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Nasal Biopsies of Children Exposed to Air Pollutants
Lilian Calderon-Garciduenas
Curriculum in Toxicology, University of North Carolina, Chapel Hill, North Carolina 27514, USA, calderon.lilian{at}epamail.epa.gov, Instituto Nacional de Pediatria, Mexico City, 14410, Mexico
Antonio Rodriguez-Alcaraz
Soc Mex ORL y CCC, Mexico City, 14410, Mexico
Gildardo Valencia-Salazar
Instituto Nacional de Pediatria, Mexico City, 14410, Mexico
Antonieta Mora-Tascareno
Instituto Nacional de Pediatria, Mexico City, 14410, Mexico
Raquel Garcia
Instituto Nacional de Pediatria, Mexico City, 14410, Mexico
Norma Osnaya
Instituto Nacional de Pediatria, Mexico City, 14410, Mexico
Anna Villarreal-Calderon
Instituto Nacional de Pediatria, Mexico City, 14410, Mexico
Robert B. Devlin
National Health and Environmental Effects Research Laboratory, Research Triangle Park, North Carolina 27711, USA
Terry Van Dyke
Biochemistry and Biophysics Department, University of North Carolina, Chapel Hill, North Carolina 27599, USA
Southwest Metropolitan Mexico City (SWMMC) atmosphere is a complex mixture of air pollutants, including ozone, particulate matter, and aldehydes. Children in SWMMC are exposed chronically and sequentially to numerous toxicants, and they exhibit signifi cant nasal damage. The objective of this study was to assess p53 accumulation by immunohistochemistry in nasal biopsies of SWMMC children. We evaluated 111 biopsies from 107 children (83 exposed SWMMC children and 24 control children residents in a pollutant-compliant Caribbean island). Complete clinical histories and physical examinations, including an ear—nose—throat (ENT) exam were done. There was a signifi cant statistical difference in the upper and lower respiratory symptomatology and ENT fi ndings between control and exposed children (p < 0.001). Control children gave no respiratory symptomatology in the 3 months prior to the study; their biopsies exhibited normal ciliated respiratory epithelium and werep53-negative. SWMMC children complained of epistaxis, nasal obstruction, and crusting. Irregular areas of whitish-gray recessed mucosa over the inferior and middle turbinates were seen in 25% of SWMMC children, and their nasal biopsies displayed basal cell hyperplasia, decreased numbers of ciliated and goblet cells, neutrophilic epithelial infi ltrates, squamous metaplasia, and mild dysplasia. Four of 21 SWMMC children with grossly abnormal mucosal changes exhibited strong transmural nuclear p53 staining in their nasal biopsies (p 0.005, odds ratio 26). In the context of lifetime exposures to toxic and potentially carcinogenic air pollutants, p53 nasal induction in children could potentially represent. a) a checkpoint response to toxic exposures, setting up a selective condition for p53 mutation, or b) a p53 mutation has already occurred as a result of such selection. Because the biological signifi cance of p53 nuclear accumulation in the nasal biopsies of these children is not clear at this point, we strongly suggest that children with macroscopic nasal mucosal abnormalities should be closely monitored by the ENT physician. Parents should be advised to decrease the children's number of outdoor exposure hours and encourag e a balanced diet with an important component of fresh fruits and vegetables.
Key Words: Air pollutants • environmental • children • ozone • particulate matter • nasal carcinogenesis • protein p53 • Mexico.
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Toxicologic Pathology, Vol. 29, No. 5,
558-564 (2001)
DOI: 10.1080/019262301317226366
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