Ozone exposure leads to changes in airway permeability, microbiota and metabolome: a randomised, double-blind, crossover trial.

The associations between atmospheric ozone pollution and increased risks of respiratory diseases have been well established [1, 2], but the underlying biological mechanisms are yet fully ascertained. Lung epithelial cells may be injured by inhaled ozone, but the results were not fully consistent [3, 4]. Furthermore, respiratory microbiota and metabolic homeostasis were deemed as key factors in maintaining human respiratory health, and any disturbances in this balance have the potential to increase the susceptibility to respiratory infectious diseases [5]. However, few human studies have investigated the potential effects of ozone inhalation on respiratory microbiota and metabolome. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflict of interest: Dr. Niu has nothing to disclose. Conflict of interest: Dr. Chen has nothing to disclose. Conflict of interest: Dr. Wang has nothing to disclose. Conflict of interest: Mr. Wang has nothing to disclose. Conflict of interest: Dr. Jiang has nothing to disclose. Conflict of interest: Dr. Wu has nothing to disclose. Conflict of interest: Dr. Cai has nothing to disclose. Conflict of interest: Dr. Zhao has nothing to disclose. Conflict of interest: Dr. Xu has nothing to disclose. Conflict of interest: Dr. Kan has nothing to disclose.