摘要
背景：呼出气一氧化氮是气道炎症的标志物之一。空气污染会引起气道炎症和氧化应激。目前对空气污染对婴儿呼出气一氧化氮的影响知之甚少。
方法：生命呼吸研究将患有哮喘的孕妇纳入一项随机对照试验，比较常规临床护理与炎症监测指导的妊娠期哮喘管理。对生命呼吸研究出生队列中的457名婴儿在六周龄时进行评估。检测未经催眠、睡眠状态婴儿的呼出气一氧化氮，并研究其与下列当地空气污染物24小时平均浓度和7天平均浓度之间的关系，包括臭氧、一氧化氮、二氧化氮、一氧化碳、二氧化硫、氨气、直径小于10μm（PM10）和小于2.5μm的颗粒物（PM2.5）。空气污染物数据来源于新南威尔士州空气质量监测网络的本地监测点。使用“最小绝对收缩和选择算子”（LASSO）方法、多变量回归和Spearman秩相关来评估上述关联性。
结果：结果显示显著季节性变化，即温暖月份呼出气一氧化氮的中位水平较高（13.6ppb），凉爽月份呼出气一氧化氮中位水平较低（11.0ppb）（P=0.008）。LASSO确定呼出气一氧化氮与24小时平均氨气浓度、7天平均氨气浓度、七天平均PM10浓度、7天平均PM2.5浓度和7天平均臭氧浓度呈正相关；呼出气一氧化氮水平与7天平均一氧化碳浓度、24小时平均一氧化氮浓度和24小时平均二氧化硫浓度呈负相关，惩罚系数的R平方为0.25。将上述LASSO（和混杂因素）所选系数输入多变量回归，所得R平方为0.27。
结论：在母亲罹患哮喘的婴幼儿队列中，呼出气一氧化氮表现出季节性变化，并与当地空气污染物浓度相关。
The association of exhaled nitric oxide with air pollutants in young infants of asthmatic mothers.
Percival E, Collison AM, da Silva Sena CR, De Queiroz Andrade E, De Gouveia Belinelo P, Gomes GMC, Oldmeadow C, Murphy VE, Gibson PG, Karmaus W, Mattes J.
Abstract
BACKGROUND: Exhaled nitric oxide is a marker of airway inflammation. Air pollution induces airway inflammation and oxidative stress. Little is known about the impact of air pollution on exhaled nitric oxide in young infants.
METHODS: The Breathing for Life Trial recruited pregnant women with asthma into a randomised controlled trial comparing usual clinical care versus inflammometry-guided asthma management in pregnancy. Four hundred fifty-seven infants from the Breathing for Life Trial birth cohort were assessed at six weeks of age. Exhaled nitric oxide was measured in unsedated, sleeping infants. Its association with local mean 24-h and mean seven-day concentrations of ozone, nitric oxide, nitrogen dioxide, carbon monoxide, sulfur dioxide, ammonia, particulate matter less than 10 μm (PM10) and less than 2.5 μm (PM2.5) in diameter was investigated. The air pollutant data were sourced from local monitoring sites of the New South Wales Air Quality Monitoring Network. The association was assessed using a 'least absolute shrinkage and selection operator' (LASSO) approach, multivariable regression and Spearman's rank correlation.
RESULTS: A seasonal variation was evident with higher median exhaled nitric oxide levels (13.6 ppb) in warmer months and lower median exhaled nitric oxide levels (11.0 ppb) in cooler months, P = 0.008. LASSO identified positive associations for exhaled nitric oxide with 24-h mean ammonia, seven-day mean ammonia, seven-day mean PM10, seven-day mean PM2.5, and seven-day mean ozone; and negative associations for eNO with seven-day mean carbon monoxide, 24-h mean nitric oxide and 24-h mean sulfur dioxide, with an R-square of 0.25 for the penalized coefficients. These coefficients selected by LASSO (and confounders) were entered in multivariable regression. The achieved R-square was 0.27.
CONCLUSION: In this cohort of young infants of asthmatic mothers, exhaled nitric oxide showed seasonal variation and an association with local air pollution concentrations.
背景：呼出气一氧化氮是气道炎症的标志物之一。空气污染会引起气道炎症和氧化应激。目前对空气污染对婴儿呼出气一氧化氮的影响知之甚少。
方法：生命呼吸研究将患有哮喘的孕妇纳入一项随机对照试验，比较常规临床护理与炎症监测指导的妊娠期哮喘管理。对生命呼吸研究出生队列中的457名婴儿在六周龄时进行评估。检测未经催眠、睡眠状态婴儿的呼出气一氧化氮，并研究其与下列当地空气污染物24小时平均浓度和7天平均浓度之间的关系，包括臭氧、一氧化氮、二氧化氮、一氧化碳、二氧化硫、氨气、直径小于10μm（PM10）和小于2.5μm的颗粒物（PM2.5）。空气污染物数据来源于新南威尔士州空气质量监测网络的本地监测点。使用“最小绝对收缩和选择算子”（LASSO）方法、多变量回归和Spearman秩相关来评估上述关联性。
结果：结果显示显著季节性变化，即温暖月份呼出气一氧化氮的中位水平较高（13.6ppb），凉爽月份呼出气一氧化氮中位水平较低（11.0ppb）（P=0.008）。LASSO确定呼出气一氧化氮与24小时平均氨气浓度、7天平均氨气浓度、七天平均PM10浓度、7天平均PM2.5浓度和7天平均臭氧浓度呈正相关；呼出气一氧化氮水平与7天平均一氧化碳浓度、24小时平均一氧化氮浓度和24小时平均二氧化硫浓度呈负相关，惩罚系数的R平方为0.25。将上述LASSO（和混杂因素）所选系数输入多变量回归，所得R平方为0.27。
结论：在母亲罹患哮喘的婴幼儿队列中，呼出气一氧化氮表现出季节性变化，并与当地空气污染物浓度相关。
(中日友好医院呼吸与危重症医学科 张婧媛 摘译 林江涛 审校)
(Environ Health. 2023 Dec 5;22(1):84. doi: 10.1186/s12940-023-01030-6.)
(Environ Health. 2023 Dec 5;22(1):84. doi: 10.1186/s12940-023-01030-6.)
The association of exhaled nitric oxide with air pollutants in young infants of asthmatic mothers.
Percival E, Collison AM, da Silva Sena CR, De Queiroz Andrade E, De Gouveia Belinelo P, Gomes GMC, Oldmeadow C, Murphy VE, Gibson PG, Karmaus W, Mattes J.
Abstract
BACKGROUND: Exhaled nitric oxide is a marker of airway inflammation. Air pollution induces airway inflammation and oxidative stress. Little is known about the impact of air pollution on exhaled nitric oxide in young infants.
METHODS: The Breathing for Life Trial recruited pregnant women with asthma into a randomised controlled trial comparing usual clinical care versus inflammometry-guided asthma management in pregnancy. Four hundred fifty-seven infants from the Breathing for Life Trial birth cohort were assessed at six weeks of age. Exhaled nitric oxide was measured in unsedated, sleeping infants. Its association with local mean 24-h and mean seven-day concentrations of ozone, nitric oxide, nitrogen dioxide, carbon monoxide, sulfur dioxide, ammonia, particulate matter less than 10 μm (PM10) and less than 2.5 μm (PM2.5) in diameter was investigated. The air pollutant data were sourced from local monitoring sites of the New South Wales Air Quality Monitoring Network. The association was assessed using a 'least absolute shrinkage and selection operator' (LASSO) approach, multivariable regression and Spearman's rank correlation.
RESULTS: A seasonal variation was evident with higher median exhaled nitric oxide levels (13.6 ppb) in warmer months and lower median exhaled nitric oxide levels (11.0 ppb) in cooler months, P = 0.008. LASSO identified positive associations for exhaled nitric oxide with 24-h mean ammonia, seven-day mean ammonia, seven-day mean PM10, seven-day mean PM2.5, and seven-day mean ozone; and negative associations for eNO with seven-day mean carbon monoxide, 24-h mean nitric oxide and 24-h mean sulfur dioxide, with an R-square of 0.25 for the penalized coefficients. These coefficients selected by LASSO (and confounders) were entered in multivariable regression. The achieved R-square was 0.27.
CONCLUSION: In this cohort of young infants of asthmatic mothers, exhaled nitric oxide showed seasonal variation and an association with local air pollution concentrations.
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