A unifying model to estimate the effect of heat stress in the human innate immunity during physical activities

The Impact of Climate Change on Immunity and Gut Microbiota in the Development of Disease

According to the definition provided by the United Nations, "climate change" describes the persistent alterations in temperatures and weather trends. These alterations may arise naturally, such as fluctuations in the solar cycle. Nonetheless, since the 19th century, human activities have emerged as the primary agent for climate change, primarily attributed to the combustion of fossil fuels such as coal, oil, and gas. Climate change can potentially influence the well-being, agricultural production, housing, safety, and employment opportunities for all individuals. The immune system is an important interface through which global climate change affects human health. Extreme heat, weather events and environmental pollutants could impair both innate and adaptive immune responses, promoting inflammation and genomic instability, and increasing the risk of autoimmune and chronic inflammatory diseases. Moreover, climate change has an impact on both soil and gut microbiome composition, which can further explain changes in human health outcomes. This narrative review aims to explore the influence of climate change on human health and disease, focusing specifically on its effects on the immune system and gut microbiota. Understanding how these factors contribute to the development of physical and mental illness may allow for the design of strategies aimed at reducing the negative impact of climate and pollution on human health.

Heat-Related Mortality in the Extreme Summer of 2022

BACKGROUND

Estimating the excess mortality attributable to heat is a central element of the documentation of the consequences of climate change for human health. Until now, estimates of heatrelated deaths in Germany by the Robert Koch Institute (RKI) have been based on weekly mortality records.

METHODS

Our study is the first to use higher resolution data-i.e. daily all-cause mortality linked to daily mean temperatures-from each of the German federal states to assess the heat-related mortality from 2000 to 2023 in Germany, employing quasi-Poisson models and multivariate meta-regression analyses. We focus our analysis on the extreme summer of 2022.

RESULTS

Our analysis yielded an estimate of 9100 (95% CI: [7300; 10 700]) heat-related deaths in Germany for the summer of 2022, whereas previous studies of the RKI estimated the number of heatrelated deaths at 4500 [2100; 7000]. When we set a higher temperature threshold in the definition of the heat risk, we arrived at a figure of 6900 [5500; 8100] heat-related deaths in 2022. In other summers that-similarly to 2022-were characterized by large fluctuations in daily mean temperatures, we also robustly estimated higher numbers of heat-related deaths than the RKI did. The exclusion of reported deaths due to COVID-19 had only a minor effect on our estimates.

CONCLUSION

Our findings suggest that previous studies based on weekly mortality data have underestimated the full extent of heat-related mortality in Germany, particularly in the extreme summer of 2022. The monitoring of heat-related mortality should be systematic and as comprehensive as possible if it is to enable the development of effective heat-health action plans.

Elephantopus scaber L. Polysaccharides Alleviate Heat Stress-Induced Systemic Inflammation in Mice via Modulation of Characteristic Gut Microbiota and Metabolites

Elephantopus scaber L. (ESL) is a Chinese herb that is used both as a food and medicine, often being added to soups in summer in south China to relieve heat stress (HS), but its exact mechanism of action is unknown. In this study, heat-stressed mice were gavaged with ESL polysaccharides (ESLP) at 0, 150, 300, and 450 mg/kg/d-1 (n = 5) for seven days. The gut microbiota composition, short-chain fatty acids (SCFAs), seven neurotransmitters in faeces, expression of intestinal epithelial tight junction (TJ) proteins (Claudin-1, Occludin), and serum inflammatory cytokines were measured. The low dose of ESLP (ESLL) improved the adverse physiological conditions; significantly reduced the cytokines (TNF-α, IL-1β, IL-6) and lipopolysaccharide (LPS) levels (p < 0.05); upregulated the expression of Claudin-1; restored the gut microbiota composition including Achromobacter and Oscillospira, which were at similar levels to those in the normal control group; significantly increased beneficial SCFAs like butyric acid and 5-HT levels in the faeces of heat-stressed mice; and significantly decreased the valeric acid and glutamic acid level. The level of inflammatory markers significantly correlated with the above-mentioned indicators (p < 0.05). Thus, ESLL reduced the HS-induced systemic inflammation by optimizing gut microbiota (Achromobacter, Oscillospira) abundance, increasing gut beneficial SCFAs like butyric acid and 5-HT levels, and reducing gut valeric and glutamic acid levels.

Spatiotemporal effects of meteorological conditions on global influenza peaks

BACKGROUND

Numerous studies have suggested that meteorological conditions such as temperature and absolute humidity are highly indicative of influenza outbreaks. However, the explanatory power of meteorological factors on the seasonal influenza peaks varied widely between countries at different latitudes.

OBJECTIVES

We aimed to explore the modification effects of meteorological factors on the seasonal influenza peaks in multi-countries.

METHODS

Data on influenza positive rate (IPR) were collected across 57 countries and data on meteorological factors were collected from ECMWF Reanalysis v5 (ERA5). We used linear regression and generalized additive models to investigate the spatiotemporal associations between meteorological conditions and influenza peaks in cold and warm seasons.

RESULTS

Influenza peaks were significantly correlated with months with both lower and higher temperatures. In temperate countries, the average intensity of cold season peaks was stronger than that of warm season peaks. However, the average intensity of warm season peaks was stronfger than of cold season peaks in tropical countries. Temperature and specific humidity had synergistic effects on influenza peaks at different latitudes, stronger in temperate countries (cold season: R2=0.90; warm season: R2=0.84) and weaker in tropical countries (cold season: R2=0.64; warm season: R2=0.03). Furthermore, the effects could be divided into cold-dry and warm-humid modes. The temperature transition threshold between the two modes was 16.5-19.5 °C. During the transition from cold-dry mode to warm-humid mode, the average 2 m specific humidity increased by 2.15 times, illustrating that transporting a large amount of water vapor may compensate for the negative effect of rising temperatures on the spread of the influenza virus.

CONCLUSION

Differences in the global influenza peaks were related to the synergistic influence of temperature and specific humidity. The global influenza peaks could be divided into cold-dry and warm-humid modes, and specific thresholds of meteorological conditions were needed for the transition of the two modes.

The footprint of human-induced climate change on heat-related deaths in the summer of 2022 in Switzerland

Human-induced climate change is leading to an increase in the intensity and frequency of extreme weather events, which are severely affecting the health of the population. The exceptional heat during the summer of 2022 in Europe is an example, with record-breaking temperatures only below the infamous 2003 summer. High ambient temperatures are associated with many health outcomes, including premature mortality. However, there is limited quantitative evidence on the contribution of anthropogenic activities to the substantial heat-related mortality observed in recent times. Here we combined methods in climate epidemiology and attribution to quantify the heat-related mortality burden attributed to human-induced climate change in Switzerland during the summer of 2022. We first estimated heat-mortality association in each canton and age/sex population between 1990 and 2017 in a two-stage time-series analysis. We then calculated the mortality attributed to heat in the summer of 2022 using observed mortality, and compared it with the hypothetical heat-related burden that would have occurred in absence of human-induced climate change. This counterfactual scenario was derived by regressing the Swiss average temperature against global mean temperature in both observations and CMIP6 models. We estimate 623 deaths [95% empirical confidence interval (95% eCI): 151-1068] due to heat between June and August 2022, corresponding to 3.5% of all-cause mortality. More importantly, we find that 60% of this burden (370 deaths [95% eCI: 133-644]) could have been avoided in absence of human-induced climate change. Older women were affected the most, as well as populations in western and southern Switzerland and more urbanized areas. Our findings demonstrate that human-induced climate change was a relevant driver of the exceptional excess health burden observed in the 2022 summer in Switzerland.

Cyanobacterial Harmful Algal Bloom Toxin Microcystin and Increased Vibrio Occurrence as Climate-Change-Induced Biological Co-Stressors: Exposure and Disease Outcomes via Their Interaction with Gut-Liver-Brain Axis

The effects of global warming are not limited to rising global temperatures and have set in motion a complex chain of events contributing to climate change. A consequence of global warming and the resultant climate change is the rise in cyanobacterial harmful algal blooms (cyano-HABs) across the world, which pose a threat to public health, aquatic biodiversity, and the livelihood of communities that depend on these water systems, such as farmers and fishers. An increase in cyano-HABs and their intensity is associated with an increase in the leakage of cyanotoxins. Microcystins (MCs) are hepatotoxins produced by some cyanobacterial species, and their organ toxicology has been extensively studied. Recent mouse studies suggest that MCs can induce gut resistome changes. Opportunistic pathogens such as Vibrios are abundantly found in the same habitat as phytoplankton, such as cyanobacteria. Further, MCs can complicate human disorders such as heat stress, cardiovascular diseases, type II diabetes, and non-alcoholic fatty liver disease. Firstly, this review describes how climate change mediates the rise in cyanobacterial harmful algal blooms in freshwater, causing increased levels of MCs. In the later sections, we aim to untangle the ways in which MCs can impact various public health concerns, either solely or in combination with other factors resulting from climate change. In conclusion, this review helps researchers understand the multiple challenges brought forth by a changing climate and the complex relationships between microcystin, Vibrios, and various environmental factors and their effect on human health and disease.

Short-term effect of ambient temperature and ambient temperature changes on the risk of warts outpatient visits in Hefei, China: a retrospective time-series study

Concerns are growing about the adverse health effects of ambient temperature and ambient temperature changes. However, the association between ambient temperature and ambient temperature changes on the risk of warts outpatient visits is poorly understood. Our study used the distributed lag non-linear model (DLNM) aimed to evaluate the association between ambient temperature, ambient temperature changes (including temperature change between neighboring days (TCN) and diurnal temperature range (DTR)), and warts outpatient visits. We also performed subgroup analyses in order to find susceptible populations by gender and age groups. The maximum relative risk (RR) of low ambient temperature (0 °C) for warts outpatient visits was 1.117 (95% CI: 1.041-1.198, lag 04 days), and the maximum RR of high ambient temperature (32 °C) for warts outpatient visits was 1.318 (95% CI: 1.083-1.605, lag 07 days). The large temperature drop (TCN =  - 3 °C) decreased the risk of warts visits, with the lowest RR value at the cumulative exposure of lag 7 days (RR = 0.888, 95% CI: 0.822-0.959), and the large temperature rise (TCN = 2 °C) increased the risk of warts visits, with the highest RR value at the cumulative exposure of lag 7 days (RR = 1.080, 95% CI: 1.022-1.142). Overall, both low and high ambient temperatures and large temperature rise can increase the risk of warts visits, while large temperature drop is a protective factor for warts visits. However, we did not find any association between DTR and warts visits. Furthermore, subgroup analyses showed that males and the young (0-17 years old) were more sensitive to low and high ambient temperatures, and the elderly (≥ 65 years old) were more susceptible to TCN. The results may provide valuable evidence for reducing the disease burden of warts in the future.

Extreme Heat and COVID-19: A Dual Burden for Farmworkers

Currently, there is an extensive literature examining heat impacts on labor productivity and health, as well as a recent surge in research around COVID-19. However, to our knowledge, no research to date examines the dual burden of COVID-19 and extreme heat on labor productivity and laborers' health and livelihoods. To close this research gap and shed light on a critical health and livelihood issue affecting a vulnerable population, we urge researchers to study the two topics in tandem. Because farmworkers have a high incidence of COVID-19 infections and a low rate of inoculation, they will be among those who suffer most from this dual burden. In this article, we discuss impacts from extreme heat and COVID-19 on farm laborers. We provide examples from the literature and a conceptual framework showing the bi-directional nature of heat impacts on COVID-19 and vice versa. We conclude with questions for further research and with specific policy recommendations to alleviate this dual burden. If implemented, these policies would enhance the wellbeing of farmworkers through improved unemployment benefits, updated regulations, and consistent implementation of outdoor labor regulations. Additionally, policies for farmworker-related health needs and cultural aspects of policy implementation and farmworker outreach are needed. These and related policies could potentially reduce the dual burden of COVID-19 and extreme heat impacts while future research explores their relative cost-effectiveness.

Effects of heat stress on cyto(chemo)kine and inflammasome gene expression and mechanical properties in isolated red and white blood cells from 4 commercial broiler lines and their ancestor jungle fowl

Commercial broilers have been selected for high growth rate and productivity; however, this has negatively impacted their susceptibility to heat stress (HS). Insight into the molecular mechanisms underlying this vulnerability can help design targeted strategies for improvement of HS tolerance. Red blood cells (RBC) and white blood cells (WBC) were isolated from red jungle fowl and 4 lines of commercial modern broilers. Lines A and B are considered standard-yielding lines, whereas Lines C and D are high-yielding. Cells were cultured at either 37°C or 45°C for 2 h to induce heat stress (HS). Gene expression of cytokines, chemokines, and inflammasome components were measured. Heat shock proteins 27 and 70 (HSPs) in RBC were significantly affected by line (P < 0.05), whereas HSP27 and 60 were affected by temperature (P < 0.05). In WBC, there was a significant line effect on HSP gene expression (P < 0.05), and a significant increase (P < 0.05) in HSP90 in Line D in HS compared to TN conditions. In RBC, there was a main effect of HS on TNFα, CCL4, and CCLL4 (P < 0.05). HS significantly increased IL-8L1 (>30-fold, P < 0.0001) in Line C. Inflammasome genes (NLRP3, NLRC5 and NLRC3) were significantly affected by the line studied (P < 0.05). In WBC, the effect of line was significant for all cytokines, chemokines, and inflammasome components studied (P < 0.05). To examine the mechanical properties of isolated RBC from the 4 commercial lines and jungle fowl, RBC were placed into nematic liquid crystals, where Lines B and D were the most strained, and Line A and the jungle fowl were the least strained. Together, these findings indicate not only the dynamic nature of circulating cells, but the differences in the stress and inflammatory response among commercially available lines and their common ancestor. These profiles have the potential to serve as a future marker for stress responses in broilers, though further study is warranted.