Indoor black carbon and biomarkers of systemic inflammation and endothelial activation in COPD patients


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Abstract

RationaleEvidence linking traffic-related particle exposure to systemic effects in chronic obstructive lung disease (COPD) patients is limited.ObjectivesAssess relationships between indoor black carbon (BC), a tracer of traffic-related particles, and plasma biomarkers of systemic inflammation and endothelial activation.MethodsBC was measured by reflectance in fine particle samples over a mean of 7.6 days in homes of 85 COPD patients up to 4 times seasonally over a year. After the completion of sampling, plasma C-reactive protein (CRP), interleukin-6 (IL-6), and soluble vascular adhesion molecule-1 (sVCAM-1) were measured. Current smokers and homes with major sources of BC were excluded; therefore, indoor BC was primarily a measure of infiltrated outdoor BC. Mixed effects regression models with a random intercept for each participant were used to assess BC effects at different times (1–9 days before phlebotomy) and in the multi-day sample.ResultsMeasured median BC was 0.19 μg/m3 (interquartile range, IQR=0.22 μg/m3). Adjusting for season, race, age, BMI, heart disease, diabetes, ambient temperature, relative humidity, a recent cold or similar illness, and blood draw time, there was a positive relationship between BC and CRP. The largest effect size was for BC averaged over the previous seven days (11.8% increase in CRP per IQR; 95%CI = 1.8–22.9). Effects were greatest among non-statin users and persons with diabetes. There were positive effects of BC on IL-6 only in non-statin users. There were no associations with sVCAM-1.ConclusionsThese results demonstrate exposure-response relationships between indoor BC with biomarkers of systemic inflammation in COPD patients, with stronger relationships in persons not using statins and with diabetes.HighlightsParticles from motor vehicles measured as black carbon (BC) infiltrate into the home.There is limited information regarding systemic effects of these particles.In COPD patients, short-term (during the past week) in-home exposure to BC is associated with increases in CRP.The greatest increase in CRP is in persons not taking statins and with diabetes.

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