An irreversible loss in lung function limits the long-term success in lung transplantation. We evaluated the role of chronic exposure to ambient air pollution on lung function levels in lung transplant recipients (LTRs).
The lung function of 520 LTRs from the Cohort in Lung Transplantation (COLT) study was measured every 6 months. The levels of air pollutants (nitrogen dioxide (NO2), particulate matter with an aerodynamic cut-off diameter of x µm (PMx) and ozone (O3)) at the patients' home address were averaged in the 12 months before each spirometry test. The effects of air pollutants on forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) in % predicted were estimated using mixed linear regressions. We assessed the effect modification of macrolide antibiotics in this relationship.
Increased 12-month levels of pollutants were associated with lower levels of FVC % pred (−2.56%, 95% CI −3.86–−1.25 for 5 µg·m−3 of PM10; −0.75%, 95% CI −1.38–−0.12 for 2 µg·m−3 of PM2.5 and −2.58%, 95% CI −4.63–−0.53 for 10 µg·m−3 of NO2). In patients not taking macrolides, the deleterious association between PM and FVC tended to be stronger and PM10 was associated with lower FEV1.
Our study suggests a deleterious effect of chronic exposure to air pollutants on lung function levels in LTRs, which might be modified with macrolides.
Chronic exposure to air pollutants is associated with reduced lung function in lung transplant recipients http://ow.ly/gH8e304Qac4
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Support statement: We are indebted to Programme Hospitalier de Recherche Clinique 2008 (Paris, France), Vaincre La Mucoviscidose (Paris, France) and Association Gregory Lemarchal for launching the project within the 11 French lung transplantation centres within the Cohort Of Lung Transplantation (COLT; Programme Transplantation 2008, PRTP-13, ClinicalTrials.gov Identifier: NCT00980967); Swiss National research fund supporting the STCS and, in particular, the lung transplant section (number 3347CO-108795). The SysCLAD study is an EU-funded project, HEALTH-F5-2012, grant agreement No. 305457 under the Seventh Framework Program (FP7). Funding information for this article has been deposited with the Open Funder Registry.
Conflict of interest: Disclosures can be found alongside this article at erj.ersjournals.com
- Received January 27, 2016.
- Accepted September 20, 2016.
- Copyright ©ERS 2017