Inhalation of particulate matter (PM) from fossil fuel combustion is associated with adverse health effects, including reduced lung function (
1) and increased mortality (
2). Although the mechanism for PM-induced health effects is not fully defined, animal models and in vitro studies suggest that pro-inflammatory cytokine release from airway cells is an important factor (
3). Inflammation may play a role in the etiology of lung cancer. Environmental agents associated with elevated lung cancer risk, such as ambient particulate matter, may damage the lung by inducing chronic inflammation. Lung cancer risk is elevated in individuals with emphysema (
4,
5), interstitial lung disease (
6), and asthma (
7), which could similarly reflect effects of the underlying inflammatory disorders.
Induction of pro-inflammatory mediators by alveolar macrophages exposed to ambient air particulate matter has been suggested to be a key factor in the pathogenesis of inflammatory and diseases in the lungs. However, receptors and mechanisms underlying these responses have not been fully elucidated. Different contributing physiological and psychosocial factors have been proposed (
8). A few prior studies have examined lung cancer risk in relation to polymorphisms in the genes coding for inflammation pathway signaling molecules, such as Interleukin 1β (IL-1β) (
9-
11), IL-1 receptor antagonist (IL-1RN) (
12,
13), IL-6 (
10,
14), IL-10 (
15), cyclooxygenase 2 (
14), and tumor necrosis factor-α (
16). These inflammatory cytokines are regulated by the pro-inflammatory transcription factor, nuclear factor NF-κB (
8).
Given the close interaction between the external environment and the lung, TLRs have been implicated in lung-associated immune responses, including airway hyper responsiveness (AHR) and allergic asthma (
17). Dysfunction and unregulated activation of the TLR pathway can contribute to decreased lung function and the pathogenesis of acute and chronic lung inflammatory diseases (
18). TLR activation, can occur via two pathways: 1- the Myeloid Differentiation primary-response protein 88 (MyD88)-dependent pathway, and 2- the MyD88-independent pathway. These two pathways correspond to early and late-phase NF-κB signaling and pathway-specific induction of pro-inflammatory cytokines and chemokines (
19,
20). Inflammation play an important role in the etiology of lung cancer.
Regular aerobic exercise results in multiple health benefits, including improvement of cardiorespiratory fitness and quality of life, reduction of obesity and blood pressure, and increased longevity (
21,
22). When performed chronically on a regular basis, aerobic exercise also reduces oxidative stress systemically (
23) in different diseases, such as heart diseases, type 2 diabetes, rheumatic arthritis, and alzheimer and parkinson diseases (
23) , as well as in the airway epithelial cells of animals with long-term allergic lung inflammation (
24). Chronic practice of regular exercise exerts a marked anti-inflammatory effect in different models of pulmonary diseases, such as in asthma models (
25-
28), acute respiratory distress syndrome (
29,
30), and chronic obstructive pulmonary disease (
31).
Studies that have investigated the effects of exposure to air pollutants during exercise have suggested that people exercising in polluted environments are at increased risk of respiratory and cardiovascular morbidity related to air pollution owing to an exercise-induced amplification in respiratory uptake, lung deposition, and toxicity of inhaled pollutants (
32-
35). Exercise may increase the likelihood of an adverse effect by increasing the dose of pollutants delivered to target sites in the lungs as ventilation increases to meet metabolic demands (
36). However, these studies do not take into account the potential anti-inflammatory and health effects of exercising in air pollution (
37), which could inhibit the pro-inflammatory events induced by air pollution.