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Mechanisms of air pollution-mediated cardio-metabolic disease Although the explanation of the mechanisms underlying the systemic CV risk mediated by air pollution is still developing, there are six fundamental subordinates effector pathways: Endothelial barrier dysfunction, distinctive and adaptive immune constituents in inflammation, prothrombotic mechanisms, autonomic inequity favoring sympathetic tone via afferent passageways in the upper airways and lungs, stimulation of the hypothalamicpituitaryadrenal (HPA) axis by the central nervous system, changes in epigenomic expression, and endothelial barrier dysfunction are just a few of the symptoms