The Hypothesis of the Interplay Between Air Particulate Matter PM2.5 and Acute Cellular Rejection Episodes Following Heart Transplantation

Background: In end-stage HF, interventional therapy is the treatment of choice, including mechanical circulatory support and heart organ transplantation. Acute cellular rejection is considered a major impediment to the long-term survival of cardiac allografts. The aim of this study is to point out a...

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Main Authors: Tomasz Urbanowicz, Krzysztof Skotak, Dominika Konecka-Mrówka, Hanna Wachowiak-Baszyńska, Rafał Skowronek, Jędrzej Sikora, Jakub Bratkowski, Jan Kaczmarek, Maksymilian Misiorny, Ewa Straburzyńska-Migaj, Jerzy Nożyński, Marek Jemielity
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Atmosphere
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Online Access:https://www.mdpi.com/2073-4433/16/2/234
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author Tomasz Urbanowicz
Krzysztof Skotak
Dominika Konecka-Mrówka
Hanna Wachowiak-Baszyńska
Rafał Skowronek
Jędrzej Sikora
Jakub Bratkowski
Jan Kaczmarek
Maksymilian Misiorny
Ewa Straburzyńska-Migaj
Jerzy Nożyński
Marek Jemielity
author_facet Tomasz Urbanowicz
Krzysztof Skotak
Dominika Konecka-Mrówka
Hanna Wachowiak-Baszyńska
Rafał Skowronek
Jędrzej Sikora
Jakub Bratkowski
Jan Kaczmarek
Maksymilian Misiorny
Ewa Straburzyńska-Migaj
Jerzy Nożyński
Marek Jemielity
author_sort Tomasz Urbanowicz
collection DOAJ
description Background: In end-stage HF, interventional therapy is the treatment of choice, including mechanical circulatory support and heart organ transplantation. Acute cellular rejection is considered a major impediment to the long-term survival of cardiac allografts. The aim of this study is to point out a possible relationship underlying acute cellular rejection risk in heart organ recipients. Methods: A total of 30 (25 (83%) men and 5 (17%) women) heart organ recipients with a median (Q1–Q3) age of 49 (38–60) were enrolled in the analysis. The results from repeated hospitalizations due to protocolar endomyocardial biopsies performed between one and three months following the heart transplantation in relation air pollution exposure were taken into the analysis. Results: The median (Q1–Q3) observation time after organ transplantation was 92 (82–97) days. A significant difference in PM2.5 exposure between the rejection group (16.10 (14.24–17.61)) μg/m<sup>3</sup> and the non-rejection group (11.97 (9.85–12.97)) μg/m<sup>3</sup> was noticed (<i>p</i> < 0.001). The odds ratio (95% confidence interval) for acute rejection prediction related to PM2.5 was 1.79 (1.11–2.89), <i>p</i> = 0.018. The reviewer operator curve for acute cellular rejection related to PM2.5 exposure was performed, and the area under the curve (AUC) was 0.873, yielding a precision of 0.600 and an f-measure of 0.545. The predicted residual plots for PM2.5 indicated a 50% increased risk for PM2.5 above 16 μg/m<sup>3</sup> and of 91% for PM2.5 above 20 μg/m<sup>3</sup>. Conclusions: The single-center study was performed on a limited number of heart organ recipients and was related to personalized individual calculations of PM2.5 exposure. The study represents a personalized approach and indicates possible links to the hypothesis, which should be verified on a higher volume of patients.
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spelling doaj-art-754d17201442425fa744fdf2cabc34bd2025-08-20T03:12:12ZengMDPI AGAtmosphere2073-44332025-02-0116223410.3390/atmos16020234The Hypothesis of the Interplay Between Air Particulate Matter PM2.5 and Acute Cellular Rejection Episodes Following Heart TransplantationTomasz Urbanowicz0Krzysztof Skotak1Dominika Konecka-Mrówka2Hanna Wachowiak-Baszyńska3Rafał Skowronek4Jędrzej Sikora5Jakub Bratkowski6Jan Kaczmarek7Maksymilian Misiorny8Ewa Straburzyńska-Migaj9Jerzy Nożyński10Marek Jemielity11Cardiac Surgery and Transplantology Department, Poznan Univeristy of Medical Sciences, 61-107 Poznan, PolandInstitute of Environmental Protection—National Research Institute, 02-170 Warsaw, PolandDepartment of Histopathology, Silesian Centre for Heart Disease, Medical University of Silesia in Katowice, 41-800 Zabrze, PolandCardiac Surgery and Transplantology Department, Poznan Univeristy of Medical Sciences, 61-107 Poznan, PolandDepartment of Histopathology, Silesian Centre for Heart Disease, Medical University of Silesia in Katowice, 41-800 Zabrze, PolandStudent Research Group, Medical Faculty, Poznań University of Medical Sciences, 61-107 Poznan, PolandInstitute of Environmental Protection—National Research Institute, 02-170 Warsaw, PolandStudent Research Group, Medical Faculty, Poznań University of Medical Sciences, 61-107 Poznan, PolandStudent Research Group, Medical Faculty, Poznań University of Medical Sciences, 61-107 Poznan, Poland1st Cardiology Department, Poznan Univeristy of Medical Sciences, 61-107 Poznan, PolandDepartment of Histopathology, Silesian Centre for Heart Disease, Medical University of Silesia in Katowice, 41-800 Zabrze, PolandCardiac Surgery and Transplantology Department, Poznan Univeristy of Medical Sciences, 61-107 Poznan, PolandBackground: In end-stage HF, interventional therapy is the treatment of choice, including mechanical circulatory support and heart organ transplantation. Acute cellular rejection is considered a major impediment to the long-term survival of cardiac allografts. The aim of this study is to point out a possible relationship underlying acute cellular rejection risk in heart organ recipients. Methods: A total of 30 (25 (83%) men and 5 (17%) women) heart organ recipients with a median (Q1–Q3) age of 49 (38–60) were enrolled in the analysis. The results from repeated hospitalizations due to protocolar endomyocardial biopsies performed between one and three months following the heart transplantation in relation air pollution exposure were taken into the analysis. Results: The median (Q1–Q3) observation time after organ transplantation was 92 (82–97) days. A significant difference in PM2.5 exposure between the rejection group (16.10 (14.24–17.61)) μg/m<sup>3</sup> and the non-rejection group (11.97 (9.85–12.97)) μg/m<sup>3</sup> was noticed (<i>p</i> < 0.001). The odds ratio (95% confidence interval) for acute rejection prediction related to PM2.5 was 1.79 (1.11–2.89), <i>p</i> = 0.018. The reviewer operator curve for acute cellular rejection related to PM2.5 exposure was performed, and the area under the curve (AUC) was 0.873, yielding a precision of 0.600 and an f-measure of 0.545. The predicted residual plots for PM2.5 indicated a 50% increased risk for PM2.5 above 16 μg/m<sup>3</sup> and of 91% for PM2.5 above 20 μg/m<sup>3</sup>. Conclusions: The single-center study was performed on a limited number of heart organ recipients and was related to personalized individual calculations of PM2.5 exposure. The study represents a personalized approach and indicates possible links to the hypothesis, which should be verified on a higher volume of patients.https://www.mdpi.com/2073-4433/16/2/234HTXACRPM2.5air pollutionacute rejection
spellingShingle Tomasz Urbanowicz
Krzysztof Skotak
Dominika Konecka-Mrówka
Hanna Wachowiak-Baszyńska
Rafał Skowronek
Jędrzej Sikora
Jakub Bratkowski
Jan Kaczmarek
Maksymilian Misiorny
Ewa Straburzyńska-Migaj
Jerzy Nożyński
Marek Jemielity
The Hypothesis of the Interplay Between Air Particulate Matter PM2.5 and Acute Cellular Rejection Episodes Following Heart Transplantation
Atmosphere
HTX
ACR
PM2.5
air pollution
acute rejection
title The Hypothesis of the Interplay Between Air Particulate Matter PM2.5 and Acute Cellular Rejection Episodes Following Heart Transplantation
title_full The Hypothesis of the Interplay Between Air Particulate Matter PM2.5 and Acute Cellular Rejection Episodes Following Heart Transplantation
title_fullStr The Hypothesis of the Interplay Between Air Particulate Matter PM2.5 and Acute Cellular Rejection Episodes Following Heart Transplantation
title_full_unstemmed The Hypothesis of the Interplay Between Air Particulate Matter PM2.5 and Acute Cellular Rejection Episodes Following Heart Transplantation
title_short The Hypothesis of the Interplay Between Air Particulate Matter PM2.5 and Acute Cellular Rejection Episodes Following Heart Transplantation
title_sort hypothesis of the interplay between air particulate matter pm2 5 and acute cellular rejection episodes following heart transplantation
topic HTX
ACR
PM2.5
air pollution
acute rejection
url https://www.mdpi.com/2073-4433/16/2/234
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