Research

Ultrafine particles and platelet activation in patients with coronary heart disease – results from a prospective panel study

Regina Rückerl¹ , Richard P Phipps² , Alexandra Schneider³ , Mark Frampton⁴ , Josef Cyrys⁵ , Günther Oberdörster⁶ , H Erich Wichmann⁷ and Annette Peters⁸

¹  Institute of Epidemiology, GSF National Research Centre for Environment and Health, Neuherberg, Germany

²  Department of Environmental Medicine – Lung Biology and Disease Program, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA

³  Institute of Epidemiology, GSF National Research Centre for Environment and Health, Neuherberg, Germany

⁴  Department of Medicine – Pulmonary and Critical Care Division, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA

⁵  Institute of Epidemiology, GSF National Research Centre for Environment and Health, Neuherberg, Germany and WZU – Environmental Science Centre of the University Augsburg, Augsburg, Germany

⁶  Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA

⁷  Institute of Epidemiology, GSF National Research Centre for Environment and Health, Neuherberg, Germany; IBE Chair of Epidemiology, Ludwig-Maximilians-University of Munich, Munich, Germany and Focus-Network Aerosols and Health, GSF National Research Center for Environment and Health, Germany

⁸  Institute of Epidemiology, GSF National Research Centre for Environment and Health, Neuherberg, Germany and Focus-Network Aerosols and Health, GSF National Research Center for Environment and Health, Neuherberg, Germany

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Particle and Fibre Toxicology 2007, 4:1doi:10.1186/1743-8977-4-1

Published:	22 January 2007

Abstract

Background

Epidemiological studies on health effects of air pollution have consistently shown adverse cardiovascular effects. Toxicological studies have provided evidence for thrombogenic effects of particles.

A prospective panel study in a susceptible population was conducted in Erfurt, Germany, to study the effects of daily changes in ambient particles on various blood cells and soluble CD40ligand (sCD40L, also known as CD154), a marker for platelet activation that can cause increased coagulation and inflammation.

Blood cells and plasma sCD40L levels were repeatedly measured in 57 male patients with coronary heart disease (CHD) during winter 2000/2001. Fixed effects linear regression models were applied, adjusting for trend, weekday and meteorological parameters.

Hourly data on ultrafine particles (UFP, number concentration of particles from 0.01 to 0.1 μm), mass concentration of particles less than 10 and 2.5 μm in diameter (PM₁₀, PM_2.5), accumulation mode particle counts (AP, 0.1–1.0 μm), elemental and organic carbon, gaseous pollutants and meteorological data were collected at central monitoring sites.

Results

An immediate increase in plasma sCD40L was found in association with UFP and AP (% change from geometric mean: 7.1; CI: [0.1, 14.5] and 6.9; CI: [0.5, 13.8], respectively). Platelet counts decreased in association with UFP showing an immediate, a three days delayed (lag 3) and a 5-day average response (% change from the mean: -1.8; CI: [-3.4,-0.2]; -2.4; CI: [-4.5,-0.3] and -2.2; CI: [-4.0,-0.3] respectively).

Conclusion

The increased plasma sCD40L levels support the hypothesis that higher levels of ambient air pollution lead to an inflammatory response in patients with CHD thus providing a possible explanation for the observed association between air pollution and cardiovascular morbidity and mortality in susceptible parts of the population.