Dietary Fat Intake, Particulate Matter Exposure, and Asthma Severity.
Dietary Fat Intake, Particulate Matter Exposure, and Asthma Severity.
复制标题
膳食脂肪摄入量、颗粒物暴露和哮喘严重程度。
DOI：
10.1164/rccm.201902-0296ed
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发表时间：
2019
影响因子：
24.7
通讯作者：
Perzanowski,MatthewS
中科院分区：
文献类型：
--
作者：
Rosa,MariaJosé;Perzanowski,MatthewS
这似乎是直观的，暴露于燃烧相关的颗粒物会恶化哮喘症状，鉴于已知的促炎作用的燃烧相关的副产物和沉积在肺部。在过去的几十年里，人们进行了大量的研究来建立这种联系。总的来说，这些研究的结果普遍支持燃烧相关的空气污染和哮喘严重程度之间的联系（1）。然而，总的来说，迄今为止所显示的相关性相对较小。例如，在英国伦敦高交通流量地区的随机交叉研究中，尽管成年哮喘患者在伦敦高交通流量地区行走后的肺功能比在海德公园行走后的肺功能稍低（低6%），但对哮喘症状没有影响（2）。此外，从世纪后半叶开始，在诸如美国城市社区的地方，哮喘患病率的大量人口增加的时间与燃烧相关的空气污染物的急剧增加不一致。一项对纽约市湖中央公园湖泊沉积物的研究发现，空气污染源中的多环芳烃在20世纪10年代至20年代达到峰值，然后在剩余的世纪随着城市从煤炭过渡到石油燃料，然后在20世纪70年代更严格的环境法规下过渡到更清洁的石油燃料而下降（3）。这表明，如果空气污染是重要的哮喘的发展和恶化的人口水平上，因素或暴露影响的敏感性燃烧副产物必须改变在美国城市社区在后半个世纪。在这一期的杂志上，Brigham及其同事的文章（pp. 1478-1486）可以提供一些洞察这些可能的效果修改器之一（4）。在一项小组研究中，他们跟踪了135名来自低收入家庭的主要是非洲裔美国儿童。这些儿童在一年内被跟踪了三个为期一周的时期，在此期间测量了家庭颗粒物，并评估了omega-3和omega-6脂肪酸的饮食摄入量和哮喘症状。值得注意的是，研究人员发现，颗粒物暴露与肺功能和症状之间的关联被报告的omega-3和omega-6脂肪酸摄入量所改变。较高的ω-6脂肪酸摄入量与空气动力学直径< 2.5 mm的颗粒物和哮喘症状之间的关联增加相关，而较高的ω-3脂肪酸摄入量与空气动力学直径< 2.5 mm的颗粒物和哮喘症状之间的关联减少相关。在美国，低收入少数族裔社区不成比例地受到哮喘流行病的影响。同样，考虑到哮喘流行的时间，美国世纪后半叶的饮食发生了巨大变化。这包括大豆衍生油的膳食脂肪显着增加，大豆衍生油通常用于加工食品，因为其成本较低（5）。从那时起，大豆衍生油一直是美国饮食中omega-6脂肪酸的主要来源，尽管最近几十年来，这些脂肪酸在较高社会经济地位的社区中有所减少，但在低收入社区中没有观察到。因此，我们不得不认为，饮食变化可能是哮喘流行病中观察到的患病率和发病率增加以及低收入城市社区中观察到的差异的基础。那个...
It seems intuitive that exposure to combustion-related particulate matter would worsen asthma symptoms, given the known proinflammatory effects of combustion-related byproducts and deposition in the lungs. A great deal of research during the past several decades has been performed to establish this link. On the whole, the findings from these studies have generally supported the connection between combustion-related air pollution and asthma severity (1). However, collectively, the associations shown to date have been relatively modest. For example, in the randomized crossover study of exposure to high-vehicle traffic areas in London, United Kingdom, although adult patients with asthma had modestly lower lung function (z6% lower) after walking in an area of London with high truck traffic than after walking in Hyde Park, there was no effect on asthma symptoms (2). Also, the timing of the large population increase in asthma prevalence in places such as urban communities of the United States, starting in the latter half of the 20th century, does not coincide with dramatic increases in combustion-related air pollutants. A study of sediments from a lake in Central Park in New York City lake found that polycyclic aromatic hydrocarbons from air pollution sources peaked in the 1910s-1920s and then decreased during the remaining century as the city transitioned from coal to petroleum fuel and then to cleaner-burning petroleum under tighter environmental regulations in the 1970s (3). This suggests that if air pollution is important in asthma development and exacerbation on a population level, that factors or exposures influencing susceptibility to combustion byproducts must have changed in urban US communities in the latter half of the 20th century. In this issue of the Journal, the article by Brigham and colleagues (pp. 1478-1486) could offer some insight into one of those possible effect modifiers (4). In a panel study, they followed 135 predominantly African-American children from low-income households. The children were followed for three 1-week periods during a year, during which domestic particulate matter was measured and dietary intake of omega-3 and omega-6 fatty acids and asthma symptoms were assessed. Notably, the researchers found that associations between particulate matter exposure and lung function and symptoms were modified by reported intake of omega-3 and omega-6 fatty acids. Higher omega-6 fatty acid intake was associated with an increased association between particulate matter< 2.5 mm in aerodynamic diameter and asthma symptoms, whereas higher omega-3 fatty acid intake was associated with a reduced association between particulate matter< 2.5 mm in aerodynamic and asthma symptoms. In the United States, low-income minority communities have suffered disproportionately from the asthma epidemic. Again, considering the timing of the asthma epidemic, the latter half of the 20th century in the United States saw dramatic changes in diet. This included a notable increase in dietary fat from soy bean-derived oils, which were commonly used in processed food because of their lower costs (5). Since then, soy bean-derived oils have been a major source of omega-6 fatty acids in the diet in the United States, although the most recent decades have seen a decrease in these fatty acids among higher-socioeconomic status communities, which has not been observed in lower-income communities (6). Therefore, it is compelling to think that dietary changes could underlie some of the increased prevalence and morbidity observed with the asthma epidemic and the disparities observed in lower-income, urban communities. The …