Environmental Air Pollution, Airway Injury and Repair: Understanding the Pathogenetic Relationship to Improve Health Outcome

Environmental air pollution (EAP) is known to cause disease and increase death from respiratory and cardiac diseases. The airways are particularly vulnerable as each breath results in contact with EAP. Patients with chronic airway diseases such as asthma, chronic obstructive lung disease and patients following lung transplant can have worsening of their disease, and lose lung function as a result of EAP exposure. The mechanisms that link EAP to airway diseases are not well understood. Studies suggest that chronic airway diseases share common features: 1. airway inflammation and injury and 2. abnormal repair that lead to changes in the airway structure and interfere with normal function. Our research will assess the effects of EAP on cells, animals and people. This allows us to identify culprit cellular mechanisms, test potential interventions such as drugs in animals (to evaluate safety before moving to clinical trials) and study relevant clinical outcomes in different patient populations. Our research is unique in several ways: 1. study of lung transplant recipients, a unique group of patients followed closely by the Toronto Lung Transplant program, one of the most active programs in the world, 2. study of patients with asthma in a controlled setting of air pollution that simulates 'real-life' exposure levels, 3. the ability to compare findings in a common disease (asthma) to a select but well-characterized group (lung transplant recipients) to look for common mechanisms, and lastly 4. inclusion of engineers and state-of-the-art instruments that allow us to accurately measure pollution exposures and characterize specific pollutants. Our team also includes government scientists from Environment Canada and the Ontario Agency for Health Protection and Promotion. This will facilitate rapid dissemination of our findings to government to develop better health and public policies that will mitigate the harmful effects of pollution.