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 Table of Contents  
REVIEW ARTICLE
Year : 2022  |  Volume : 6  |  Issue : 1  |  Page : 7-13

Common respiratory viruses and collapsing health: Prodigious focus on ambient air pollution


Department of Pharmacology, Institute of Pharmaceutical Research, GLA University Mathura, Mathura, Uttar Pradesh, India

Date of Submission25-Aug-2021
Date of Acceptance13-Oct-2021
Date of Web Publication11-Mar-2022

Correspondence Address:
Jeetendra Kumar Gupta
Institute of Pharmaceutical Research, GLA University Mathura, Mathura - 281 406, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bbrj.bbrj_201_21

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  Abstract 


Ambient air pollution is one of the treacherous and malign problems facing humanity and other living beings on the earth today. Although the air pollutants such as particulate matters (PM) and microscopic contaminants have been associated with widespread morbidity and mortality, studies have also indicated those pollutants as a potential synergist to respiratory infirmities in both adults and children. Many viral contaminants have also been reported as potential detriments of respiratory distresses. Exposure to poor grades of ambient air can lead to numerous health consequences, such as adverse effects on the lung, heart, and other vital organs. In recent years, many studies infer that pollution along with viral contaminants impart substantial worldwide burden of diseases on human beings. Excessive air suspended pollutants such as micro or nanoparticulate matters bring down the life expectancy of human beings in many ways. Regardless of the passage of entry, fine and ultrafine PM that enter into systemic circulation affect vascular endothelial cells by producing local oxidative stress and have the capacity to cross biological barriers, thereby creating numerous deleterious effects on vital organs. Pollution-induced systemic inflammation is mediated by proinflammatory cytokines such as interleukin-6, interleukin-1 β, and tumor necrotic factor-α. These systemic inflammatory mediators are implicated in causing or exacerbating many complications in the human body. This article is an attempt to accentuate the pollution-linked health impediments, as well as the fountainheads of ambient air pollution so that some effective strategies can be developed to manage this global peril.

Keywords: COVID-19, environment, health, pollution, virus


How to cite this article:
Gupta JK. Common respiratory viruses and collapsing health: Prodigious focus on ambient air pollution. Biomed Biotechnol Res J 2022;6:7-13

How to cite this URL:
Gupta JK. Common respiratory viruses and collapsing health: Prodigious focus on ambient air pollution. Biomed Biotechnol Res J [serial online] 2022 [cited 2022 May 19];6:7-13. Available from: https://www.bmbtrj.org/text.asp?2022/6/1/7/339365




  Introduction Top


Earth is a unique planet of the solar system which has gaseous surroundings and suitable temperatures for the survival of human beings. The presence of air and water with requisite atmospheric conditions facilitate human lives and their endurance on the Earth. The planet is not an isolated system, and there is the continuous flow of energy from the sun. It has suitable atmospheric gases which allow and trap adequate solar radiations. In case of any disproportion, either in the life-saving atmospheric gases or in radiation trapping components can cause severe imbalance. A suitable equilibrium among those components is essentially required for the survival of life on the earth.[1] Earth's atmosphere is now facing a lot of imbalances because of huge industrial wastes, motorization, combustion of fossil fuel, and massive deforestation. Huge gases and noxious byproducts released from these sources are smudges to the environment.[2] The introduction of any contaminants into the natural environment is called pollution. The contaminants may be in the form of toxic byproducts, extreme temperature, excessive sound, or light. Among these, toxic gases and extreme temperature are the prime factors responsible for many devastating changes in human physiology. Toxic pollutants affect more than millions of people worldwide. According to the World Health Organization (WHO), about 4.2 million premature deaths globally are due to ambient air pollution.[3] Environmental conditions on the earth are now so impaired that a new geological epoch “the Anthropocene” may said to be declared. The rogue pollution is the end-product of human's audacious ethos. Humanity on this planet is heavily impaired and most of the humans are seeking for their own insatiability even at the cost of the mother Earth, environment, and against their consciences. Human beings live in an ecosystem where the action of one has intense effects on many. Any wicked action with respect to our environment may cause many ill effects on our ecosystem. At present time, viral hassles have also grown up in our ambiance due to the unaspiring invasion of some respiratory viruses along with atmospheric pollutants.[4] A global burden of morbidity and mortality are being reported due to ambient air pollution and related diseases. Despite facing many catastrophic effects on the living system, humankinds are less acknowledged and the quantum of pollution is still expanding day by day. In this article, the issue of the growing magnitude of ambient air pollution, as well as undue load of common respiratory viruses, have been raised along with their detrimental effects on human physiology.


  Common Respiratory Viruses Top


In the present scenario, viral respiratory diseases are getting synergized with the global burden of maladies attributable to air pollution. The viruses involved in the fabrication of respiratory diseases are rhinovirus, metapneumovirus, respiratory syncytial virus, bocaviruses, influenza viruses, parainfluenza viruses, adenoviruses, and coronaviruses.[5] Respiratory viruses are the most common cause of pulmonary pestilence in human beings. The spreading nature of these viruses is extremely treacherous, and transmissible in a global scale as agents of endemic or epidemic. They have multiple adverse effects on the human body [Figure 1]. The influence of respiratory viruses along with environmental pollutants in the pathogenesis of serious respiratory issues is a concern of great importance.[6] Despite existing regulations and environment act, there are still a number of complications that result from the exposure of those noxious agents. Many epidemiological studies have been documented referring association between ambient air pollution and criticality of hospitalized patients for disparate health reasons.[7],[8] Respiratory viruses are accountable for diversified clinical symptoms such as pneumonia, common cold, bronchiolitis, laryngitis, otitis, sinusitis, and exacerbation of other pulmonary diseases.[9]
Figure 1: Effect of respiratory viruses and toxic pollutants on respiratory epithelial cells

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Rhinovirus

Rhinovirus is the most common viral agent responsible for the common cold in human beings. The infection of rhinovirus generally escalates at temperature 33°C–35°C. It is a weighty cause of distress in patients of respiratory illnesses. The manner of transmission of this virus is controversial. There are two modes of transmission of rhinovirus, namely aerosol or droplet mode and from contaminated surfaces (fomites). Rhinovirus is a member of the picornavirus family. It is a nonenveloped single-stranded RNA virus.[10] Incidences and expression of rhinovirus become more perplexed in the region where the quality of ambient air is highly distressed.

Metapneumovirus

Human metapneumovirus can cause difficulties in the upper as well as in the lower respiratory system. It has the capacity to infect people of all ages. This virus is a negative-sense single-stranded RNA virus of the Pneumoviridae family. The symptoms which are associated with metapneumovirus include nasal congestion, cough, shortness of breath, and fever. Its clinical symptoms are similar to the symptoms of bronchitis and pneumonia. The most preferable time of proliferation for this virus is winter and early spring. Although, the infection can spread in all age groups its prevalence is mostly seen in children under the age of five. It is a self-limiting malady and typically go away in a few days. However, in case of geriatric people (over 75 years of age), its onset may be complicated and turn to pneumonia-like symptoms.[11] Stringent climatic conditions may aggravate the illness. This virus shows synergism with elevated levels of ambient air pollution.

Respiratory syncytial virus

The respiratory syncytial virus is a common virus for mild to moderate respiratory infections. It is a negative sense, single-stranded RNA virus that infects via nose and eye to the epithelial cells of the upper and lower respiratory tract. It imparts inflammation and airway obstruction with cold-like symptoms. In general, people infected with the respiratory syncytial virus can be recovered in a week or two depending on criticality, however, the infection may be harsh for small children and very old (geriatric) patients. The rate of infection is typically outrageous during the winter season. It causes bronchiolitis and the common cold in infants and adults. The seriousness of the disease is high in geriatrics and immunocompromised patients. Titanium dioxide nanoparticles catastrophize inflammations caused by the respiratory syncytial virus.[12] It is a well-known pollutant of industrial origin. The natural source of titanium dioxide is ilmenite ore. Seasonal weather conditions and levels of ambient air pollution have the tendency to exaggerate the severity of respiratory syncytial virus in infected patients.[13]

Bocavirus

Human bocavirus belongs to the family Parvoviridae and its genus is Bocaparvovirus. It is a new viral genus that was reported in 2005 in the nasal secretions of infected children. Scientists have evaluated human bocavirus as the fourth-most common virus of respiratory tract infection considering rhinovirus, respiratory syncytial virus, and adenovirus as the most common type. Clinically, the infection of bocavirus is diagnosed with the symptoms of cough, wheezing, fever, runny nose, vomiting tendency, and diarrhea. Human bocaviruses are nonenveloped single-stranded DNA viruses having approximately 5300 nucleotides. Its presence has been seen in the exudates of the respiratory system as well as in the stool of patients with gastroenteritis symptoms.[14] Although the behavior of bocavirus in the infection of respiratory organs or gastrointestinal tract still remains to be fully elucidated, the possibility of infection via contaminated water or droplet mode should be taken into consideration. Patient's condition and concentration of ambient air pollutants seem to influence the infection-related clinical symptoms.[15]

Influenza viruses

Influenza viruses are responsible for influenza (flue) disease and are characterized by fever, sore throat, coughing, runny nose, headache, and fever. All influenza viruses are characterized by negative-sense, single-stranded RNA. Influenza viruses exist in four types, namely Influenza A virus, Influenza B virus, Influenza C virus, and Influenza D virus. Influenza A virus and Influenza B virus can infect humans and cause seasonal epidemics. Influenza C virus has the tendency to cause mild symptoms, while Influenza D virus is not yet known to cause illnesses in human beings. It has been confirmed by many studies that exposure to the increased degree of air pollutants enhances the risk and severity of influenza in human beings.[16] The pollutants which are associated with an increase in the cases of influenza include diesel exhaust, particulate matter (PM), sulfur dioxide, nitrogen oxides, and ozone.[17]

Parainfluenza viruses

Hunan parainfluenza viruses can cause respiratory tract infections in infants, young children, old aged people, and adults with poor immunity. These viruses are a paraphyletic group of single-stranded RNA viruses of the family Paramyxoviridae and closely connected with both human and veterinary disease. Hunan parainfluenza viral infection is associated with a wide range of clinical symptoms, such as fever, pharyngeal erythema, nasal congestion, and nonproductive to mild productive cough.[18] Many scientific studies have been conducted to find out the interactions between environmental pollutants and the incidences of acute and chronic respiratory illnesses.[19],[20] The severity and complexity of the viral diseases of respiratory organs are directly proportional to the levels of atmospheric pollution.

Adenoviruses

Adenoviruses are a group of viruses that invade the lining of multiple organs, such as airways, lungs, eyes, urinary tract, intestine, and nervous system. The common clinical symptoms of adenovirus infection are fever, cough, sore throat, pink eye, and diarrhea. The infection of adenovirus can happen in human beings of any age, but children are more prone to the infection. They belong to the family Adenoviridae. At present, more than 100 serologically distinct types of adenoviruses have been reported. They are nonenveloped icosahedral, medium sized with double-stranded DNA.[21] Adenoviruses have been detected in polluted water.[22] They are among the most common viruses in untreated sewage where the reported concentration was 10 times greater than the enteroviruses. The infection mainly transmits via droplet mode as well as through contact with the oro-nasal secretions of the infected person. Although adenoviruses are predominantly present in untreated sewage, their activities and virulence have been seen in patients of polluted zones.[23]

Coronaviruses

Coronaviruses are a large family of viruses usually responsible for respiratory tract illnesses. These viruses have offended mankind through several pandemics globally.[24] Recently, two pandemics of coronaviruses have occurred, namely Middle East Respiratory Syndrome (MERS) and COVID-19. MERS occurs due to the invasion of MERS-CoV (a strain of coronavirus) which was reported in Saudi Arabia in September 2012, while the causative agent of COVID-19 is SARS-CoV-2 reported first from China in December 2019. The SARS-CoV-2 virus is responsible for the recent pandemic declared by WHO. A relationship has been observed between the viral spread and atmospheric pollutants, where atmospheric PM could play a crucial role in the transmission of viruses.[4],[25]


  Ambient Air Pollution and the Health Hazards Top


Retrospection of the intermediaries of collapsing health is absolute need of our time. In the past few years, pollution has become a major concern worldwide, which precipitates serious impact on human health and the environment. Persistent exposure to polluted air leads to various health hazards. The major sources of ambient air pollution include huge motorization, pollution creating factories, combustion of municipal and agricultural wastes, and other illegitimate sources such as the use of polluting fuels in heating and lighting. It has become a serious hassle of recent decades. It triggers critical disturbance in the neutral environment which has many toxicological impacts on human physiology. The prime culprits for those ailments are carbon monoxide, sulfur dioxide, nitrogen oxide, lead, and suspended PMs. The crucial health hazards associated with the factors of air pollution are studied by the WHO. Approximately 4.2 million people expire every year due to exposure of air pollution.[26] Ambient air pollution accounts for many illnesses such as stroke, lung disease, heart disease, and chronic respiratory diseases [Figure 2]. In 2019, approximately 17.8% of deaths were attributed to air pollution in India. Of the total morbidities, the largest proportion of death was due to chronic obstructive pulmonary disease (32.5%), while the pollution conjugated mortalities due to ischemic heart disease (29.2%), lower respiratory infections (11.2%), stroke (16.2%), and lung cancer (1.7%) were also influential in the deterioration of the vital statistics of human health.[27]
Figure 2: Ambient air pollution linked maladies

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The disturbance in ambient air can lead to impairment in lung function, precipitation of asthma, cardiovascular disorder, neurological disorder, and many other inflammatory reactions also. Erroneous human activities such as huge motorization and emission of unchecked industrial wastes are the prime factors of ambient air pollution that contribute to the global pollution of air every day. The major components are carbon monoxide, sulfur dioxide, nitrogen oxides, lead compounds, and PM.[28],[29]

Carbon monoxide

The prime sources of carbon monoxide are incomplete combustion of fuels and vehicle emissions. It is colorless, tasteless, and odorless pollutant. Its affinity with hemoglobin is 230 times stronger than oxygen. Hence, a little increase in the level of carbon monoxide can cause drastic changes in human physiology. It can lead to suffocation, dizziness, nausea, capillary hemorrhage and even permanent damage to the brain cells at elevated level.[30]

Sulfur dioxide

It is a toxic pollutant having burnt match smell and released by combustion of fossil fuels contaminated with sulfur compounds and also from metallurgical plants. Inhalation of sulfur dioxide can cause inflammation and irritation in the mucosal membrane of the respiratory tract. It is a well-known irritant for the skin, eye, nose, and throat. It induces respiratory apnea and can lead to premature death also.[31]

Nitrogen oxides

The oxides of nitrogen are generally released in the area of high motor vehicle traffics. It is produced by the combustion of fossil fuels and also by some industrial processes. When fossil fuel burns, the nitrogen content gets oxidized creating nitrous oxide. Nitrous oxide is an effective greenhouse gas and can be oxidized into nitric oxide also. It is a major cause of ozone layer depletion. Almost all oxides of nitrogen can damage the lining of the lung and can cause respiratory organ toxicity.[32]

Lead compounds

The major source of lead in the atmosphere is lead-containing fuels. Few countries like Afghanistan, Yaman, and Myamar have ambiguous rules for the use of tetraethyl lead (TEL). Fuels of those countries have still TEL as anti-knocking agent especially in gasoline to boost octane rating. TEL has very deleterious effect on human health. It causes lead poisoning. TEL is readily absorbed from the skin, lung, and gastrointestinal tract. In the body fluid, it is converted into triethyl lead which is more toxic. Since it is highly lipophilic it can easily cross the blood-brain-barrier and can cause neurotoxicity as well. TEL after combustion converted into lead oxide and lead sulfide in ambient air, which is more toxic and carcinogenic also. Other sources of lead emission are lead factories and wastes incineration. The incineration of lead-coated papers is also a substantial source of lead emissions.[33]

Particulate matters

It is well known that air pollution is unpleasant for our pulmonary system, but approximately 20 years ago researchers observed the shocking and detrimental findings that fine PM of polluted air can also affect our vital organs and tissues.[34] Suspended PM of pollutants in ambient air are quite harmful for human health. Sources of PM are combustion of fossil fuels in vehicles, power plants, and stubble burning. Particulates are pernicious form of air pollution since they have the tendency to penetrate deep into the lungs and finally to the bloodstream. They can induce many complications such as respiratory disease, heart disease, DNA mutation as well as premature death. The PM include both organic and inorganic particles, such as carbon soot, smoke, dust, liquid droplets of toxic fumes, and other pollutants.[35] These particles vary in size from course particles (PM10) to ultrafine particles (PM0.1). Fine particles (PM2.5) are particles which are smaller than course particles but bigger than ultrafine particles. The particulate pollutants can damage various organs [Figure 3].
Figure 3: Body parts where particulate matters can rich

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The pollutants can also affect many vital organs of the human body. The consequential upshots can lead to many disturbances in primordial structures as well as ramifications of living tissues. According to the WHO, pollution has become a “public health emergency” and persistent exposure to ambient air pollution can lead to abrogation in the functioning of vital organs.[36]


  Adverse Effects on Respiratory System Top


Pollution-induced incidences of respiratory troubles are growing up day by day. Recent epidemiologic studies suggest that pollutants contribute a big burden of diseases on human beings.[37],[38] Over the past few decades, it has become a sizable factor for acute and chronic pulmonary dysfunctions. Ambient air pollutants are greatly associated with asthma, chronic obstructive pulmonary diseases, and other respiratory conditions.

Once those pollutants inhaled up, the fine and ultrafine PM rapidly cross the pleural barriers and enter into circulation with the potential to affect the vascular system. The capacity of PM to cross the biological barriers is influenced by many factors such as particle diameter, charges, chemical nature, and their tendency to form aggregates. In a recent study, it is seen that PM2.5 induces necrosis in respiratory epithelial cells.[39] Pollutants of particulate nature have capacity to muddle sensory neurons of the respiratory system that trigger the release of neuropeptides such as neurokinin A and substance P. These mediators have grievous impact on leukocytes also.[40]


  Adverse Effects on Cardiovascular System Top


Ambient air pollution is a consequential aggressive factor for those who already struggling with some cardiovascular impairments. Long-term exposure to ambient air pollution has been closely associated with many hostile effects on the respiratory system. The PMs, toxic fumes, and elemental carbon have tendency to cause numerous cardiovascular maladies. The fumes of nitrogen dioxide and particulate matter (PM2.5) have notable associations with the risk of acute myocardial infarction.[41] The immoderate exposure of PM has also been shown to induce prothrombotic state that may exhibit a critical role in deep venous thrombosis and ischemic vascular events.[42] Exposure to the high concentration of PM2.5 elevates lipid and protein oxidation in human beings that lead to high oxidative stress as well as activation of transcription factors such as protein-1 activator and nuclear factor-kappa-b. These transcription factors have coherent link with the production of chemokines, cytokines, and other proinflammatory mediators.[43]


  Adverse Effects on Central Nervous System Top


The rogue pollutants have many adverse effects on the central nervous system also. In recent years, it has been ascertained by many researchers that air pollutants have profound association with the diseases of the central nervous system. Many illnesses such as Alzheimer's disease,[44] Parkinson's disease,[45] stroke,[46] and neurodevelopmental disorders[47] are frequently occurring due to chronic exposure of polluted ambient air. Although the underlying molecular mechanism of these maladies and their association with pollutants are not fully understood yet, however many emerging evidence indicate their role in inflammatory responses such as neuroinflammation,[48] cerebrovascular inflammation,[49] oxidative stresses,[50] and microglial activation.[51] In the course of the exposure, many inflammatory mediators are generated. Cytokines are one of them. They typically activate cerebral endothelial cells and upset the integrity of blood–brain barrier. They also trigger signaling cascades that lead to rouse nuclear factor κB and mitogen-activated protein kinase transcription factor-mediated pathways.[52]


  Other Inflammatory Illnesses Top


Pollutants have many other hazardous effects on human physiology also. They are suspected of causing cancer and other serious harms such as birth defects and fetal anomalies. Teratogenic pollutants may be the droplets or fumes of benzene, toluene, and dioxin or the dust of asbestos or elements such as mercury, chromium, and cadmium. After absorption, a number of inflammatory mediators are produced in the circulation that can lead to endothelial injury as well as many other systemic inflammations. The systemic inflammatory responses are mediated by many proinflammatory cytokines such as interleukin-6, interleukin-1 β, and tumor necrotic factor-α. The noxious pollutants are also capable to trigger activation of mast cells mediated allergic response and increase in the level of leukocytes.[53] Air-born bacterial endotoxin (Lipopolysaccharide) is also a well-known pollutant that induces inflammatory responses in central as well as peripheral compartments of the body.[54] In many researches, it has been observed that lipopolysaccharides have a severe inflammatory response on dopaminergic neurons also.


  Conclusion Top


Any unfavorable disturbance in the natural consistency of the environment is known as pollution. It is the result of the inclusion of toxic gases and contaminating PM in the atmosphere. Recurrent exposure of PM induces inflammation in the respiratory epithelium that increases susceptibility and criticality of viral infections. Common respiratory viruses are rhinovirus, metapneumovirus, respiratory syncytial virus, bocaviruses, influenza viruses, parainfluenza viruses, adenoviruses, and coronaviruses. The incidences of pollutant-influenced viral infections are growing up day by day. The detrimental effects of air pollution on human health have been recognized as a rising setback over the past half-century. Human activities are the major sources of ambient air pollution which erect many adverse health upshots such as pulmonary diseases, heart diseases, stroke, and cancer. Worldwide increase in the rate of occurrence of pollution-induced maladies indicates an alarming nod for health and well-being. Toxic pollutants represent a varied mixture of organic compounds, toxic gases, PM and industrial wastes, such as polycyclic hydrocarbons, sulfur oxides, nitrogen oxides, ozone, carbon monoxide, lead compounds, and bacterial end toxins. Among these, PM (PM0.1, PM2.5 and PM10) originated from volatile organic compounds and oxides of nitrogen, pop up to be the most deleterious and ubiquitous components. Chronic exposure of air pollutants enhances the severity of respiratory tract infection. Synchronous exposure of ambient pollutants and contagious viruses has substantial adverse effects on many vital organs. Nervous system injuries are mostly executed by PM of smaller diameters (PM0.1 and PM2.5). Focal sources of PM0.1 and PM2.5 are the gaseous matters that appear from vehicles and industrial activities. Long-term exposure to these pollutants gives rise to several adverse effects on human health. Effective strategies, plausible rules as well as impervious protections are required to reduce the ill effects of these pollutants on humanity and other forms of life. A better understanding of the factors, mediators, and mechanism enables the invention of contemporary strategies and methods to reduce the global freight of pollutants on human health.

Financial support and sponsorship

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Conflicts of interest

There are no conflicts of interest.



 
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