Characterization of the external exposome and its contribution to the clinical respiratory and early biological effects in children: The PROMESA cohort study protocol

Abstract

Background Air pollution contains a mixture of different pollutants from multiple sources. However, the interaction of these pollutants with other environmental exposures, as well as their harmful effects on children under five in tropical countries, is not well known. Objective This study aims to characterize the external exposome (ambient and indoor exposures) and its contribution to clinical respiratory and early biological effects in children. Materials and methods A cohort study will be conducted on children under five (n = 500) with a one-year follow-up. Enrolled children will be followed monthly (phone call) and at months 6 and 12 (in person) post-enrolment with upper and lower Acute Respiratory Infections (ARI) examinations, asthma development, asthma control, and genotoxic damage. The asthma diagnosis will be pediatric pulmonologist-based and a standardized protocol will be used. Exposure, effect, and susceptibility biomarkers will be measured on buccal cells samples. For environmental exposures PM2.5 will be sampled, and questionnaires, geographic information, dispersion models and Land Use Regression models for PM2.5 and NO2 will be used. Different statistical methods that include Bayesian and machine learning techniques will be used for the ambient and indoor exposures-and outcomes. This study was approved by the ethics committee at Universidad Pontificia Bolivariana. Expected study outcomes/findings To estimate i) The toxic effect of particulate matter transcending the approach based on pollutant concentration levels; ii) The risk of developing an upper and lower ARI, based on different exposure windows; iii) A baseline of early biological damage in children under five, and describe its progression after a one-year follow-up; and iv) How physical and chemical PM2.5 characteristics influence toxicity and children’s health.

Particulate Matter Induces Oxidative Stress and Ferroptosis in Human Lung Epithelial Cells

“…The concept of the “exposome” aims to comprehensively analyze an individual’s lifetime exposure to environmental factors. By exploring the exposome, researchers aim to unravel the complex relationship between environmental exposures and health, potentially providing new insights into disease causation and prevention, and personalized therapeutic strategies [ 66 , 67 , 68 ].…”

Exposome and pharmacogenomics: towards precision medicine in childhood asthma

“…The authors reported that lower values of FEV 1 were associated with prenatal perfluorononanoate and perfluorooctanoate exposures, as well as with 9 postnatal exposures (copper, ethyl-paraben, phthalate metabolites concentrations, house crowding, and facility density around schools), whereas the inverse distance to the nearest road during pregnancy was associated with a higher FEV 1 (22). More recently, the PROMESA cohort study protocol aims to characterize the external exposome (ambient and indoor exposures) and its contribution to clinical respiratory and early biological effects in children under five in tropical countries (23).…”

EUFOREUM Berlin 2023: Optimizing care for type 2 inflammatory diseases from clinic to AI: A pediatric focus

“…In a subgroup of patient's genetic markers help to predict severity 28 or comorbidity. 29 Knowing that lifestyle factors and the exposome [30][31][32][33][34] are key factors regarding epigenetics and activating and silencing of genes, the environment is a target for prevention. [30][31][32][33][34] However, given the complexity, apart from general recommendations like avoidance of tobacco smoke exposure, 35 control of pollution and the beneficial environment of a farming community and/or dog keeping, 24,30 no clear preventive strategies are available for the prevention of allergic airway disease and asthma in childhood.…”