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Air Pollution and Diet: Potential Interacting Exposures in Asthma

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Abstract

Purpose of Review

To provide a review of emerging literature describing the impact of diet on the respiratory response to air pollution in asthma.

Recent Findings

Asthma phenotyping (observable characteristics) and endotyping (mechanistic pathways) have increased the specificity of diagnostic and treatment pathways and opened the doors to the identification of subphenotypes with enhanced susceptibility to exposures and interventions. Mechanisms underlying the airway immune response to air pollution are still being defined but include oxidative stress, inflammation, and activation of adaptive and innate immune responses, with genetic susceptibility highlighted. Of these, neutrophil recruitment and activation appear prominent; however, understanding neutrophil function in response to pollutant exposures is a research gap. Diet may play a role in asthma pathogenesis and morbidity; therefore, diet modification is a potential target opportunity to protect against pollutant-induced lung injury. In particular, in vivo and in vitro data suggest the potential for diet to modify the inflammatory response in the airways, including impacts on neutrophil recruitment and function. Murine models provide compelling results in regard to the potential for dietary components (including fiber, antioxidants, and omega-3 fatty acids) to buffer against the inflammatory response to air pollution in the lung.

Summary

Precision lifestyle approaches to asthma management and respiratory protection in the context of air pollution exposures may evolve to include diet, pending the results of further epidemiologic and causal investigation and with neutrophil recruitment and activation as a candidate mechanism.

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Data Availability

This is a review rather than a primary data analysis- this should not apply. 

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Authors and Affiliations

  1. Division of Respirology, University of British Columbia, Vancouver, BC, Canada

    Emily Brigham

  2. Vancouver Coastal Health Research Institute, Vancouver, BC, Canada

    Emily Brigham

  3. Faculty of Science, University of British Columbia, BC, Vancouver, Canada

    Alisa Hashimoto

  4. Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Neil E. Alexis

  5. Department of Pediatrics, Division of Allergy, Immunology, Rheumatology and Infectious Disease, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Neil E. Alexis

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Brigham, E., Hashimoto, A. & Alexis, N.E. Air Pollution and Diet: Potential Interacting Exposures in Asthma. Curr Allergy Asthma Rep 23, 541–553 (2023). https://doi.org/10.1007/s11882-023-01101-1

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