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It has long been known that children living in congested cities have higher rates of asthma. All those vehicles, all that pollution. A recent study found that prenatal air pollution exposure is also important in asthma development.

Pregnant women exposed to high levels of tiny ultra-fine particles (UFPs, <0.1 µm) in the air were more likely to have children who developed asthma in the preschool years. Both boys and girls were affected, but high levels seemed to be especially harmful for girl babies exposed late in pregnancy.

Many of the women lived near major roadways with high traffic density - exposure to ultra-fine particles is greater there.

Ultra-fine particles are so small (<0.1 µm) that they can be considered nanoparticles. Their small size makes them so harmful - they can enter the lungs easily and from there travel throughout the body (including the organs), where they cause inflammation and other health effects. Unfortunately, ultra-fine particles are not regulated or routinely monitored in the United States.

From Science Daily: In utero exposure to tiny air pollution particles is linked to asthma in preschoolers

Women who were highly exposed to ultra-fine particles in air pollution during their pregnancy were more likely to have children who developed asthma, according to a study published in the American Journal of Respiratory and Critical Care Medicine in May. ...continue reading "Pregnancy and Air Pollution Linked to Asthma in the Children"

A recent study found that giving daily vitamin D supplements to children with severe asthma and low vitamin D levels did not prevent severe asthma attacks, reduce the time to an asthmatic attack, or enable the children to reduce the maintenance dose of an inhaled corticosteroid. Very disappointing!

As of 2018, it is estimated that 5.5 million children in the US have asthma, and that asthma led to more than 546,000 emergency department visits and 80,000 hospitalizations. So the researchers started the study hoping that vitamin D3 supplements could help with asthma attacks.

The well-done year long study recruited children (6 to 16 years old) from 7 US medical centers. They were assigned randomly to different groups (vitamin D or placebo), and with no one knowing who got vitamin D and who didn't. The children took 4000 IU/day of vitamin D3 or a placebo for 48 weeks, and all were maintained with a low-dose of inhaled corticosteroid (fluticasone propionate).

The findings contrast with earlier observational studies (basically a snap-shot of  groups of people) that found a link with severe asthma and lower vitamin D levels. Meanwhile, other well-done studies (women assigned randomly to different groups, etc) have found no protective effect from vitamin D3 supplementation during pregnancy - that is, it did not protect children up to the age of 6 from asthma.

Excerpts from Science Daily: Compared to placebo, vitamin D has no benefit for severe asthma attacks, study finds

Contrary to earlier results, vitamin D supplements do not prevent severe asthma attacks in at-risk children, according to the first placebo-controlled clinical trial to test this relationship.  ...continue reading "Children With Severe Asthma Not Helped By Vitamin D Supplements"

Want to prevent your children from having allergies or asthma? A recent study adds support to increasing evidence that growing up on a farm, or living among multiple pets in the first year of life is protective against developing allergies and asthma. This is because exposure to lots of animal and outdoor soil bacteria in early childhood is good for the developing immune system. The study, which was conducted by Finland's National Institute  of Health and Welfare, carried this line of work further and found that this type of beneficial farm microbial exposure could be duplicated in non-farm homes.

They found that children's risk of developing asthma decreased as the similarity of their home's bacteria became more similar to that of farm homes. The researchers analyzed living room dust from homes and found that certain types of outdoor soil microbes were beneficial for preventing asthma. They found higher levels of these bacteria (and archaea, another microbe) in homes where people wore their outdoor shoes in the house, as well as 3 or more children, and increased moisture in houses. The types of fungi found in the dust of farm and non-farm houses didn't seem to matter. The researchers mention that the same kind of protective (for asthma) results of soil microbes has also been shown in mice.

Additional thoughts reading this: The study results can be interpreted as playing and crawling outdoors is definitely beneficial to children's health, especially young children. Exposure to soil microbes! And, of course, having pets. But wearing outdoor shoes indoors is problematic in areas with high lawn and garden pesticide use (e.g. suburban NY and NJ!) because studies show the pesticides get tracked indoors. This same problem occurs in areas with high lead levels (around older homes) or other heavy metals.

From Science Daily: Farm-like indoor microbiota may protect children from asthma also in urban homes   ...continue reading "Outdoor Soil Microbes In the Home and Asthma"

An interesting possibility - that taking supplements of  a type of vitamin E known as gamma tocopherol may reduce the inflammation of the airways common in asthma patients – eosinophilic inflammation.

Note that these findings were from a preliminary study of 15 people with mild asthma, done by researchers at the Univ. of North Carolina. Now larger and longer studies need to be done, especially to make sure that side-effects and an increased risk for hemorrhagic stroke won't occur with gamma tocopherol, as it does for the other form of vitamin E (alpha tocopherol) commonly found in supplements. From Medical Xpress:

Can asthma be controlled with a vitamin supplement?

The shortness of breath experienced by the nearly 26 million Americans who suffer from asthma is usually the result of inflammation of the airways. People with asthma typically use albuterol for acute attacks and inhaled steroids to limit chronic inflammation. Both medications come with side effects. But what if it was possible to keep asthma under control by changing one's diet or taking a vitamin supplement? It may happen sooner than you think.

Preliminary research results from the UNC School of Medicine indicate that a type of vitamin E known as gamma tocopherol may reduce eosinophilic inflammation – a kind of airway inflammation common in asthma patients. The results were published in the Journal of Allergy & Clinical Immunology.

"We started looking into vitamin E because epidemiologic data suggested that people with high amounts of vitamin E in their diet were less prone to asthma and allergic disease," said Michelle Hernandez, MD, professor of pediatrics and senior author of the study.  There are several different isoforms of vitamin E. The type commonly found in vitamin supplements – alpha tocopherol – has been studied previously, but the results suggested that alpha tocopherol was not particularly effective. Even worse, the alpha isoform seemed to be associated with an increased risk for hemorrhagic stroke.

So UNC researchers took a different tack and asked whether the kind of vitamin E being used might have an effect on the outcome. They began looking more closely at gamma tocopherol, the type of vitamin E commonly found in a diet rich in nuts and nut oil. .... "While the alpha isoform does have antioxidant activities, gamma tocopherol has both an antioxidant and a very unique anti-inflammatory action as well," she said "That anti-inflammatory effect is what we think made the difference in this study."

Participants in the study were randomized into two groups that received either gamma tocopherol supplement or a placebo for two weeks. At the end of that period, they were asked to cough up sputum..... After a three week "washout period" where they took nothing, subjects were placed in the other group: if they took the supplement for the first two weeks, they took a placebo for the second period.

"The advantage of a cross-over design like this is that we are able to compare the subjects to themselves," said Burbank. "And what we found is that when people were taking the vitamin E supplement, they had less eosinophilic inflammation." In addition to decreased inflammation, those who were taking vitamin E were also found to have lower levels of proteins called mucins, which affect the stickiness of mucus. Mucins are often elevated in asthmatics.

Another study finding overdiagnosis (diagnosing something that isn't likely to cause problems) and misdiagnosis (diagnosing something that isn't there) which leads to overtreatment (unnecessary treatment) - this time of asthma in adults. A new study found that as many as 1 in 3 adults diagnosed with asthma may not actually have the disease. Was this due to spontaneous remission or to initial misdiagnosis? After all, many other diseases mimic the symptoms of asthma, and there is no test that can diagnose asthma with 100% accuracy. The study authors thought that of the 33% without asthma - that many of the adults had been originally misdiagnosed, while others had gone into remission. Excerpts from the thought-provoking site Health News Review:

Is it asthma? Many diagnosed with condition receiving unnecessary or incorrect treatment

As many as 1 in 3 adults diagnosed with asthma may not actually have the disease, according to new research published in the Journal of the American Medical Association (JAMA). Canadian researchers evaluated 613 patients with physician-diagnosed asthma and found that 203 participants (33%) most likely did not have the disease. After an additional 12 months of follow-up of this latter group, 181 subjects (30%) continued to exhibit no clinical or laboratory evidence of asthma.

This study, and its accompanying editorials, hit on a theme we’ve often raised with regard to cancer and many other chronic diseases: overdiagnosis leading to overtreatment. But it also raises the specter of misdiagnosis from the get-go, which can lead to erroneously treating a condition that isn’t there. The Canadian results may also confuse many of us who have grown accustomed to news stories warning us that asthma is on the rise. So which is it? More asthma which needs more aggressive treatment or less asthma warning against overtreatment?

“I think asthma is both overdiagnosed and underdiagnosed,” says Dr. Nancy Ott, an allergy and immunology specialist in practice for 28 years. “We don’t have a specific test that is definitive for asthma, and the diagnosis is nuanced. You need to look at the symptoms, the patient’s history, their family history, and the objective tests collectively. And I think we need to be much more strict in what constitutes asthma because the symptoms alone overlap with so many other conditions.”

This is not a message we hear nearly enough in news stories: the diagnosis of asthma, although common, is anything but cut-and-dried. In outpatient clinics – where most asthma is diagnosed – time pressures can lead to incomplete evaluations, which lead to misdiagnoses (which, by the way, includes over-, under-, and no diagnoses), and this can ultimately lead to patients suffering physically, emotionally and financially.

“We think that a large proportion of them had been misdiagnosed in the first place and another proportion that (was) a bit smaller had actually gone into remission, their asthma was no longer active,” said principal investigator Dr. Shawn Aaron, head of respirology at the University of Ottawa. Medical textbooks say about six per cent of people with asthma go into remission over a 10-year period, said Aaron. “But we found at least 20 per cent had gone into remission.” However, “one of the main messages I want to get across is that some people are being misdiagnosed because they’re not being properly investigated to begin with,” he said from Ottawa.

Which brings up an important point: the symptoms of asthma overlap with several other diseases. In the Canadian study, 12 people, or 2 percent of the participants, had serious conditions other than asthma, like heart disease and pulmonary hypertension. Others had problems such as hyperventilation from panic attacks, and gastroesophageal reflux (GERD). These latter two conditions frequently mimic asthma. As does vocal cord dysfunction. Suffice to say that if you were to take each of the classic symptoms of asthma individually, the list of diseases associated with that symptom is well over a dozen.

Earlier posts discussed research that showed that farm and animal (pets such as dogs) exposures in the first year of life is protective against allergies and asthma (lowers the risk of developing them). New research examined this further by looking at Amish and Hutterite groups - looking at not just "farm life", but whether children had much exposure to farm animals. The Amish have close exposure to farm animals (traditional farming methods), but the Hutterites don't (communal highly industrialized farming). Both groups studied had similar lifestyles (drank raw milk, breastfeeding, little exposure to smoking), but both groups did not have indoor pets ("taboos against indoor pets"). Thus farming methods were important for exposures to animals and their microbes.

The researchers said: "The importance of environmental exposures in the development of asthma is most exquisitely illustrated by epidemiologic studies conducted in Central Europe that show significant protection from asthma and allergic disease in children raised on traditional dairy farms. In particular, children’s contact with farm animals and the associated high microbial exposures4,5have been related to the reduced risk." Traditional farming exposed the children to an environment rich in microbes, and these children had very low rates of asthma and "distinct immune profiles that suggest profound effects on innate immunity." Once again, note the importance of microbes in the development of the immune system. From Science Daily:

Growing up on an Amish farm protects children against asthma by reprogramming immune cells

By probing the differences between two farming communities -- the Amish of Indiana and the Hutterites of South Dakota -- an interdisciplinary team of researchers found that specific aspects of the Amish environment are associated with changes to immune cells that appear to protect children from developing asthma. In the Aug. 4, 2016, issue of The New England Journal of Medicine, the researchers showed that substances in the house dust from Amish, but not Hutterite, homes were able to engage and shape the innate immune system (the body's front-line response to most microbes) in young Amish children in ways that may suppress pathologic responses leading to allergic asthma.

The Amish and Hutterite farming communities in the United States, founded by immigrants from Central Europe in the 18th and 19th centuries, respectively, provide textbook opportunities for such comparative studies. The Amish and the Hutterites have similar genetic ancestry. They share similar lifestyles and customs, such as no television and a Germanic farming diet. They have large families, get childhood vaccinations, breastfeed their children, drink raw milk and don't allow indoor pets.

The communities, however, are distinct in two important ways. Although both groups depend on agriculture, their farming practices differ. The Amish have retained traditional methods. They live on single-family dairy farms and rely on horses for fieldwork and transportation. In contrast, the Hutterites live on large communal farms. They use modern, industrialized farm machinery. This distances young Hutterite children from the constant daily exposure to farm animals. The other striking difference is what Ober calls a "whopping disparity in asthma." About 5 percent of Amish schoolchildren aged 6 to 14 have asthma. This is about half of the U.S. average (10.3%) for children aged 5 to 14, and one-fourth of the prevalence (21.3%) among Hutterite children.

To understand this disparity, the researchers studied 30 Amish children 7 to 14 years old, and 30 age-matched Hutterite children. They scrutinized the children's genetic profiles, which confirmed the remarkable similarities between Amish and Hutterite children. They compared the types of immune cells in the children's blood, collected airborne dust from Amish and Hutterite homes and measured the microbial load in homes in both communities.

The first gee-whiz moment came from the blood studies. These revealed startling differences between the innate immune response from the Amish and Hutterites. "The Amish had more and younger neutrophils, blood cells crucial to fight infections, and fewer eosinophils, blood cells that promote allergic inflammation," said study co-author, immunologist Anne Sperling, PhD, associate professor of medicine at the University of Chicago. Gene expression profiles in blood cells also revealed enhanced activation of key innate immunity genes in Amish children.

The second eureka moment came from experiments using mice. When study co-author, immunologist Donata Vercelli, MD, professor of cellular and molecular medicine and associate director of the Asthma and Airway Disease Research Center at the University of Arizona, exposed mice to house-dust extracts, she found the airways of mice that received Amish dust were protected from asthma-like responses to allergens. In contrast, mice exposed to Hutterite house dust were not protected.

What was different? Dust collected from Amish homes was "much richer in microbial products," the authors note, than dust from Hutterite homes. "Neither the Amish nor the Hutterites have dirty homes," Ober explained. "Both are tidy. The Amish barns, however, are much closer to their homes. Their children run in and out of them, often barefoot, all day long. There's no obvious dirt in the Amish homes, no lapse of cleanliness. It's just in the air, and in the dust."

To better understand how asthma protection was achieved, the researchers used mice that lack MyD88 and Trif, genes crucial for innate immune responses. In these mice, the protective effect of the Amish dust was completely lost. "The results of the mouse experiments conclusively prove that products from the Amish environment are sufficient to confer protection from asthma, and highlight the novel, central role that innate immunity plays in directing this process," Vercelli said.

Newly published research found that children who are thumb-suckers or nail-biters are less likely to develop atopic sensitization or allergic sensitivities (as measured by positive skin-prick tests to common allergens). And, if they have both 'habits', they are even less likely to be allergic to such things as house dust mites, grass, cats, dogs, horses, wool, or airborne fungi. The finding emerges from a longitudinal study which followed the progress of 1,037 persons born in Dunedin, New Zealand in 1972-1973 from childhood into adulthood. However, the researchers found no relationship to these 2 habits to allergic asthma or "hay fever" - a contradictory finding that the researchers don't have an answer for.

"Our findings are consistent with the hygiene theory that early exposure to dirt or germs reduces the risk of developing allergies," said Professor Sears (one of the researchers).  The researchers were testing the idea that the common childhood habits of thumb-sucking and nail-biting would increase microbial exposures, affecting the immune system and reducing the development of allergic reactions also known as atopic sensitization. 31% of the children were frequent thumb suckers or nail biters.

Among all children at 13 years old, 45% showed atopic sensitization, but among those with no habits 49% had allergic sensitization; and those with one oral habit - 40% had allergic sensitization. Among those with both habits, only 31% had allergic sensitization. This trend continued into adulthood, and showed no difference depending on smoking in the household, ownership of cats or dogs; or exposure to house dust mites.

Excerpts of the study from Pediatrics: Thumb-Sucking, Nail-Biting, and Atopic Sensitization, Asthma, and Hay Fever

The hygiene hypothesis suggests that early-life exposure to microbial organisms reduces the risk of developing allergies. Thumb-sucking and nail-biting are common childhood habits that may increase microbial exposures. We tested the hypothesis that children who suck their thumbs or bite their nails have a lower risk of developing atopy, asthma, and hay fever in a population-based birth cohort followed to adulthood. Parents reported children’s thumb-sucking and nail-biting habits when their children were ages 5, 7, 9, and 11 years. Atopic sensitization was defined as a positive skin-prick test (≥2-mm weal) to ≥1 common allergen at 13 and 32 years. 

Thirty-one percent of children were frequent thumb-suckers or nail-biters at ≥1 of the ages. These children had a lower risk of atopic sensitization at age 13 years  and age 32 years. These associations persisted when adjusted for multiple confounding factors. Children who had both habits had a lower risk of atopic sensitization than those who had only 1. No associations were found for nail-biting, thumb-sucking, and asthma or hay fever at either age.

What This Study Adds: Children who sucked their thumbs or bit their nails between ages 5 and 11 years were less likely to have atopic sensitization at age 13. This reduced risk persisted until adulthood. There was no association with asthma or hay fever.

The “hygiene hypothesis” was suggested by Strachan1 to explain why children from larger families and those with older siblings are less likely to develop hay fever. Strahan hypothesized that this could be explained if “allergic diseases were prevented by infection in early childhood transmitted by unhygienic contact with older siblings, or acquired prenatally from a mother infected by contact with her older children.” The hypothesis is supported by evidence showing that children who grow up in large families are at greater risk of coming into contact with more infections....The hygiene hypothesis remains controversial, however, as it is unable to fully explain many associations, including the rise of allergies in “unhygienic” inner-city environments, and why probiotics are ineffective at preventing allergic diseases.3

Thumb-sucking and nail-biting are common oral habits among children, although the reported prevalence varies widely, from <1% to 25%.47 These habits have the potential to increase the exposure to environmental microorganisms, and have been associated with the oral carriage of Enterobacteriaceae, such as Escherichia coli and intestinal parasite infections.812 It seems likely that thumb-sucking and nail-biting would introduce a wide variety of microbes into the body, thus increasing the diversity of the child’s microbiome. If the hygiene hypothesis is correct, it is plausible that this would influence the risk for allergies.... 

Of 1013 children providing data, 317 (31%) had ≥1 oral habit: there was no significant sex difference in prevalence of these habits. Of the 724 children who had skin-prick tests at age 13 years, 328 (45%) showed atopic sensitization. The prevalence of sensitization was lower among children who had an oral habit (38%) compared with those who did not (49%) (P = .009). The lower risk of atopic sensitization was similar for thumb-sucking and nail-biting. Children with only 1 habit were less likely to be atopic (40%) than children with no habit at all (49%), but those with both habits had the lowest prevalence of sensitization (31%) .

 A number of recent studies looked at vitamin D and various diseases. All showed benefits of higher vitamin D levels in the blood: lower rates of cancer incidence, improved heart function in those with heart failure, lower rates of leukemia incidence, lower rates of breast cancer, and less aggressive breast and prostate cancer. However, one study found no benefits to vitamin D supplementation during pregnancy and the child's asthma risk. Older studies found low levels of vitamin D linked to higher risk of premenopausal breast cancer, and also to thicker melanomas at diagnosis (the thinner the melanoma, the better the prognosis).

Everyone agrees that sunshine is an excellent source of vitamin D, but there is still disagreement over what are the best daily vitamin D supplement dosages, or even what are optimal levels of vitamin D in the blood (measured as serum 25-hydroxyvitamin D or 25(OH)D). In 2010, the Institute of Medicine (IOM) concluded that levels lower than 12 ng/ml represented a vitamin D deficiency and recommended a target of 20 ng/ml, which could be met in most healthy adults (ages 19 to 70) with 600 International Units of vitamin D each day. Since then most researchers have argued for higher blood serum levels: most agreeing that over 30 ng/ml is best, while some advocating 50 ng/ml or more. But even what's too high (and could cause problems) is debated. Many vitamin D supporters now advocate taking 800 to 1,000 IUs of vitamin D daily (some say up to 4000 IUs daily is OK). Remember to look for vitamin D3 supplements, not D2.

This study found that higher levels of vitamin D (measured as serum 25(OH)D) are better, with 25(OH)D concentrations of at least 40 ng/ml best to reduce cancer risk (all types of cancer). From Medical Xpress: Higher levels of vitamin D correspond to lower cancer risk, researchers say

Researchers at University of California, San Diego School of Medicine report that higher levels of vitamin D - specifically serum 25-hydroxyvitamin D - are associated with a correspondingly reduced risk of cancer. The findings are published in the April 6, online issue of PLOS ONE.

Garland and his late brother, Frank, made the first connection between vitamin D deficiency and some cancers in 1980 when they noted populations at higher latitudes (with less available sunlight) were more likely to be deficient in vitamin D, which is produced by the body through exposure to sunshine, and experience higher rates of colon cancer. Subsequent studies by the Garlands and others found vitamin D links to other cancers, such as breast, lung and bladder.

The new PLOS ONE study sought to determine what blood level of vitamin D was required to effectively reduce cancer risk....The only accurate measure of vitamin D levels in a person is a blood test....Cancer incidence declined with increased 25(OH)D. Women with 25(OH)D concentrations of 40 ng/ml or greater had a 67 percent lower risk of cancer than women with levels of 20 ng/ml or less.

Garland does not identify a singular, optimum daily intake of vitamin D or the manner of intake, which may be sunlight exposure, diet and/or supplementation. He said the current study simply clarifies that reduced cancer risk becomes measurable at 40 ng/ml, with additional benefit at higher levels. "These findings support an inverse association between 25(OH)D and risk of cancer," he said, "and highlight the importance for cancer prevention of achieving a vitamin D blood serum concentration above 20 ng/ml, the concentration recommended by the IOM for bone health."

From Science Daily: Vitamin D improves heart function, study finds

A daily dose of vitamin D3 improves heart function in people with chronic heart failure, a five-year research project has found. The study involved more than 160 patients who were already being treated for their heart failure using proven treatments including beta-blockers, ACE-inhibitors and pacemakers.

Participants were asked to take vitamin D3 or a dummy (placebo) tablet for one year. Those patients who took vitamin D3 experienced an improvement in heart function which was not seen in those who took a placebo....In the 80 patients who took Vitamin D3, the heart's pumping function improved from 26% to 34%. In the others, who took placebo, there was no change in cardiac function.

Disappointing results. From Medscape: Vitamin D Disappoints: Prenatal Supplementation and Childhood Asthma

Two recent clinical trials examined maternal supplementation with vitamin D and postpregnancy offspring outcomes for asthma and wheezing....However, with respect to preventing asthma in offspring, there is no clear evidence for vitamin D supplementation in pregnant women.

From PLOS ONE: Vitamin D Deficiency at Melanoma Diagnosis Is Associated with Higher Breslow Thickness

Vitamin D deficiency at the time of melanoma diagnosis is associated with thicker tumours that are likely to have a poorer prognosis. Ensuring vitamin D levels of 50 nmol/L or higher in this population could potentially result in 18% of melanomas having Breslow thickness of <0.75 mm rather than ≥0.75 mm.

Reported in 2013. From Medical Express: Low vitamin D levels linked to high risk of premenopausal breast cancer

A prospective study led by researchers from the University of California, San Diego School of Medicine has found that low serum vitamin D levels in the months preceding diagnosis may predict a high risk of premenopausal breast cancer. The study of blood levels of 1,200 healthy women found that women whose serum vitamin D level was low during the three-month period just before diagnosis had approximately three times the risk of breast cancer as women in the highest vitamin D group. 

A 2011 meta-analysis by Garland and colleagues estimated that a serum level of 50 ng/ml is associated with 50 percent lower risk of breast cancer. While there are some variations in absorption, those who consume 4000 IU per day of vitamin D from food or a supplement normally would reach a serum level of 50 ng/ml.

Labrador Retriever image Other studies have found this same association - that living with a dog or farm animal has health benefits such as lower risk of allergies and asthma. In a Swedish nationwide study looking at over a million children, the association between early exposure to dogs and farm animals and the risk of asthma was evaluated. All children born in Sweden from January 1, 2001, to December 31, 2010 were included. The researchers found that exposure to dogs and farm animals during the first year of life reduces the risk of asthma in children at age 6 years. From Science Daily:

Early contact with dogs linked to lower risk of asthma

A team of Swedish scientists have used national register information in more than one million Swedish children to study the association of early life contact with dogs and subsequent development of asthma. This question has been studied extensively previously, but conclusive findings have been lacking. The new study showed that children who grew up with dogs had about 15 percent less asthma than children without dogs.

A total of more than one million children were included in the researchers' study linking together nine different national data sources, including two dog ownership registers not previously used for medical research...."Earlier studies have shown that growing up on a farm reduces a child's risk of asthma to about half. We wanted to see if this relationship also was true also for children growing up with dogs in their homes. Our results confirmed the farming effect, and we also saw that children who grew up with dogs had about 15 percent less asthma than children without dogs.

"These kind of epidemiological studies look for associations in large populations but do not provide answers on whether and how animals could protect children from developing asthma. We know that children with established allergy to cats or dogs should avoid them, but our results also indicate that children who grow up with dogs have reduced risks of asthma later in life. Thanks to the population-based design, our results are generalizable to the Swedish population, and probably also to other European populations with similar culture regarding pet ownership and farming" says Catarina Almqvist Malmros, senior author on the study, Paediatrician at Astrid Lindgren Children's Hospital and Professor in Clinical epidemiology at Dept of Medical Epidemiology and Biostatistics at Karolinska Institutet, Stockholm.

Scary study results showing what may scientists have long feared - that carbon nanotubes are being released into the environment and getting into our bodies with unknown health effects. The researchers point out that fine particulate matter (PMs) from air pollution penetrate lower airways and are associated with adverse health effects even with low concentrations and that carbon nanotubes are part of this fine particulate matter. Here they discussed how catalytic converters may convert carbon monoxide into carbon nanotubes during the process of converting carbon monoxide into safer emissions. The problem with carbon nanotubes is that they are so small - so small that we inhale them, but can't cough them out. Carbon nanotubes can be envisioned as one-atom thick sheets of carbon atoms that have been rolled into tubes with diameters as small as 1 nm and lengths up to several centimeters. And scientists are concerned that they may have inflammatory effects on the lungs (similar to what asbestos does). Of course the long-term studies have not yet been done....Because once again, technological advances have outpaced any safety sudies. The researchers studied the lung cells of children with asthma, but it is unclear whether the carbon nanotubes had any effect on or caused their asthma.

Two additional areas of serious concern regarding carbon nanotubes: (1) many tires now contain carbon nanotubes, and with abrasion (wear and tear) the nanotubes are released into the air (air pollution), and (2) the tire crumb fill used in synthetic turf fields. People, including athletes and developing children, are playing on these fields and whatever is in the tires (toxic chemicals, lead, etc. and carbon nanotubes) is being released into the air, and inhaled and ingested by those playing and exercising on the synthetic turf. From Futurity:

Nanotubes Found in Lungs of French Kids

Cells taken from the airways of Parisian children with asthma contained man-made carbon nanotubes—just like the kind found in the exhaust pipes of vehicles in Paris. The researchers report in the journal EBioMedicine that these samples align with what has been found elsewhere in US cities, in spider webs in India, and in ice cores. The research in no way ascribes the children’s conditions to the nanotubes, says Rice University chemist Lon Wilson, a corresponding author of a new paper describing the work. But the nanotubes’ apparent ubiquity should be the focus of further investigation, he adds.

“We know that carbon nanoparticles are found in nature,” Wilson says, noting that round fullerene molecules like those discovered at Rice are commonly produced by volcanoes, forest fires, and other combustion of carbon materials. “All you need is a little catalysis to make carbon nanotubes instead of fullerenes.

Carbon nanotubes (the long rods) and nanoparticles (the black clumps) appear in vehicle exhaust from tailpipes of cars in Paris.

 

 

 

 

 

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Carbon inside a lung cell vacuole takes the form of nanotubes (rods) and nanoparticles (black clumps). Credit: Both photos Fathi Moussa, Paris-Saclay Univ.

 

A car’s catalytic converter, which turns toxic carbon monoxide into safer emissions, bears at least a passing resemblance to the high-pressure carbon monoxide, or HiPco, process to make carbon nanotubes, he says. “So it is not a big surprise, when you think about it,” Wilson adds.

The team—led by Wilson, Fathi Moussa of Paris-Saclay University, and lead author Jelena Kolosnjaj-Tabi, a graduate student at Paris-Saclay—analyzed particulate matter found in the alveolar macrophage cells (also known as dust cells) that help stop foreign materials like particles and bacteria from entering the lungs. 

The cells were taken from 69 randomly selected asthma patients aged 2 to 17 who underwent routine fiber-optic bronchoscopies as part of their treatment. For ethical reasons, no cells from healthy patients were analyzed, but because nanotubes were found in all of the samples, the study led the researchers to conclude that carbon nanotubes are likely to be found in everybody.

The study notes but does not make definitive conclusions about the controversial proposition that carbon nanotube fibers may act like asbestos, a proven carcinogen. But the authors reminded that “long carbon nanotubes and large aggregates of short ones can induce a granulomatous (inflammation) reaction.”

The study partially answers the question of what makes up the black material inside alveolar macrophages, the original focus of the study. The researchers found single-walled and multiwalled carbon nanotubes and amorphous carbon among the cells, as well as in samples swabbed from the tailpipes of cars in Paris and dust from various buildings in and around the city. “The concentrations of nanotubes are so low in these samples that it’s hard to believe they would cause asthma, but you never know,” Wilson says. “What surprised me the most was that carbon nanotubes were the major component of the carbonaceous pollution we found in the samples.”

The nanotube aggregates in the cells ranged in size from 10 to 60 nanometers in diameter and up to several hundred nanometers in length, small enough that optical microscopes would not have been able to identify them in samples from former patients. The new study used more sophisticated tools, including high-resolution transmission electron microscopy, X-ray spectroscopy, Raman spectroscopy, and near-infrared fluorescence microscopy to definitively identify them in the cells and in the environmental samples.

“We collected samples from the exhaust pipes of cars in Paris as well as from busy and non-busy intersections there and found the same type of structures as in the human samples,” Wilson says. “It’s kind of ironic. In our laboratory, working with carbon nanotubes, we wear facemasks to prevent exactly what we’re seeing in these samples, yet everyone walking around out there in the world probably has at least a small concentration of carbon nanotubes in their lungs,” he says. The researchers also suggest that the large surface areas of nanotubes and their ability to adhere to substances may make them effective carriers for other pollutants.