Potential Biological Mediators of Myocardial and Vascular Complications of Air Pollution-A State-of-the-Art Review

Sina Fathieh; Stuart M Grieve; Kazuaki Negishi; Gemma A Figtree

doi:10.1016/j.hlc.2022.11.014

Potential Biological Mediators of Myocardial and Vascular Complications of Air Pollution-A State-of-the-Art Review

Heart Lung Circ. 2023 Jan;32(1):26-42. doi: 10.1016/j.hlc.2022.11.014. Epub 2022 Dec 28.

Authors

Sina Fathieh¹, Stuart M Grieve², Kazuaki Negishi³, Gemma A Figtree⁴

Affiliations

¹ Kolling Institute of Medical Research, Sydney, NSW, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.
² Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia; Department of Radiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
³ Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas, Australia; Department of Cardiology, Graduate School of Medicine, Gunma University, Maebashi, Gunma, Japan; Sydney Medical School Nepean, Faculty of Medicine and Health, Charles Perkins Centre Nepean, The University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Nepean Hospital, Sydney, NSW, Australia.
⁴ Kolling Institute of Medical Research, Sydney, NSW, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, NSW, Australia. Electronic address: gemma.figtree@sydney.edu.au.

PMID: 36585310
DOI: 10.1016/j.hlc.2022.11.014

Abstract

Ambient air pollution is recognised globally as a significant contributor to the burden of cardiovascular diseases. The evidence from both human and animal studies supporting the cardiovascular impact of exposure to air pollution has grown substantially, implicating numerous pathophysiological pathways and related signalling mediators. In this review, we summarise the list of activated mediators for each pathway that lead to myocardial and vascular injury in response to air pollutants. We performed a systematic search of multiple databases, including articles between 1990 and Jan 2022, summarising the evidence for activated pathways in response to each significant air pollutant. Particulate matter <2.5 μm (PM_2.5) was the most studied pollutant, followed by particulate matter between 2.5 μm-10 μm (PM₁₀), nitrogen dioxide (NO₂) and ozone (O₃). Key pathogenic pathways that emerged included activation of systemic and local inflammation, oxidative stress, endothelial dysfunction, and autonomic dysfunction. We looked at how potential mediators of each of these pathways were linked to both cardiovascular disease and air pollution and included the overlapping mediators. This review illustrates the complex relationship between air pollution and cardiovascular diseases, and discusses challenges in moving beyond associations, towards understanding causal contributions of specific pathways and markers that may inform us regarding an individual's exposure, response, and likely risk.

Keywords: Air pollution; Environmental health; Inflammation; Myocardial injury; Particulate matter.

Publication types

Review

MeSH terms

Air Pollutants* / analysis
Air Pollutants* / toxicity
Air Pollution* / adverse effects
Air Pollution* / analysis
Cardiovascular Diseases* / etiology
Environmental Exposure / analysis
Humans
Particulate Matter / analysis
Particulate Matter / toxicity

Substances

Air Pollutants
Particulate Matter