背景:越来越多的证据表明,暴露于细颗粒物(PM2.5)和肠道微生物群的生态失调对神经精神疾病的影响,但由于观察性研究中的残余混杂因素,因果推断仍然存在争议。
方法:这项研究旨在研究暴露于PM2.5对4种主要神经精神疾病的因果影响(自闭症谱系障碍[ASD]的病例数=18,381,38,691用于注意缺陷多动障碍[ADHD],67,390精神分裂症,和21,982例阿尔茨海默病[AD]),以及通过肠道微生物群的调解途径。进行了两个样本孟德尔随机化(MR)分析,其中从全基因组关联研究(GWAS)中鉴定出遗传仪器。纳入的GWASs可从(1)MRC综合流行病学单位(MRC-IEU)获得,用于PM2.5、PM2.5、PM10和NOX;(2)ASD精神病学基因组学联盟(PGC),多动症,和精神分裂症;(3)用于AD的MRC-IEU;和(4)用于肠道微生物群的MiBioGen。进行了多变量MR分析,以调整暴露于NOX,PM粗略,PM10我们还研究了肠道微生物群在PM2.5暴露水平与神经精神疾病之间的关系中的调解作用。使用两步MR分析。
结果:PM2.5浓度每增加1个标准差(1.06ug/m3)与ASD风险升高相关(比值比[OR]1.42,95%置信区间[CI]1.00-2.02),ADHD(1.51,1.15-1.98),精神分裂症(1.47,1.15-1.87),和AD(1.57,1.16-2.12)。对于所有四种神经发育障碍,在各种敏感性分析下,结果是稳健的,而MR-Egger方法产生的结果不显著。在调整了PMarrow后,所有4种神经精神疾病的关联仍然显着。而在调整NOX和PM10后不显著。PM2.5暴露对ADHD和精神分裂症的影响部分是由Lachnospileaceae和Barnesiella介导的,比例从8.31%到15.77%不等。
结论:这项研究表明,暴露于PM2.5会增加神经精神疾病的风险,部分是通过影响肠道微生物群的概况。需要对空气污染物进行全面监管,以帮助预防神经精神疾病。
BACKGROUND: Growing evidence has revealed the impacts of exposure to fine particulate matter (PM2.5) and dysbiosis of gut microbiota on neuropsychiatric disorders, but the causal inference remains controversial due to residual confounders in observational studies.
METHODS: This
study aimed to examine the causal effects of exposure to PM2.5 on 4 major neuropsychiatric disorders (number of cases = 18,381 for autism spectrum disorder [ASD], 38,691 for attention deficit hyperactivity disorder [ADHD], 67,390 for schizophrenia, and 21,982 cases for Alzheimer\'s disease [AD]), and the mediation pathway through gut microbiota. Two-sample Mendelian randomization (MR) analyses were performed, in which genetic instruments were identified from genome-wide association studies (GWASs). The included GWASs were available from (1) MRC Integrative Epidemiology Unit (MRC-IEU) for PM2.5, PMcoarse, PM10, and NOX; (2) the Psychiatric Genomics Consortium (PGC) for ASD, ADHD, and schizophrenia; (3) MRC-IEU for AD; and (4) MiBioGen for gut microbiota. Multivariable MR analyses were conducted to adjust for exposure to NOX, PMcoarse, and PM10. We also examined the mediation effects of gut microbiota in the associations between PM2.5 exposure levels and neuropsychiatric disorders, using two-step MR analyses.
RESULTS: Each 1 standard deviation (1.06 ug/m3) increment in PM2.5 concentrations was associated with elevated risk of ASD (odds ratio [OR] 1.42, 95% confidence interval [CI] 1.00-2.02), ADHD (1.51, 1.15-1.98), schizophrenia (1.47, 1.15-1.87), and AD (1.57, 1.16-2.12). For all the 4 neurodevelopmental disorders, the results were robust under various sensitivity analyses, while the MR-Egger method yielded non-significant outcomes. The associations remained significant for all the 4 neuropsychiatric disorders after adjusting for PMcoarse, while non-significant after adjusting for NOX and PM10. The effects of PM2.5 exposure on ADHD and schizophrenia were partially mediated by Lachnospiraceae and Barnesiella, with the proportions ranging from 8.31% to 15.77%.
CONCLUSIONS: This
study suggested that exposure to PM2.5 would increase the risk of neuropsychiatric disorders, partially by influencing the profile of gut microbiota. Comprehensive regulations on air pollutants are needed to help prevent neuropsychiatric disorders.