Exposure to pollution is a worldwide societal challenge participating in the etiology and progression of different diseases. However, the scarce information hinders our understanding of the actual level of human exposure and its specific effects. Inadequate and excessive immune responses underlie diverse chronic diseases. Yet, it is unclear which and how toxicant exposures affect the immune system functions. There is a multiplicity of immunological outcomes and biomarkers being studied in human trials related to exposure to different toxicants but still without clear evidence of their value as biomarkers of exposure or effect.

The main aim of this study was to collect scientific evidence and identify relevant immunological biomarkers used at the clinical level for toxicant exposures. We used the platform clinical trials.gov as a database tool. First, we performed a search combining research items related to toxicants and immunological parameters. The resulting117 clinical trials were examined for immune-related outcomes and specific biomarkers evaluated in subjects exposed to occupational and environmental toxicants. After categorization, relevant immunological outcomes and biomarkers were identified related to systemic and airway inflammation, modulation of immune cells, allergy and autoimmunity. In general, the immune markers related to inflammation are more frequently investigated for exposure to pollutants, namely IL-6, C-reactive protein (CRP) and nitric oxide (NO). Nevertheless, the data also indicated that prospective biomarkers of effect are gaining ground and a guiding representation of the established and novel biomarkers is suggested for upcoming trials. Finally, potential protective strategies to mitigate the adverse effects of specific toxicants are underlined for future studies.

暴露于污染是参与不同疾病的病因和进展的世界性社会挑战。然而，稀缺的信息阻碍了我们对人类暴露的实际水平及其具体影响的理解。免疫反应不足和过度是多种慢性疾病的基础。然而，尚不清楚毒物暴露会影响免疫系统功能以及如何影响免疫系统功能。在人体试验中正在研究多种与暴露于不同毒物相关的免疫学结果和生物标志物，但仍然没有明确的证据表明它们作为暴露或效应的生物标志物的价值。

本研究的主要目的是收集科学证据并确定在临床水平上用于毒物暴露的相关免疫生物标志物。我们使用平台临床试验.gov 作为数据库工具。首先，我们结合与毒物和免疫学参数相关的研究项目进行了搜索。结果 117 临床试验检查了与暴露于职业和环境毒物的受试者的免疫相关结果和特定生物标志物。分类后，确定了与全身和气道炎症、免疫细胞调节、过敏和自身免疫相关的相关免疫结果和生物标志物。一般来说，与炎症相关的免疫标志物更频繁地被研究用于暴露于污染物，即 IL-6、C 反应蛋白 (CRP) 和一氧化氮 (NO)。尽管如此，数据还表明，具有前瞻性的生物标志物正在取得进展，并且建议为即将进行的试验提供已建立和新型生物标志物的指导性代表。最后，为未来的研究强调了减轻特定毒物不利影响的潜在保护策略。