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预防痴呆和脑中风,减少PM2.5是我们可以做的

已有 3781 次阅读 2016-11-29 13:37 |个人分类:神经科学临床和基础|系统分类:观点评述


从何说起?

  昨天,我们找了很多证据支持饮酒和脑损害之间的相关性。今天,我们将从最近大家关注的雾霾、空气颗粒物和PM2.5入手,来谈谈雾霾、颗粒物、PM2.5是如何影响我们的大脑健康的。

   

雾霾、颗粒物和PM2.5损害大脑的结构

1. 女性长期暴露于PM2.5的环境中,大脑的白质和灰质的体积都会减少;

参考文献:

A Voxel-Based Morphometry Study Reveals Local Brain Structural Alterations Associated with    Ambient Fine Particles in Older Women.

Long-term exposure to fine particulate matter, residential proximity to major roads and  measures  ofbrain structure.

2. PM2.5和老年女性的脑白质体积减少相关——国际权威证据;

参考文献:

Ambient air pollution and neurotoxicity on brain structure: Evidence from women's health initiative memory study.


雾霾、颗粒物和PM2.5和脑疾病

1.长期暴露于PM2.5的环境中可能会增加自闭症的发生;

参考文献:

A Systematic Review and Meta-Analysis of Multiple Airborne Pollutants and Autism Spectrum Disorder.  

2. PM2.5能够损害小鼠的神经生物学行为和大脑线粒体功能;

参考文献:

PM2.5, SO2 and NO2 co-exposure impairs neurobehavior and induces mitochondrial injuries in the mouse brain.

3. PM2.5可能会损害青少年的认知能力,尤其是APOE e4携带者;

参考文献:

Interactive and additive influences of Gender, BMI and Apolipoprotein 4 on cognition in children chronically exposed to high concentrations of PM2.5 and ozone. APOE 4 females are at highest risk in Mexico City.

Air pollution, a rising environmental risk factor for cognition, neuroinflammation and neurodegeneration: The clinical impact on children and beyond.

4. 胎儿期空气颗粒物暴露可能有损胎儿将来大脑和精神发育;

参考文献:

Prenatal and childhood traffic-related air pollution exposure and childhood executive function and behavior.

Prenatal particulate air pollution and neurodevelopment in urban children: Examining sensitive windows and sex-specific associations.

Air Pollution and Neuropsychological Development: A Review of the Latest Evidence.

Traffic-related air pollution and brain development.

5. 肥胖的人暴露于轻度空气污染环境中,更易于发生脑肿瘤;

参考文献:

Long-term exposure to ambient air pollution and incidence of brain tumours: The Danish Nurse Cohort.

6. 暴露于高PM2.5的环境中的老年人更容易发生缺血性脑卒中,即使是短期暴露也会增加住院率和死亡率;

参考文献:

Assessment of associations between ischaemic attacks in patients with type 2 diabetes mellitus and air concentrations of particulate matter <2.5 μm.

Ethnic differences in ambient air pollution and risk of acute ischemic stroke.

Short term exposure to air pollution and stroke: systematic review and meta-analysis.

Short-term changes in ambient particulate matter and risk of stroke: a systematic review and meta-analysis.

7. 暴露于高PM2.5环境中可能会增加阿尔茨海默病的病理改变和脑代谢异常;

参考文献:

Air pollution and children: neural and tight junction antibodies and combustion metals, the role of barrier breakdown and brain immunity in neurodegeneration.

Prefrontal white matter pathology in air pollution exposed Mexico City young urbanites and their potential impact on neurovascular unit dysfunction and the development of Alzheimer's disease.

A Critical Proton MR Spectroscopy Marker of Alzheimer's Disease Early Neurodegenerative Change: Low Hippocampal NAA/Cr Ratio Impacts APOE ɛ4 Mexico City Children and Their Parents.

Mexico City normal weight children exposed to high concentrations of ambient PM2.5 show high blood leptin and endothelin-1, vitamin D deficiency, and food reward hormone dysregulation versus low pollution controls. Relevance for obesity and Alzheimer disease.

A pilot study to assess effects of long-term inhalation of airborne particulate matter on early Alzheimer-like changes in the mouse brain.

8. PM2.5可能和出血性脑卒中更相关;

参考文献:

Differentiating the effects of characteristics of PM pollution on mortality from ischemic and hemorrhagic strokes.

9. PM2.5增加大脑中多个区域的氧化应激水平;

参考文献:

Direct contact with particulate matter increases oxidative stress in different brain structures.

10. PM2.5和老年女性的认知功能损害相关,尤其是APOEe4携带者;

参考文献:

Association of air pollution with cognitive functions and its modification by APOE gene variants in elderly women.

11.PM2.5增加帕金森病、糖尿病的住院率和全因死亡率。

参考文献:

A national case-crossover analysis of the short-term effect of PM2.5 on hospitalizations and mortality  in  subjects with diabetes and neurological disorders.

12. 长期暴露于PM2.5环境中可能增加高血压的发生;

参考文献:

Long-term exposure to concentrated ambient PM2.5 increases mouse blood pressure through  abnormal activation of the sympathetic nervous system: a role for hypothalamic inflammation.



不支持证据

1. 短期暴露于轻度空气污染并不和缺血性卒中相关;

参考文献:

Short-term exposures to ambient air pollution and risk of recurrent ischemic stroke.

2. PM2.5等颗粒物与帕金森病发生无关;

参考文献:

Particulate matter and risk of Parkinson disease in a large prospective study of women.

3. PM2.5和缺血性卒中发生无关,较早的研究(2011)。

参考文献:

Fine particulate air pollution (PM2.5) and the risk of acute ischemic stroke.



主要评价

   我们发现,雾霾中的颗粒物PM2.5等显著的和胎儿的大脑发育异常相关,损害大脑白质和灰质,促进多种神经系统疾病的发生。可见,我们需要保护环境,进一步减少空气颗粒物含量。毋庸置疑,减少空气污染已经成为当前我国社会极需重视的问题了。



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