Ganiyu O. Arinola

Relationship between Household Air Pollution from Biomass Smoke Exposure, and Pulmonary Dysfunction, Oxidant-Antioxidant Imbalance and Systemic Inflammation in Rural Women and Children in Nigeria

Background: Exposure to particulate matter from burning biomass fuels is believed to affect oxidant-antioxidant balance and to induce oxidative stress. Methods: Fifty-nine mother-child pairs from 59 households that used firewood exclusively for cooking in three rural communities in southwest Nigeria underwent blood test for albumin, pre-albumin, retinol-binding protein (RBP), superoxide dismutase (SOD), vitamins C, vitamin E, malondialdehyde (MDA) and C-reactive protein (CRP). Spirometry was performed and indoor levels of PM2.5 were determined. Results: Mean age (± SD; years) of mothers and children was 43.0±11.7 and 13.6±3.2, respectively. The median indoor PM2.5 level was 1575.1 µg/m3 (IQR 943.6–2847.0, p<0.001), which is substantially higher than the World Health Organization (WHO) standard of 25 µg/m3. The mean levels of pre-albumin (0.21±0.14 g/dL) and RBP (0.03±0.03 g/dL) in women were significantly lower than their respective normal ranges (1-3 g/dL and 0.2-0.6 g/dL, respectively, p<0.05). Similarly, the mean levels of pre-albumin (0.19±0.13 g/dL) and RBP (0.01±0.01 g/dL) in children were significantly lower than the respective normal ranges (1-3 g/dL and 0.2-0.6 g/dL, respectively, p<0.05). Mean serum concentrations of MDA in children (5.44±1.88 µmol/L) was positively correlated to serum concentrations of CRP (r=0.3, p=0.04) and negatively correlated to lung function (FEV1/FVC) in both mothers and children (both r=-0.3, p<0.05). Also, regression analysis indicates that CRP and SOD are associated with lung function impairment in mothers (-2.55±1.08, p<0.05) and children (-5.96±3.05, p=0.05) respectively. Conclusion: Exposure to HAP from biomass fuel is associated with pulmonary dysfunction, reduced antioxidant defense and inflammation of the airways. Further studies are needed to better define causal relationships and the mechanisms involved.

Effect of a clean stove intervention on inflammatory biomarkers in pregnant women in Ibadan, Nigeria: A randomized controlled study

BACKGROUND Exposure to household air pollution (HAP) has been linked to systemic inflammation. We determined the impact of transition from traditional firewood/kerosene stove to bioethanol-burning stove on inflammatory biomarkers in pregnant Nigerian women. METHODS Women (n=324), cooking with kerosene/firewood, were recruited during their first trimester of pregnancy from June 2013-October 2015 and were randomly allocated to either control (n=162) or intervention (n=162) group using web-based randomization. Controls continued to use their own firewood/kerosene stove, while intervention participants received bioethanol CleanCook stoves. Serum concentrations of retinol-binding protein (RBP), malondialdehyde (MDA), tumor necrosis factor alpha (TNF)-α, interleukin (IL)-6, and IL-8 were measured by ELISA. RESULTS After excluding 53 women (loss of follow-up, untimely biomarker assessments, incorrect dates of enrollment), data from 271 women were included in analysis. Mean (SD) change in RBP, MDA, TNF-α, IL-6, and IL-8 between baseline and third trimester was -2.16 (4.47), -19.6 (46.4), 3.72 (37.2), 0.51 (14.4), and 13.2 (197), respectively, in intervention and -2.25 (4.30), -24.6 (43.6), 7.17 (32.6), -1.79, (11.4), and 31.3 (296) in control groups. None of these changes differed significantly between the two treatment arms. However, changes from baseline in TNF-α levels were significantly different between intervention and control groups in subset of women (n=99) using firewood before trial (-7.03 [32.9] vs. +12.4 [33.6]; 95% CI for group difference: -35.4 to -3.4, p=0.018). CONCLUSIONS Decrease in TNF-α concentration from baseline to third trimesters in intervention group women could indicate reduced cardiovascular stress and prothrombotic effects from decreased HAP. Our findings suggest that ethanol-burning stoves may mitigate cardiovascular health risks.

Serum Micronutrients in Helminth-infected Pregnant Women and Children: Suggestions for Differential Supplementation During Anti-helminthic Treatment

BACKGROUND The prevalence of helminth infection, which is known to affect nutritional status of the host, varies with age. The complex interplay between ages, nutrient requirements, and infection necessitated the need to recommend micronutrient supplementation during helminth infection among different age groups. OBJECTIVE The aim of this study was to determine the pattern of alteration in selected micronutrients in pregnant women and preschool- and school-aged children with helminth infection. METHODS We screened 245 pregnant women and 349 children for helminth infection. Of these, 17 (6.9%) pregnant women and 102 (29.2%) children (42 preschool- and 60 school-aged) had helminth infection. Only Ascaris lumbricoides was found in pregnant women, whereas the children had A lumbricoides, hookworm, Fasciola hepatica, and Trichuris trichiura infections. The helminth-infected (HI) pregnant women, preschool-aged children, and school-aged children were matched with helminth-negative (HN) pregnant women (n = 21), preschool-aged children (n = 42), and school-aged children (n = 50) who served as controls. Venous blood samples were obtained and analyzed for iron (Fe), zinc (Zn), selenium (Se), and vitamins A and C. Statistical analysis was done using Students t test, and P < 0.05 was considered statistically significant. FINDINGS Serum levels of Fe, Zn, and Se were significantly lower in HI pregnant women than HN pregnant women. In preschool-aged children, serum levels of Fe, Zn, and vitamin A were significantly lower in the HI than in the HN group. Similarly, serum levels of Zn and vitamin A were significantly lower in HI school-aged children than in the HN group. However, serum levels of Se were significantly higher in HI children (both age groups) than in the corresponding HN group. CONCLUSION Helminth infection alters different types of micronutrients in children and pregnant women. Results from the present study therefore suggest monitoring Fe, Zn, or vitamin A supplementation with an anti-helminthic regimen.

Serum Levels of Cytokines and IgE in Helminth-Infected Nigerian Pregnant Women and Children

BACKGROUND Helminth infection is an important health challenge. Because of modulation of the immune response toward T-helper 2 (Th2) cells, the immunologic interplay that manifest during the coexistence of helminth infection with other conditions is still poorly understood. OBJECTIVE This study determined the pattern of alteration in selected cytokines and immunoglobulin E (IgE) in pregnant women, preschool aged children, and school-aged children with helminth infection compared with uninfected groups. METHODS Seventeen pregnant women, 42 preschool-aged children, and 60 school-aged children with helminth infection (HI) were recruited into this study. They were matched with 21 pregnant women, 42 preschool-aged children, and 50 school-aged children without helminth infection (HN) who served as controls. Venous blood samples were collected from each participant and analyzed for serum levels of tumor necrosis factor α (TNF-α), interleukin-10 (IL-10), interleukin-8 (IL-8), interleukin-6 (IL-6), and IgE. Statistical analysis was done using the Student t test, and P < .05 was considered as statistically significant. FINDINGS Only serum level of IgE was significantly elevated in HI pregnant women compared with HN pregnant women. In HI preschool- and school-aged children, serum levels of IL-8, IL-6, and IgE were significantly elevated compared with HN children. However, preschool- and school-aged children with HI had similar levels of serum TNF-α and IL-10 compared with their corresponding HN groups. CONCLUSIONS It could be concluded that altered cytokines expression in children and pregnant women with helminth infection might have some implications on need for deworming programs to improve pregnancy outcomes and vaccine responses.

Renal Corpuscles Were Protected From Dichlorvos: Induced Morphological Alterations in Rats by Antioxidant Vitamins

El diclorvos (DDVP), un pesticidas organofosforado, es un compuesto volatil que entra en el cuerpo humano a traves de la via oral, dermica y por rutas inhalacion, excretandose por via renal. Este estudio evaluo los efectos histologicos del DDVP sobre el rinon. Veinticinco ratas machos (75,05±5,55 g) se dividieron en 5 grupos de 5 ratas cada uno: grupo no expuesto, expuesto a DDVP durante 5 semanas, y otros 3 grupos expuestos a DDVP durante 5 semanas, suplementados con vitamina E (VTE), vitamina C (VTC) y aceite de palma roja (APR). Las ratas fueron expuestas a DDVP en jaulas de carton con poca ventilacion por 4 horas diarias. Al termino de la exposicion, las ratas se sacrificaron y el tejido fue procesado para inclusion en parafina y tincion con H&E. Las alteraciones morfologicas se evaluaron mediante estudios histologicos y morfometricos utilizando reticulas y software. Los datos se analizaron con la prueba ANOVA considerado un p<0,05 como significativo. El DDVP causo una reduccion significativa (10%) en el diametro maximo glomerular y ancho maximo del copusculo renal (18%), en comparacion con las ratas no expuestas. Sin embargo, el diametro maximo glomerular fue significativamente elevado con VTE, VTC y APR en 21%, 22% y 23%, respectivamente, asi como para el ancho maximo del corpusculo renal por 17%, 19% y 20%, respectivamente. La celularidad de la red glomerular no fue afectada por el DDVP ni aumento con el tratamiento de vitamina. El DDVP inhalado provoco alteraciones histologicas en la anatomia microscopica de los corpusculos renales de rata, las que fueron mitigadas por la suplementacion de vitamina. Los datos sugieren relacion entre la exposicion prolongada a DDVP y la etiologia de la insuficiencia renal.

Biomass fuel exposure and asthma symptoms among rural school children in Nigeria.

ABSTRACT Background: Approximately 70% of rural Nigerian households rely on biomass fuels for cooking. The International Study of Asthma and Allergies in Childhood (ISAAC) estimates the prevalence of current wheeze among children in Nigeria to have risen from 10.7% in 1999 to approximately 20% in 2014. Objective: To examine the effects of biomass smoke exposure on asthma symptom prevalence in rural children in Nigeria. Methods: We conducted a cross-sectional survey in rural communities in Nigeria. Asthma symptoms were defined according to ISAAC definitions. Biomass smoke exposure was determined by the types of fuel used for cooking. Logistic regression was used to explore associations between biomass smoke and asthma symptoms. Results: The study population comprised 1,690 school children, of which 865 lived in households cooking with biomass and 825 lived in households not using biomass. Asthma symptoms were reported in 481 (28.5%) children. Biomass fuel was associated with increased odds of asthma symptoms. Adjusted odds ratios (aORs) were 1.38 (95% CI: 1.05–1.80) for nocturnal cough, 1.26 (95% CI: 1.00–1.61) for current wheeze, and 1.33 (95% CI: 1.05–1.69) for report of any asthma-related symptoms. Sex modified the associations between asthma symptoms with biomass fuel: aORs were stronger and significant for males (nocturnal cough = 1.85, 95% CI: 1.24–2.76; current wheeze = 1.48, 95% CI: 1.03–2.13; report of any asthma-related symptoms = 1.60, 95% CI: 1.12–2.28), but weaker and non-significant for females.Conclusion: The risk of asthma symptoms related to biomass smoke exposure appears to differ by sex.

Household biomass fuel use, asthma symptoms severity, and asthma underdiagnosis in rural schoolchildren in Nigeria: a cross-sectional observational study

BackgroundIn 2014, the International Study of Asthma and Allergies in Childhood (ISAAC) reported that the highest prevalence of symptoms of severe asthma was found in the low- and middle-income countries (LMICs), including Nigeria. While exposure to biomass fuel use may be an important risk factor in the development of asthma, its association with asthma symptoms severity has not been well-established. The aim of this study is to extend the spectrum of environmental risk factors that may be contributing towards increasing asthma morbidity, especially asthma symptoms severity in rural schoolchildren in Nigeria and to examine possible asthma underdiagnosis among this population.MethodsAuthors conducted a cross-sectional survey in three rural communities in Nigeria. Asthma symptoms were defined according to the ISAAC criteria. Information on the types of household fuel used for cooking was used to determine household cooking fuel status. Asthma symptoms severity was defined based on frequencies of wheeze, day- and night-time symptoms, and speech limitations. Logistic regression analyses were used to explore associations.ResultsA total of 1,690 Nigerian schoolchildren participated in the study. Overall, 37 (2.2%) had diagnosed asthma and 413 (24.4%) had possible asthma (asthma-related symptoms but not diagnosed asthma). Children from biomass fuel households had higher proportion of possible asthma (27.7 vs. 22.2%; p < 0.05) and symptoms of severe asthma (18.2 vs. 7.6%; p = 0.048). In adjusted analyses, biomass fuel use was associated with increased odds of severe symptoms of asthma [odds ratios (OR) = 2.37; 95% CI: 1.16–4.84], but not with possible asthma (OR = 1.22; 95% CI: 0.95–1.56).ConclusionIn rural Nigerian children with asthma symptoms, the use of biomass fuel for cooking is associated with an increased risk of severe asthma symptoms. There is additional evidence that rural children might be underdiagnosed for asthma.

Innate Cellular Immunity in Newly Diagnosed Pulmonary Tuberculosis Patients and During Chemotherapy

BACKGROUND Leukocyte migration (LM) and intracellular killing aspects of the innate immune response play important roles in protection against and containment and cure of Mycobacterium tuberculosis infection, and thus may be exploited as immunotherapeutic targets to improve the management and treatment outcomes of patients with tuberculosis (TB). OBJECTIVES The aim of this study was to assess LM and mediators of intracellular killing in patients with TB at the time of diagnosis and during anti-TB chemotherapy and compare them with apparently healthy controls. METHODS We recruited 24 patients who were newly diagnosed with pulmonary TB and 20 apparently healthy individuals. Blood was drawn from patients with TB at the time of diagnosis, and after 2, 4, and 6 months of anti-TB chemotherapy and control. In vitro percentage LM (%LM) upon stimulation with Bacillus Calmette-Guérin vaccine, percentage nitroblue tetrazolium (%NBT) reduction, plasma concentrations of hydrogen peroxide (H2O2), and nitric oxide (NO) were assessed in both groups. FINDINGS Percentage NBT was significantly reduced in patients with TB at 2 months of anti-TB chemotherapy compared with patients at diagnosis and in healthy controls, whereas %LM was significantly increased in patients at 4 months of anti-TB chemotherapy compared with patients at diagnosis and controls. Mean plasma H2O2 and NO were significantly reduced in patients at diagnosis and throughout the period of anti-TB chemotherapy compared with the control group. Significant decreases were demonstrated in mean plasma H2O2 and NO in patients at 2 and 4 months of anti-TB chemotherapy, respectively, compared with patients at diagnosis. There was significant positive correlation between %NBT with plasma H2O2 and NO, but %LM was negatively correlated with plasma H2O2 in this group. CONCLUSION The intracellular killing aspect of innate cellular immunity is deficient in patients with TB, especially 2 to 4 months after commencement of treatment. Therefore, measures (eg, arginine supplementation) to improve intracellular killing in these patients is advocated. Moreover, %LM assay with Bacillus Calmette-Guérin vaccine as an antigen may be used to differentiate those newly diagnosed patients from those on anti-TB chemotherapy.

Abstract 1584: Lead toxicity and oxidative stress: Possible causes of complications and grave prognosis in acute leukemic Nigeria patients

Toxic metals, especially implants are common causes of leukemia. Established relationship exsists between leukemia and oxidative stress. Leukemic cells produce larger amounts of reactive oxygen species (ROS). Cytokines are particulate immune proteins that serve as chemical messengers. They can have their production affected in many ways, including malignancy. Antioxidants, which control the oxidative stress state, represent a major line of physiological defense. The relationship between antioxidant status and the levels of well-known markers of oxidative stress that are measured as lipid peroxides reflects better health indices. This study, apart from investigating possible relationship between toxic metals especially Lead (Pb) in leukemic Nigeria patients, also evaluate the cytokine and antioxidant defense in this patients. Fifty subjects including 25 acute leukemia patients and 25 apparently healthy aged matched controls were recruited for the study. Toxic trace elements (Cd, Pb, Hg, and As) were determined with AAS. The total antioxidants potential (TAP) was determined using the ferric reducing/antioxidants power (FRAP) assay and MDA was measured to evaluate the level of lipid peroxidation. Cytokines (IFN-λ, IL-4 and IgE) plasma levels were measured with ELISA. We observed significant increase in the mean plasma level of Pb in leukemic patients compared to controls (p 0.05). The total antioxidant (TAP) reduced significantly in leukemic patient (p 0.05). The plasma level of all the cytokine investigated was significant increase in acute leukemia patients compared with controls (p This study implicates Pb in the pathogenesis of leukemia in Nigeria patients. Pb, apart from its potential influence in enhancing toxic effect of other metals, especially Cd, possibly plays a role in depletion of antioxidant level in Leukemic patients. The reduction in total antioxidant may be in addition to increase consumption of antioxidants by aggressive production of free radical usually associated with acute leukemia. In addition, increase production of cytokine and its correlation with Pb and TAP may imply possible complications. In conclusion, this study reveals a multiple contributing factors and possible complication in the grave prognosis of leukemia in Nigeria. These factors include Pb toxicity, reduced total antioxidant, increased lipid peroxidation and possible danger of ‘cytokine storm’. Thus, antioxidant supplementation may be worthwhile in early leukemia prophylaxis intervention and could possibly prevent the grave effect of complications associated with acute leukemia. Citation Format: Oluyemi Akinloye, Mary Bolanle Ajadi, Adebayo M. Adegbenro, Ganiyu O. Arinola. Lead toxicity and oxidative stress: Possible causes of complications and grave prognosis in acute leukemic Nigeria patients. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1584. doi:10.1158/1538-7445.AM2014-1584