MARINA LAZZARI NICOLA
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- Aerobic exercise in polluted urban environments: effects on airway defense mechanisms in young healthy amateur runners(2016) SA, Matheus Cavalcante de; NAKAGAWA, Naomi Kondo; ANDRE, Carmen Diva Saldiva de; CARVALHO-OLIVEIRA, Regiani; CARVALHO, Tamas de Santana; NICOLA, Marina Lazzari; ANDRE, Paulo Afonso de; SALDIVA, Paulo Hilario Nascimento; VAISBERG, MauroIn this study, the effects of aerobic exercise on the upper airways and their defense mechanisms were investigated in athletes. The athletes ran in two different environments: the downtown streets of the city of Sao Paulo (Street), more polluted, and an urban forest (Forest), less polluted. Thirty-eight young healthy athletes ran for 45 min d(-1) randomly during five consecutive days, with an interval of 48 h before changing environment. Clinical parameters and respiratory tract defense markers were evaluated before and after the first run on Mondays (1 d) and on Fridays (5 d). Street presented higher mean PM2.5 concentrations (65.1 +/- 39.1 mu gm(-3), p < 0.001) and lower temperature (22.0 degrees C, p = 0.010) than Forest (22.6 +/- 15.3 mu g m(-3) and 22.8 degrees C). After 1 d Street running, subjects showed an increment in heart rate (p < 0.001). At day 5, there was twice the number of athletes with impaired nasal mucociliary clearance (MCC) in the Street runners group when compared to the Forest runners group. Exhaled breath condensate pH values increased in the Forest group, with significant differences between groups in day 1 (p = 0.006) and day 5 (p < 0.001), despite the fact that both groups showed values within the normal range. After exposure to both environments, the number of cells in the nasal lavage fluid was reduced after exercise (p = 0.014), without alterations in cell type and IL-8 and IL-10 concentrations. Aerobic exercise can either maintain or acutely enhance MCC and it may help to regulate inflammatory responses in the airways. Here we show that exercise practice in polluted outdoor environment, over a 5 d period, impairs MCC. In contrast, athletes running in the less polluted environment (Forest) show higher exhaled breath condensate pH values when compared to those who exercised in a more polluted environment (Street).
- Mucociliary clearance, airway inflammation and nasal symptoms in urban motorcyclists(2014) BRANT, Tereza C. S.; YOSHIDA, Carolina T.; CARVALHO, Tomas de S.; NICOLA, Marina L.; MARTINS, Jocimar A.; BRAGA, Lays M.; OLIVEIRA, Regiani C. de; LEYTON, Vilma; ANDRE, Carmen S. de; SALDIVA, Paulo H. N.; RUBIN, Bruce K.; NAKAGAWA, Naomi K.OBJECTIVES: There is evidence that outdoor workers exposed to high levels of air pollution exhibit airway inflammation and increased airway symptoms. We hypothesized that these workers would experience increased airway symptoms and decreased nasal mucociliary clearance associated with their exposure to air pollution. METHODS: In total, 25 non-smoking commercial motorcyclists, aged 18-44 years, were included in this study. These drivers work 8-12 hours per day, 5 days per week, driving on urban streets. Nasal mucociliary clearance was measured by the saccharine transit test; airway acidification was measured by assessing the pH of exhaled breath condensate; and airway symptoms were measured by the Sino-nasal Outcome Test-20 questionnaire. To assess personal air pollution exposure, the subjects used a passive-diffusion nitrogen dioxide (NO2) concentration-monitoring system during the 14 days before each assessment. The associations between NO2 and the airway outcomes were analyzed using the Mann-Whitney test and the Chi-Square test. Clinicaltrials.gov: NCT01976039. RESULTS: Compared with clearance in healthy adult males, mucociliary clearance was decreased in 32% of the motorcyclists. Additionally, 64% of the motorcyclists had airway acidification and 92% experienced airway symptoms. The median personal NO2 exposure level was 75 mg/m(3) for these subjects and a significant association was observed between NO2 and impaired mucociliary clearance (p = 0.036). CONCLUSION: Non-smoking commercial motorcyclists exhibit increased airway symptoms and airway acidification as well as decreased nasal mucociliary clearance, all of which are significantly associated with the amount of exposure to air pollution.
- Humidification and mucus transport in critical patients: Clinical and therapeutic implications(2012) NAKAGAWA, N. K.; NASCIMENTO, J. A.; NICOLA, M. L.; SALDIVA, P. H. N.An adult man inhales more than 12,000 l of air per day, which may contain particles and microorganisms. The epithelium of the conducting airways, from the nose to the bronchioli, are anatomically and physiologically designed to protect the alveoli by providing clean, warmed and fully saturated air at this level, where an efficient gas exchange must occur, and by providing specific defense mechanisms, such as trapping particles and microorganisms in the mucus and mucociliary transport of these agents in the direction of the oropharynx, where they will be swallowed or expectorated. Mucociliary transport (MCT) is an important respiratory defense mechanism, which efficiency depends on the equilibrium among three major components: ciliary beating, airway surface liquid (the periciliary liquid and mucus), and the interaction between cilia and mucus. In the intensive care unit (ICU) and emergency department, many factors can increase the risks of mucus transport dysfunction. Among them, artificial inspired air conditioning is a basic factor with physiological and clinical impact in critically ill patients. © Springer-Verlag Berlin Heidelberg 2012.
- Young ""Healthy"" Smokers Have Functional and Inflammatory Changes in the Nasal and the Lower Airways(2014) NICOLA, Marina Lazzari; CARVALHO, Heraclito Barbosa de; YOSHIDA, Carolina Tieko; ANJOS, Fabyana Maria dos; NAKAO, Mayumi; SANTOS, Ubiratan de Paula; CARDOZO, Karina Helena Morais; CARVALHO, Valdemir Melechco; PINTO, Ernani; FARSKY, Sandra Helena Poliselli; SALDIVA, Paulo Hilario Nascimento; RUBIN, Bruce K.; NAKAGAWA, Naomi KondoBackground: Smoking is responsible for most COPD. Although people with COPD often have concomitant nasal disease, there are few studies that report physiologic or inflammatory changes in the upper airways in young asymptomatic smokers. We investigated physiologic and inflammatory changes in the nasal and lower airways of young smokers and if these changes were related to smoking history. Methods: Seventy-two subjects aged between 18 and 35 years (32 healthy nonsmokers and 40 young smokers) participated in this study. We measured nasal mucociliary clearance (MCC), nasal mucus surface contact angle, cell counts, myeloperoxidase and cytokine concentrations in nasal lavage fluid, exhaled breath condensate (EBC) pH, and lung function. Results: Smokers had faster MCC, an increased number of cells (macrophages, ciliated cells, and goblet cells), increased lavage myeloperoxidase concentration, and decreased EBC pH compared with nonsmokers. There was a significant inverse relationship between pack-year smoking history and EBC pH. There were no differences in lung function or mucus surface properties comparing smokers to nonsmokers. Conclusions: Young adult smokers have functional and inflammatory changes in the nasal and lower airways and these correlate with smoking history. However, in these young smokers, smoking history was not associated with pulmonary function decline, probably because it is unlikely that spirometry detects early physiologic changes in the airways.