Abstract
From episodic crises and epidemiological studies of the past decades, air pollution is identified as the most important environmental determinant of human health, and this is supported by experimental studies in animals. Findings of these studies indicate that short- and long-term exposure to air pollution increases the risk for lung cancer, pulmonary and cardiovascular diseases, diabetes, and neurodegenerative disorders, all of which cause morbidity and mortality in humans. Polluted air is a complex mixture of gases (e.g., carbon monoxide and dioxide, ozone, nitric oxide, sulfur- and nitrogen dioxide), volatiles (e.g., hydrocarbons, aldehydes), and particulate matter, which affect multiple organ systems and cell types, leading to a variety of negative health consequences. The adverse health effects of air pollution appear to be, in part, mechanistically driven by the induction of both pulmonary and systemic oxidative stress. Many exposure studies using a variety of techniques have demonstrated increased oxidative stress in pulmonary and cardiovascular compartments that trigger lipid peroxidation and downstream inflammatory signaling. In this chapter, we review the evidence linking air pollutant-induced oxidative stress with specific pulmonary and cardiovascular outcomes of air pollution.
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References
Adetona O, Dunn K, Hall DB, Achtemeier G, Stock A, Naeher LP (2011) Personal PM(2.5) exposure among wildland firefighters working at prescribed forest burns in southeastern United States. J Occup Environ Hyg 8:503–511
Albrecht C, Knaapen AM, Becker A, Hohr D, Haberzettl P, van Schooten FJ, Borm PJ, Schins RP (2005) The crucial role of particle surface reactivity in respirable quartz-induced reactive oxygen/nitrogen species formation and APE/Ref-1 induction in rat lung. Respir Res 6:129
Albrecht C, Hohr D, Haberzettl P, Becker A, Borm PJ, Schins RP (2007) Surface-dependent quartz uptake by macrophages: potential role in pulmonary inflammation and lung clearance. Inhal Toxicol 19(Suppl 1):39–48
Al-Shmgani HS, Moate RM, Sneyd JR, Macnaughton PD, Moody AJ (2012) Hyperoxia-induced ciliary loss and oxidative damage in an in vitro bovine model: the protective role of antioxidant vitamins E and C. Biochem Biophys Res Commun 429:191–196
Anderson JO, Thundiyil JG, Stolbach A (2012) Clearing the air: a review of the effects of particulate matter air pollution on human health. J Med Toxicol 8:166–175
Araujo JA, Nel AE (2009) Particulate matter and atherosclerosis: role of particle size, composition and oxidative stress. Part Fibre Toxicol 6:24
Araujo JA, Barajas B, Kleinman M, Wang X, Bennett BJ, Gong KW, Navab M, Harkema J, Sioutas C, Lusis AJ, Nel AE (2008) Ambient particulate pollutants in the ultrafine range promote early atherosclerosis and systemic oxidative stress. Circ Res 102:589–596
Avissar N, Finkelstein JN, Horowitz S, Willey JC, Coy E, Frampton MW, Watkins RH, Khullar P, Xu YL, Cohen HJ (1996) Extracellular glutathione peroxidase in human lung epithelial lining fluid and in lung cells. Am J Physiol 270:L173–L182
Ayaori M, Hisada T, Suzukawa M, Yoshida H, Nishiwaki M, Ito T, Nakajima K, Higashi K, Yonemura A, Ohsuzu F, Ishikawa T, Nakamura H (2000) Plasma levels and redox status of ascorbic acid and levels of lipid peroxidation products in active and passive smokers. Environ Health Perspect 108:105–108
Babior BM (1999) NADPH oxidase: an update. Blood 93:1464–1476
Bae S, Pan XC, Kim SY, Park K, Kim YH, Kim H, Hong YC (2010) Exposures to particulate matter and polycyclic aromatic hydrocarbons and oxidative stress in schoolchildren. Environ Health Perspect 118:579–583
Bagate K, Meiring JJ, Gerlofs-Nijland ME, Cassee FR, Borm PJ (2006) Signal transduction pathways involved in particulate matter induced relaxation in rat aorta–spontaneous hypertensive versus Wistar Kyoto rats. Toxicol In Vitro 20:52–62
Banerjee A, Trueblood MB, Zhang X, Manda KR, Lobo P, Whitefield PD, Hagen DE, Ercal N (2009) N-acetylcysteineamide (NACA) prevents inflammation and oxidative stress in animals exposed to diesel engine exhaust. Toxicol Lett 187:187–193
Bartoli CR, Wellenius GA, Diaz EA, Lawrence J, Coull BA, Akiyama I, Lee LM, Okabe K, Verrier RL, Godleski JJ (2009) Mechanisms of inhaled fine particulate air pollution-induced arterial blood pressure changes. Environ Health Perspect 117:361–366
Bates DV (1995) The effects of air pollution on children. Environ Health Perspect 103(Suppl 6): 49–53
Beamer CA, Holian A (2005) Scavenger receptor class A type I/II (CD204) null mice fail to develop fibrosis following silica exposure. Am J Physiol Lung Cell Mol Physiol 289:L186–L195
Becker S, Dailey LA, Soukup JM, Grambow SC, Devlin RB, Huang YC (2005) Seasonal variations in air pollution particle-induced inflammatory mediator release and oxidative stress. Environ Health Perspect 113:1032–1038
Bell ML (2012) Assessment of the health impacts of particulate matter characteristics. Res Rep Health Eff Inst 161:5–38
Bell ML, Davis DL (2001) Reassessment of the lethal London fog of 1952: novel indicators of acute and chronic consequences of acute exposure to air pollution. Environ Health Perspect 109(Suppl 3):389–394
Bhatnagar A (2004) Cardiovascular pathophysiology of environmental pollutants. Am J Physiol Heart Circ Physiol 286:H479–H485
Bhatnagar A (2006) Environmental cardiology: studying mechanistic links between pollution and heart disease. Circ Res 99:692–705
Bhopal RS, Phillimore P, Moffatt S, Foy C (1994) Is living near a coking works harmful to health? A study of industrial air pollution. J Epidemiol Community Health 48:237–247
Binkova B, Cerna M, Pastorkova A, Jelinek R, Benes I, Novak J, Sram RJ (2003) Biological activities of organic compounds adsorbed onto ambient air particles: comparison between the cities of Teplice and Prague during the summer and winter seasons 2000–2001. Mutat Res 525:43–59
Boland S, Bonvallot V, Fournier T, Baeza-Squiban A, Aubier M, Marano F (2000) Mechanisms of GM-CSF increase by diesel exhaust particles in human airway epithelial cells. Am J Physiol Lung Cell Mol Physiol 278:L25–L32
Bonner JC, Rice AB, Moomaw CR, Morgan DL (2000) Airway fibrosis in rats induced by vanadium pentoxide. Am J Physiol Lung Cell Mol Physiol 278:L209–L216
Borm PJ, Schins RP, Albrecht C (2004) Inhaled particles and lung cancer, part B: paradigms and risk assessment. Int J Cancer 110:3–14
Braga AL, Zanobetti A, Schwartz J (2000) Do respiratory epidemics confound the association between air pollution and daily deaths? Eur Respir J 16:723–728
Brauer M, Amann M, Burnett RT, Cohen A, Dentener F, Ezzati M, Henderson SB, Krzyzanowski M, Martin RV, van Dingenen R, van Donkelaar A, Thurston GD (2012) Exposure assessment for estimation of the global burden of disease attributable to outdoor air pollution. Environ Sci Technol 46:652–660
Bridges JP, Davis HW, Damodarasamy M, Kuroki Y, Howles G, Hui DY, McCormack FX (2000) Pulmonary surfactant proteins A and D are potent endogenous inhibitors of lipid peroxidation and oxidative cellular injury. J Biol Chem 275:38848–38855
Brook RD, Brook JR (2011) A road forward to improve public health. Circulation 123:1705–1708
Brook RD, Rajagopalan S (2009) Particulate matter, air pollution, and blood pressure. J Am Soc Hypertens 3:332–350
Brook RD, Brook JR, Urch B, Vincent R, Rajagopalan S, Silverman F (2002) Inhalation of fine particulate air pollution and ozone causes acute arterial vasoconstriction in healthy adults. Circulation 105:1534–1536
Brook RD, Brook JR, Rajagopalan S (2003) Air pollution: the “Heart” of the problem. Curr Hypertens Rep 5:32–39
Brook RD, Franklin B, Cascio W, Hong Y, Howard G, Lipsett M, Luepker R, Mittleman M, Samet J, Smith SC JR, Tager I (2004) Air pollution and cardiovascular disease: a statement for healthcare professionals from the Expert Panel on Population and Prevention Science of the American Heart Association. Circulation 109:2655–2671
Brook RD, Urch B, Dvonch JT, Bard RL, Speck M, Keeler G, Morishita M, Marsik FJ, Kamal AS, Kaciroti N, Harkema J, Corey P, Silverman F, Gold DR, Wellenius G, Mittleman MA, Rajagopalan S, Brook JR (2009) Insights into the mechanisms and mediators of the effects of air pollution exposure on blood pressure and vascular function in healthy humans. Hypertension 54:659–667
Brook RD, Rajagopalan S, Pope CA 3rd, Brook JR, Bhatnagar A, Diez-Roux AV, Holguin F, Hong Y, Luepker RV, Mittleman MA, Peters A, Siscovick D, Smith SC Jr, Whitsel L, Kaufman JD (2010) Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the American Heart Association. Circulation 121:2331–2378
Brown DM, Stone V, Findlay P, Macnee W, Donaldson K (2000) Increased inflammation and intracellular calcium caused by ultrafine carbon black is independent of transition metals or other soluble components. Occup Environ Med 57:685–691
Brown DM, Wilson MR, Macnee W, Stone V, Donaldson K (2001) Size-dependent proinflammatory effects of ultrafine polystyrene particles: a role for surface area and oxidative stress in the enhanced activity of ultrafines. Toxicol Appl Pharmacol 175:191–199
Burnett RT, Brook J, Dann T, Delocla C, Philips O, Cakmak S, Vincent R, Goldberg MS, Krewski D (2000) Association between particulate- and gas-phase components of urban air pollution and daily mortality in eight Canadian cities. Inhal Toxicol 12(Suppl 4):15–39
Campen MJ (2009) Nitric oxide synthase: “enzyme zero” in air pollution-induced vascular toxicity. Toxicol Sci 110:1–3
Campen MJ, Nolan JP, Schladweiler MC, Kodavanti UP, Evansky PA, Costa DL, Watkinson WP (2001) Cardiovascular and thermoregulatory effects of inhaled PM-associated transition metals: a potential interaction between nickel and vanadium sulfate. Toxicol Sci 64:243–252
Campen MJ, Nolan JP, Schladweiler MC, Kodavanti UP, Costa DL, Watkinson WP (2002) Cardiac and thermoregulatory effects of instilled particulate matter-associated transition metals in healthy and cardiopulmonary-compromised rats. J Toxicol Environ Health A 65:1615–1631
Campen MJ, Lund AK, Knuckles TL, Conklin DJ, Bishop B, Young D, Seilkop S, Seagrave J, Reed MD, McDonald JD (2010) Inhaled diesel emissions alter atherosclerotic plaque composition in ApoE(−/−) mice. Toxicol Appl Pharmacol 242:310–317
Cao Q, Zhang S, Dong C, Song W (2007) Pulmonary responses to fine particles: differences between the spontaneously hypertensive rats and wistar kyoto rats. Toxicol Lett 171:126–137
Castranova V, Vallyathan V (2000) Silicosis and coal workers’ pneumoconiosis. Environ Health Perspect 108(Suppl 4):675–684
Chen JC, Schwartz J (2008) Metabolic syndrome and inflammatory responses to long-term particulate air pollutants. Environ Health Perspect 116:612–617
Chen LW, Chow JC, Doddridge BG, Dickerson RR, Ryan WF, Mueller PK (2003) Analysis of a summertime PM2.5 and haze episode in the mid-Atlantic region. J Air Waste Manag Assoc 53:946–956
Cherng TW, Campen MJ, Knuckles TL, Gonzalez Bosc L, Kanagy NL (2009) Impairment of coronary endothelial cell ET(B) receptor function after short-term inhalation exposure to whole diesel emissions. Am J Physiol Regul Integr Comp Physiol 297:R640–R647
Colburn KA, Johnson PR (2003) Public health. Air pollution concerns not changed by S-PLUS flaw. Science 299:665–666
Conklin DJ (2011) Beware the air! Why particulate matter matters. Circ Res 108:644–647
Conklin DJ, Haberzettl P, Prough RA, Bhatnagar A (2009) Glutathione-S-transferase P protects against endothelial dysfunction induced by exposure to tobacco smoke. Am J Physiol Heart Circ Physiol 296:H1586–H1597
Coogan PF, White LF, Jerrett M, Brook RD, Su JG, Seto E, Burnett R, Palmer JR, Rosenberg L (2012) Air pollution and incidence of hypertension and diabetes mellitus in black women living in Los Angeles. Circulation 125:767–772
Courtois A, Andujar P, Ladeiro Y, Baudrimont I, Delannoy E, Leblais V, Begueret H, Galland MA, Brochard P, Marano F, Marthan R, Muller B (2008) Impairment of NO-dependent relaxation in intralobar pulmonary arteries: comparison of urban particulate matter and manufactured nanoparticles. Environ Health Perspect 116:1294–1299
Dai YT, Yu CP (1998) Alveolar deposition of fibers in rodents and humans. J Aerosol Med 11:247–258
Danielsen PH, Loft S, Jacobsen NR, Jensen KA, Autrup H, Ravanat JL, Wallin H, Moller P (2010) Oxidative stress, inflammation, and DNA damage in rats after intratracheal instillation or oral exposure to ambient air and wood smoke particulate matter. Toxicol Sci 118:574–585
de Groot P, Munden RF (2012) Lung cancer epidemiology, risk factors, and prevention. Radiol Clin North Am 50:863–876
Delfino RJ, Staimer N, Tjoa T, Polidori A, Arhami M, Gillen DL, Kleinman MT, Vaziri ND, Longhurst J, Zaldivar F, Sioutas C (2008) Circulating biomarkers of inflammation, antioxidant activity, and platelet activation are associated with primary combustion aerosols in subjects with coronary artery disease. Environ Health Perspect 116:898–906
Dey S, Di Girolamo L, Van Donkelaar A, Trpathi SN, Gupta T, Mohan M (2012) Variability of outdoor fine particulate (PM2.5) concentration in the Indian Subcontinent: A remote sensing approach. Remote Sens Environ 127:153–161
Diaz-Sanchez D (1997) The role of diesel exhaust particles and their associated polyaromatic hydrocarbons in the induction of allergic airway disease. Allergy 52:52–56, discussion 57–58
Dockery DW, Pope CA III, Xu X, Spengler JD, Ware JH, Fay ME, Ferris BG Jr, Speizer FE (1993) An association between air pollution and mortality in six U.S. cities. N Engl J Med 329:1753–1759
Dominici F, Peng RD, Zeger SL, White RH, Samet JM (2007) Particulate air pollution and mortality in the United States: did the risks change from 1987 to 2000? Am J Epidemiol 166:880–888
Droge W (2002) Free radicals in the physiological control of cell function. Physiol Rev 82:47–95
Dye JA, Lehmann JR, McGee JK, Winsett DW, Ledbetter AD, Everitt JI, Ghio AJ, Costa DL (2001) Acute pulmonary toxicity of particulate matter filter extracts in rats: coherence with epidemiologic studies in Utah Valley residents. Environ Health Perspect 109(Suppl 3):395–403
Feldman C, Anderson R, Kanthakumar K, Vargas A, Cole PJ, Wilson R (1994) Oxidant-mediated ciliary dysfunction in human respiratory epithelium. Free Radic Biol Med 17:1–10
Forsberg B, Stjernberg N, Falk M, Lundback B, Wall S (1993) Air pollution levels, meteorological conditions and asthma symptoms. Eur Respir J 6:1109–1115
Frampton MW, Ghio AJ, Samet JM, Carson JL, Carter JD, Devlin RB (1999) Effects of aqueous extracts of PM(10) filters from the Utah valley on human airway epithelial cells. Am J Physiol 277:L960–L967
Franchini M, Mannucci PM (2009) Particulate air pollution and cardiovascular risk: short-term and long-term effects. Semin Thromb Hemost 35:665–670
Franchini M, Mannucci PM (2011) Thrombogenicity and cardiovascular effects of ambient air pollution. Blood 118:2405–2412
Garcia-Suastegui WA, Huerta-Chagoya A, Carrasco-Colin KL, Pratt MM, John K, Petrosyan P, Rubio J, Poirier MC, Gonsebatt ME (2011) Seasonal variations in the levels of PAH-DNA adducts in young adults living in Mexico City. Mutagenesis 26:385–391
Geiser M, Rothen-Rutishauser B, Kapp N, Schurch S, Kreyling W, Schulz H, Semmler M, Im Hof V, Heyder J, Gehr P (2005) Ultrafine particles cross cellular membranes by nonphagocytic mechanisms in lungs and in cultured cells. Environ Health Perspect 113:1555–1560
Ghio AJ, Devlin RB (2001) Inflammatory lung injury after bronchial instillation of air pollution particles. Am J Respir Crit Care Med 164:704–708
Ghio AJ, Suliman HB, Carter JD, Abushamaa AM, Folz RJ (2002) Overexpression of extracellular superoxide dismutase decreases lung injury after exposure to oil fly ash. Am J Physiol Lung Cell Mol Physiol 283:L211–L218
Ghio AJ, Carraway MS, Madden MC (2012) Composition of air pollution particles and oxidative stress in cells, tissues, and living systems. J Toxicol Environ Health B Crit Rev 15:1–21
Ginnan R, Guikema BJ, Halligan KE, Singer HA, Jourd’Heuil D (2008) Regulation of smooth muscle by inducible nitric oxide synthase and NADPH oxidase in vascular proliferative diseases. Free Radic Biol Med 44:1232–1245
Goldsmith CA, Frevert C, Imrich A, Sioutas C, Kobzik L (1997) Alveolar macrophage interaction with air pollution particulates. Environ Health Perspect 105(Suppl 5):1191–1195
Grievink L, Smit HA, Brunekreef B (2000) Anti-oxidants and air pollution in relation to indicators of asthma and COPD: a review of the current evidence. Clin Exp Allergy 30:1344–1354
Griffith DE, Levin JL (1989) Respiratory effects of outdoor air pollution. Postgrad Med 86(111):116, 118
Haberzettl P, Duffin R, Kramer U, Hohr D, Schins RP, Borm PJ, Albrecht C (2007) Actin plays a crucial role in the phagocytosis and biological response to respirable quartz particles in macrophages. Arch Toxicol 81:459–470
Haberzettl P, Schins RP, Hohr D, Wilhelmi V, Borm PJ, Albrecht C (2008) Impact of the FcgammaII-receptor on quartz uptake and inflammatory response by alveolar macrophages. Am J Physiol Lung Cell Mol Physiol 294:L1137–L1148
Haberzettl P, Lee J, Duggineni D, McCracken J, Bolanowski D, O’Toole TE, Bhatnagar A, Conklin DJ (2012) Exposure to ambient air fine particulate matter prevents VEGF-induced mobilization of endothelial progenitor cells from the bone marrow. Environ Health Perspect 120:848–856
Hampel R, Breitner S, Schneider A, Zareba W, Kraus U, Cyrys J, Geruschkat U, Belcredi P, Muller M, Wichmann HE, Peters A (2012) Acute air pollution effects on heart rate variability are modified by SNPs involved in cardiac rhythm in individuals with diabetes or impaired glucose tolerance. Environ Res 112:177–185
Happo MS, Uski O, Jalava PI, Kelz J, Brunner T, Hakulinen P, Maki-Paakkanen J, Kosma VM, Jokiniemi J, Obernberger I, Hirvonen MR (2013) Pulmonary inflammation and tissue damage in the mouse lung after exposure to PM samples from biomass heating appliances of old and modern technologies. Sci Total Environ 443:256–266
Harris RL Jr, Timbrell V (1975) The influence of fibre shape in lung deposition-mathematical estimates. Inhaled Part 4(Pt 1):75–89
Harrison RM, Smith DJ, Kibble AJ (2004) What is responsible for the carcinogenicity of PM2.5? Occup Environ Med 61:799–805
Hassing C, Twickler M, Brunekreef B, Cassee F, Doevendans P, Kastelein J, Cramer MJ (2009) Particulate air pollution, coronary heart disease and individual risk assessment: a general overview. Eur J Cardiovasc Prev Rehabil 16:10–15
Hernandez-Garduno E, Brauer M, Perez-Neria J, Vedal S (2004) Wood smoke exposure and lung adenocarcinoma in non-smoking Mexican women. Int J Tuberc Lung Dis 8:377–383
Heyder J (1982) Particle transport onto human airway surfaces. Eur J Respir Dis Suppl 119:29–50
Hiura TS, Kaszubowski MP, Li N, Nel AE (1999) Chemicals in diesel exhaust particles generate reactive oxygen radicals and induce apoptosis in macrophages. J Immunol 163:5582–5591
Hofmann W, Morawska L, Winkler-Heil R, Moustafa M (2009) Deposition of combustion aerosols in the human respiratory tract: comparison of theoretical predictions with experimental data considering nonspherical shape. Inhal Toxicol 21:1154–1164
Imrich A, Ning YY, Kobzik L (1999) Intracellular oxidant production and cytokine responses in lung macrophages: evaluation of fluorescent probes. J Leukoc Biol 65:499–507
Janib SM, Moses AS, Mackay JA (2010) Imaging and drug delivery using theranostic nanoparticles. Adv Drug Deliv Rev 62:1052–1063
Junk J, Helbig A, Luers J (2003) Urban climate and air quality in Trier Germany. Int J Biometeorol 47:230–238
Kadiiska MB, Mason RP, Dreher KL, Costa DL, Ghio AJ (1997) In vivo evidence of free radical formation in the rat lung after exposure to an emission source air pollution particle. Chem Res Toxicol 10:1104–1108
Kampfrath T, Maiseyeu A, Ying Z, Shah Z, Deiuliis JA, Xu X, Kherada N, Brook RD, Reddy KM, Padture NP, Parthasarathy S, Chen LC, Moffatt-Bruce S, Sun Q, Morawietz H, Rajagopalan S (2011) Chronic fine particulate matter exposure induces systemic vascular dysfunction via NADPH oxidase and TLR4 pathways. Circ Res 108:716–726
Kelishadi R, Mirghaffari N, Poursafa P, Gidding SS (2009) Lifestyle and environmental factors associated with inflammation, oxidative stress and insulin resistance in children. Atherosclerosis 203:311–319
Kendall M, Brown L, Trought K (2004) Molecular adsorption at particle surfaces: a PM toxicity mediation mechanism. Inhal Toxicol 16(Suppl 1):99–105
Knaapen AM, Shi T, Borm PJ, Schins RP (2002) Soluble metals as well as the insoluble particle fraction are involved in cellular DNA damage induced by particulate matter. Mol Cell Biochem 234–235:317–326
Knuckles TL, Lund AK, Lucas SN, Campen MJ (2008) Diesel exhaust exposure enhances venoconstriction via uncoupling of eNOS. Toxicol Appl Pharmacol 230:346–351
Knuckles TL, Yi J, Frazer DG, Leonard HD, Chen BT, Castranova V, Nurkiewicz TR (2012) Nanoparticle inhalation alters systemic arteriolar vasoreactivity through sympathetic and cyclooxygenase-mediated pathways. Nanotoxicology 6:724–735
Kobzik L (1995) Lung macrophage uptake of unopsonized environmental particulates. Role of scavenger-type receptors. J Immunol 155:367–376
Kodavanti UP, Moyer CF, Ledbetter AD, Schladweiler MC, Costa DL, Hauser R, Christiani DC, Nyska A (2003) Inhaled environmental combustion particles cause myocardial injury in the Wistar Kyoto rat. Toxicol Sci 71:237–245
Kramer U, Herder C, Sugiri D, Strassburger K, Schikowski T, Ranft U, Rathmann W (2010) Traffic-related air pollution and incident type 2 diabetes: results from the SALIA cohort study. Environ Health Perspect 118:1273–1279
Kreyling WG, Semmler M, Erbe F, Mayer P, Takenaka S, Schulz H, Oberdorster G, Ziesenis A (2002) Translocation of ultrafine insoluble iridium particles from lung epithelium to extrapulmonary organs is size dependent but very low. J Toxicol Environ Health A 65:1513–1530
Kuempel ED, Attfield MD, Vallyathan V, Lapp NL, Hale JM, Smith RJ, Castranova V (2003) Pulmonary inflammation and crystalline silica in respirable coal mine dust: dose–response. J Biosci 28:61–69
Kumagai Y, Koide S, Taguchi K, Endo A, Nakai Y, Yoshikawa T, Shimojo N (2002) Oxidation of proximal protein sulfhydryls by phenanthraquinone, a component of diesel exhaust particles. Chem Res Toxicol 15:483–489
Laden F, Neas LM, Dockery DW, Schwartz J (2000) Association of fine particulate matter from different sources with daily mortality in six U.S. cities. Environ Health Perspect 108:941–947
Larson BA, Rosen S (2002) Understanding household demand for indoor air pollution control in develo** countries. Soc Sci Med 55:571–584
Laskin DL, Mainelis G, Turpin BJ, Patel KJ, Sunil VR (2010) Pulmonary effects of inhaled diesel exhaust in young and old mice: a pilot project. Res Rep Health Eff Inst 151:3–31
Lei YC, Hwang JS, Chan CC, Lee CT, Cheng TJ (2005) Enhanced oxidative stress and endothelial dysfunction in streptozotocin-diabetic rats exposed to fine particles. Environ Res 99:335–343
Lewis AB, Taylor MD, Roberts JR, Leonard SS, Shi X, Antonini JM (2003) Role of metal-induced reactive oxygen species generation in lung responses caused by residual oil fly ash. J Biosci 28:13–18
Li XY, Gilmour PS, Donaldson K, Macnee W (1996) Free radical activity and pro-inflammatory effects of particulate air pollution (PM10) in vivo and in vitro. Thorax 51:1216–1222
Li Z, Carter JD, Dailey LA, Huang YC (2005) Pollutant particles produce vasoconstriction and enhance MAPK signaling via angiotensin type I receptor. Environ Health Perspect 113:1009–1014
Lindgren A, Stroh E, Montnemery P, Nihlen U, Jakobsson K, Axmon A (2009) Traffic-related air pollution associated with prevalence of asthma and COPD/chronic bronchitis. A cross-sectional study in Southern Sweden. Int J Health Geogr 8:2
Liu L, Ruddy TD, Dalipaj M, Szyszkowicz M, You H, Poon R, Wheeler A, Dales R (2007) Influence of personal exposure to particulate air pollution on cardiovascular physiology and biomarkers of inflammation and oxidative stress in subjects with diabetes. J Occup Environ Med 49:258–265
Liu L, Poon R, Chen L, Frescura AM, Montuschi P, Ciabattoni G, Wheeler A, Dales R (2009) Acute effects of air pollution on pulmonary function, airway inflammation, and oxidative stress in asthmatic children. Environ Health Perspect 117:668–674
Lund AK, Lucero J, Lucas S, Madden MC, McDonald JD, Seagrave JC, Knuckles TL, Campen MJ (2009) Vehicular emissions induce vascular MMP-9 expression and activity associated with endothelin-1-mediated pathways. Arterioscler Thromb Vasc Biol 29:511–517
Lund AK, Lucero J, Harman M, Madden MC, McDonald JD, Seagrave JC, Campen MJ (2011) The oxidized low-density lipoprotein receptor mediates vascular effects of inhaled vehicle emissions. Am J Respir Crit Care Med 184:82–91
McNeely TB, Coonrod JD (1994) Aggregation and opsonization of type A but not type B Hemophilus influenzae by surfactant protein A. Am J Respir Cell Mol Biol 11:114–122
Mills NL, Tornqvist H, Robinson SD, Gonzalez M, Darnley K, Macnee W, Boon NA, Donaldson K, Blomberg A, Sandstrom T, Newby DE (2005) Diesel exhaust inhalation causes vascular dysfunction and impaired endogenous fibrinolysis. Circulation 112:3930–3936
Mills NL, Amin N, Robinson SD, Anand A, Davies J, Patel D, de la Fuente JM, Cassee FR, Boon NA, Macnee W, Millar AM, Donaldson K, Newby DE (2006) Do inhaled carbon nanoparticles translocate directly into the circulation in humans? Am J Respir Crit Care Med 173:426–431
Mills NL, Robinson SD, Fokkens PH, Leseman DL, Miller MR, Anderson D, Freney EJ, Heal MR, Donovan RJ, Blomberg A, Sandstrom T, Macnee W, Boon NA, Donaldson K, Newby DE, Cassee FR (2008) Exposure to concentrated ambient particles does not affect vascular function in patients with coronary heart disease. Environ Health Perspect 116:709–715
Moghimi SM, Hunter AC, Murray JC (2005) Nanomedicine: current status and future prospects. FASEB J 19:311–330
Monn C, Fendt R, Koller T (2002) Ambient PM(10) extracts inhibit phagocytosis of defined inert model particles by alveolar macrophages. Inhal Toxicol 14:369–385
Muhlfeld C, Geiser M, Kapp N, Gehr P, Rothen-Rutishauser B (2007) Re-evaluation of pulmonary titanium dioxide nanoparticle distribution using the “relative deposition index”: evidence for clearance through microvasculature. Part Fibre Toxicol 4:7
Nadel JA (2001) Role of epidermal growth factor receptor activation in regulating mucin synthesis. Respir Res 2:85–89
Nemmar A, Hoet PH, Vanquickenborne B, Dinsdale D, Thomeer M, Hoylaerts MF, Vanbilloen H, Mortelmans L, Nemery B (2002) Passage of inhaled particles into the blood circulation in humans. Circulation 105:411–414
Nemmar A, Hoylaerts MF, Hoet PH, Nemery B (2004) Possible mechanisms of the cardiovascular effects of inhaled particles: systemic translocation and prothrombotic effects. Toxicol Lett 149:243–253
Nemmar A, Hoylaerts MF, Nemery B (2006) Effects of particulate air pollution on hemostasis. Clin Occup Environ Med 5:865–881
Nurkiewicz TR, Porter DW, Barger M, Millecchia L, Rao KM, Marvar PJ, Hubbs AF, Castranova V, Boegehold MA (2006) Systemic microvascular dysfunction and inflammation after pulmonary particulate matter exposure. Environ Health Perspect 114:412–419
Nurkiewicz TR, Porter DW, Hubbs AF, Stone S, Chen BT, Frazer DG, Boegehold MA, Castranova V (2009) Pulmonary nanoparticle exposure disrupts systemic microvascular nitric oxide signaling. Toxicol Sci 110:191–203
Nurkiewicz TR, Porter DW, Hubbs AF, Stone S, Moseley AM, Cumpston JL, Goodwill AG, Frisbee SJ, Perrotta PL, Brock RW, Frisbee JC, Boegehold MA, Frazer DG, Chen BT, Castranova V (2011) Pulmonary particulate matter and systemic microvascular dysfunction. Res Rep Health Eff Inst 164:3–48
Oberdorster G, Ferin J, Morrow PE (1992) Volumetric loading of alveolar macrophages (AM): a possible basis for diminished AM-mediated particle clearance. Exp Lung Res 18:87–104
Oberdorster G, Ferin J, Lehnert BE (1994) Correlation between particle size, in vivo particle persistence, and lung injury. Environ Health Perspect 102(Suppl 5):173–179
Oberdorster G, Oberdorster E, Oberdorster J (2005) Nanotoxicology: an emerging discipline evolving from studies of ultrafine particles. Environ Health Perspect 113:823–839
Ohtoshi T, Takizawa H, Okazaki H, Kawasaki S, Takeuchi N, Ohta K, Ito K (1998) Diesel exhaust particles stimulate human airway epithelial cells to produce cytokines relevant to airway inflammation in vitro. J Allergy Clin Immunol 101:778–785
O’Neill MS, Veves A, Sarnat JA, Zanobetti A, Gold DR, Economides PA, Horton ES, Schwartz J (2007) Air pollution and inflammation in type 2 diabetes: a mechanism for susceptibility. Occup Environ Med 64:373–379
O’Toole TE, Hellmann J, Wheat L, Haberzettl P, Lee J, Conklin DJ, Bhatnagar A, Pope CA 3RD (2010) Episodic exposure to fine particulate air pollution decreases circulating levels of endothelial progenitor cells. Circ Res 107:200–203
Oury TD, Chang LY, Marklund SL, Day BJ, Crapo JD (1994) Immunocytochemical localization of extracellular superoxide dismutase in human lung. Lab Invest 70:889–898
Park JB (2003) Phagocytosis induces superoxide formation and apoptosis in macrophages. Exp Mol Med 35:325–335
Patton JS, Fishburn CS, Weers JG (2004) The lungs as a portal of entry for systemic drug delivery. Proc Am Thorac Soc 1:338–344
Pearson JF, Bachireddy C, Shyamprasad S, Goldfine AB, Brownstein JS (2010) Association between fine particulate matter and diabetes prevalence in the U.S. Diabetes Care 33:2196–2201
Pedersen M (1990) Ciliary activity and pollution. Lung 168(Suppl):368–376
Peel JL, Tolbert PE, Klein M, Metzger KB, Flanders WD, Todd K, Mulholland JA, Ryan PB, Frumkin H (2005) Ambient air pollution and respiratory emergency department visits. Epidemiology 16:164–174
Pereira Filho MA, Pereira LA, Arbex FF, Arbex M, Conceicao GM, Santos UP, Lopes AC, Saldiva PH, Braga AL, Cendon S (2008) Effect of air pollution on diabetes and cardiovascular diseases in Sao Paulo, Brazil. Braz J Med Biol Res 41:526–532
Peters A, Dockery DW, Heinrich J, Wichmann HE (1997) Short-term effects of particulate air pollution on respiratory morbidity in asthmatic children. Eur Respir J 10:872–879
Peters S, Thomassen Y, Fechter-Rink E, Kromhout H (2009) Personal exposure to inhalable cement dust among construction workers. J Environ Monit 11:174–180
Pinkerton KE, Zhou Y, Zhong C, Smith KR, Teague SV, Kennedy IM, Menache MG (2008) Mechanisms of particulate matter toxicity in neonatal and young adult rat lungs. Res Rep Health Eff Inst 3–41, discussion 43–52
Pope CA 3RD (2004) Air pollution and health - good news and bad. N Engl J Med 351:1132–1134
Pope CA III, Thun MJ, Namboodiri MM, Dockery DW, Evans JS, Speizer FE, Heath CW Jr (1995) Particulate air pollution as a predictor of mortality in a prospective study of U.S. adults. Am J Respir Crit Care Med 151:669–674
Pope CA III, Burnett RT, Thun MJ, Calle EE, Krewski D, Ito K, Thurston GD (2002) Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. JAMA 287:1132–1141
Pope CA III, Burnett RT, Thurston GD, Thun MJ, Calle EE, Krewski D, Godleski JJ (2004) Cardiovascular mortality and long-term exposure to particulate air pollution: epidemiological evidence of general pathophysiological pathways of disease. Circulation 109:71–77
Pope CA III, Renlund DG, Kfoury AG, May HT, Horne BD (2008) Relation of heart failure hospitalization to exposure to fine particulate air pollution. Am J Cardiol 102:1230–1234
Possamai FP, Junior SA, Parisotto EB, Moratelli AM, Inacio DB, Garlet TR, Dal-Pizzol F, Filho DW (2010) Antioxidant intervention compensates oxidative stress in blood of subjects exposed to emissions from a coal electric-power plant in South Brazil. Environ Toxicol Pharmacol 30:175–180
Pradhan A, Waseem M, Dogra S, Khanna AK, Kaw JL (2005) Alterations in bronchoalveolar lavage constituents, oxidant/antioxidant status, and lung histology following intratracheal instillation of respirable suspended particulate matter. J Environ Pathol Toxicol Oncol 24:19–32
Puett RC, Hart JE, Schwartz J, Hu FB, Liese AD, Laden F (2011) Are particulate matter exposures associated with risk of type 2 diabetes? Environ Health Perspect 119:384–389
Puranik R, Celermajer DS (2003) Smoking and endothelial function. Prog Cardiovasc Dis 45:443–458
Rajagopalan S, Brook RD (2012) Air pollution and type 2 diabetes: mechanistic insights. Diabetes 61:3037–3045
Rehn B, Seiler F, Rehn S, Bruch J, Maier M (2003) Investigations on the inflammatory and genotoxic lung effects of two types of titanium dioxide: untreated and surface treated. Toxicol Appl Pharmacol 189:84–95
Reis MA, Carvalho A, Taborda A, Quaresma A, Dias G, Alves LC, Mota M, Chaves PC, Teixeira R, Rodrigues PO (2009) High airborne PM2.5 chlorine concentrations link to diabetes surge in Portugal. Sci Total Environ 407:5726–5734
Riles E, Brook R (2011) The air quality index: a tool for managing patients with cardiopulmonary disease. Am J Med 124:705–707
Roberts S, Martin MA (2007) Methods for bias reduction in time-series studies of particulate matter air pollution and mortality. J Toxicol Environ Health A 70:665–675
Rogers DF (2001) Mucus hypersecretion in chronic obstructive pulmonary disease. Novartis Found Symp 234:65–77, discussion 77–83
Roman AO, Prieto CM, Mancilla FP, Astudillo OP, Dussaubat AA, Miguel WC, Lara MJ (2009) Association between air pollution and cardiovascular risk. Rev Med Chil 137:1217–1224
Sagai M, Saito H, Ichinose T, Kodama M, Mori Y (1993) Biological effects of diesel exhaust particles. I. In vitro production of superoxide and in vivo toxicity in mouse. Free Radic Biol Med 14:37–47
Sakamoto N, Hayashi S, Gosselink J, Ishii H, Ishimatsu Y, Mukae H, Hogg JC, van Eeden SF (2007) Calcium dependent and independent cytokine synthesis by air pollution particle-exposed human bronchial epithelial cells. Toxicol Appl Pharmacol 225:134–141
Samet JM, Dominici F, Curriero FC, Coursac I, Zeger SL (2000) Fine particulate air pollution and mortality in 20 U.S. cities, 1987–1994. N Engl J Med 343:1742–1749
Sato H, Sone H, Sagai M, Suzuki KT, Aoki Y (2000) Increase in mutation frequency in lung of Big Blue rat by exposure to diesel exhaust. Carcinogenesis 21:653–661
Schaumann F, Borm PJ, Herbrich A, Knoch J, Pitz M, Schins RP, Luettig B, Hohlfeld JM, Heinrich J, Krug N (2004) Metal-rich ambient particles (particulate matter 2.5) cause airway inflammation in healthy subjects. Am J Respir Crit Care Med 170:898–903
Schins RP, Lightbody JH, Borm PJ, Shi T, Donaldson K, Stone V (2004) Inflammatory effects of coarse and fine particulate matter in relation to chemical and biological constituents. Toxicol Appl Pharmacol 195:1–11
Schneider A, Neas L, Herbst MC, Case M, Williams RW, Cascio W, Hinderliter A, Holguin F, Buse JB, Dungan K, Styner M, Peters A, Devlin RB (2008) Endothelial dysfunction: associations with exposure to ambient fine particles in diabetic individuals. Environ Health Perspect 116:1666–1674
Schneider A, Hampel R, Ibald-Mulli A, Zareba W, Schmidt G, Schneider R, Ruckerl R, Couderc JP, Mykins B, Oberdorster G, Wolke G, Pitz M, Wichmann HE, Peters A (2010) Changes in deceleration capacity of heart rate and heart rate variability induced by ambient air pollution in individuals with coronary artery disease. Part Fibre Toxicol 7:29
Seagrave J, Campen MJ, McDonald JD, Mauderly JL, Rohr AC (2008) Oxidative stress, inflammation, and pulmonary function assessment in rats exposed to laboratory-generated pollutant mixtures. J Toxicol Environ Health A 71:1352–1362
Semmler M, Seitz J, Erbe F, Mayer P, Heyder J, Oberdorster G, Kreyling WG (2004) Long-term clearance kinetics of inhaled ultrafine insoluble iridium particles from the rat lung, including transient translocation into secondary organs. Inhal Toxicol 16:453–459
Serinelli M, Gianicolo EA, Cervino M, Mangia C, Portaluri M, Vigotti MA (2010) Acute effects of air pollution in Brindisi (Italy): a case-crossover analysis. Epidemiol Prev 34:100–107
Shinyashiki M, Eiguren-Fernandez A, Schmitz DA, di Stefano E, Li N, Linak WP, Cho SH, Froines JR, Cho AK (2009) Electrophilic and redox properties of diesel exhaust particles. Environ Res 109:239–244
Stahlhofen W, Gebhart J, Heyder J (1980) Experimental determination of the regional deposition of aerosol particles in the human respiratory tract. Am Ind Hyg Assoc J 41:385–398a
Stewart JC, Chalupa DC, Devlin RB, Frasier LM, Huang LS, Little EL, Lee SM, Phipps RP, Pietropaoli AP, Taubman MB, Utell MJ, Frampton MW (2010) Vascular effects of ultrafine particles in persons with type 2 diabetes. Environ Health Perspect 118:1692–1698
Stout SL, Wyatt TA, Adams JJ, Sisson JH (2007) Nitric oxide-dependent cilia regulatory enzyme localization in bovine bronchial epithelial cells. J Histochem Cytochem 55:433–442
Sun G, Crissman K, Norwood J, Richards J, Slade R, Hatch GE (2001) Oxidative interactions of synthetic lung epithelial lining fluid with metal-containing particulate matter. Am J Physiol Lung Cell Mol Physiol 281:L807–L815
Sun Q, Wang A, ** X, Natanzon A, Duquaine D, Brook RD, Aguinaldo JG, Fayad ZA, Fuster V, Lippmann M, Chen LC, Rajagopalan S (2005) Long-term air pollution exposure and acceleration of atherosclerosis and vascular inflammation in an animal model. JAMA 294:3003–3010
Sun Q, Yue P, Deiuliis JA, Lumeng CN, Kampfrath T, Mikolaj MB, Cai Y, Ostrowski MC, Lu B, Parthasarathy S, Brook RD, Moffatt-Bruce SD, Chen LC, Rajagopalan S (2009) Ambient air pollution exaggerates adipose inflammation and insulin resistance in a mouse model of diet-induced obesity. Circulation 119:538–546
Suzuki T, Kanoh T, Kanbayashi M, Todome Y, Ohkuni H (1993) The adjuvant activity of pyrene in diesel exhaust on IgE antibody production in mice. Arerugi 42:963–968
Triantaphyllopoulos K, Hussain F, Pinart M, Zhang M, Li F, Adcock I, Kirkham P, Zhu J, Chung KF (2011) A model of chronic inflammation and pulmonary emphysema after multiple ozone exposures in mice. Am J Physiol Lung Cell Mol Physiol 300:L691–L700
Valavanidis A, Fiotakis K, Bakeas E, Vlahogianni T (2005) Electron paramagnetic resonance study of the generation of reactive oxygen species catalysed by transition metals and quinoid redox cycling by inhalable ambient particulate matter. Redox Rep 10:37–51
Valavanidis A, Fiotakis K, Vlachogianni T (2008) Airborne particulate matter and human health: toxicological assessment and importance of size and composition of particles for oxidative damage and carcinogenic mechanisms. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev 26:339–362
van der Vliet A, O’Neill CA, Cross CE, Koostra JM, Volz WG, Halliwell B, Louie S (1999) Determination of low-molecular-mass antioxidant concentrations in human respiratory tract lining fluids. Am J Physiol 276:L289–L296
Veranth JM, Moss TA, Chow JC, Labban R, Nichols WK, Walton JC, Watson JG, Yost GS (2006) Correlation of in vitro cytokine responses with the chemical composition of soil-derived particulate matter. Environ Health Perspect 114:341–349
Wang XK, Lu WZ (2006) Seasonal variation of air pollution index: Hong Kong case study. Chemosphere 63:1261–1272
Wellenius GA, Burger MR, Coull BA, Schwartz J, Suh HH, Koutrakis P, Schlaug G, Gold DR, Mittleman MA (2012) Ambient air pollution and the risk of acute ischemic stroke. Arch Intern Med 172:229–234
Welty LJ, Peng RD, Zeger SL, Dominici F (2009) Bayesian distributed lag models: estimating effects of particulate matter air pollution on daily mortality. Biometrics 65:282–291
Wheat LA, Haberzettl P, Hellmann J, Baba SP, Bertke M, Lee J, McCracken J, O’Toole TE, Bhatnagar A, Conklin DJ (2011) Acrolein inhalation prevents vascular endothelial growth factor-induced mobilization of Flk-1+/Sca-1+ cells in mice. Arterioscler Thromb Vasc Biol 31:1598–1606
Wheeler AJ, Xu X, Kulka R, You H, Wallace L, Mallach G, van Ryswyk K, Macneill M, Kearney J, Dabek-Zlotorzynska E, Wang D, Poon R, Williams R, Stocco C, Anastassopoulos A, Miller JD, Dales R, Brook JR (2011) Windsor, Ontario exposure assessment study: design and methods validation of personal, indoor, and outdoor air pollution monitoring. J Air Waste Manag Assoc 61:142–156
Wiebert P, Sanchez-Crespo A, Seitz J, Falk R, Philipson K, Kreyling WG, Moller W, Sommerer K, Larsson S, Svartengren M (2006) Negligible clearance of ultrafine particles retained in healthy and affected human lungs. Eur Respir J 28:286–290
Willeke K, Baron PA (1990) Sampling and interpretation errors in aerosol monitoring. Am Ind Hyg Assoc J 51:160–168
Xu X, Yavar Z, Verdin M, Ying Z, Mihai G, Kampfrath T, Wang A, Zhong M, Lippmann M, Chen LC, Rajagopalan S, Sun Q (2010) Effect of early particulate air pollution exposure on obesity in mice: role of p47phox. Arterioscler Thromb Vasc Biol 30:2518–2527
Xu X, Deng F, Guo X, Lv P, Zhong M, Liu C, Wang A, Tzan K, Jiang SY, Lippmann M, Rajagopalan S, Qu Q, Chen LC, Sun Q (2012) Association of systemic inflammation with marked changes in particulate air pollution in Bei**g in 2008. Toxicol Lett 212:147–156
Yang W, Omaye ST (2009) Air pollutants, oxidative stress and human health. Mutat Res 674:45–54
Ying Z, Kampfrath T, Thurston G, Farrar B, Lippmann M, Wang A, Sun Q, Chen LC, Rajagopalan S (2009) Ambient particulates alter vascular function through induction of reactive oxygen and nitrogen species. Toxicol Sci 111:80–88
Yoshida T, Tuder RM (2007) Pathobiology of cigarette smoke-induced chronic obstructive pulmonary disease. Physiol Rev 87:1047–1082
Zanobetti A, Schwartz J, Dockery DW (2000) Airborne particles are a risk factor for hospital admissions for heart and lung disease. Environ Health Perspect 108:1071–1077
Zanobetti A, Schwartz J, Samoli E, Gryparis A, Touloumi G, Atkinson R, Le Tertre A, Bobros J, Celko M, Goren A, Forsberg B, Michelozzi P, Rabczenko D, Aranguez Ruiz E, Katsouyanni K (2002) The temporal pattern of mortality responses to air pollution: a multicity assessment of mortality displacement. Epidemiology 13:87–93
Zanobetti A, Schwartz J, Samoli E, Gryparis A, Touloumi G, Peacock J, Anderson RH, le Tertre A, Bobros J, Celko M, Goren A, Forsberg B, Michelozzi P, Rabczenko D, Hoyos SP, Wichmann HE, Katsouyanni K (2003) The temporal pattern of respiratory and heart disease mortality in response to air pollution. Environ Health Perspect 111:1188–1193
Zanobetti A, Bind MA, Schwartz J (2008) Particulate air pollution and survival in a COPD cohort. Environ Health 7:48
Zhao PS, Dong F, He D, Zhao XJ, Zhang WZ, Yao Q, Liu HY (2013) Characteristics of concentrations and chemical compositions for PM2.5 in the region of Bei**g, Tian**, and Hebei, China. Atmos Chem Phys Discuss 13:863–901
Acknowledgments
We thank James McCracken, Ph.D., Timothy E. O’Toole, Ph.D., David Young, Jongmin Lee, Ph.D., and Duane Bolanowski for technical assistance. Work in the authors’ laboratories is supported by grants from AHA, EPA, DOD and NIH.
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Haberzettl, P., Bhatnagar, A., Conklin, D.J. (2014). Particulate Matter and Oxidative Stress – Pulmonary and Cardiovascular Targets and Consequences. In: Laher, I. (eds) Systems Biology of Free Radicals and Antioxidants. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-30018-9_120
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