Health At risk As Climate Changes

The health risks of global climate change read like a chapter out of the Book of Revelation: plagues from mosquitoes and other insects; floods and droughts that cause sickness and mental anguish; food-borne scourges and malnutrition.

In a report released recently by federal scientists, led by the National Institute of Environmental Health Sciences in Research Triangle Park, the wide-reaching health problems associated with climate change were laid out to help government officials decide where they should spend research dollars.

Christopher Portier, lead author of the study and a mathematical statistician at the NIEHS, said the magnitude of the health problems, some of which are already occurring, requires unified approach among the nation’s health agencies. The National Institutes of Health, the Environmental Protection Agency and the Centers for Disease Control and Prevention, among others, are leading the way.

“Everybody understands about malaria moving north and dengue fever moving north, and that is getting support. But other things like cancer and mental health – those have received less attention,” Portier said.

Most of the world’s scientists consider climate change a man-made phenomenon, Portier said. Evidence indicates it is caused by industrial pollutants, including carbon dioxide and other gas emissions from power plants, factories and vehicles, which trap heat in the atmosphere to alter normal climate patterns.

Some scientists and members of the public have questioned the phenomenon, but Portier said debate now principally centers on the magnitude of events and how soon they might occur.

“That the Earth’s climate is changing is not really a debate in the scientific community, it’s more a debate in the popular press,” Portier said.

Cost of inaction

Other scientists not involved in the study agreed and noted that failing to plan for the inevitable health consequences would be both harmful and expensive.

“What is not well understood by many people is that there is this economic connection between what we do or don’t do now, and how these things will play out in the future,” said Randall Kramer, a professor of environmental economics at Duke University. “There are economic and health consequences of the many different paths we might take.”

Hurricane Katrina provided a lesson about the costly health problems climate change might inflict, Portier said. Although it’s not clear the disaster was related to climate change, it has served as a model for the scope of catastrophic storms that scientists anticipate will increase as the planet warms.

Among the immediate problems were injuries, flood-related diseases and infections. But depression and mental trauma were also major concerns as people were uprooted from their homes for months, even years, he said. Understanding how to treat and ease such issues will be important.

“Extreme weather events create tremendous stress,” Portier said. “If we see more extreme weather events – flooding, hurricanes, tornadoes – we need to understand what effects those have on populations and at least try to reduce them.”

Among other issues are crop disruptions that could result in food shortages, challenges to keeping food fresh and free of disease-causing bugs, and new exposures to cancer-causing toxins.

Spread of disease

Some health problems associated with climate change are already becoming evident, the NIEHS report says. The geographic range of viral, bacterial and fungal infections is shifting, for example, as pathogens now find fertile ground in once inhospitable regions.

West Nile virus, Lyme disease and malaria are all carried by insects that have moved into new territories. Just recently, scientists have questioned whether warming trends in the Pacific Northwest might be responsible for cases of a deadly airborne fungus that has spread into Washington and Oregon.

“Let’s be clear – climate change is not going to cause any new diseases,” Portier said. “It’s simply going to alter the frequency of disease in the population. All of these things are already there. In some cases it will lower disease rates, and in other cases it will raise them. The problem is, we aren’t sure yet. The linkage between climate change and health needs more research.” By Sarah Avery, The News & Observer

Purple Periwinkles Battle Inflammatory Diseases

A widely and safely used plant extract acts as a novel anti-inflammatory agent that may one day be used for the treatment of chronic obstructive pulmonary disease, or COPD, as well as other inflammatory conditions. There is an urgent need for new therapies for the treatment of chronic inflammatory diseases, such as COPD, otitis media (ear infection), and atherosclerosis (chronic inflammation in the walls of arteries), because the most effective and commonly used agents – steroids – often cause serious side effects, such as liver damage, which prevent long-term use.

In a study published today in the Proceedings of the National Academy of Sciences, researchers at the University of Rochester Medical Center were the first to find that vinpocetine, a natural product derived from the periwinkle plant, acts as a potent anti-inflammatory agent when tested in a mouse model of lung inflammation, as well as several other types of human cells. Results of the study show that vinpocetine greatly reduces inflammation, and, unlike steroids, does not cause severe side effects.

“What is extremely exciting and promising about these findings is vinpocetine’s excellent safety profile,” said Chen Yan, Ph.D., associate professor within the Aab Cardiovascular Research Institute at the Medical Center and a senior author of the study. “Previously, most drugs tested in this area have failed, not because of a lack of efficacy, but because of safety issues. We’re very encouraged by these results and believe vinpocetine has great potential for the treatment of COPD and other inflammatory diseases.”

Vinpocetine is a well-known natural product that was originally discovered nearly 30 years ago and is currently used as a dietary supplement for the prevention and treatment of cognitive disorders, such as stroke and memory loss, in Europe, Japan and China. The therapy has no evidence of toxicity or noticeable side effects in human patients. Scientists at the University of Rochester hope to reposition this compound as an anti-inflammatory agent for the treatment of COPD, and potentially other inflammatory conditions, such as asthma, otitis media, rheumatoid arthritis, atherosclerosis and psoriasis in the future.

While steroids successfully combat inflammation, patients often pay a high price when it comes to side effects. Steroids can cause liver damage, and can also suppress the immune system, increasing the likelihood of infections. With such a high risk profile, steroids are usually only used for a short period of time, which is problematic when treating chronic diseases.

“In managing chronic conditions such as COPD, it is crucial to have a therapy that can be used safely over the long term,” said Jian-Dong Li, M.D., Ph.D., professor in the Department of Microbiology and Immunology at the University of Rochester Medical Center and a senior author of the study. “There is a great need for a drug like vinpocetine, because patients currently have no good options when it comes to long-term care.”

Vinpocetine decreases inflammation by targeting the activity of a specific enzyme, known as IKK. IKK is responsible for regulating inflammation, and does so through the activation of a key protein, nuclear-factor kappaB (NF-κB). By directly inhibiting IKK, vinpocetine is able to switch off NF-κB, which normally produces pro-inflammatory molecules that cause inflammation. Halting the activity of NF-κB ultimately reduces inflammation.

“Inflammation is a hallmark of a wide range of human diseases, so there is great potential for vinpocetine to be used for several indications,” said Bradford C. Berk, M.D., Ph.D., CEO of the University of Rochester Medical Center and co-author of the study. “Given vinpocetine’s efficacy and solid safety profile, we believe there is great potential to bring this drug to market.”

Repositioning a therapy – taking a known compound that has been used safely in humans and testing it for a new application – can be an effective way to bring new therapies to market more quickly than starting the discovery process from scratch.

Inflammatory diseases are a major cause of illness worldwide. For example, chronic obstructive pulmonary disease is the fourth leading cause of death in the United States. In people with COPD, airflow is blocked due to chronic bronchitis or emphysema, making it increasingly difficult to breathe. Most COPD is caused by long-term smoking, although genetics may play a role as well. Approximately 13.5 million people in the United States are diagnosed with COPD each year, and in 2004 the annual cost of the disease was $37.2 billion. PhysOrg

Obesity Associated With Increased Risk Of Fibromyalgia

Researchers at the Norwegian University of Science and Technology have found an association between the level of leisure time physical exercise and a future risk of developing fibromyalgia. The research team also identified BMI as an independent risk factor for fibromyalgia. Details of the study appear in the May issue of Arthritis Care & Research, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology.

Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread pain lasting more than 3 months, and tender point sites in the neck, shoulders, back, hips, arms, and legs. Associated features often include unexplained fatigue, sleep disturbances, headache, cognitive difficulty, and mood disturbances. The prevalence of FM increases with age and is considerably higher among women than men. Although the etiology of FM is poorly understood, many authors have suggested that a dysfunctional autonomic nervous system involving deficiencies in the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system contributes to the development of FM by altering pain perception and endogenous pain inhibition.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, FM has been linked to stressful or traumatic events, such as car accidents, repetitive injuries, illness, certain diseases, or FM can occur spontaneously. Some scientists speculate that a gene or genes might be involved in fibromyalgia that could make a person react strongly to things that other people would not find painful.

Longitudinal studies have shown that physical exercise is associated with less musculoskeletal pain and stiff or painful joints among aging women. The Norwegian researchers, led by Paul Mork, D.Phil., proposed that first, there is an association between levels of leisure time physical exercise and future risk of FM and, second, being overweight/obese may represent an independent risk factor for future development of FM. Data for the study was collected from the Nord-Trøndelag Health (HUNT) Study, the first part conducted in 1984 (HUNT 1) and the second in 1995 (HUNT 2). During the 11 years between HUNT 1 and HUNT 2, 380 cases of incident FM were reported among 15,990 women who provided information on relevant variables at both surveys and who reported no FM or physical impairment at HUNT 1.

“Women who reported exercising 4 times per week had a 29% lower risk of FM compared with inactive women,” says Dr. Mork. “Similar results were found in the analysis of the summary score combining information on frequency, duration, and intensity of exercise; women with the highest exercise level had a somewhat lower risk than inactive women. The study further shows that a high BMI (i.e., being overweight or obese) is a strong and independent risk factor for future development of FM. Moreover, the higher relative risks for the combined effect of being overweight/obese and inactive, relative to being overweight/obese alone, point to a further disadvantage for overweight women who do not exercise.”

While the causal relationship between obesity and FM remains unknown, there are some etiologic factors in common. Studies suggest that proinflammatory cytokines play a role in FM and the relationship between FM and obesity. Other studies point to dysregulation of the HPA axis, which has been observed in both FM and obesity. Finally, increased sympathetic tonus and reduced sympathetic reactivity, as recorded by heart rate variability, has been observed in patients with FM as well as in overweight and obese subjects. Dr. Mork concludes, “These findings, together with the current study, indicate that regular physical exercise, and thereby improved physical fitness, may serve as a buffer against the perpetuation of musculoskeletal symptoms that eventually lead to the development of FM.” PhysOrg