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Antoniewicz, L., Brynedal, A., Hedman, L., Lundbäck, M. & Bosson, J. A. (2019). Acute Effects of Electronic Cigarette Inhalation on the Vasculature and the Conducting Airways. Cardiovascular Toxicology, 19(5), 441-450
Öppna denna publikation i ny flik eller fönster >>Acute Effects of Electronic Cigarette Inhalation on the Vasculature and the Conducting Airways
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2019 (Engelska)Ingår i: Cardiovascular Toxicology, ISSN 1530-7905, E-ISSN 1559-0259, Vol. 19, nr 5, s. 441-450Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

The use of electronic cigarettes has increased exponentially since its introduction onto the global market in 2006. However, short- and long-term health effects remain largely unknown due to the novelty of this product. The present study examines the acute effects of e-cigarette aerosol inhalation, with and without nicotine, on vascular and pulmonary function in healthy volunteers. Seventeen healthy subjects inhaled electronic cigarette aerosol with and without nicotine on two separate occasions in a double-blinded crossover fashion. Blood pressure, heart rate, and arterial stiffness measured by pulse wave velocity and pulse wave analysis were assessed at baseline, and then at 0 h, 2 h, and 4 h following exposure. Dynamic spirometry and impulse oscillometry were measured following vascular assessments at these time points, as well as at 6 h following exposure. e-Cigarette aerosol with nicotine caused a significant increase in heart rate and arterial stiffness. Furthermore, e-cigarette aerosol-containing nicotine caused a sudden increase in flow resistance as measured by impulse oscillometry, indicating obstruction of the conducting airways. Both aerosols caused an increase in blood pressure. The present study indicates that inhaled e-cigarette aerosol with nicotine has an acute impact on vascular and pulmonary function. Thus, chronic usage may lead to long-term adverse health effects. Further investigation is warranted.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2019
Nyckelord
Arterial stiffness, Augmentation index, ENDS, Electronic cigarettes, IOS, Pulse wave velocity, e-Cig
Nationell ämneskategori
Arbetsmedicin och miljömedicin Kardiologi
Identifikatorer
urn:nbn:se:umu:diva-158824 (URN)10.1007/s12012-019-09516-x (DOI)000486337400006 ()30963443 (PubMedID)
Tillgänglig från: 2019-05-09 Skapad: 2019-05-09 Senast uppdaterad: 2019-11-11Bibliografiskt granskad
Rankin, G. D., Wingfors, H., Uski, O., Hedman, L., Ekstrand-Hammarström, B., Bosson, J. & Lundbäck, M. (2019). The toxic potential of a fourth-generation E-cigarette on human lung cell lines and tissue explants. Journal of Applied Toxicology, 39(8), 1143-1154
Öppna denna publikation i ny flik eller fönster >>The toxic potential of a fourth-generation E-cigarette on human lung cell lines and tissue explants
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2019 (Engelska)Ingår i: Journal of Applied Toxicology, ISSN 0260-437X, E-ISSN 1099-1263, Vol. 39, nr 8, s. 1143-1154Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

The use of electronic cigarettes (E‐cigs) is rapidly increasing. The latest generation of E‐cigs is highly customizable, allowing for high heating coil temperatures. The aim of this study was to assess the toxic potential of a fourth‐generation E‐cig. Aerosols generated from E‐liquid with (24 mg/mL) and without nicotine, using a fourth‐generation E‐cig, were chemically analysed and compared with cigarette smoke (K3R4F). Human lung epithelial cell lines and distal lung tissue explants were exposed to E‐cig vapour extract (EVE) and cigarette smoke extract for 24 hours and assessed for viability, inflammation, oxidative stress and genotoxicity. E‐cig aerosols contained measurable levels of volatile organic compounds, aldehydes and polycyclic aromatic hydrocarbons, in general, to a much lesser extent than cigarette smoke. Higher levels of certain carbonyls, e.g. formaldehyde, were detected in the E‐cig aerosols. EVEs decreased cell viability of BEAS‐2B cells, whereas little effect was seen in A549 cells and distal lung tissue. The nicotine‐containing EVE caused a greater decrease in cell viability and significant increase in DNA damage than the nicotine‐free EVE. Increased cytotoxicity, reactive oxygen species production and genotoxicity were seen with cells and tissue exposed to cigarette smoke extract compared with EVEs. Although E‐cig aerosols were less toxic than cigarette smoke, it was not benign. Moreover, the EVE containing nicotine was more toxic than the nicotine‐free EVE. More research is needed on the short‐ and long‐term health effects of vaping and the usage of newly emerging E‐cig devices to evaluate better the potential negative effects of E‐cigs on human health.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2019
Nyckelord
A549, BEAS-2B, DNA damage, aerosol characterization, cell cycle, electronic cigarette extract, human distal lung tissue, inflammatory cytokines, viability
Nationell ämneskategori
Arbetsmedicin och miljömedicin
Identifikatorer
urn:nbn:se:umu:diva-158814 (URN)10.1002/jat.3799 (DOI)000475406700006 ()30957912 (PubMedID)2-s2.0-85063979647 (Scopus ID)
Tillgänglig från: 2019-05-09 Skapad: 2019-05-09 Senast uppdaterad: 2019-08-12Bibliografiskt granskad
Bosson, J. A., Mudway, I. S. & Sandström, T. (2019). Traffic-related Air Pollution, Health, and Allergy: The Role of Nitrogen Dioxide. American Journal of Respiratory and Critical Care Medicine, 200(5), 523-524
Öppna denna publikation i ny flik eller fönster >>Traffic-related Air Pollution, Health, and Allergy: The Role of Nitrogen Dioxide
2019 (Engelska)Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 200, nr 5, s. 523-524Artikel i tidskrift, Editorial material (Övrigt vetenskapligt) Published
Ort, förlag, år, upplaga, sidor
AMER THORACIC SOC, 2019
Nyckelord
SHORT-TERM EXPOSURE, HOSPITAL ADMISSIONS, CHALLENGE, IGE
Nationell ämneskategori
Lungmedicin och allergi
Identifikatorer
urn:nbn:se:umu:diva-164510 (URN)10.1164/rccm.201904-0834ED (DOI)000484033400003 ()31059649 (PubMedID)
Tillgänglig från: 2019-11-20 Skapad: 2019-11-20 Senast uppdaterad: 2019-11-20Bibliografiskt granskad
Lundback, M., Mobarrez, F., Antoniewicz, L. & Bosson, J. A. (2018). Acute effects of e-cigarette inhalation with or without nicotine on levels of microvesicles in the blood of human volunteers. Paper presented at 28th International Congress of the European-Respiratory-Society (ERS), SEP 15-19, 2018, Paris, FRANCE. European Respiratory Journal, 52
Öppna denna publikation i ny flik eller fönster >>Acute effects of e-cigarette inhalation with or without nicotine on levels of microvesicles in the blood of human volunteers
2018 (Engelska)Ingår i: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 52Artikel i tidskrift, Meeting abstract (Övrigt vetenskapligt) Published
Abstract [en]

Background: The e-cigarette use has increased dramatically. Our group has demonstrated signs of possible vascular damage following e-cigarette use.

We study the effects of e-cigarette inhalation (vaping) on vascular function, inflammation and hemostasis. Microvesicles (MV) of endothelial, leukocyte and platelet origin is measured in blood. MV are biomarkers that reflect cell function and can be used when assessing the risk of cardiovascular complications. We have recently shown that cigarette smoking causes an acute increase in MV in blood of healthy volunteers, suggesting vascular injury, inflammation and negative impact on hemostasis. We now investigate if the e-cigarette has similar effects.

Methods: Seventeen healthy sporadic smokers vaped 30 puffs from an e-cigarette with and without nicotine in a crossover fashion. Blood sampling was performed at 0, 2, 4 and 6 hours following exposures. MVs was determined by flow cytometry and measured from platelets (PMV), leukocytes (LMV) and endothelial cells (EMV).

Results: Inhalation of e-cigarettes containing nicotine caused a significant increase in PMV and EMV over time. PMV that exposed P-selectin and/or CD40L increased significantly as well. Nicotine free e-cigarette vapour did not cause a significant increase in PMV and EMV over time.

Discussion: As little as 30 puffs of nicotine containing e-cigarette vapor cause increased levels of circulating MVs of endothelial and platelet origin, indicating possible vascular injury. This may lead to increased progression of atherosclerosis, the underlying cause of myocardial infarction and stroke.

Ort, förlag, år, upplaga, sidor
European Respiratory Society, 2018
Identifikatorer
urn:nbn:se:umu:diva-155992 (URN)10.1183/13993003.congress-2018.PA1725 (DOI)000455567102134 ()
Konferens
28th International Congress of the European-Respiratory-Society (ERS), SEP 15-19, 2018, Paris, FRANCE
Anmärkning

Supplement: 62

Meeting Abstract: PA1725

Tillgänglig från: 2019-02-07 Skapad: 2019-02-07 Senast uppdaterad: 2019-02-07Bibliografiskt granskad
Hedman, L., Backman, H., Stridsman, C., Bosson, J. A., Lundbäck, M., Lindberg, A., . . . Ekerljung, L. (2018). Association of Electronic Cigarette Use With Smoking Habits, Demographic Factors, and Respiratory Symptoms. JAMA NETWORK OPEN, 1(3), Article ID e180789.
Öppna denna publikation i ny flik eller fönster >>Association of Electronic Cigarette Use With Smoking Habits, Demographic Factors, and Respiratory Symptoms
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2018 (Engelska)Ingår i: JAMA NETWORK OPEN, ISSN 2574-3805, Vol. 1, nr 3, artikel-id e180789Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

IMPORTANCE There is an ongoing debate about whether electronic cigarettes (e-cigarettes) are the solution to the tobacco epidemic or a new public health threat. Large representative studies are needed to study e-cigarette use in the general population, but hardly any have been published. OBJECTIVES To estimate the prevalence of e-cigarette use and to investigate the association of e-cigarette use with smoking habits, demographic factors, and respiratory symptoms. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional, population-based study of random samples of the population, performed within the Obstructive Lung Disease in Northern Sweden (OLIN) study and West Sweden Asthma Study (WSAS). The same validated questionnaire including identical questions was used in OLIN and WSAS. In 2016, OLIN and WSAS conducted postal questionnaire surveys in random samples of adults aged 20 to 75 years. In OLIN, 6519 participated (response rate, 56.4%); in WSAS, 23 753 participated (response rate, 50.1%). MAIN OUTCOMES AND MEASURES Electronic cigarette use, smoking habits, and respiratory symptoms. RESULTS Of 30 272 participants (16 325 women [53.9%]). 3897 (12.9%) were aged 20 to 29 years; 4242 (14.0%). 30 to 39 years; 5082 (16.8%). 40 to 49 years; 6052 (20.0%), 50 to 59 years; 6628 (21.9%), 60 to 69 years; and 4371(14.4%), 70 to 75 years. The number of current smokers was 3694 (12.3%), and 7305 (24.4%) were former smokers. The number of e-cigarette users was 529 (2.0%). and e-cigarette use was more common among men (275 of 12 347 [2.2%; 95% CI, 2.0%-2.5%]) than women (254 of 14 022 [1.8%; 95% CI, 1.6%-2.0%]). Among current smokers. 350 of 3566 (9.8%; 95% CI, 8.8%10.8%) used e-cigarettes compared with 79 of 6875 (1.1%; 95% CI, 0.9%-1.3%) in former smokers and 96 of 15 832 (0.6%; 95% CI, 0.5%-0.7%) in nonsmokers (P < .001). Among e-cigarette users who answered the survey question about cigarette-smoking habits (n = 525). 350 (66.7%; 95% CI, 62.7%-70.7%) were current smokers, 79 (15.0%; 95% CI, 11.9%-18.1%) were former smokers, and 96 (18.3%; 95% CI, 15.0%-21.6%) were nonsmokers (P < .001 for trend). In a regression analysis, e-cigarette use was associated with male sex (odds ratio [OR], 1.35; 95% CI. 1.12-1.62); age groups 20 to 29 years (OR. 2.77; 95% CI, 1.90-4.05), 30 to 39 years (OR, 2.27; 95% CI, 1.53-3.36), 40 to 49 years (OR, 1.65; 95% CI, 1.11-2.44). and 50 to 59 years (OR, 1.47; 95% CI, 1.01-2.12); educational level at primary school (OR, 1.99; 95% CI, 1.51-2.64) and upper secondary school (OR, 1.57; 95% CI, 1.25-1.96); former smoking (OR. 2.37; 95% CI, 1.73-3.24); and current smoking (OR. 18.10; 95% CI, 14.19-23.09). All respiratory symptoms were most common among dual users and former smokers and nonsmokers who used e-cigarettes. CONCLUSIONS AND RELEVANCE Use of e-cigarettes was most common among smokers, and dual users had the highest prevalence of respiratory symptoms. On a population level, this study indicates that the present use of e-cigarettes does not adequately serve as a smoking cessation tool.

Ort, förlag, år, upplaga, sidor
American Medical Association, 2018
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi Beroendelära
Identifikatorer
urn:nbn:se:umu:diva-154863 (URN)10.1001/jamanetworkopen.2018.0789 (DOI)000452641400010 ()
Tillgänglig från: 2019-01-03 Skapad: 2019-01-03 Senast uppdaterad: 2019-01-03Bibliografiskt granskad
Antoniewicz, L., Novo, M., Bosson, J. A. & Lundbäck, M. (2018). Brief exposure to Swedish snus causes divergent vascular responses in healthy male and female volunteers. PLoS ONE, 13(4), Article ID e0195493.
Öppna denna publikation i ny flik eller fönster >>Brief exposure to Swedish snus causes divergent vascular responses in healthy male and female volunteers
2018 (Engelska)Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, nr 4, artikel-id e0195493Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Introduction: The use of Swedish oral moist snuff, known as snus, has for a long time been limited to the Scandinavian countries. With declining cigarette sales in the western world, tobacco companies have looked to the development of alternative tobacco products. In 2006 snus products were launched in the US. Even though several studies have demonstrated negative health effects, snus is often depicted as harmless.

The aim of the present study was to investigate acute vascular effects of snus as measured by arterial stiffness as well as blood pressure and heart rate.

Methods: Two separate randomized double-blind crossover studies with the same study design were pooled for analysis. Twenty-nine healthy snus-users (17 females, 12 males) were included. Snus (Göteborgs Rapé) and tobacco free snus (Onico) were administered in a randomized order at two separate visits. Arterial stiffness, blood pressure and heart rate were measured at baseline as well as every five minutes for 40 minutes during exposure. Following snus removal, measurements continued for 30 minutes post exposure. Arterial stiffness was measured using pulse wave velocity (Vicorder) and pulse wave analysis (Sphygmocor).

Results: Compared to placebo, snus significantly increased systolic and diastolic blood pressure as well as heart rate, however, only in females (p = 0.004, p = 0.006 and p<0.001 respectively). No changes were seen in arterial stiffness measurements in either gender.

Conclusion: We observed an increase in blood pressure and heart rate only in females, but not in males due to snus usage as compared to placebo. This novel finding was surprising and needs to be further investigated considering most of the earlier studies have mainly focused on male snus users and the increasing usage of snus among females.

Ort, förlag, år, upplaga, sidor
PUBLIC LIBRARY SCIENCE, 2018
Nationell ämneskategori
Kardiologi
Identifikatorer
urn:nbn:se:umu:diva-151174 (URN)10.1371/journal.pone.0195493 (DOI)000430290200044 ()29668699 (PubMedID)2-s2.0-85045611591 (Scopus ID)
Tillgänglig från: 2018-09-05 Skapad: 2018-09-05 Senast uppdaterad: 2019-05-21Bibliografiskt granskad
Uski, O., Rankin, G., Lindgren, R., Lopez, N., Blomberg, A., Muala, A., . . . Sandström, T. (2018). In vitro toxicity of particulate matter derived from biomass cook stoves used in developing countries. Paper presented at International Conference of the American-Thoracic-Society, MAY 18-23, 2018, San Diego, CA. American Journal of Respiratory and Critical Care Medicine, 197
Öppna denna publikation i ny flik eller fönster >>In vitro toxicity of particulate matter derived from biomass cook stoves used in developing countries
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2018 (Engelska)Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 197Artikel i tidskrift, Meeting abstract (Övrigt vetenskapligt) Published
Ort, förlag, år, upplaga, sidor
American Thoraric Society, 2018
Nationell ämneskategori
Lungmedicin och allergi
Identifikatorer
urn:nbn:se:umu:diva-154090 (URN)000449978902089 ()
Konferens
International Conference of the American-Thoracic-Society, MAY 18-23, 2018, San Diego, CA
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärdHjärt-Lungfonden
Tillgänglig från: 2018-12-12 Skapad: 2018-12-12 Senast uppdaterad: 2018-12-12Bibliografiskt granskad
Gouveia-Figueira, S. C., Karimpour, M., Bosson, J. A., Blomberg, A., Unosson, J., Sehlstedt, M., . . . Nording, M. L. (2018). Mass spectrometry profiling reveals altered plasma levels of monohydroxy fatty acids and related lipids in healthy humans after controlled exposure to biodiesel exhaust. Analytica Chimica Acta, 1018, 62-69
Öppna denna publikation i ny flik eller fönster >>Mass spectrometry profiling reveals altered plasma levels of monohydroxy fatty acids and related lipids in healthy humans after controlled exposure to biodiesel exhaust
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2018 (Engelska)Ingår i: Analytica Chimica Acta, ISSN 0003-2670, E-ISSN 1873-4324, Vol. 1018, s. 62-69Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Experimental human exposure studies are an effective tool to study adverse health effects from acute inhalation of particulate matter and other constituents of air pollution. In this randomized and double-blinded crossover study, we investigated the systemic effect on bioactive lipid metabolite levels after controlled biodiesel exhaust exposure of healthy humans and compared it to filtered air at a separate exposure occasion. Eicosanoids and other oxylipins, as well as endocannabinoids and related lipids, were quantified in plasma from 14 healthy volunteers at baseline and at three subsequent time points (2, 6, and 24 h) after 1 h exposure sessions. Protocols based on liquid chromatography (LC) coupled to tandem mass spectrometry (MS/MS) methods were developed to detect temporal changes in circulating levels after biodiesel exhaust exposure. The exhaust was generated by a diesel engine fed with an undiluted rapeseed methyl ester fuel. Among the 51 analyzed lipid metabolites, PGF(2 alpha), 9,10-DiHOME, 9-HODE, 5-HETE, 11-HETE, 12-HETE, and DEA displayed significant responsiveness to the biodiesel exhaust exposure as opposed to filtered air. Of these, 9-HODE and 5-HETE at 24 h survived the 10% false discovery rate cutoff (p < 0.003). Hence, the majority of the responsive lipid metabolites were monohydroxy fatty acids. We conclude that it is possible to detect alterations in circulating bioactive lipid metabolites in response to biodiesel exhaust exposure using LC-MS/MS, with emphasis on metabolites with inflammation related properties and implications on cardiovascular health and disease. These observations aid future investigations on air pollution effects, especially with regard to cardiovascular outcomes.

Ort, förlag, år, upplaga, sidor
Elsevier, 2018
Nyckelord
Oxylipin, Endocannabinoid, Eicosanoid, Mass spectrometry, Rapeseed methyl ester, Inflammation
Nationell ämneskategori
Arbetsmedicin och miljömedicin Lungmedicin och allergi
Identifikatorer
urn:nbn:se:umu:diva-148622 (URN)10.1016/j.aca.2018.02.032 (DOI)000428798200008 ()29605135 (PubMedID)
Forskningsfinansiär
Vetenskapsrådet, 2010-303AFA Försäkring, 130320
Tillgänglig från: 2018-06-26 Skapad: 2018-06-26 Senast uppdaterad: 2018-06-26Bibliografiskt granskad
Antoniewicz, L., Kabele, M., Lundback, M. & Bosson, J. A. (2017). Increased Arterial Stiffness In Chronic Swedish Snus Users. Paper presented at International Conference of the American-Thoracic-Society (ATS), MAY 19-24, 2017, Washington, AFGHANISTAN. American Journal of Respiratory and Critical Care Medicine, 195
Öppna denna publikation i ny flik eller fönster >>Increased Arterial Stiffness In Chronic Swedish Snus Users
2017 (Engelska)Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 195Artikel i tidskrift, Meeting abstract (Refereegranskat) Published
Nationell ämneskategori
Kardiologi
Identifikatorer
urn:nbn:se:umu:diva-136347 (URN)000400372502372 ()
Konferens
International Conference of the American-Thoracic-Society (ATS), MAY 19-24, 2017, Washington, AFGHANISTAN
Tillgänglig från: 2017-06-16 Skapad: 2017-06-16 Senast uppdaterad: 2018-06-09Bibliografiskt granskad
Gouveia-Figueira, S., Karimpour, M., Bosson, J. A., Blomberg, A., Unosson, J., Pourazar, J., . . . Nording, M. L. (2017). Mass spectrometry profiling of oxylipins, endocannabinoids, and N-acylethanolamines in human lung lavage fluids reveals responsiveness of prostaglandin E2 and associated lipid metabolites to biodiesel exhaust exposure. Analytical and Bioanalytical Chemistry, 409(11), 2967-2980
Öppna denna publikation i ny flik eller fönster >>Mass spectrometry profiling of oxylipins, endocannabinoids, and N-acylethanolamines in human lung lavage fluids reveals responsiveness of prostaglandin E2 and associated lipid metabolites to biodiesel exhaust exposure
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2017 (Engelska)Ingår i: Analytical and Bioanalytical Chemistry, ISSN 1618-2642, E-ISSN 1618-2650, Vol. 409, nr 11, s. 2967-2980Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

The adverse effects of petrodiesel exhaust exposure on the cardiovascular and respiratory systems are well recognized. While biofuels such as rapeseed methyl ester (RME) biodiesel may have ecological advantages, the exhaust generated may cause adverse health effects. In the current study, we investigated the responses of bioactive lipid mediators in human airways after biodiesel exhaust exposure using lipidomic profiling methods. Lipid mediator levels in lung lavage were assessed following 1-h biodiesel exhaust (average particulate matter concentration, 159 mu g/m(3)) or filtered air exposure in 15 healthy individuals in a double-blinded, randomized, controlled, crossover study design. Bronchoscopy was performed 6 h post exposure and lung lavage fluids, i.e., bronchial wash (BW) and bronchoalveolar lavage (BAL), were sequentially collected. Mass spectrometry methods were used to detect a wide array of oxylipins (including eicosanoids), endocannabinoids, Nacylethanolamines, and related lipid metabolites in the collected BWand BAL samples. Six lipids in the human lung lavage samples were altered following biodiesel exhaust exposure, three from BAL samples and three from BW samples. Of these, elevated levels of PGE2, 12,13-DiHOME, and 13-HODE, all of which were found in BAL samples, reached Bonferroni-corrected significance. This is the first study in humans reporting responses of bioactive lipids following biodiesel exhaust exposure and the most pronounced responses were seen in the more peripheral and alveolar lung compartments, reflected by BAL collection. Since the responsiveness and diagnostic value of a subset of the studied lipid metabolites were established in lavage fluids, we conclude that our mass spectrometry profiling method is useful to assess effects of human exposure to vehicle exhaust.

Ort, förlag, år, upplaga, sidor
SPRINGER HEIDELBERG, 2017
Nyckelord
BAL, BW, Lipidome, Air pollution, Bronchoscopy, Eicosanoid
Nationell ämneskategori
Arbetsmedicin och miljömedicin
Identifikatorer
urn:nbn:se:umu:diva-134210 (URN)10.1007/s00216-017-0243-8 (DOI)000398515900019 ()28235994 (PubMedID)
Tillgänglig från: 2017-06-20 Skapad: 2017-06-20 Senast uppdaterad: 2018-06-09Bibliografiskt granskad
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