Biomerkers in neuslavage voor effecten van luchtverontreiniging bij gezonde personen en patienten met allergische en astmatische aandoeningen. (Een literatuurstudie)

Several times per year the one-hour maximum ozone concentration of 240 mug/m3, which is the Dutch air quality guideline, is exceeded. Epidemiological studies show a relation between photochemical episodes, like ozone, and an increase in respiratory symptoms. It is important to show which effects ozone has on the respiratory tract and at which concentration these effects occur. In experimental studies in which humans are exposed to ozone, the lower airway is investigated by studying biopsies and bronchial lavage fluid (BAL). These techniques can not be applied in epidemiological studies with large healthy human populations, because the techniques are very time consuming and invasive. The nose is the prime port of entry for inspired air, and therefore, the first region of the respiratory tract that comes into contact with airborne pollutants. Nasal lavage (NAL) has helped to analyse the stage of infection, immune response or allergic reaction. A literature search was undertaken to investigate whether or not NAL is useful to determine effects of photochemical air pollution and biomarkers predicting the presence of effects of pollution in the lower respiratory tract. This literature search showed that in experimental studies to ozone and in epidemiological studies at increased concentrations of photochemical air pollution the number of polymorphonuclear cells (PMN's), like neutrophils, and to a lower extent eosinophils is increased in NAL. These were not only shown in NAL, but also in BAL.