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，极端温度是哮喘的重要诱因和潜在的激活剂，然而，极端温度对哮喘的影响报道不一致，其潜在机制尚不清楚。
目的：通过系统总结已有的从流行病学证据到生物学证据的研究，评估极端高温、极端寒冷和温度变化对哮喘的影响。
方法：我们在PubMed、Embase和Web of Science上进行了系统的搜索，从最初到2022年6月30日，我们检索了流行病学和生物学研究的文章，评估了极端温度和哮喘之间的联系。该方案已在PROSPERO(CRD42021273613)注册。
结果：从12,435篇文章中，111篇符合条件的研究纳入定性综合分析，37篇文章进入Meta分析(20篇与极端炎热有关，16篇与极端寒冷有关，15篇与温度变化有关)。对于流行病学证据，我们发现极端温度、室内/室外环境和个体脆弱性的协同效应是哮喘发作的重要触发因素，特别是在极端炎热或寒冷的情况下。Meta分析进一步证实了两者之间的关系，合并后的极端高温和极端寒冷条件下哮喘发作的相对危险度分别为1.07(95%可信区间：1.03-1.12)和1.20(95%可信区间：1.12-1.29)。此外，该综述还讨论了极端温度与哮喘加重之间潜在的炎症机制，并强调了免疫途径和瞬时受体电位离子通道在极端温度引发的哮喘中的调节作用。
结论：我们得出的结论是，极端炎热和极端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，这对于理解疾病的发病机制非常重要，该框架揭示了极端温度引发哮喘的复杂机制，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,
Abstrast
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.
Objective: 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.
Conclusions: 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，极端温度是哮喘的重要诱因和潜在的激活剂，然而，极端温度对哮喘的影响报道不一致，其潜在机制尚不清楚。
目的：通过系统总结已有的从流行病学证据到生物学证据的研究，评估极端高温、极端寒冷和温度变化对哮喘的影响。
方法：我们在PubMed、Embase和Web of Science上进行了系统的搜索，从最初到2022年6月30日，我们检索了流行病学和生物学研究的文章，评估了极端温度和哮喘之间的联系。该方案已在PROSPERO(CRD42021273613)注册。
结果：从12,435篇文章中，111篇符合条件的研究纳入定性综合分析，37篇文章进入Meta分析(20篇与极端炎热有关，16篇与极端寒冷有关，15篇与温度变化有关)。对于流行病学证据，我们发现极端温度、室内/室外环境和个体脆弱性的协同效应是哮喘发作的重要触发因素，特别是在极端炎热或寒冷的情况下。Meta分析进一步证实了两者之间的关系，合并后的极端高温和极端寒冷条件下哮喘发作的相对危险度分别为1.07(95%可信区间：1.03-1.12)和1.20(95%可信区间：1.12-1.29)。此外，该综述还讨论了极端温度与哮喘加重之间潜在的炎症机制，并强调了免疫途径和瞬时受体电位离子通道在极端温度引发的哮喘中的调节作用。
结论：我们得出的结论是，极端炎热和极端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，这对于理解疾病的发病机制非常重要，该框架揭示了极端温度引发哮喘的复杂机制，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 万静萱 摘译 林江涛 审校)
(Environ Res. 2023 Jan 01; doi: 216. 10.1016/j.envres.2022.114489. IF: 5.715)
(Environ Res. 2023 Jan 01; doi: 216. 10.1016/j.envres.2022.114489. IF: 5.715)
Asthma triggered by extreme temperatures: From epidemiological evidence to biological plausibility.
Han A, Deng S, Yu J, Zhang Y, Jalaludin B, Huang C,
Abstrast
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.
Objective: 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.
Conclusions: 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.
上一篇：
真菌相关性哮喘的临床表现和结局:台湾多机构数据库研究
下一篇：
中国颗粒物污染与哮喘死亡率：2015-2020年间全国时间分层病例交叉研究
