| Objective:Air pollution could stimulate the body to produce inflammatory reaction,change coagulation function,and affect the normal physiological state of human body,which is related to the occurrence of adult acute respiratory distress syndrome（ARDS）.Children is more likely to be affected by air pollution,but whether air pollution affects the occurrence of pediatric acute respiratory distress syndrome（PARDS）is unclear.In this study,we aimed to analyze the correlation between the number of PARDS admitted to hospital and the exposure concentrations and levels of various air pollutants,and explore the correlation between the indicators of inflammation,coagulation in PARDS and air pollution exposure.Methods:In the first section,children with PARDS admitted to children’s Hospital of Chongqing Medical University from 2015 to 2018were retrospectively collected.And local air pollution data in the same period were obtained,including fine particulate matter(PM2.5),inhalable particles(PM10),sulfur dioxide（SO2）,carbon monoxide（CO）,nitrogen dioxide（NO2）and ozone（O3）.Pearson correlation analysis and Spearman correlation analysis were used to study the correlation between the number of admitted PARDS and the monthly average exposure concentrations and levels of various air pollutants.And a multiple stepwise regression model was built to explore the impact of air pollution exposure on the number of admitted PARDS.In the second section,we collected white blood cell count（WBC）,hemoglobin（HGB）,percentage of neutrophils（NEU%）,C-reactive protein（CRP）,procalcitonin（PCT）,prothrombin time（PT）and activated partial thromboplastin time（APTT）of children with PARDS admitted to children’s Hospital of Chongqing Medical University in 2019,and the data of air pollutants in the same period.Pearson correlation analysis and Spearman correlation analysis were used to analyze the correlation between the clinical test results of PARDS and the exposure concentrations and levels of air pollutants in different periods.Results:In the first section,a total of 666 local cases from Chongqing diagnosed with PARDS were included.Pearson correlation analysis showed that there was a significant correlation between the number of monthly admission of PARDS in Chongqing and the monthly average concentrations of NO2 and O3.Spearman correlation analysis showed that the number of monthly admission of PARDS in Chongqing had a significant correlation with the exposure level of PM2.5,NO2 and O3.The results of multiple stepwise regression analysis showed that the number of admission of PARDS was significantly affected by the monthly average concentration of O3,SO2 and NO2.In the second section,a total of 214 local cases from Chongqing diagnosed with PARDS were finally included.The results showed that CRP,PCT,APTT and NEU%of PARDS at the time of admission were significantly correlated with NO2,O3,PM2.5,PM10.And the most obvious correlation between the clinical test indicators of PARDS and the air pollutants exposure was found in the three weeks before admission,and the correlation results with the absolute value of the correlation coefficient exceeding 0.2 are the most in both Pearson correlation analysis and Spearman correlation analysis.Conclusion:There is a significant correlation between the number of hospitalized children with PARDS and traffic air pollution.Air pollution exposure may cause inflammation,activate neutrophil function and affect the occurrence of PARDS.However,it needs to be further confirmed by a larger sample size and multi center research,and the mechanism involved needs to be further studied.Objective:Neutrophils play an important role in the development of acute respiratory distress syndrome（ARDS）,but the mechanism of neutrophils in pediatric acute respiratory distress syndrome（PARDS）and the relationship between neutrophils and air pollution exposure are not clear.We aim to analyze the key genes of neutrophils involved in the development of ARDS,and explore the role of the key genes in PARDS and the relationship between their expressions and air pollutants,in order to investigate the mechanism of air pollutants affecting the development of PARDS.Methods:In the first section,we used the transcription profile data of neutrophils from patients with ARDS and healthy volunteers in gene expression comprehensive database to analyze the changes of neutrophils in transcriptome level in the process of ARDS and identify the related key genes.In the second section,30 cases of PARDS from Chongqing that met the research requirements were included in the PARDS group,and 30 healthy children who were matched with the gender and age of the PARDS group were included in the healthy children group.We tested the expression of the selected key genes of ARDS in neutrophils of PARDS and healthy children with q RT-PCR,and analyzed the relationship between the expression and the level of air pollution.Results:In the first section,we found that MHC class II molecules had obvious changes in biological processes during the development of ARDS,and neutrophil degranulation pathway played an important role in the pathogenesis of ARDS.Finally,we screened six key genes in the process of ARDS,including ARG1,CHI3L1,HP,LCN2,MMP8,SLC11A1,and they were all enriched in the pathway of neutrophils degranulation.In the second section,we found that the expression level of the key genes of ARDS in the PARDS group was significantly higher than that in the healthy children group.The expression of LCN2,MMP8 and SLC11A1 in healthy children was influenced by the exposure level of air pollution.And the exposure level of air pollutants also affected the expression of HP,LCN2 and MMP8 in children with PARDS.Conclusion:Neutrophil degranulation and ARG1,CHI3L1,HP,LCN2,MMP8,SLC11A1 involved play an important role in the development of both ARDS and PARDS.Air pollution exposure may affect the expression of the six key genes in healthy children and children with PARDS.Exposure to air pollution may activate neutrophils in children through the inflammatory pathway,promote the neutrophils degranulation,and may increase the risk of PARDS. |
