Asma y contaminación
Resumen
La contaminación atmosférica es una mezcla de partículas en suspensión y gases generados por las actividades industriales, vehículos o centrales termoeléctricas a la que se añaden la combustión de biomasa y combustibles fósiles que afectan al pulmón ya que este ofrece una amplia superficie en contacto directo con el medio externo. El mecanismo de acción más aceptado es un aumento del estrés oxidativo en el epitelio respiratorio. Cuando las partículas en suspensión y los gases, que poseen un gran poder de oxidación, entran en contacto con el epitelio, se induce la formación de radicales libres hasta un nivel que es imposible neutralizar, poniendo en marcha la cascada inflamatoria, aunque la capacidad del individuo de dar respuesta al incremento del estrés oxidativo puede evitar o mitigar la aparición de síntomas.
Los efectos sobre el asma bronquial pueden cifrarse en dos vertientes. En primer lugar, se asocia con un aumento de las exacerbaciones, lo cual implica un incremento en el número de visitas a urgencias y hospitalización, junto con un peor control de la enfermedad manifestado por un aumento de los síntomas y del uso de la medicación de rescate. En segundo lugar, se ha sugerido que la exposición a la contaminación atmosférica origina nuevos casos de asma, poniéndose como ejemplo el incremento de la incidencia en China donde un desarrollo industrial exponencial origina una exposición a contaminantes elevada en un amplio porcentaje de la población.
Referencias
Real Academia Española. Diccionario de la lengua española. [Consultado: 19/08/2016]. Disponible en: http://dle.rae. es/?id=AU1m1dd.
Salvi SS, Barnes PJ. Chronic obstructive pulmonary disease in non-smokers. Lancet. 2009;374:733–43.
Po JY, FitzGerald JM, Carlsten C. Respiratory disease associated with solid biomass fuel exposure in rural women and children: systematic review and meta-analysis. Thorax. 2011;66:232–9.
Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2224–60.
Hansell A, Ghosh RE, Blangiardo M, Perkins C, Vienneau D, Goffe K, et al. Historic air pollution exposure and long-term mortality risks in England and Wales: prospective longitudinal cohort study. Thorax. 2016;71:330–8.
Perez L, Declercq C, Iñiguez C, Aguilera I, Badaloni C, Ballester F, et al. Chronic burden of near-roadway traffic pollution in 10 European cities (APHEKOM network). Eur Respir J. 2013;42:594–605.
Robinson CL, Baumann LM, Romero K, Combe JM, Gomez A, Gilman RH, et al. Effect of urbanisation on asthma, allergy and airways inflammation in a developing country setting. Thorax. 2011;66:1051–7.
Guarnieri M, Balmes JR. Outdoor air pollution and asthma. Lancet. 2014;383:1581–92.
Kelly FJ, Fussell JC. Size, source and chemical composition as determinants of toxicity attributable to ambient particulate matter. Atmos Environ. 2012;60:504–26.
Mann JK, Balmes JR, Bruckner TA, Mortimer KM, Margolis HG, Pratt B, et al. Short-term effects of air pollution on wheeze in asthmatic children in Fresno, California. Environ Health Perspect. 2010;118:1497–502.
Jacquemin B, Kauffmann F, Pin I, Le Moual N, Bousquet J, Gormand F, et al.; Epidemiological study on the Genetics and Environment of Asthma (EGEA). Air pollution and asthma control in the Epidemiological study on the Genetics and Environment of Asthma. J Epidemiol Community Health. 2012;66:796–802.
U.S. EPA. 2013 Final Report: Integrated Science Assessment of Ozone and Related Photochemical Oxidants. U.S. Environmental Protection Agency, Washington, DC, EPA/600/R-10/076F, 2013. [Consultado: 19/08/2016]. Disponible en: https://cfpub.epa.gov/ncea/isa/recordisplay. cfm?deid=247492.
Health Effects Institute. Traffic-related air pollution: a critical review of the literature on emissions, exposure, and health effects. Boston, MA: Health Effects Institute; 2010. Panel on the Health Effects of Traffic-Related Air Pollution. [Consultado: 19/08/2016]. Disponible en: https://www.healtheffects.org/publication/traffic-related-air-pollution-critical-review-literature-emissions-exposure-and-health.
Brunekreef B, Stewart AW, Anderson HR, Lai CK, Strachan DP, Pearce N; ISAAC Phase 3 Study Group. Self-reported truck traffic on the street of residence and symptoms of asthma and allergic disease: a global relationship in ISAAC phase 3. Environ Health Perspect. 2009;117:1791–8.
Balmes JR, Earnest G, Katz PP, Yelin EH, Eisner MD, Chen H, et al. Exposure to traffic: lung function and health status in adults with asthma. J Allergy Clin Immunol. 2009;123:626–31.
Delfino RJ, Wu J, Tjoa T, Gullesserian SK, Nickerson B, Gillen DL. Asthma morbidity and ambient air pollution: effect modification by residential traffic-related air pollution. Epidemiology. 2014;25:48–57.
Perez L, Künzli N, Avol E, Hricko AM, Lurmann F, Nicholas E, et al. Global goods movement and the local burden of childhood asthma in southern California. Am J Public Health. 2009;99 Supl 3:S622–8.
Kelly F, Armstrong B, Atkinson R, Anderson HR, Barratt B, Beevers S, et al.; HEI Health Review Committee. The London low emission zone baseline study. Res Rep Health Eff Inst. 2011;163:3–79. [Consultado: 19/08/2016]. Disponible en: https://www.healtheffects.org/publication/london-low-emission-zone-baseline-study.
Miller MD, Marty MA. Impact of environmental chemicals on lung development. Environ Health Perspect. 2010;118:1155–64.
Horwood LJ, Fergusson DM, Shannon FT. Social and familial factors in the development of early childhood asthma. Pediatrics. 1985;75:859–68.
Shankardass K, McConnell R, Jerrett M, Milam J, Richardson J, Berhane K. Parental stress increases the effect of traffic-related air pollution on childhood asthma incidence. Proc Natl Acad Sci USA. 2009;106:12406–11.
Neophytou AM, White MJ, Oh SS, Thakur N, Galanter JM, Nishimura KK, et al. Air Pollution and Lung Function in Minority Youth with Asthma in the GALA II (Genes-Environments and Admixture in Latino Americans) and SAGE II (Study of African Americans, Asthma, Genes, and Environments) Studies. Am J Respir Crit Care Med. 2016;193:1271–80.
Moon KY, Park MK, Leikauf GD, Park CS, Jang AS. Diesel exhaust particle-induced airway responses are augmented in obese rats. Int J Toxicol. 2014;33:21–8.
Stapleton M, Howard-Thompson A, George C, Hoover RM, Self TH. Smoking and asthma. J Am Board Fam Med. 2011;24:313–22.
Rabinovitch N, Silveira L, Gelfand EW, Strand M. The response of children with asthma to ambient particulate is modified by tobacco smoke exposure. Am J Respir Crit Care Med. 2011;184:1350–7.
Arbex MA, Santos Ude P, Martins LC, Saldiva PH, Pereira LA, Braga AL. Air pollution and the respiratory system. J Bras Pneumol. 2012;38:643–55.
Delfino RJ, Staimer N, Gillen D, Tjoa T, Sioutas C, Fung K, et al. Personal and ambient air pollution is associated with increased exhaled nitric oxide in children with asthma. Environ Health Perspect. 2006;114:1736–43.
Poynter ME, Persinger RL, Irvin CG, Butnor KJ, Van Hirtum H, Blay W, et al. Nitrogen dioxide enhances allergic airway inflammation and hyperresponsiveness in the mouse. Am J Physiol Lung Cell Mol Physiol. 2006;290:L144–52.
Patel MM, Chillrud SN, Deepti KC, Ross JM, Kinney PL. Traffic-related air pollutants and exhaled markers of airway inflammation and oxidative stress in New York City adolescents. Environ Res. 2013;121:71–8.
Islam T, Berhane K, McConnell R, Gauderman WJ, Avol E, Peters JM, et al. Glutathione-S-transferase (GST) P1, GSTM1, exercise, ozone and asthma incidence in school children. Thorax. 2009;64:197–202.
Li YF, Gauderman WJ, Avol E, Dubeau L, Gilliland FD. Associations of tumor necrosis factor G-308A with childhood asthma and wheezing. Am J Respir Crit Care Med. 2006;173:970–6.
Nadeau K, McDonald-Hyman C, Noth EM, Pratt B, Hammond SK, Balmes J, et al. Ambient air pollution impairs regulatory T-cell function in asthma. J Allergy Clin Immunol. 2010;126:845–52.
Kohli A, Garcia MA, Miller RL, Maher C, Humblet O, Hammond SK, et al. Secondhand smoke in combination with ambient air pollution exposure is associated with increasedx CpG methylation and decreased expression of IFN-γ in T effector cells and Foxp3 in T regulatory cells in children. Clin Epigenetics. 2012;4:17.
Brandt EB, Kovacic MB, Lee GB, Gibson AM, Acciani TH, Le Cras TD, et al. Diesel exhaust particle induction of IL-17A contributes to severe asthma. J Allergy Clin Immunol. 2013;132:1194–204.
Nel AE, Diaz-Sanchez D, Ng D, Hiura T, Saxon A. Enhancement of allergic inflammation by the interaction between diesel exhaust particles and the immune system. J Allergy Clin Immunol. 1998;102:539–54.
Diaz-Sanchez D, Garcia MP, Wang M, Jyrala M, Saxon
A. Nasal challenge with diesel exhaust particles can induce sensitization to a neoallergen in the human mucosa. J Allergy Clin Immunol. 1999;104:1183–8.
Kelly FJ, Fussell JC. Air pollution and airway disease. Clin Exp Allergy. 2011;41:1059–71.
Watts J. Doctors blame air pollution for China’s asthma increases. Lancet. 2006;368:719–20.
McCreanor J, Cullinan P, Nieuwenhuijsen MJ, Stewart-Evans J, Malliarou E, Jarup L, et al. Respiratory effects of exposure to diesel traffic in persons with asthma. N Engl J Med. 2007;357:2348–58.
Manchester-Neesvig JB, Schauer JJ, Cass GR. The distribution of particle-phase organic compounds in the atmosphere and their use for source apportionment during the Southern California Children’s Health Study. J Air Waste Manag Assoc. 2003;53:1065–79.
Abe S, Takizawa H, Sugawara I, Kudoh S. Diesel exhaust (DE)-induced cytokine expression in human bronchial epithelial cells: a study with a new cell exposure system to freshly generated DE in vitro. Am J Respir Cell Mol Biol. 2000;22:296–303.
Penttinen P, Timonen KL, Tiittanen P, Mirme A, Ruuskanen J, Pekkanen J. Ultrafine particles in urban air and respiratory health among adult asthmatics. Eur Respir
J. 2001;17:428–35.
Samoli E, Nastos PT, Paliatsos AG, Katsouyanni K, Priftis KN. Acute effects of air pollution on pediatric asthma exacerbation: evidence of association and effect modification. Environ Res. 2011;111:418–24.
Iskandar A, Andersen ZJ, Bønnelykke K, Ellermann T, Andersen KK, Bisgaard H. Coarse and fine particles but not ultrafine particles in urban air trigger hospital admission for asthma in children. Thorax. 2012;67:252–7.
McConnell R, Berhane K, Gilliland F, London SJ, Islam T, Gauderman WJ, et al. Asthma in exercising children exposed to ozone: a cohort study. Lancet. 2002;359:386–91.
Gehring U, Wijga AH, Brauer M, Fischer P, De Jongste JC, Kerkhof M, et al. Traffic-related air pollution and the development of asthma and allergies during the first 8 years of life. Am J Respir Crit Care Med. 2010;181:596–603.
Morgenstern V, Zutavern A, Cyrys J, Brockow I, Koletzko S, Krämer U, et al. Atopic diseases, allergic sensitization, and exposure to traffic-related air pollution in children. Am J Respir Crit Care Med. 2008;177:1331–7.
Künzli N, Bridevaux PO, Liu LJ, Garcia-Esteban R, Schindler C, Gerbase MW, et al. Traffic-related air pollution correlates with adult-onset asthma among never-smokers. Thorax. 2009;64:664–70.
Neidell M. Air quality warnings and outdoor activities: evidence from Southern California using a regression discontinuity design. J Epidemiol Community Health. 2010;64:921–6.
Zhu Y, Hinds WC, Kim S, Sioutas C. Concentration and size distribution of ultrafine particles near a major highway. J Air Waste Manag Assoc. 2002;52:1032–42.
Zhu Y, Eiguren-Fernandez A, Hinds WC, Miguel AH. In-cabin commuter exposure to ultrafine particles on Los Angeles freeways. Environ Sci Technol. 2007;41:2138–45.
Comité Ejecutivo de GEMA. GEMA 4.0. Guía Española para el Manejo del Asma. Arch Bronconeumol. 2015;51: 2–54.
Delfino RJ, Zeiger RS, Seltzer JM, Street DH, McLaren CE. Association of asthma symptoms with peak particulate air pollution and effect modification by anti-inflammatory medication use. Environ Health Perspect. 2002;110: A607–17.
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