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We therefore determined the associations between exposure to multiple air pollutants and both immunological outcomes (methylation and protein expression of immune cell types associated with immune regulation) and cardiovascular outcomes (blood pressure) in a cohort of school-aged children (6\u20138\u00a0years; n\u2009=\u2009221) living in a city with known elevated pollution levels. Exposure to fine particular matter (PM<jats:sub>2.5<\/jats:sub>), carbon monoxide (CO), and ozone (O<jats:sub>3<\/jats:sub>) was linked to altered methylation of most CpG sites for genes Foxp3, IL-4, IL-10 and IFN-g, all involved in immune regulation (e.g. higher PM<jats:sub>2.5<\/jats:sub> exposure 1\u00a0month prior to the study visit was independently associated with methylation of the IL-4 CpG24 site (est\u2009=\u20090.16; <jats:italic>P<\/jats:italic>\u2009=\u20090.0095). Also, immune T helper cell types (Th1, Th2 and Th17) were associated with short-term exposure to PM<jats:sub>2.5<\/jats:sub>, O<jats:sub>3<\/jats:sub> and CO (e.g. Th1 cells associated with PM<jats:sub>2.5<\/jats:sub> at 30\u00a0days: est\u2009=\u2009\u2212\u00a00.34, P\u2009&lt;\u20090.0001). Both B cells (est\u2009=\u2009\u2212\u00a00.19) and CD4+ cells (est\u2009=\u20090.16) were associated with 1\u00a0day NO2 exposure (P\u2009\u2264\u20090.031), whereas CD4+ and CD8+ cells were associated with chronic exposure to PAH<jats:sub>456<\/jats:sub>, NOx and\/or NO<jats:sub>2<\/jats:sub> (<jats:italic>P<\/jats:italic>\u2009\u2264\u20090.038 for all). Finally, diastolic BP (DBP) was inversely associated with long-term exposures to both CO and PAH<jats:sub>456<\/jats:sub>, and both systolic and pulse pressure were associated with short-term NO<jats:sub>2<\/jats:sub> and chronic NOx exposure. Our findings demonstrate links between air pollution exposure and methylation of immunoregulatory genes, immune cell profiles and blood pressure, suggesting that even at a young age, the immune and cardiovascular systems are negatively impacted by exposure to air pollution.<\/jats:p>","DOI":"10.1038\/s41598-021-83577-3","type":"journal-article","created":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T09:14:59Z","timestamp":1613812499000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":96,"title":["Air pollution exposure is linked with methylation of immunoregulatory genes, altered immune cell profiles, and increased blood pressure in children"],"prefix":"10.1038","volume":"11","author":[{"given":"Mary","family":"Prunicki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Cauwenberghs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoying","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hesam","family":"Movassagh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Noth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fred","family":"Lurmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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