Background

Colder temperature exposure is a known trigger for pediatric asthma exacerbation. The induction of oxidative stress is a known pathophysiologic pathway for asthma exacerbation. However, the role of oxidative stress in linking colder temperature exposure and worsened pediatric asthma symptoms is poorly understood.

Methods

In a panel study involving 43 children with asthma, aged 5–13 years old, each child was visited 4 times with a 2-week interval. At each visit, nasal fluid, urine, and saliva samples were obtained and measured for biomarkers of oxidative stress in the nasal cavity (nasal malondialdehyde [MDA]), the circulatory system (urinary MDA), and the oral cavity (salivary MDA). Childhood Asthma-Control Test (CACT) was used to assess asthma symptoms.

Results

When ambient daily-average temperature ranged from 7 to 18 °C, a 2 °C decrement in personal temperature exposures were significantly associated with higher nasal MDA and urinary MDA concentrations by 47–77% and 6–14%, respectively. We estimated that, of the decrease in child-reported CACT scores (indicating worsened asthma symptoms and asthma control) associated with colder temperature exposure, 14–57% were mediated by nasal MDA.

Conclusion

These results suggest a plausible pathway that colder temperature exposure worsens pediatric asthma symptoms partly via inducing nasal oxidative stress.

Impact

• The role of oxidative stress in linking colder temperature exposure and worsened asthma symptoms is still poorly understood.

• Lower temperature exposure in a colder season was associated with higher nasal and systemic oxidative stress in children with asthma.

• Nasal MDA, a biomarker of nasal oxidative stress, mediated the associations between colder temperature exposures and pediatric asthma symptoms.

• The results firstly suggest a plausible pathway that colder temperature exposure worsens pediatric asthma symptoms partly via inducing oxidative stress in the nasal cavity.

中文翻译：

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鼻氧化应激介导低温暴露对小儿哮喘症状的影响

背景

众所周知，暴露在较低的温度下会导致小儿哮喘恶化。氧化应激的诱导是哮喘恶化的已知病理生理途径。然而，人们对氧化应激在较低温度暴露与儿童哮喘症状恶化之间的联系知之甚少。

方法

在一项涉及 43 名 5-13 岁哮喘儿童的小组研究中，每个孩子都被探访了 4 次，每次间隔为 2 周。每次访视时，都会获取鼻液、尿液和唾液样本，并测量鼻腔（鼻丙二醛 [MDA]）、循环系统（泌尿 MDA）和口腔（唾液 MDA）氧化应激的生物标志物。儿童哮喘控制测试（CACT）用于评估哮喘症状。

结果

当环境日平均温度在 7°C 至 18°C 范围内时，个人温度暴露降低 2°C 与鼻腔 MDA 和尿 MDA 浓度分别升高 47-77% 和 6-14% 显着相关。我们估计，儿童报告的 CACT 评分（表明哮喘症状恶化和哮喘控制）与较低温度暴露相关的下降中，14-57% 是由鼻腔 MDA 介导的。

结论

这些结果表明，较低的温度暴露会部分通过诱导鼻氧化应激而恶化小儿哮喘症状，这似乎是一个合理的途径。

影响

• 氧化应激在较低温度暴露与哮喘症状恶化之间的联系仍知之甚少。

• 寒冷季节的较低温度暴露与哮喘儿童较高的鼻腔和全身氧化应激有关。

• 鼻 MDA 是鼻氧化应激的生物标志物，介导较低温度暴露与小儿哮喘症状之间的关联。

• 研究结果首先提出了一种可能的途径，即较低的温度暴露会部分通过诱导鼻腔氧化应激而恶化小儿哮喘症状。