor air pollution is far greater than the burden from outdoor air pollution. This review focuses on two indoor pollutants, one that has been well studied, and another that deserves additional study. There is very strong evidence about the harmful effects of tobacco. Policy to decrease children's tobacco exposure and use should be implemented without delay. The emerging findings linking household inhalation of mould spores and infant pulmonary hemorrhage merit follow-up in other countries, because they may provide clues to some deaths from the sudden infant death syndrome.     

本溪市大气污染与急慢性呼吸系统疾病的关系

目的 灯一溪市大气污染治理。方法 于１９９４年和１９９５年连续二年调查室外大气污染对呼呼统健康的影响,经对市内５个衡区２５岁以上成中呼吸系统症状生咳 、气短、突发性喘息）三种疾病（慢性支气管炎,慢性阻塞性疾患及上呼吸道感染）以内外多种暴露的流行病学调查,用多因素Ｌｏｇｉｓｔｉｃ回归分析,调整了年龄、性别、文化程度、职业、室内煤及吸烟状况后,得出室外大气污染和一呼吸系统疾病的联系。结果 ６种呼吸系统     

Car indoor air pollution - analysis of potential sources

ABSTRACT: The population of industrialized countries such as the United States or of countries from the European Union spends approximately more than one hour each day in vehicles. In this respect, numerous studies have so far addressed outdoor air pollution that arises from traffic. By contrast, only little is known about indoor air quality in vehicles and influences by non-vehicle sources.Therefore the present article aims to summarize recent studies that address i.e. particulate matter exposure. It can be stated that although there is a large amount of data present for outdoor air pollution, research in the area of indoor air quality in vehicles is still limited. Especially, knowledge on non-vehicular sources is missing. In this respect, an understanding of the effects and interactions of i.e. tobacco smoke under realistic automobile conditions should be achieved in future.     

Association of indoor and outdoor air pollutant level with respiratory problems among children in an industrial area of Delhi, India

The authors conducted this prospective study at the Shahdara industrial area of Delhi, India. They examined the effects of indoor and outdoor air pollutant levels on respiratory health in 394 children aged 7 to 15 years. The majority of children had a history of respiratory problems, including cough (62.7%), sputum production (24.4%), shortness of breath (32.0%), wheezing (25.6%), common cold (44.4%), and throat congestion (43.1%). The association of indoor and outdoor air pollutant levels showed that outdoor SO2 and NO2 was significantly higher than indoor SO2 and NO2 levels, whereas the mean indoor level of suspended particulate matter (SPM) was significantly higher than outdoor SPM level. Indoor SPM level also was significantly higher in homes of children with a history of respiratory illness than homes of children having no history of respiratory illness. Results suggest that both indoor and outdoor particulate exposure may be important risk factors in the development of respiratory illness in children.     

Respiratory function as measured by peak expiratory flow rate and PM10: six communities study.

This Six Communities Study conducted at six communities in southwestern North Carolina investigates the respiratory health status of residents whose households are located near an incinerator. This diary study makes it possible to estimate the daily variation of pulmonary function measured as peak expiratory flow rate (PEFR) related to 24-h mean PM10 levels, which were observed at each monitoring station placed in the six study communities, as a surrogate exposure measure of outdoor air pollution. Observations of PEFR among participants in each community were analyzed to determine how they varied according to the degree of exposure to ambient pollutants as well as to other cofactors including, sex, age, respiratory hypersensitivity, hours spent outdoors within the area of the selected community, and surrogate measures for indoor air pollution exposure (vacuum use and experience of air irritants at work). The findings revealed that respiratory hypersensitivity status is a predictor of declining PEFR. PM10 concentrations measured in each study area did not seem to be related to the variations of respiratory health as measured by PEFR. This study did not show any difference in respiratory health between subjects of an incinerator community and those of its comparison community. Even though this community-based study with free-living subjects shows negative findings on the relationship between respiratory health and PM10, it is worth noting that these findings must be interpreted cautiously because exposure estimation based on monitoring of ambient air likely results in misclassification of true exposure levels.