Acute changes in serum immune markers due to swimming in a chlorinated pool

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Title: Acute changes in serum immune markers due to swimming in a chlorinated pool
Authors: Vlaanderen, J
Van Veldhoven, K
Font-Ribera, L
Villanueva, CM
Chadeau-Hyam, M
Portengen, L
Grimalt, JO
Zwiener, C
Heederik, D
Zhang, X
Vineis, P
Kogevinas, M
Vermeulen, R
Item Type: Journal Article
Abstract: Background Exposure to disinfectants and disinfection byproducts (DBPs) due to swimming in chlorinated water has been associated with allergic and respiratory health effects, including asthma. Objectives Biological mechanisms contributing to these associations are largely unknown. We hypothesized a potential pathway involving modulation of the immune system. Methods We assessed levels of immune markers (CCL11, CCL22, CXCL10, CRP, EGF, GCSF, IL-8, IL-17, IL-1RA, MPO, VEGF, Periostin) in serum collected from 30 women and 29 men before and after 40 min of swimming in a chlorinated pool. Exposure to DBPs was assessed by measuring bromodichloromethane, bromoform, chloroform, and dibromochloromethane in exhaled breath before and after swimming. Covariate data including information on physical activity was available through questionnaires and measurements. We assessed the association between indicators of swimming in a chlorinated pool and changes in serum immune marker concentrations using linear regression with bivariate normal distributions and adjusted for multiple comparisons by applying the Benjamini-Hochberg procedure. Results We observed a significant decrease in serum concentrations of IL-8 (− 12.53%; q = 2.00e-03), CCL22 (− 7.28%; q = 4.00e-04), CCL11 (− 7.15%; q = 9.48e-02), CRP (− 7.06%; q = 4.68e-05), and CXCL10 (− 13.03%; q = 6.34e-14) and a significant increase in IL-1RA (20.16%; q = 4.18e-06) from before to after swimming. Associations with quantitative measurements of DBPs or physical activity were similar in direction and strength. Most of the observed associations became non-significant when we adjusted the effects of exposure to DBPs for physical activity or vice-versa. Conclusions Our study indicates that swimming in a chlorinated pool induces perturbations of the immune response through acute alterations of patterns of cytokine and chemokine secretion. The observed effects could not be uniquely attributed to either exposure to DBPs or physical activity. Evidence in the literature suggests that observed decreases in immune markers are possibly due to an immunosuppressive effect of DBPs, while the increase in IL-1RA might be due to physical activity.
Issue Date: 5-May-2017
Date of Acceptance: 24-Apr-2017
ISSN: 0160-4120
Publisher: Elsevier
Start Page: 1
End Page: 11
Journal / Book Title: Environment International
Volume: 105
Copyright Statement: © 2017 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Sponsor/Funder: Commission of the European Communities
Wellcome Trust
Funder's Grant Number: 308610
Keywords: Science & Technology
Life Sciences & Biomedicine
Environmental Sciences
Environmental Sciences & Ecology
Immune markers
Disinfection byproducts
MD Multidisciplinary
Publication Status: Published
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care

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