Inflammatory health effects of indoor and outdoor particulate matter - 07/03/18

Doi : 10.1016/j.jaci.2017.12.981

Weidong Wu, PhD ^a,^{∗
These authors contributed equally to this work.}, Yuefei Jin, MD ^b,^{∗
These authors contributed equally to this work.}, Chris Carlsten, MD, MPH ^c,^⁎^{∗
These authors contributed equally to this work.}
^a Department of Occupational and Environmental Health, School of Public Health, Xinxiang Medical University, Xinxiang, China
^b Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
^c Air Pollution Exposure Laboratory, Department of Medicine and School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada

^∗Corresponding author: Chris Carlsten, MD, MPH, Department of Medicine, 2775 Laurel St, Vancouver General Hospital, Vancouver, British Columbia V5Z 1M9, Canada.Department of Medicine2775 Laurel StVancouver General HospitalVancouverBritish ColumbiaV5Z 1M9Canada

Abstract

Information for Category 1 CME Credit

Credit can now be obtained, free for a limited time, by reading the review articles in this issue. Please note the following instructions.

Method of Physician Participation in Learning Process: The core material for these activities can be read in this issue of the Journal or online at the JACI Web site: www.jacionline.org. The accompanying tests may only be submitted online at www.jacionline.org. Fax or other copies will not be accepted.

Date of Original Release: March 2018. Credit may be obtained for these courses until February 28, 2019.

Overall Purpose/Goal: To provide excellent reviews on key aspects of allergic disease to those who research, treat, or manage allergic disease.

Target Audience: Physicians and researchers within the field of allergic disease.

Accreditation/Provider Statements and Credit Designation: The American Academy of Allergy, Asthma & Immunology (AAAAI) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The AAAAI designates this journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

List of Design Committee Members: Weidong Wu, PhD, Yuefei Jin, MD, and Chris Carlsten, MD, MPH (authors); Zuhair K. Ballas, MD (editor)

Disclosure of Significant Relationships with Relevant Commercial

Companies/Organizations: The authors declare that they have no relevant conflicts of interest. Z. K. Ballas (editor) disclosed no relevant financial relationships.

Activity Objectives:

1.	To recognize that particulate matter (PM) can have significant pulmonary and cardiovascular effects.
2.	To identify some of the inflammatory changes and potential health consequences that can occur with exposure to PM.

Recognition of Commercial Support: This CME activity has not received external commercial support.

List of CME Exam Authors: Evelyn Angulo, MD, Anna Lang, MD, PhD, David Peloza, MD, Cheryl Steiman, MD, and Sameer K. Mathur, MD, PhD.

Disclosure of Significant Relationships with Relevant Commercial

Companies/Organizations: The exam authors disclosed no relevant financial relationships.

Inflammation is a common and essential event in the pathogenesis of diverse diseases. Decades of research has converged on an understanding that all combustion-derived particulate matter (PM) is inflammatory to some extent in the lungs and also systemically, substantially explaining a significant portion of the massive cardiopulmonary disease burden associated with these exposures. In general, this means that efforts to do the following can all be beneficial: reduce particulates at the source, decrease the inflammatory potential of PM output, and, where PM inhalation is unavoidable, administer anti-inflammatory treatment. A range of research, including basic illumination of inflammatory pathways, assessment of disease burden in large cohorts, tailored treatment trials, and epidemiologic, animal, and in vitro studies, is highlighted in this review. However, meaningful translation of this research to decrease the burden of disease and deliver a clear and cohesive message to guide daily clinical practice remains rudimentary. Ongoing efforts to better understand substantial differences in the concentration and type of PM to which the global community is exposed and then distill how that influences inflammation promises to have real-world benefit. This review addresses this complex topic in 3 sections, including ambient PM (typically associated with ground-level transportation), wildfire-induced PM, and PM from indoor biomass burning. Recognizing the overlap between these domains, we also describe differences and suggest future directions to better inform clinical practice and public health.

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Key words : Air pollution, inflammation, particulate matter, wildfire, biomass

Abbreviations used : ALRI, BAL, COPD, CVD, ED, ICS, PAH, PM, TLR