Short-term Effects Of Air Pollution Exposure On Patients With Allergic Rhinoconjunctivitis

Allergic rhinoconjunctivitis(ARC)is a type I allergic disease involving the nose and eyes,which leads to the joint allergic reaction of nasal mucosa and eye conjunctiva.Its incidence rate is increasing in large and medium-sized cities in China.Air pollution is considered as a trigger for the occurrence and development of allergic diseases and respiratory diseases.However,at present,the population research on ARC patients and the understanding of the potential biological mechanism behind the epidemiological association are very limited.This study combined with the design of population study and individual study.First,time series analysis was used to explore the impact of air pollution exposure on the risk of allergic rhinitis outpatients from a population perspective,and identify important pollutants and time windows.Under this background,this study selected ARC patients with complex allergic symptoms to carry out a panel study.Individual exposure monitoring and health indicators measurement were completed in different seasons to quantitatively assess the short-term effects of air pollution on the inflammatory reaction,lung function and symptoms of ARC patients,and explore potential biological mechanisms.The main research results are as follows.(1)Based on the time series study,air pollution exposure was significantly related to the increase of the outpatient risk of allergic rhinitis,and the maximum effect exposure time window appears in lag0 and lag01.The risk of AR related to air pollution exposure in adults(18-45 years old)was higher than children.The risks of NO2 and PM2.5 were significant in the current period(2018～2020).(2)Air pollution exposure affected the inflammatory reaction in the body and nasal cavity of ARC patients,mainly in the number of eosinophils(β=0.05)and basophils(β=0.06),and concentration of IL-4(β=3.09%),IL-5(β=18.2%),inflammatory protein ECP(β=4.0%)and TNF-α(β=-15.4%),affecting the balance of Th1 and Th2.(3)Short term exposure to air pollution leads to impairment of lung function in patients with ARC.The most acute exposure window of significant effect was lag12h,and the most delayed was lag72h.Serum total IgE regulated the effect of particles on pulmonary function in patients with ARC,and the threshold concentration of IgE was 46.8～59.6 IU/mL.Serum ECP played a part of intermediary effect in the influence of particles on pulmonary function in patients with ARC,and the proportion of intermediary effect was 6.83%～34.93%.(4)Air pollution,mainly particulate matter exposure,aggravated allergic symptoms of ARC.The number of eosinophils,and the concentration of serum IgE,IL-4 and IL-5 in nasal lavage fluid were positively correlated with the symptom score.The study suggests that the possible mechanism of air pollution affecting ARC was Thl/Th2 immune imbalance and B lymphocyte signal pathway.This study revealed that air pollution exposure could lead to an increased risk of allergic rhinitis,and further evaluated the effect of air pollution exposure on the expression level of individual inflammatory factors,lung function impairment and symptom aggravation of ARC patients and the exposure time windows.This study helps to provide scientific basis and data support for reducing air pollution and promoting health management of ARC patients at the individual level.