Environmental pollution and covid-19: The molecular terms and predominant disease outcomes of their sweetheart agreement

Annamaria Colacci*, Giuseppe Bortone, Giangabriele Maffei, Stefano Marchesi, Ada Mescoli, Federica Parmagnani, Gelsomina Pillo, Andrea Ranzi, Francesca Rotondo, Stefania Serra, Monica Vaccari, Stefano Zauli Sajani, Maria Grazia Mascolo, Miriam Naomi Jacobs

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


As the Coronavirus situation (COVID-19) continues to evolve, many questions concerning the factors relating to the diffusion and severity of the disease remain unanswered. Whilst opinions regarding the weight of evidence for these risk factors, and the studies published so far are often in-conclusive or offer contrasting results, the role of comorbidi-ties in the risk of serious adverse outcomes in patients affect-ed with COVID-19 appears to be evident since the outset. Hypertension, diabetes, and obesity are under discussion as important factors affecting the severity of disease. Air pollution has been considered to play a role in the diffusion of the virus, in the propagation of the contagion, in the severity of symptoms, and in the poor prognosis. Accumulating evidence supports the hypothesis that environmental particulate matter (PM) can trigger inflammatory responses at molecular, cellular, and organ levels, sustaining respiratory, cardiovascu-lar, and dysmetabolic diseases. To better understand the intricate relationships among pre-existing conditions, PM, and viral infection, we examined the response at the molecular level of T47D human breast ade-nocarcinoma cells exposed to different fractions of PM. T47D cells express several receptors, including the aryl hydrocarbon receptor (AhR), and ACE2, the main – but not the only – receptor for SARS-CoV-2 entry. PM samples were collected in an urban background site lo-cated in the Northern area of the City of Bologna (Emilia-Romagna Region, Northern Italy) during winter 2013. T47D cells were exposed to organic or aqueous (inorganic) extracts at the final concentration of 8 m3 for a 4-hour duration. Both the concentration and the exposure time were chosen to re-semble an average outdoor exposure. RNA was extracted from cells, purified and hybridised on 66k microarray slides from Agilent. The lists of differentially expressed genes in PM organic extracts were evaluated by using Metacore, and an enrichment analysis was performed to identify pathways maps, process networks, and disease by biomarkers altered after T47D treatment. The analysis of the modulated genes gave evidence for the involvement of PM in dysmetabolic diseases, including diabetes and obesity, and hypertension through the activation of the aryl hydrocarbon receptor (AhR) canonical pathway. On the basis of current knowledge, existing data, and ex-ploratory experimental evidence, we tease out the likely molecular interplay that can ultimately tip the disease outcome into severity. Looking beyond ACE2, several additional key markers are identified. Disruption of these targets worsens pre-existing conditions and/or exacerbates the adverse effects induced by SARS-CoV-2 infection. Whilst appropriate-ly designed, epidemiological studies are very much needed to investigate these associations based on our hypothesis of investigation, by reviewing recent experimental and epide-miological evidence, here we speculate and provide new insights on the possible role of environmental pollution in the exacerbation of effects by SARS-CoV-2 and other respiratory viruses. This work is intended to assist in the development of appropriate investigative approaches to protect public health.

Original languageEnglish
Pages (from-to)169-182
Number of pages14
JournalEpidemiologia e Prevenzione
Issue number5-6
Publication statusPublished - 1 Sept 2020

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© 2020, Inferenze Scarl. All rights reserved.


  • COVID-19
  • Diabetes
  • Hypertension
  • Inflammation
  • Obesity
  • Particulate matter
  • SARS-CoV-2


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