Environmental Factor, October 2008, National Institute of Environmental Health Sciences
Environmental Cardiology Grantees Meet
By Eddy Ball
Air pollution researchers funded by grants from NIEHS and the Environmental Protection Agency (EPA) attended a full-day workshop September 3 in Rodbell Auditorium. They gathered to share the results of their studies on the effects of particulate matter (PM) on cardiovascular disease (CVD) and to speculate on future directions.
For several of the grantees and attendees, the meeting also served as a preliminary to the two-day Global Variability in Response to Air Pollution meeting held September 4 - 5 in Chapel Hill (see related story (http://www.niehs.nih.gov/news/newsletter/2008/october/meetingexplores.cfm)).
The meeting represented the fifth in a series of meetings on the cardiovascular effects of air pollution exposure that began in 2001. The 2002 meeting in Durham formed the basis for a request for applications (RFA) in 2003. This latest meeting was organized by NIEHS Division of Extramural Research and Training (DERT) Cellular, Organ and Systems Pathobiology Branch Health Science Administrator Srikanth Nadadur, Ph.D., DERT Acting Deputy Director Pat Mastin, Ph.D., and their colleagues at EPA. Representing EPA were Dan Costa, Sc.D., David Diaz-Sanchez, Ph.D., and Bob Devlin, Ph.D. EPA organizing committee members Stacy Katz and Gail Robarge were also in attendance.
In his welcoming remarks, NIEHS Acting Deputy Director Bill Suk, Ph.D., praised the Institute's "long-standing relationship with EPA" in synergistic efforts to improve the health of vulnerable populations. He described the meeting as "a fine example of how two organizations with similar missions, although with different cultures, can come together to establish a program... [that] gives us a better understanding of the link between exposure, in this case particulate matter and air pollution, and disease."
Mastin opened the meeting with an overview of the rationale for developing the network of 12 NIEHS and EPA grants that has supported the research over the past five years. "The idea for the RFA came about because at the time - and I think it still holds true - the epidemiological data linking cardiovascular disease to air pollution was robust and getting more robust," he explained. The information on the mechanisms [by which] air pollution could cause or contribute to cardiovascular disease, [however], was far less established." He pointed to a grantee meeting in 2004 at the University of Louisville, "where I think the term environmental cardiology may has been born."
The meeting was organized into three sessions on vascular and endothelial function, biochemical/pathophysiological mechanisms of cardiac effects and cardiovascular disease susceptibility, and a wrap-up session on future directions and plans. The three subject-themed sessions reserved 45 minutes for participants to view and discuss groups of five to eight posters on each session's theme, followed by hour-long informal moderated discussions by panels of the study authors.
The final panel on future directions and plans pulled together findings and attempted to address the implications of the question posed at the beginning of the session by Nadadur - "Where are we after four years?" As the discussion made clear, there are still questions that the researchers cannot answer definitively.
Some of those questions concern whether the effects of air pollution on CVD are direct or indirect, whether experiments could be standardized in future collaborative and centers studies, and how best to integrate mechanistic and genetic research in future investigations. Additional issues include questions about which specific mechanisms, such as oxidative stress and inflammation, seem to be most important in terms of effects on CVD, whether there is a consensus yet about markers, and how much progress has been made toward finding an ideal disease model for studying air pollution-induced CVD.
One thing that the panelists all agreed upon was the important contribution the research has made in changing the discourse on air pollution and CVD. "I think we've answered the question of biologic plausibility that PM [particulate matter] can kill," Devlin concluded. While that represents a significant accomplishment, he acknowledged "we have a long way to go" in understanding the mechanisms.