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We aimed to study the role of plasma fluorescent oxidation products levels (FlOPs; an oxidative stress-related biomarker), as potential mediators, in the associations between outdoor air pollution and persistent asthma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Analyses were conducted in 204 adult asthmatics followed up in the French case-control and family study on asthma (EGEA; the Epidemiological study of the Genetic and Environmental factors of Asthma). Persistent asthma was defined as having current asthma at EGEA2 (baseline, 2003\u20132007) and EGEA3 (follow-up, 2011\u20132013). Exposures to nitrogen dioxide, nitrogen oxides, road traffic, particulate matter with a diameter\u2009\u2264\u200910\u2009\u03bcm (PM<jats:sub>10<\/jats:sub>) and\u2009\u2264\u20092.5\u2009\u03bcm were estimated by ESCAPE models (2009\u20132010), and ozone (O<jats:sub>3<\/jats:sub>) by IFEN models (2004). We used a mediation analysis to assess the mediated effect by FlOPs levels and the interaction between FlOPs levels and air pollution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>FlOPs levels increased with PM<jats:sub>10<\/jats:sub>and O<jats:sub>3<\/jats:sub>(adjusted \u03b2\u2009=\u20090.04 (95%CI 0.001\u20130.08), a\u03b2\u2009=\u20090.04 (95%CI 0.009\u20130.07) per 10\u2009\u03bcg\/m<jats:sup>3<\/jats:sup>, respectively), and the risk of persistent asthma increased with FlOPs levels (aOR\u2009=\u00a01.81 (95%CI 1.08\u20133.02)). The risk of persistent asthma decreased with exposures to NO<jats:sub>2<\/jats:sub>, NOx and PM<jats:sub>2.5<\/jats:sub>(aOR ranging from 0.62 to 0.94), and increased with exposures to PM<jats:sub>10<\/jats:sub>, O<jats:sub>3<\/jats:sub>, O<jats:sub>3-summer<\/jats:sub>and road traffic, the greater effect being observed for O<jats:sub>3<\/jats:sub>(aOR\u2009=\u20091.78, 95% CI 0.73\u20134.37, per 10\u2009\u03bcg\/m<jats:sup>3<\/jats:sup>). Using mediation analysis, we observed a positive total effect (aOR\u2009=\u20092.16, 95%CI 0.70\u201311.9), a positive direct effect of O<jats:sub>3<\/jats:sub>on persistent asthma (OR\u2009=\u20091.68, 95%CI 0.57\u20137.25), and a positive indirect effect mediated by FIOPs levels (aOR\u2009=\u20091.28 (95%CI 1.01\u20132.29)) accounting for 41% of the total effect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results add insights on the role of oxidative stress in the association between air pollution and persistent asthma.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12940-019-0532-0","type":"journal-article","created":{"date-parts":[[2019,10,30]],"date-time":"2019-10-30T20:44:07Z","timestamp":1572468247000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Does the oxidative stress play a role in the associations between outdoor air pollution and persistent asthma in adults? 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