Master of Science / Department of Food, Nutrition, Dietetics and Health / Mark Haub / The coronary microcirculation is the principle site of blood flow control and myocardium oxygen delivery within the coronary artery tree. Coronary arteriole tone is determined by three major endothelium derived vasoactive substances: endothelin, nitric oxide (NO), and reactive oxygen species (ROS). The effects of these substances change with aging and differ between sexes. Endothelin-1 (ET-1), the primary endothelin isoform in the coronary circulation, acts on smooth muscle receptors endothelin-A (ET[subscript A]) and endothelin-B (ET[subscript B]) to induce vascular smooth muscle (VSM) contraction and vasoconstriction. Whereas ET-1 activation of the ET[subscript B] receptor on the endothelium initiates a cascade of events leading to NO production via endothelium derived NO synthase (eNOS) enzyme activation and VSM relaxation. Aged males maintain ET[subscript A] receptor expression and higher levels of vasoconstriction than do age-matched females. High levels of ET[subscript A] receptor activity are associated with hypertension, myocardial infarction, coronary artery spasm, atherosclerosis, and finally heart failure (HF). Additionally, NO can displace ET-1 from the VSM ET[subscript A] and ET[subscript B] receptors. Thus, with reduced eNOS activity and decreased NO production, there is a simultaneous loss of vasodilatory capacity and increase in vasoconstrictive capacity. In both rodent and human models aged males and females ROS production increases with age. ROS, such as superoxide, scavenge NO, decreasing its bioavailability and producing peroxynitrite. Peroxynitrite is a potent reactive nitrogen species that leads to endothelial cell apoptosis and eNOS enzyme dissociation, potentiating superoxide production and NO reduction. It has been shown that the reduction in NO bioavailability may be a primary mechanism of coronary artery disease. However, the ROS hydrogen peroxide, also increased with aging, produces a potent vasodilatory effect in the coronary microcirculation and seems to be one mechanism that buffers the loss of NO-induced vasodilation. In postmenopausal women diminished estrogen levels further reduce eNOS production of NO. Males, however, tend to experience decrements in arteriole function a decade before women and estrogen may be one mechanism preserving vascular health into middle age that separates the chronology of coronary artery disease between sexes. Determining the mechanisms of disease onset that accompany the aging process will provide insight into potential therapies to preserve endothelium dependent dilation with aging such as exercise, dietary NO supplementation, and increased dietary anti-oxidant consumption.

INTRODUÇÃO: A exposição contínua desde o nascimento à poluição atmosférica de grandes centros urbanos de origem predominante veicular, contribui para eventos cardiopulmonares em adultos. A inflamação e remodelamento induzidos pelos poluentes podem modular a resposta vascular a mediadores e alterar a sua patência e reatividade contribuindo para eventos isquêmicos. MÉTODOS: Verificar alterações inflamatórias e estruturais nos pulmões e corações de camundongos Swiss machos cronicamente expostos, desde o nascimento até a idade adulta, às câmaras seletivas com filtros (câmara limpa) e sem filtros (câmara poluída) para particulados e gases tóxicos, situadas a 20m de um cruzamento de tráfego intenso da cidade de São Paulo, 24 h/7dias/semana/4 meses. Realizaram-se medidas internas e externas dos poluentes: PM2,5; NO2 e Black Carbon (BC) e análises morfométricas nos pulmões e corações. RESULTADOS: A filtragem da câmara limpa clareou 100% de BC, 52% de PM2,5 e 32% de NO2. Nos pulmões, as alterações predominaram na região peribronquiolar. Os animais submetidos à câmara poluída apresentaram inflamação peribronquiolar caracterizada por aumento do infiltrado perivascular (p=0,022), hiperplasia do epitélio bronquiolar (p=0,037), escore inflamatório total (p=0,015), e diminuição do infiltrado polimorfonuclear na região do septo alveolar distal (p=0.001). A parede dos vasos peribronquiolares não demonstrou alteração da razão lúmen/parede (L/P) entre os grupos (0,094), porém, os animais submetidos à câmara poluída, apresentaram remodelamento estrutural com diminuição de fibras elásticas na adventícia (p= 0,006) e na túnica média (p= 0,008) e das fibras colágenas apenas na adventícia (p= 0,016). No miocárdio, verificamos aumento do número de núcleos por área do VE, sem alteração de peso dos corações entre os grupos (p=0,005). As coronárias dos camundongos expostos à câmara poluída também não demonstraram diferenças na razão L/P, porém a poluição induziu remodelamento através de aumento de fibras colágenas e elásticas na camada adventícia e média dos vasos (p<0.001; p=0,03 respectivamente), mesmo quando categorizados os vasos por seu calibre e por ventrículo separadamente (p<0,001). CONCLUSÃO: A poluição atmosférica da cidade de São Paulo, Brasil, induziu alterações inflamatórias e estruturais nos pulmões e corações dos animais normais expostos desde o nascimento até a idade adulta. A resposta pulmonar caracterizou-se por inflamação e diminuição das fibras da matriz extracelular dos vasos, enquanto as coronárias apresentaram fibrose e elastogênese em toda parede vascular. Esses achados reforçam a hipótese de que a poluição atmosférica de grandes centros urbanos induz alterações silenciosas porém significativas, órgão-específicas, modulando a resposta vascular, podendo contribuir para alteração da patência e reatividade dos vasos e eventos isquêmicos na idade adulta / INTRODUCTION: The continuous exposition since birth to atmospheric pollution of great urban centers originated by vehicles predominantly, contributes to cardiopulmonary events in adults. The remodeling and inflammation induced by airborne pollutants may modulate the vascular response to mediators and alter the vascular patency and reactivity which may contribute to ischemic events. METHODS: To verify the inflammatory and structural alterations of the lungs and heart of Swiss male mice chronically and continuously exposed since birth to adulthood, to selective chambers with (clean) or without (polluted) filter devices for particles and toxic gases, 7days/24h/4 months, located 20m far from a cross-road with heavy traffic in Sao Paulo city downtown. Measurements of PM2,5; NO2 and Black Carbon (BC) inside the chambers and in the external environment and morphometric analyses of the lung and heart were made. RESULTS: Filters cleared 100% of BC, 47% of PM2,5 and 68% of NO2 in the clean chamber. In the lungs, pollutants affected predominantly the peribronchiolar area. Animals submitted to the polluted chamber presented peribronchiolar inflammation characterized by increased perivascular influx (p=0.022), bronchiolar epithelial hyperplasia (p=0.037), total inflammatory scores (p=0.015), and decrement of polymorphonuclear cells infiltration in the distal septa (p=0.001). There was no difference of the lumen/wall ratio (L/W) of peribronchiolar vessels (p=0.094) between groups. However, mice from polluted chamber presented structural remodeling characterized by decrement of elastic fibers in both adventitia (p=0.006) and media layers (p= 0.008) and collagen content in the adventitia (p= 0.016). In the heart, there was an increase of nucleus of myocytes/left ventricle area, but no alteration of the myocardial weight between groups (p=0.005). Although the coronary arterioles from mice exposed to polluted ambient did not show differences of L/W ratio when compared to those from clean ambient, pollutants induced increment of collagen and elastic fibers in the adventitia and media vascular layer (p<0.001; p=0.03 respectively), even when vessels were categorized by caliber and per ventricle chamber separately (p<0.001). CONCLUSION: The continuous exposure to atmospheric pollution of São Paulo city, Brazil, since birth to adulthood, induced inflammatory and structural alterations in the lungs and heart. The lung response was characterized by inflammation and decrement of extracellular matrix fibers while in the heart, there was fibrosis and elastin increment in the coronary arteriolar wall. These results reinforce the hypothesis that urban airborne pollution predominantly generated by traffic, induces silent but significant organ-specific alterations, which may impair vascular patency and reactivity and may contribute to ischemic cardiac events in the adulthood

INTRODUÇÃO: A exposição contínua desde o nascimento à poluição atmosférica de grandes centros urbanos de origem predominante veicular, contribui para eventos cardiopulmonares em adultos. A inflamação e remodelamento induzidos pelos poluentes podem modular a resposta vascular a mediadores e alterar a sua patência e reatividade contribuindo para eventos isquêmicos. MÉTODOS: Verificar alterações inflamatórias e estruturais nos pulmões e corações de camundongos Swiss machos cronicamente expostos, desde o nascimento até a idade adulta, às câmaras seletivas com filtros (câmara limpa) e sem filtros (câmara poluída) para particulados e gases tóxicos, situadas a 20m de um cruzamento de tráfego intenso da cidade de São Paulo, 24 h/7dias/semana/4 meses. Realizaram-se medidas internas e externas dos poluentes: PM2,5; NO2 e Black Carbon (BC) e análises morfométricas nos pulmões e corações. RESULTADOS: A filtragem da câmara limpa clareou 100% de BC, 52% de PM2,5 e 32% de NO2. Nos pulmões, as alterações predominaram na região peribronquiolar. Os animais submetidos à câmara poluída apresentaram inflamação peribronquiolar caracterizada por aumento do infiltrado perivascular (p=0,022), hiperplasia do epitélio bronquiolar (p=0,037), escore inflamatório total (p=0,015), e diminuição do infiltrado polimorfonuclear na região do septo alveolar distal (p=0.001). A parede dos vasos peribronquiolares não demonstrou alteração da razão lúmen/parede (L/P) entre os grupos (0,094), porém, os animais submetidos à câmara poluída, apresentaram remodelamento estrutural com diminuição de fibras elásticas na adventícia (p= 0,006) e na túnica média (p= 0,008) e das fibras colágenas apenas na adventícia (p= 0,016). No miocárdio, verificamos aumento do número de núcleos por área do VE, sem alteração de peso dos corações entre os grupos (p=0,005). As coronárias dos camundongos expostos à câmara poluída também não demonstraram diferenças na razão L/P, porém a poluição induziu remodelamento através de aumento de fibras colágenas e elásticas na camada adventícia e média dos vasos (p<0.001; p=0,03 respectivamente), mesmo quando categorizados os vasos por seu calibre e por ventrículo separadamente (p<0,001). CONCLUSÃO: A poluição atmosférica da cidade de São Paulo, Brasil, induziu alterações inflamatórias e estruturais nos pulmões e corações dos animais normais expostos desde o nascimento até a idade adulta. A resposta pulmonar caracterizou-se por inflamação e diminuição das fibras da matriz extracelular dos vasos, enquanto as coronárias apresentaram fibrose e elastogênese em toda parede vascular. Esses achados reforçam a hipótese de que a poluição atmosférica de grandes centros urbanos induz alterações silenciosas porém significativas, órgão-específicas, modulando a resposta vascular, podendo contribuir para alteração da patência e reatividade dos vasos e eventos isquêmicos na idade adulta / INTRODUCTION: The continuous exposition since birth to atmospheric pollution of great urban centers originated by vehicles predominantly, contributes to cardiopulmonary events in adults. The remodeling and inflammation induced by airborne pollutants may modulate the vascular response to mediators and alter the vascular patency and reactivity which may contribute to ischemic events. METHODS: To verify the inflammatory and structural alterations of the lungs and heart of Swiss male mice chronically and continuously exposed since birth to adulthood, to selective chambers with (clean) or without (polluted) filter devices for particles and toxic gases, 7days/24h/4 months, located 20m far from a cross-road with heavy traffic in Sao Paulo city downtown. Measurements of PM2,5; NO2 and Black Carbon (BC) inside the chambers and in the external environment and morphometric analyses of the lung and heart were made. RESULTS: Filters cleared 100% of BC, 47% of PM2,5 and 68% of NO2 in the clean chamber. In the lungs, pollutants affected predominantly the peribronchiolar area. Animals submitted to the polluted chamber presented peribronchiolar inflammation characterized by increased perivascular influx (p=0.022), bronchiolar epithelial hyperplasia (p=0.037), total inflammatory scores (p=0.015), and decrement of polymorphonuclear cells infiltration in the distal septa (p=0.001). There was no difference of the lumen/wall ratio (L/W) of peribronchiolar vessels (p=0.094) between groups. However, mice from polluted chamber presented structural remodeling characterized by decrement of elastic fibers in both adventitia (p=0.006) and media layers (p= 0.008) and collagen content in the adventitia (p= 0.016). In the heart, there was an increase of nucleus of myocytes/left ventricle area, but no alteration of the myocardial weight between groups (p=0.005). Although the coronary arterioles from mice exposed to polluted ambient did not show differences of L/W ratio when compared to those from clean ambient, pollutants induced increment of collagen and elastic fibers in the adventitia and media vascular layer (p<0.001; p=0.03 respectively), even when vessels were categorized by caliber and per ventricle chamber separately (p<0.001). CONCLUSION: The continuous exposure to atmospheric pollution of São Paulo city, Brazil, since birth to adulthood, induced inflammatory and structural alterations in the lungs and heart. The lung response was characterized by inflammation and decrement of extracellular matrix fibers while in the heart, there was fibrosis and elastin increment in the coronary arteriolar wall. These results reinforce the hypothesis that urban airborne pollution predominantly generated by traffic, induces silent but significant organ-specific alterations, which may impair vascular patency and reactivity and may contribute to ischemic cardiac events in the adulthood