Research advance on the role of meteorological factors in inflammatory immune diseases
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摘要: 随着全球气候变化和人类活动的增加，环境因素对人类健康的影响逐渐凸显。空气污染与气象因素作为环境因素的重要组成，对人类健康的影响引起了广泛关注。炎症免疫性疾病是一组引起多器官系统损伤的慢性炎症性疾病，主要受遗传因素和环境因素影响。近年来研究表明，颗粒物、二氧化氮、臭氧等空气污染物与炎症免疫性疾病的发病密切相关。然而，气象因素对这类疾病的影响尚不清楚。流行病学研究显示，气象因素与炎症免疫性疾病的发病和复发有关，但具体机制仍未阐明，可能为诱发氧化应激、炎症反应、促炎细胞因子的产生和T淋巴细胞失衡等，最终导致多器官、多系统损伤。此外，气象因素和空气污染物间的协同或拮抗作用，以及环境因素与遗传易感性的交互作用均可能影响炎症免疫性疾病的发生发展。本文主要概述了气象因素与常见炎症免疫性疾病之间的关联和可能的机制，以期为进一步揭示该类疾病的发病机制，制定综合性防制策略提供依据。Abstract: With the intensification of global climate change and human activities, the role of environmental factors in human health is gradually highlighted. Air pollution and meteorological factors, as the main components of environmental factors, have attracted widespread attention to their impact on human health. Inflammatory immune diseases are a group of chronic inflammatory diseases that cause damage to multiple organ systems and are mainly influenced by genetic and environmental factors. Recent studies have shown that the role of air pollutants such as particulate matter, nitrogen dioxide, and ozone are strongly associated with the onset of inflammatory immune diseases. However, the impact of meteorological factors on these diseases remains to be fully elucidated. A large number of epidemiological studies have shown that meteorological factors may induce onset and recurrence of inflammatory immune diseases. The specific mechanism is still not elucidated fully and probably includes oxidative stress, inflammation, production of proinflammatory cytokines, T cell imbalance, etc, eventually leading to multiple organ system damage. In addition, the synergistic or antagonistic effects of meteorological factors and air pollutants, as well as the interaction between environmental factors and genetic susceptibility may influence the development of inflammatory immune diseases. In this review, we summarized the epidemiologic and pathogenic evidence linking meteorological factors to common inflammatory immune diseases. The information obtained may be beneficial for further elucidating the pathogenesis of inflammatory immune disease and making proper preventive strategies for these diseases.
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表 1 气象因素与炎症免疫性疾病相关的流行病学证据
Table 1. Epidemiological evidence on the association between meteorological factors and inflammatory immune diseases
第一作者 发表年份 国家 设计类型 暴露因素 结局 主要发现 Zhang Y[6] 2020 中国 时间序列分析 低环境温度 急性期COPD的入院率 较低的环境温度增加急性期COPD的入院率 Xie J[7] 2020 中国 时间分层的病例交叉研究 降雨 RA再入院率 降雨与滞后6 d的RA再入院率呈正相关 Byun S[8] 2020 韩国 时间分层的病例交叉研究 气温日较差 MS急性发作 气温日较差与MS急性发作风险呈正相关 Hu Y[9] 2020 中国 时间序列分析 温度、相对湿度和风速 哮喘发作 平均温度、气温日较差、相对湿度和风速均与哮喘发作相关 Wu Y[10] 2021 巴西 病例交叉研究 温度 哮喘住院 温度与哮喘住院率呈正相关 Lam HCY[11] 2019 中国 时间序列分析 环境温度 哮喘再入院 与首次入院相比，哮喘患者的再入院与环境温度呈现更强的关联 Lei X[15] 2021 中国 时间序列分析 温度 儿童哮喘恶化 温度升高增加儿童哮喘恶化的风险 Kabir AF[16] 2021 孟加拉国 时间分层病例交叉研究 温度 哮喘发作 气温下降引发了成年人和老年人的哮喘发作 Wei Q[17] 2020 中国 时间序列分析 气温日较差 哮喘住院率 高气温日较差与儿童哮喘住院率的增加相关 Watanabe M[21] 2011 日本 横断面研究 沙尘暴 哮喘发作 沙尘暴与哮喘的恶化相关 Chen J[23] 2019 中国 横断面研究 寒冷气候 COPD死亡率 寒冷气候增加了呼吸系统疾病和COPD的死亡率 Peng Q[24] 2021 中国 病例对照研究 低环境温度 COPD死亡率 前1个月的极低环境温度与COPD死亡率增加有关 De Miguel-Díez J[26] 2019 西班牙 病例交叉研究 低环境温度 COPD入院 较低的环境温度与急性COPD入院后更高的死亡率相关 Zhao Q[27] 2019 巴西 病例交叉研究 高温环境 COPD入院率 暴露于高温环境与COPD入院率呈正相关 Yin P[28] 2018 中国 时间序列分析 热浪 COPD死亡风险 热浪增加总体和心肺疾病的死亡风险，包括冠状动脉粥样硬化性心脏病、缺血性中风和COPD Lin Z[29] 2018 中国 时间序列分析 环境温度 呼气峰流速 高温和低温均可使呼气峰流速下降 Shen Y[30] 2021 中国 时间序列分析 环境温度 COPD患者急性加重 < 65岁的急性加重COPD患者更容易受到高温环境的影响，而≥65岁的COPD患者对低温环境更敏感 Zhan ZY[31] 2020 中国 时间序列分析 温度变化 COPD住院 温度变化与COPD住院之间呈线性关系 Ma Y[32] 2018 中国 时间序列分析 相邻两日的温差 COPD住院人数 相邻2 d的温差与COPD住院人数呈正比 Tian L[33] 2019 中国 横断面研究 相对湿度 COPD住院率 相对湿度的增加与COPD的住院率呈正比 Mu Z[34] 2017 中国 横断面研究 湿度和温度 COPD发病风险 高湿度会增加因低温而患COPD的风险 Lorentzou C[35] 2019 希腊 横断面研究 沙尘暴 COPD入院率 沙尘暴增加急性COPD的入院率 Wu Q[38] 2021 中国 时间序列分析 低环境温度 SLE再入院 低温环境增加SLE患者的再入院风险 Tsai WS[39] 2006 中国 横断面研究 低环境温度 RA的疼痛评分 RA的疼痛评分在寒潮出现后的第1 d升高 Stellmann JP[40] 2017 德国 横断面研究 高环境温度 MS患者的行走能力 较高的环境温度可能会影响MS患者的行走能力 Leavitt VM[42] 2014 美国 横断面研究 高环境温度 MS患者的认知状态 较高的室外温度与MS患者较差的认知状态有关 Roberg BL[43] 2016 美国 横断面研究 环境温度 MS患者的认知状态 室外温度与MS患者认知状态无关 Sun H[44] 2017 美国 横断面研究 高环境温度 MS死亡率和流行率 高环境温度降低低纬度地区MS死亡率和流行率 Waernbaum I[45] 2016 瑞典 横断面研究 低平均气温 T1DM发病率 儿童T1DM的发病率与低平均气温存在相关性 Jantchou P[47] 2014 法国 队列研究 日照时间 克罗恩病和溃疡性结肠炎 日照时间长与克罗恩病较低的患病率有关，与溃疡性结肠炎无关 Nerich V[48] 2011 法国 横断面研究 日照 克罗恩病的发病率 低日照与克罗恩病的发病率增加有关 Olmedo-Martín RV[49] 2019 西班牙 横断面研究 日光照射 IBD的临床活动性 低日光照射与IBD的临床活动性相关 Janssen CE[50] 2019 德国 回顾性队列研究 季节性 IBD的发生 IBD的发生呈现季节性 Koido S[51] 2013 日本 横断面研究 季节性 IBD的发生和恶化 IBD的发生和恶化呈季节性变化 Jung YS[52] 2013 韩国 横断面研究 季节性 IBD易感性 怀孕期间和产后的季节性环境因素与母亲孕后期IBD易感性有关 Manser CN[53] 2013 瑞士 横断面研究 热浪 IBD住院人数 在热浪期间，IBD的住院人数增加 Aamodt G[54] 2013 挪威 队列研究 温度 溃疡性结肠炎的流行 溃疡性结肠炎的流行与夏季温度有关 
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