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Nasal oxidative stress mediating the effects of colder temperature exposure on pediatric asthma symptoms

Pediatric Research (2024)Cite this article

Abstract

Background

Colder temperature exposure is a known trigger for pediatric asthma exacerbation. The induction of oxidative stress is a known pathophysiologic pathway for asthma exacerbation. However, the role of oxidative stress in linking colder temperature exposure and worsened pediatric asthma symptoms is poorly understood.

Methods

In a panel study involving 43 children with asthma, aged 5–13 years old, each child was visited 4 times with a 2-week interval. At each visit, nasal fluid, urine, and saliva samples were obtained and measured for biomarkers of oxidative stress in the nasal cavity (nasal malondialdehyde [MDA]), the circulatory system (urinary MDA), and the oral cavity (salivary MDA). Childhood Asthma-Control Test (CACT) was used to assess asthma symptoms.

Results

When ambient daily-average temperature ranged from 7 to 18 °C, a 2 °C decrement in personal temperature exposures were significantly associated with higher nasal MDA and urinary MDA concentrations by 47–77% and 6–14%, respectively. We estimated that, of the decrease in child-reported CACT scores (indicating worsened asthma symptoms and asthma control) associated with colder temperature exposure, 14–57% were mediated by nasal MDA.

Conclusion

These results suggest a plausible pathway that colder temperature exposure worsens pediatric asthma symptoms partly via inducing nasal oxidative stress.

Impact

  • The role of oxidative stress in linking colder temperature exposure and worsened asthma symptoms is still poorly understood.

  • Lower temperature exposure in a colder season was associated with higher nasal and systemic oxidative stress in children with asthma.

  • Nasal MDA, a biomarker of nasal oxidative stress, mediated the associations between colder temperature exposures and pediatric asthma symptoms.

  • The results firstly suggest a plausible pathway that colder temperature exposure worsens pediatric asthma symptoms partly via inducing oxidative stress in the nasal cavity.

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Fig. 1: The associations between personal temperature exposures and oxidative stress biomarkers.
Fig. 2: The associations between personal temperature exposures and airway mechanics indicators.
Fig. 3: The associations between personal temperature exposures and CACT scores.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available to preserve individuals’ privacy but are available from the corresponding author on reasonable request.

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Acknowledgements

We thank Xiaoxing Cui, Lin Fang, Yanbo Teng, Lili Lin, Xiaojian Zhou, Jianguo Hong, and Qian Wang for their valuable contributions to the collection of field data.

Funding

This study received funding from NSFC (No. 51521005 & 51420105010) and Underwriters Laboratories Inc.

Author information

Authors and Affiliations

  1. Department of Community and Population Health, College of Health, Lehigh University, Bethlehem, PA, USA

    Linchen He & Kimberly Palaguachi-Lopez

  2. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Christina Norris

  3. Department of Civil and Environmental Engineering, Duke University, Durham, NC, USA

    Karoline Barkjohn & Michael H. Bergin

  4. Current Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, Durham, NC, USA

    Karoline Barkjohn

  5. Department of Pediatrics, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China

    Zhen Li

  6. Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China

    Feng Li

  7. Department of Building Science, Tsinghua University, Beijing, China

    Yinping Zhang

  8. Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing, China

    Yinping Zhang

  9. Underwriters Laboratories, Inc, Marietta, GA, USA

    Marilyn Black

  10. Nicholas School of the Environment, Duke University, Durham, NC, USA

    Junfeng (Jim) Zhang

  11. Duke Global Health Institute, Duke University, Durham, NC, USA

    Junfeng (Jim) Zhang

  12. Duke Kunshan University, Kunshan, Jiangsu, China

    Junfeng (Jim) Zhang

Authors
  1. Linchen He
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Contributions

Drs. He and J. Zhang had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data: He, Norris, Barkjohn, Z. Li, F.Li, Y. Zhang, Black, Bergin, J. Zhang, Drafting the article or revising it critically for important intellectual content: He, Norris, Palaguachi-Lopez, Barkjohn, Bergin, and J. Zhang., Final approval of the version to be published: He, Norris, Palaguachi-Lopez, Barkjohn, Z. Li, F.Li, Y. Zhang, Black, Bergin, J. Zhang.

Corresponding authors

Correspondence to Linchen He or Junfeng (Jim) Zhang.

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All the authors declare no competing interests.

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He, L., Norris, C., Palaguachi-Lopez, K. et al. Nasal oxidative stress mediating the effects of colder temperature exposure on pediatric asthma symptoms. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03196-2

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  • DOI: https://doi.org/10.1038/s41390-024-03196-2

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