Effects of ultrafine particles on the allergic inflammation in the lung of asthmatics: results of a double-blinded rando
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RESEARCH
Open Access
Effects of ultrafine particles on the allergic inflammation in the lung of asthmatics: results of a double-blinded randomized cross-over clinical pilot study Frank Schaumann1, Cornelia Frömke2, Dorothea Dijkstra1,2, Francesca Alessandrini3, Horst Windt1, Erwin Karg4, Meike Müller1, Carla Winkler1,2, Armin Braun1,7, Armin Koch2, Jens Michael Hohlfeld1,2,7, Heidrun Behrendt3, Otmar Schmid5, Wolfgang Koch1, Holger Schulz6 and Norbert Krug1,7*
Abstract Background: Epidemiological and experimental studies suggest that exposure to ultrafine particles (UFP) might aggravate the allergic inflammation of the lung in asthmatics. Methods: We exposed 12 allergic asthmatics in two subgroups in a double-blinded randomized cross-over design, first to freshly generated ultrafine carbon particles (64 μg/m3; 6.1 ± 0.4 × 105 particles/cm3 for 2 h) and then to filtered air or vice versa with a 28-day recovery period in-between. Eighteen hours after each exposure, grass pollen was instilled into a lung lobe via bronchoscopy. Another 24 hours later, inflammatory cells were collected by means of bronchoalveolar lavage (BAL). (Trial registration: NCT00527462) Results: For the entire study group, inhalation of UFP by itself had no significant effect on the allergen induced inflammatory response measured with total cell count as compared to exposure with filtered air (p = 0.188). However, the subgroup of subjects, which inhaled UFP during the first exposure, exhibited a significant increase in total BAL cells (p = 0.021), eosinophils (p = 0.031) and monocytes (p = 0.013) after filtered air exposure and subsequent allergen challenge 28 days later. Additionally, the potential of BAL cells to generate oxidant radicals was significantly elevated at that time point. The subgroup that was exposed first to filtered air and 28 days later to UFP did not reveal differences between sessions. Conclusions: Our data demonstrate that pre-allergen exposure to UFP had no acute effect on the allergic inflammation. However, the subgroup analysis lead to the speculation that inhaled UFP particles might have a long-term effect on the inflammatory course in asthmatic patients. This should be reconfirmed in further studies with an appropriate study design and sufficient number of subjects. Keywords: Ultrafine particles, Asthma, Pulmonary inflammation, Aerosol exposure, Aeroallergen
* Correspondence: [email protected] 1 Fraunhofer Institute for Toxicology and Experimental Medicine, Nikolai-Fuchs-Str. 1a, 30625 Hannover, Germany 7 Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany Full list of author information is available at the end of the article © 2014 Schaumann et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0) which permits unrestricted use, distribution, and reproduction in any medium, provided t
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