极端温度引发的哮喘：从流行病学证据到生物学合理性
2022/12/21
摘要
背景：越来越多的证据表明，极端温度是哮喘的关键诱因和潜在诱因；然而，关于极端温度对哮喘的影响的报道并不一致，其潜在机制尚不明确。
研究目的：这篇综述旨在通过系统总结现有的从流行病学证据到生物学合理性的研究，评估酷热、严寒和温度变化对哮喘的影响
方法：从开始到2022年6月30日，我们在PubMed、Embase和Web of Science进行了系统搜索，检索了流行病学和生物学研究的文章，评估了极端温度与哮喘之间的关联。该方案已在PROSPERO（CRD42021273613）注册。
结果：从12435份已确定的记录中，111项合格的研究被纳入定性综合，37篇文章被纳入荟萃分析（20篇针对酷热，16篇针对严寒，15篇针对温度变化）。对于流行病学证据，我们发现极端温度、室内/室外环境和个人脆弱性的协同效应是哮喘发作的重要诱因，特别是在酷热或寒冷的情况下。Meta分析进一步证实了这种关联，在酷热和严寒条件下，哮喘发作的合并相对风险分别为1.07（95%CI:1.03-1.12）和1.20（95%CI:1.12-1.29）。此外，这篇综述还讨论了极端温度与哮喘恶化之间的潜在炎症机制，并强调了极端温度引发的哮喘中免疫途径和瞬时受体电位离子通道的调节作用。
结论：我们得出结论，酷热和寒冷都会显著增加哮喘的风险。此外，我们提出了一个潜在的机制框架，这对于理解疾病发病机制非常重要，它揭示了极端温度引发的哮喘的复杂机制，并保护敏感个体免受极端天气事件和气候变化的影响。
Asthma triggered by extreme temperatures: From epidemiological evidence to biological plausibility
Han, A., Deng, S., Yu, J., Zhang, Y., Jalaludin, B., & Huang, C
Abstract
BACKGROUND:There is rapidly growing evidence indicating that extreme temperature is a crucial trigger and potential activator of asthma; however, the effects of extreme temperature on asthma are inconsistently reported and the its potential mechanisms remain undefined.
OBJECTIVES:This review aims to estimate the impacts of extreme heat, extreme cold, and temperature variations on asthma by systematically summarizing the existing studies from epidemiological evidence to biological plausibility.
METHODS:We conducted a systematic search in PubMed, Embase, and Web of Science from inception to June 30, 2022, and we retrieved articles of epidemiology and biological studies which assessed associations between extreme temperatures and asthma. This protocol was registered with PROSPERO (CRD42021273613).
RESULTS:From 12,435 identified records, 111 eligible studies were included in the qualitative synthesis, and 37 articles were included in the meta-analysis (20 for extreme heat, 16 for extreme cold, and 15 for temperature variations). For epidemiological evidence, we found that the synergistic effects of extreme temperatures, indoor/outdoor environments, and individual vulnerabilities are important triggers for asthma attacks, especially when there is extreme heat or cold. Meta-analysis further confirmed the associations, and the pooled relative risks for asthma attacks in extreme heat and extreme cold were 1.07 (95%CI: 1.03-1.12) and 1.20 (95%CI: 1.12-1.29), respectively. Additionally, this review discussed the potential inflammatory mechanisms behind the associations between extreme temperatures and asthma exacerbation, and highlighted the regulatory role of immunological pathways and transient receptor potential ion channels in asthma triggered by extreme temperatures.
CONCLUSION:We concluded that both extreme heat and cold could significantly increase the risk of asthma. Additionally, we proposed a potential mechanistic framework, which is important for understanding the disease pathogenesis that uncovers the complex mechanisms of asthma triggered by extreme temperatures and protects the sensitive individuals from impacts of extreme weather events and climate change.
背景：越来越多的证据表明，极端温度是哮喘的关键诱因和潜在诱因；然而，关于极端温度对哮喘的影响的报道并不一致，其潜在机制尚不明确。
研究目的：这篇综述旨在通过系统总结现有的从流行病学证据到生物学合理性的研究，评估酷热、严寒和温度变化对哮喘的影响
方法：从开始到2022年6月30日，我们在PubMed、Embase和Web of Science进行了系统搜索，检索了流行病学和生物学研究的文章，评估了极端温度与哮喘之间的关联。该方案已在PROSPERO（CRD42021273613）注册。
结果：从12435份已确定的记录中，111项合格的研究被纳入定性综合，37篇文章被纳入荟萃分析（20篇针对酷热，16篇针对严寒，15篇针对温度变化）。对于流行病学证据，我们发现极端温度、室内/室外环境和个人脆弱性的协同效应是哮喘发作的重要诱因，特别是在酷热或寒冷的情况下。Meta分析进一步证实了这种关联，在酷热和严寒条件下，哮喘发作的合并相对风险分别为1.07（95%CI:1.03-1.12）和1.20（95%CI:1.12-1.29）。此外，这篇综述还讨论了极端温度与哮喘恶化之间的潜在炎症机制，并强调了极端温度引发的哮喘中免疫途径和瞬时受体电位离子通道的调节作用。
结论：我们得出结论，酷热和寒冷都会显著增加哮喘的风险。此外，我们提出了一个潜在的机制框架，这对于理解疾病发病机制非常重要，它揭示了极端温度引发的哮喘的复杂机制，并保护敏感个体免受极端天气事件和气候变化的影响。
(中日友好医院呼吸与危重症医学科 沈焜路 摘译 林江涛 审校)
(Environ Res. 2023 Jan 1; DOI: 10.1016/j.envres.2022.114489)
(Environ Res. 2023 Jan 1; DOI: 10.1016/j.envres.2022.114489)
Asthma triggered by extreme temperatures: From epidemiological evidence to biological plausibility
Han, A., Deng, S., Yu, J., Zhang, Y., Jalaludin, B., & Huang, C
Abstract
BACKGROUND:There is rapidly growing evidence indicating that extreme temperature is a crucial trigger and potential activator of asthma; however, the effects of extreme temperature on asthma are inconsistently reported and the its potential mechanisms remain undefined.
OBJECTIVES:This review aims to estimate the impacts of extreme heat, extreme cold, and temperature variations on asthma by systematically summarizing the existing studies from epidemiological evidence to biological plausibility.
METHODS:We conducted a systematic search in PubMed, Embase, and Web of Science from inception to June 30, 2022, and we retrieved articles of epidemiology and biological studies which assessed associations between extreme temperatures and asthma. This protocol was registered with PROSPERO (CRD42021273613).
RESULTS:From 12,435 identified records, 111 eligible studies were included in the qualitative synthesis, and 37 articles were included in the meta-analysis (20 for extreme heat, 16 for extreme cold, and 15 for temperature variations). For epidemiological evidence, we found that the synergistic effects of extreme temperatures, indoor/outdoor environments, and individual vulnerabilities are important triggers for asthma attacks, especially when there is extreme heat or cold. Meta-analysis further confirmed the associations, and the pooled relative risks for asthma attacks in extreme heat and extreme cold were 1.07 (95%CI: 1.03-1.12) and 1.20 (95%CI: 1.12-1.29), respectively. Additionally, this review discussed the potential inflammatory mechanisms behind the associations between extreme temperatures and asthma exacerbation, and highlighted the regulatory role of immunological pathways and transient receptor potential ion channels in asthma triggered by extreme temperatures.
CONCLUSION:We concluded that both extreme heat and cold could significantly increase the risk of asthma. Additionally, we proposed a potential mechanistic framework, which is important for understanding the disease pathogenesis that uncovers the complex mechanisms of asthma triggered by extreme temperatures and protects the sensitive individuals from impacts of extreme weather events and climate change.
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支气管哮喘与精神障碍类型的双向相关性分析
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中重度哮喘成人和儿童中新冠肺炎严重结局的风险：一项系统回顾和荟萃分析
