Air pollution mixture associated with oxidative stress exacerbation and symptoms deterioration in allergic rhinitis patients: Evidence from a panel study

Jinhui Li; Haisheng Wu; Weiwei Xing; Xin Li; Zheshen Han; Renyue Ji; Zhengyi Deng; Minji Jung; Shengzhi Sun; Benjamin I Chung; Andres Cardenas; Marvin E Langston

doi:10.1016/j.scitotenv.2024.172688

Air pollution mixture associated with oxidative stress exacerbation and symptoms deterioration in allergic rhinitis patients: Evidence from a panel study

Sci Total Environ. 2024 Apr 23:930:172688. doi: 10.1016/j.scitotenv.2024.172688. Online ahead of print.

Authors

Jinhui Li¹, Haisheng Wu², Weiwei Xing³, Xin Li⁴, Zheshen Han², Renyue Ji², Zhengyi Deng⁵, Minji Jung⁵, Shengzhi Sun⁶, Benjamin I Chung⁵, Andres Cardenas⁷, Marvin E Langston⁷

Affiliations

¹ Department of Urology, Stanford University Medical Center, Stanford, CA, USA. Electronic address: jinhuili@stanford.edu.
² School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong.
³ Beijing Institute of Basic Medical Sciences, Beijing, China.
⁴ Department of Otorhinolaryngology-Head and Neck Surgery, Shanxi Provincial People's Hospital, Taiyuan, China.
⁵ Department of Urology, Stanford University Medical Center, Stanford, CA, USA.
⁶ Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China.
⁷ Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, USA.

PMID: 38663627
DOI: 10.1016/j.scitotenv.2024.172688

Abstract

With allergic rhinitis (AR) on the rise globally, there has been a growing focus on the role of environmental pollutants in the onset of AR. However, the potential mechanisms by how and which these pollutants exacerbate AR conditions remain unknown. This panel study of 49 patients diagnosed with AR over one year aimed to assess the individual and combined effects of short-term exposure to multiple ambient pollutants on oxidative stress, symptoms, and quality of life among patients with AR. All participants underwent four repeated assessments of health conditions and personal environmental exposures (PM_2.5, O₃, SO_2, and NO₂) over warm and cold seasons during 2017-2018. We evaluated two oxidative stress biomarkers (malondialdehyde [MDA], and superoxide dismutase [SOD]) via nasal lavage. We collected information on self-reported symptoms and quality of life using the Rhinitis Symptom Scale (SRS), the Visual Analog Scale (VAS), and the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) through in-person interviews. Bayesian kernel machine regression (BKMR) was used to evaluate the joint effects of pollutant mixture and identify key contributors. The results revealed a significant association of the pollutant mixture when all four pollutants were at or above their median levels, with increased oxidative stress. This was evidenced by elevated MDA and reduced SOD. We found a joint detrimental effect of the pollutant mixture on AR symptoms with a strong association with increased SRS scores, but a non-significant positive association with VAS and RQLQ scores. PM_2.5, O₃, and SO₂ presented as the potentially primary contributors to the adverse health effects associated with the pollutant mixture in Taiyuan city. Patients with AR exposed to short-term air pollutant mixture are more likely to have greater nasal symptoms and worse quality of life from increased oxidative stress and reduced antioxidant capacity. Further research is warranted to better elucidate the underlying mechanisms.

Keywords: Air pollution mixture; Allergic rhinitis; Bayesian kernel machine regression; Oxidative stress; Quality of life.