Evaluation of relation between air pollution and IBD flare

Pezhman Alavinejad, Seyed ali Mard, Sadegh Larki, Abdolrahim Masjedizadeh, Eskandar Hajiani, Seyed Jalal Hashemi, Farzad Jassemi Zergani, Elham Karimi Moghaddam

Abstract


Background: To evaluate relation between air pollution and rate of flare and   hospital admission among IBD patients.

Methods: During a 10 months period, the number and average duration of hospitalization of patients admitted in GI ward due to IBD flare were recorded in an industrial capital city. Concomitantly the level of 4 major air pollutants including SO2, CO, NO2 and O3 measured and the correlation between severity of IBD flare and air pollution determined by Pearson correlation coefficient.

Results: Average number of admission was 7 patients per month (1-12). This figure for Crohn's disease (CD) was 2.9 and 3.7 for ulcerative colitis (UC). The average duration of hospitalization for UC and CD were 2.8 days (1 – 13) and 2.9 days (1 – 22) respectively. After comparison of average concentration of 4 major air pollutants with rate of IBD flare, , there was a relation, although non-meaningful, between CO concentration and number and duration of admissions due to UC flare (P= 0.135 & 0.08, correlation coefficient 0.196 & 0.251 respectively). DATA analysis did not reveal any significant relation between SO2 and NO2 and the rate of admission due to IBD flare (P > 0.05) and Interestingly there were a reverse meaningful correlation between concentration of O3 and number and duration of admissions due to Crohn’s disease flare (P= 0.016 and 0.006, Correlation Coefficient -0.338 & -0.413 respectively).

Conclusion: It seems that CO as one of the major air pollutants can aggravates course of ulcerative colitis and on the other hand O3 could have a potential protective effect on Crohn’s disease. This issue should further be clarified in future studies.

Keywords


CD, UC, flare, air pollution

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References


- DiMarino, Anthony J., Robert Coben, and Anthony Infantolino. Sleisenger and Fordtran's Gastrointestinal and Liver Disease Review and Assessment. Elsevier Health Sciences, 2010.

- Edwards, Felicity C., and S. C. Truelove. "The course and prognosis of ulcerative colitis Part I Short-term prognosis." Gut 4.4 (1963): 299-308.

- Hendriksen, C., S. Kreiner, and Vi Binder. "Long term prognosis in ulcerative colitis--based on results from a regional patient group from the county of Copenhagen." Gut 26.2 (1985): 158-163.

- Stonnington, C. M., et al. "Prognosis of chronic ulcerative colitis in a community." Gut 28.10 (1987): 1261-1266.

- D'Haens, Geert R., et al. "Early lesions of recurrent Crohn's disease caused by infusion of intestinal contents in excluded ileum." Gastroenterology 114.2 (1998): 262-267.

- Taurog, Joel D., et al. "The germfree state prevents development of gut and joint inflammatory disease in HLA-B27 transgenic rats." The Journal of experimental medicine 180.6 (1994): 2359-2364.

- Rath, Heiko C., et al. "Normal luminal bacteria, especially Bacteroides species, mediate chronic colitis, gastritis, and arthritis in HLA-B27/human beta2 microglobulin transgenic rats." Journal of Clinical Investigation 98.4 (1996): 945.

- Veltkamp, Claudia, et al. "Continuous stimulation by normal luminal bacteria is essential for the development and perpetuation of colitis in Tg?26 mice." Gastroenterology 120.4 (2001): 900-913.

- Sartor, R. Balfour. "Therapeutic manipulation of the enteric microflora in inflammatory bowel diseases: antibiotics, probiotics, and prebiotics." Gastroenterology 126.6 (2004): 1620-1633.

- Boyko, E. J., et al. "Effects of cigarette smoking on the clinical course of ulcerative colitis." Scandinavian journal of gastroenterology 23.9 (1988): 1147-1152.

- Lindberg, E., et al. "Smoking and inflammatory bowel disease. A case control study." Gut 29.3 (1988): 352-357.

- Jones, Deborah T., et al. "Passive smoking and inflammatory bowel disease: a meta-analysis." The American journal of gastroenterology 103.9 (2008): 2382-2393.

- Mahid, Suhal S., et al. "Active and passive smoking in childhood is related to the development of inflammatory bowel disease." Inflammatory bowel diseases 13.4 (2007): 431-438.

- Beamish, Leigh A., Alvaro R. Osornio-Vargas, and Eytan Wine. "Air pollution: An environmental factor contributing to intestinal disease." Journal of Crohn's and Colitis 5.4 (2011): 279-286.

- Barreiro-de Acosta, M., et al. "Emigration to western industrialized countries: A risk factor for developing inflammatory bowel disease." Journal of Crohn's and Colitis 5.6 (2011): 566-569.

- Kaplan, Gilaad G., et al. "The inflammatory bowel diseases and ambient air pollution: a novel association." The American journal of gastroenterology 105.11 (2010): 2412-2419.

- Ananthakrishnan, Ashwin N., et al. "Ambient air pollution correlates with hospitalizations for inflammatory bowel disease: an ecologic analysis." Inflammatory bowel diseases 17.5 (2011): 1138-1145.

- Carter, Martyn J., Alan J. Lobo, and Simon PL Travis. "Guidelines for the management of inflammatory bowel disease in adults." Gut 53.suppl 5 (2004): v1-v16.

- Farrokhyar, F., E. T. Swarbrick, and E. Jan Irvine. "A critical review of epidemiological studies in inflammatory bowel disease." Scandinavian journal of gastroenterology 36.1 (2001): 2-15.

- Hanauer, Stephen B. "Inflammatory bowel disease: epidemiology, pathogenesis, and therapeutic opportunities." Inflammatory bowel diseases 12.5 (2006): S3-S9.

- Möller, Winfried, et al. "Mucociliary and long-term particle clearance in the airways of healthy nonsmoker subjects." Journal of Applied Physiology 97.6 (2004): 2200-2206.

- Calderón-Garcidueñas, Lilian, et al. "Pediatric respiratory and systemic effects of chronic air pollution exposure: nose, lung, heart, and brain pathology." Toxicologic Pathology 35.1 (2007): 154-162.

- Cho, Hye-Youn, Liu-Yi Zhang, and Steven R. Kleeberger. "Ozone-induced lung inflammation and hyperreactivity are mediated via tumor necrosis factor-? receptors." American Journal of Physiology-Lung Cellular and Molecular Physiology 280.3 (2001): L537-L546.

- Hollingsworth, John W., Steven R. Kleeberger, and W. Michael Foster. "Ozone and pulmonary innate immunity." Proceedings of the American Thoracic Society 4.3 (2007): 240-246.

- Lakatos, Peter Laszlo, Tamas Szamosi, and Laszlo Lakatos. "Smoking in inflammatory bowel diseases: good, bad or ugly?." World journal of gastroenterology: WJG 13.46 (2007): 6134-6139.

- Guven, Ahmet, et al. "Medical ozone therapy reduces oxidative stress and intestinal damage in an experimental model of necrotizing enterocolitis in neonatal rats." Journal of pediatric surgery 44.9 (2009): 1730-1735.

- Kesik, Vural, et al. "Ozone ameliorates methotrexate-induced intestinal injury in rats." Cancer biology & therapy 8.17 (2009): 1623-1628.




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