A NEW international study reveals that exposure to air pollution and socioeconomic disadvantage can accelerate biological ageing in patients with fibrotic interstitial lung disease (fILD), significantly worsening their prognosis.
Researchers from the University of Pittsburgh and the University of British Columbia analysed data from 476 patients with fILD to assess how environmental and social stressors affect epigenetic ageing, a marker of cellular ageing measured by DNA methylation patterns. They estimated long-term exposure to fine particulate matter (PM2.5) using satellite-derived models and assessed neighbourhood disadvantage using census-based indices in the USA and Canada. They then compared patients’ epigenetic age to their actual age, calculating the epigenetic age difference (EAD), and investigated its impact on transplant-free survival.
Strikingly, patients with fILD had a median epigenetic age >11 years older than their chronological age. In the combined analysis, each interquartile range (IQR) increase in PM2.5 exposure corresponded to an average EAD increase of 2.88 years (95% CI: 1.39–4.38; p<0.001). Among Pittsburgh patients, higher neighbourhood disadvantage was associated with a 1.16-year increase in EAD per IQR (95% CI: 0.22–2.09; p=0.02). Most importantly, greater EAD predicted significantly worse transplant-free survival, with each additional year of accelerated ageing raising the hazard of death or transplant by 17% (HR: 1.17, 95% CI: 1.10–1.24; p<0.001). Mediation analysis revealed that EAD explained 40% of the effect of PM2.5 and 59% of the effect of neighbourhood disadvantage on survival.
This is one of the first studies to show that environmental and social exposures influence disease prognosis through measurable acceleration of biological ageing. It also found that epigenetic age was a better predictor of survival than actual age in people with fILD. Mitigating environmental exposures and addressing health disparities may help improve outcomes in fILD. Measuring epigenetic age may also offer a powerful new tool to assess disease risk and progression in vulnerable populations.
Reference
Goobie GC et al. Accelerated epigenetic ageing worsens survival and mediates environmental stressors in fibrotic interstitial lung disease. Eur Respir J. 2025;65(6):2401618.
