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STUDY OF THE ASSOCIATION BETWEEN RURAL-URBAN ENVIRONMENT, IMMUNE RESPONSE AND ASTHMA SEVERITY.

Grant number: 23/07590-0
Support Opportunities:Regular Research Grants
Duration: June 01, 2024 - May 31, 2026
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal Investigator:Eduardo Vieira Ponte
Grantee:Eduardo Vieira Ponte
Host Institution: Faculdade de Medicina de Jundiaí (FMJ). Prefeitura Municipal de Jundiaí. Jundiaí , SP, Brazil
Associated researchers:Ronei Luciano Mamoni

Abstract

Introduction: Studies indicate that exposures typical of the urban environment induce atopy, which partially explains the higher prevalence of asthma in cities. The pathogenesis of asthma, however, is not limited to the atopic phenotype. Therefore, it is relevant to establish whether exposure to the urban environment modifies the production of interleukins and cells involved in the pathogenesis of other asthma phenotypes. Objective: In individuals with asthma, to assess whether there is an association between exposure to the rural-urban environment and the concentration of interleukins in peripheral blood; asthma cell phenotype; response to treatment; and presence of airway obstruction. Methods: Cross-sectional study, in which 1,710 asthmatic individuals aged over nine years, residing in the municipality of Jundiaí, will be evaluated. Volunteers will be evaluated by a pulmonologist, answer the study questionnaires, undergo spirometry, skin prick test and collect a peripheral blood sample. Individuals will be grouped according to the environmental characteristics of the place of residence in three groups: ¨urban area with high occupation density¨, ¨urban area with low-medium occupation density¨ and ¨rural area¨. The groups will be compared in terms of plasma concentration of interleukins, frequency of atopy, eosinophilic phenotype, response to asthma treatment and presence of airway obstruction. Preliminary results: To date, 1,202 volunteers have been included in the study. The clinical, environmental and spirometry data of 830 individuals are entered into the database, and are being presented as preliminary results. The results of blood counts and allergy tests of the 1,202 individuals included in the study are still being entered into the database, which is why they were not presented in the preliminary analyses. Analyzes demonstrate that individuals living in urban areas with a high occupancy rate have a higher risk of post-bronchodilator airway obstruction and asthma exacerbation compared to those living in rural areas. We also observed a correlation between a greater extension of the green area close to the place of residence and better FEV1 and FVC values; and association between asthma exacerbation and proximity to sources of anthropogenic air pollution. Preliminary conclusions: Individuals living in urban environments have a higher frequency of airway obstruction and asthma exacerbations, especially individuals residing in densely occupied urban regions or close to sources of anthropogenic air pollution. Our results also indicate that increasing the extent of green areas can minimize the harmful effect of urban exposure on individuals with asthma. In the authors' opinion, the conclusions presented are interesting and important, but they will be even more enlightening if we obtain funding to measure plasma interleukins to relate them to environmental characteristics; this way, we will be able to understand more about the role of the immune response in the relationship between urbanization and clinical manifestations of asthma. This knowledge will make it possible to improve urban planning and establish effective preventive measures. (AU)

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