Climate Change and Human Health: A Review of Allergies, Autoimmunity and the Microbiome

Inhalant Mediated Allergy: Immunobiology, Clinical Manifestations and Diagnosis

Inhalant allergen-mediated respiratory diseases, including asthma and allergic rhinitis, have become increasing global health issues. While air pollution is believed to favor allergic sensitization and intensify clinical symptoms of allergy, allergen sensitization can vary highly with geographical location, climate, and lifestyle differences. Pollen sensitization is higher in European countries, while dust mite is more common in regions with high humidity. Domestic pet sensitization is on the rising trend in industrialized nations, but the paradoxical effect of intensive cat exposure in early childhood is also observed. Clinical management of inhalant allergic diseases has greatly benefited from the immunological and mechanistic understanding of pathophysiology. In this review, we discuss the current knowledge on inhalant mediated allergic disorders with emphasis on (1) the major immune cells and relevant chemokines and cytokines in the sensitization and effector phase with aeroallergen exposure, (2) their manifestation in asthma and allergic rhinitis, (3) characterization of inhalant allergens, (4) chemical contributions to the development of allergic diseases, and (5) clinical diagnosis of aeroallergen sensitization and management of inhalant allergy. Knowledge on the role of Th2 skewing, IgE, basophil, mast cells, and eosinophils in respiratory allergic diseases are fundamental in the diagnosis and management of these disorders. Skin test, basophil activation test, and specific IgE component-resolved diagnostics are used for diagnosis and facilitate further management. Advances in the development of biologics and allergen-specific immunotherapy will strategize the future approaches in the clinical care of respiratory allergic diseases.

Blood under pressure: how climate change threatens blood safety and supply chains

Climate change substantially threatens public health, including the blood supply chain, which is crucial for medical treatments such as surgeries, trauma care, and chronic disease management. Extreme weather events, vector-borne disease shifts, and temperature fluctuations can disrupt blood collection, testing, transport, and storage, threatening both the safety and sufficiency of blood products. Although studies have highlighted some connections between climate change, transfusion-transmissible infections, and blood safety, there remains a lack of comprehensive understanding of the climate effects on each supply chain stage. In this Personal View, we address the potential climate-driven challenges across the blood supply chain, from donor health to blood component stability, emphasising the importance of proactive measures. To protect the availability and safety of blood supplies in an evolving climate, further research and adaptive strategies are needed to build a resilient blood supply system that can withstand emerging climate-related disruptions.

Neurodevelopment and climate change

OBJECTIVE

This article aims to assess the impact of climate change, a reality already present on the neurodevelopment of both neurotypical and atypical children.

DATA SOURCES

A narrative review of the literature was carried out based on articles available in the PubMed database, published in the last five years using the keywords neurodevelopment and climate change, as well as websites of organizations dedicated to childhood such as UNICEF, the American Academy of Pediatrics and the Center for Developing Childhood at Harvard University.

SUMMARY OF FINDINGS

Children and adolescents are more directly affected by the effects of climate change due to their developmental stage and greater vulnerability. Prolonged exposure to air pollutants can affect brain development, resulting in cognitive and behavioral problems. Extreme weather events, such as floods, cyclones, and heat waves, can destroy essential infrastructure such as schools and hospitals, interrupting the educational process and access to health care. Changes in rainfall patterns and extreme droughts can affect food production, leading to malnutrition and food insecurity. Direct experience of natural disasters can cause stress and psychological trauma, affecting children's emotional and mental well-being.

CONCLUSIONS

Studies clearly demonstrate the potential impact of climate change on the neurodevelopment and mental health of children and adolescents. This topic should be part of the current agenda of pediatricians, not only treating the resulting illnesses but mainly acting on the front line and supporting proposals to attenuate the environmental disaster that has already occurred.

Waste and Greenhouse Gas Emissions Produced from Ophthalmic Surgeries: A Scoping Review

(1) Background: Healthcare is a major contributor to global greenhouse gas (GHG) emissions, especially within the surgical suite. Ophthalmologists play a role, since they frequently perform high-volume procedures, such as cataract surgery. This review aims to summarize the current literature on surgical waste and GHG emissions in ophthalmology and proposes a framework to standardize future studies. (2) Methods: Protocol and reporting methods were based on PRISMA guidelines for scoping reviews. Articles that reported any quantitative measurement of waste or GHGs produced from ophthalmic surgeries were eligible for inclusion. Commentaries, opinion papers, reviews and articles in a non-English language were excluded. (3) Results: A total of 713 articles were reviewed, with 10 articles found to meet inclusion criteria. Six studies produced level 3 evidence, two level 4 evidence, and one level 5 evidence. According to studies, most of the GHGs came from procurement of surgical materials, followed by travel emissions and building energy. (4) Conclusions: Research on waste and GHGs produced in ophthalmic surgery is limited, and existing studies utilize varied approaches to quantify this waste. We propose a standardized waste-lifecycle framework for researchers to organize future research. Such standardization will help in comparing studies and may uncover more opportunities to implement impactful waste reduction strategies in ophthalmology.

Impact of urban biodiversity and climate change on children's health and well being

In recent decades, biodiversity loss has greatly impacted planetary and human health. Children are at additional risk of adverse effects due to unique biological, developmental, and behavioral factors, as well as their longer exposure to an altered planet as a function of their young age. These effects are heightened for children living in vulnerable socioeconomic conditions. Here, we review the role of biodiversity loss on accelerating the consequences of climate change from the perspective of pediatric health. With the loss of biodiversity's protective role against the consequences of climate change, the adverse effects of the changing planet are impacting pediatric health. For example, trees provide shelter against heat waves, unsealed soil and wetlands mitigate flooding, and rewilded green space hosts high microbial richness and consequently supports immune and mental health. The effects of the loss of biodiversity may impact the discovery and development of novel pharmaceuticals and thus the future of children's medicine as a whole. We also highlight areas for further study and detail efforts that have been made to restore biodiversity, with the aim to improve the current and future health of local pediatric populations. IMPACT: Loss of biodiversity is occurring at a rapid pace affecting the health of the planet and disproportionately pediatric health. This paper describes the role of biodiversity loss in accelerating the impact of climate change on children's health, and highlights particularly vulnerable populations. This paper details steps that can be taken to maintain and restore biodiversity at the local and global levels to protect these populations and pediatric health in general.

[Position paper from the "Climate and Sustainability" working group in the German Society for Rehabilitation Sciences]

The "Climate and Sustainability" working group of the German Society for Rehabilitation Sciences was founded in March 2023. The members represent research, practice, and service providers in rehabilitation. The aim is to make rehabilitation in Germany sustainable and to focus on climate protection and the health consequences of climate change. Dealing with these issues should become the new social norm for all stakeholders in rehabilitation. Therefore, existing knowledge is used, and new findings are developed that are passed on directly to and support the quality-assured transformation in the facilities. The focus of current activities is on two fields of action: promoting climate protection through the ecological transformation of rehabilitation facilities and promoting climate resilience through further development of rehabilitation services and social medicine. Activities to date include specialist publications and research, statements and submissions, events, and training courses as well as dissemination, networking, and public relations work to establish sustainability concepts in rehabilitation.

Global change, climate change, and asthma in children: Direct and indirect effects - A WAO Pediatric Asthma Committee Report

The twenty-first century has seen a fundamental shift in disease epidemiology with anthropogenic environmental change emerging as the likely dominant factor affecting the distribution and severity of current and future human disease. This is especially true of allergic diseases and asthma with their intimate relationship with the natural environment. Climate change-related variables including increased ambient temperature, heat waves, extreme weather events, air pollution, and rainfall distribution, all can directly affect asthma in children, but each of these variables also indirectly affects asthma via alterations in pollen production and release, outdoor allergen exposure or the microbiome. Air pollution, with its many and varied respiratory consequences, is likely to have the greatest effect, as it has increased globally due to rapid increases in fossil fuel combustion, global population, crowding, and megacities, as well as forest burning and trees succumbing to an increasingly hostile environment. Human activities have also caused substantial deterioration of the global microbiome with reductions in biodiversity for molds, bacteria, and viruses. Reduced microbiome diversity has, in turn, been associated with increases in Th2 allergic responses and allergic disease. The collective effect of these changes has already shifted allergy and asthma disease patterns. Given that changes in climate have been relatively small to date, the unavoidable, much greater shifts in climate in the future are concerning. Determining the relative scale of the direct versus indirect effects of climate change variables is needed if effective avoidance and adaptive measures are to be implemented. This would also require much more basic, epidemiological, and clinical research to understand the causal mechanisms, the most relevant climate factors involved, the regions most affected and, most importantly, effective and actionable adaptation measures. We suggest that allergy and respiratory health workers should follow current guidance to reduce present risks related to climate change and watch for new recommendations to reduce future risks. Since the respiratory system is the one most affected by climate change, they also need to call for more research in this area and show strong leadership in advocating for urgent action to protect children by reducing or reversing factors that have led to our deteriorating climate.

The impact of increasing ambient temperature on allergic rhinitis: A systematic review and meta-analysis of observational studies

INTRODUCTION

Global warming appears to initiate and aggravate allergic respiratory conditions via interaction with numerous environmental factors. Temperature, commonly identified as a factor in climate change, is important in this process. Allergic rhinitis, a common respiratory allergy, is on the rise and affects approximately 500 million individuals worldwide. The increasing ambient temperature requires evaluation regarding its influence on allergic rhinitis, taking into account regional climate zones.

METHODS

A detailed search of PubMed, EMBASE, Scopus, Web of Science, MEDLINE, and CINAHL Plus databases, was conducted, encompassing observational studies published from 1991 to 2023. Original studies examining the relationship between increasing temperature and allergic rhinitis were assessed for eligibility followed by a risk of bias assessment. Random effects meta-analysis was utilized to measure the association between a 1 °C increase in temperature and allergic rhinitis-related outcomes.

RESULTS

20 studies were included in the qualitative synthesis, with nine of them subsequently selected for the quantitative synthesis. 20 included studies were rated as Level 4 evidence according to the Oxford Centre for Evidence-Based Medicine, and the majority of these reported good-quality evidence based on the Newcastle-Ottawa Quality Rating Scale. Using the Risk of Bias In Non-Randomized Studies of Exposure tool, the majority of studies exhibit a high risk of bias. Every 1 °C increase in temperature significantly raised the risk of allergic rhinitis-related outcomes by 29 % (RR = 1.26, 95 % CI: 1.11 to 1.50). Conversely, every 1 °C rise in temperature showed no significant increase in the odds of allergic rhinitis-related outcomes by 7 % (OR = 1.07, 95 % CI: 0.95 to 1.21). Subsequent subgroup analysis identified climate zone as an influential factor influencing this association.

CONCLUSION

It is inconclusive to definitively suggest a harmful effect of increasing temperature exposure on allergic rhinitis, due overall very low certainty of evidence. Further original research with better methodological quality is required.

Autoimmune Diseases Following Environmental Disasters: A Narrative Review of the Literature

Environmental disasters are extreme environmental processes such as earthquakes, volcanic eruptions, landslides, tsunamis, floods, cyclones, storms, wildfires and droughts that are the consequences of the climate crisis due to human intervention in the environment. Their effects on human health have alarmed the global scientific community. Among them, autoimmune diseases, a heterogeneous group of disorders, have increased dramatically in many parts of the world, likely as a result of changes in our exposure to environmental factors. However, only a limited number of studies have attempted to discover and analyze the complex association between environmental disasters and autoimmune diseases. This narrative review has therefore tried to fill this gap. First of all, the activation pathways of autoimmunity after environmental disasters have been analyzed. It has also been shown that wildfires, earthquakes, desert dust storms and volcanic eruptions may damage human health and induce autoimmune responses to inhaled PM2.5, mainly through oxidative stress pathways, increased pro-inflammatory cytokines and epithelial barrier damage. In addition, it has been shown that heat stress, in addition to increasing pro-inflammatory cytokines, may also disrupt the intestinal barrier, thereby increasing its permeability to toxins and pathogens or inducing epigenetic changes. In addition, toxic volcanic elements may accelerate the progressive destruction of myelin, which may potentially trigger multiple sclerosis. The complex and diverse mechanisms by which vector-borne, water-, food-, and rodent-borne diseases that often follow environmental diseases may also trigger autoimmune responses have also been described. In addition, the association between post-disaster stress and the onset or worsening of autoimmune disease has been demonstrated. Given all of the above, the rapid restoration of post-disaster health services to mitigate the flare-up of autoimmune conditions is critical.

Impact of temperature and relative humidity variability on children's allergic diseases and critical time window identification

BACKGROUND

The effects of temperature and relative humidity on different types of children's allergic diseases have not been comprehensively evaluated so far. This study aims to assess the impact of temperature and relative humidity variability on children's allergic diseases and to identify the critical time window.

METHODS

We collected outpatient data on allergen testing in children between July 2020 and January 2022 from the Affiliated Children's Hospital of Nanjing Medical University. We defined the 1st, 10th, 90th, and 99th percentiles as extreme cold, moderate cold, moderate hot, and extreme hot for temperature, and as low, moderate high, and extreme high for relative humidity, respectively. A distributed lag nonlinear model (DLNM) combined with a binomial regression model was used to assess the possible nonlinear relationship at different periods. Subgroup analysis by gender and age was conducted.

RESULTS

We found that extreme and moderate cold temperatures were positively associated with skin allergies and total allergies (28 days: OR = 4.69, 95% CI: 2.88, 7.63; OR = 3.36, 95% CI: 2.39, 4.73) and (28 days: OR = 3.76, CI: 2.43, 5.81; OR = 2.71, 95% CI: 2.00, 3.68), respectively. Moderate and extreme hot temperatures were negatively associated with food allergies (28 days: OR = 0.13, 95% CI: 0.04, 0.41 and OR = 0.04; 95% CI: 0.01, 0.27). Low relative humidity was negatively associated with respiratory allergies, skin allergies, and total allergic diseases (28 days: OR = 0.26, 95% CI: 0.10, 0.71; OR = 0.29, 95% CI: 0.15, 0.55; and OR = 0.42, 95% CI: 0.26, 0.68). Meanwhile, extreme high relative humidity was negatively associated with respiratory allergies, and positively associated with skin allergies, food allergies, and total allergies (28 days: OR = 0.16, 95%CI: 0.07, 0.37; OR = 3.60, 95% CI: 2.52, 5.14; OR = 15.61, 95% CI: 3.23, 75.56; and OR = 2.33, 95% CI: 1.73, 3.15). A stronger relationship between temperature, relative humidity, and allergic diseases was observed in children under 5 years, specifically girls.

CONCLUSIONS

Our study provides evidence that temperature and relative humidity variability may be associated with allergic diseases, however, the directionality of the relationship differs by allergic type.

Perspectives on the future of host-microbe biology from the Council on Microbial Sciences of the American Society for Microbiology

Host-microbe biology (HMB) stands on the cusp of redefinition, challenging conventional paradigms to instead embrace a more holistic understanding of the microbial sciences. The American Society for Microbiology (ASM) Council on Microbial Sciences hosted a virtual retreat in 2023 to identify the future of the HMB field and innovations needed to advance the microbial sciences. The retreat presentations and discussions collectively emphasized the interconnectedness of microbes and their profound influence on humans, animals, and environmental health, as well as the need to broaden perspectives to fully embrace the complexity of these interactions. To advance HMB research, microbial scientists would benefit from enhancing interdisciplinary and transdisciplinary research to utilize expertise in diverse fields, integrate different disciplines, and promote equity and accessibility within HMB. Data integration will be pivotal in shaping the future of HMB research by bringing together varied scientific perspectives, new and innovative techniques, and 'omics approaches. ASM can empower under-resourced groups with the goal of ensuring that the benefits of cutting-edge research reach every corner of the scientific community. Thus, ASM will be poised to steer HMB toward a future that champions inclusivity, innovation, and accessible scientific progress.

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.

Global, regional, and national levels and trends in burden of urticaria: A systematic analysis for the Global Burden of Disease study 2019

Background

Urticaria places a significant burden on individuals and society due to its widespread nature. The aim of this study was to evaluate the burden of urticaria in different regions and nations by analysing data from the Global Burden of Disease study 2019 (GBD 2019), with the goal of providing information to health care policymakers.

Methods

By utilising data from the GBD 2019 database, this study analysed metrics such as incidence, prevalence, disability-adjusted life years (DALYs), age-standardised rate (ASR), and estimated annual percentage changes (EAPC) globally and across 204 countries and regions. The data was further stratified by age, sex, and sociodemographic index (SDI).

Results

In 2019, global incidence cases, prevalence cases, and overall disease burden as measured by DALYs all increased. The distribution of the burden exhibited marked geographical heterogeneity. At the regional level, the burden is highest in Central and Eastern Europe and Central Asia, with the strongest growth in South Asia, compared with a decline in the high-income Asia Pacific. At the country level, Nepal reports the highest burden of urticaria, while Portugal has the lowest. Gender and age analyses showed that the burden of urticaria is higher in females than in males, with urticaria cases declining with age, especially in children, and picking up among the elderly. The study also finds a correlation between the burden of urticaria and the SDI, with the central part of the SDI showing a consistent increasing trend.

Conclusion

This study found that the global burden of urticaria has risen from 1990 to 2019. Factors like geographic location, gender, and SDI influenced the urticaria burden. Overall, these results offer a resource to guide public health strategies seeking to reduce the burden of urticaria.

Climate change and its impact on asthma

ABSTRACT

Earth's climate is changing at an unprecedented pace, primarily due to anthropogenic causes including greenhouse gas emissions. Evidence shows a strong link between climate change and its effects on asthma. Healthcare professionals must be educated to advocate for and lead effective strategies to reduce the health risks of climate change.

Impact of climate change on immune responses and barrier defense

Climate change is not just jeopardizing the health of our planet but is also increasingly affecting our immune health. There is an expanding body of evidence that climate-related exposures such as air pollution, heat, wildfires, extreme weather events, and biodiversity loss significantly disrupt the functioning of the human immune system. These exposures manifest in a broad range of stimuli, including antigens, allergens, heat stress, pollutants, microbiota changes, and other toxic substances. Such exposures pose a direct and indirect threat to our body's primary line of defense, the epithelial barrier, affecting its physical integrity and functional efficacy. Furthermore, these climate-related environmental stressors can hyperstimulate the innate immune system and influence adaptive immunity-notably, in terms of developing and preserving immune tolerance. The loss or failure of immune tolerance can instigate a wide spectrum of noncommunicable diseases such as autoimmune conditions, allergy, respiratory illnesses, metabolic diseases, obesity, and others. As new evidence unfolds, there is a need for additional research in climate change and immunology that covers diverse environments in different global settings and uses modern biologic and epidemiologic tools.

A toxicological perspective on climate change and the exposome

Climate change is accompanied by changes in the exposome, including increased heat, ground-level ozone, and other air pollutants, infectious agents, pollens, and psychosocial stress. These exposures alter the internal component of the exposome and account for some of the health effects of climate change. The adverse outcome pathways describe biological events leading to an unfavorable health outcome. In this perspective study, I propose to use this toxicological framework to better describe the biological steps linking a stressor associated with climate change to an adverse outcome. Such a framework also allows for better identification of possible interactions between stressors related to climate change and others, such as chemical pollution. More generally, I call for the incorporation of climate change as part of the exposome and for improved identification of the biological pathways involved in its health effects.

Temporal dynamic effects of meteorological factors and air quality on the physical health of the older adults in Shenzhen, China

Introduction

Meteorological and environmental factors can affect people's lives and health, which is crucial among the older adults. However, it is currently unclear how they specifically affect the physical condition of older adults people.

Methods

We collected and analyzed the basic physical examination indicators of 41 older adults people for two consecutive years (2021 and 2022), and correlated them with meteorological and environmental factors. Partial correlation was also conducted to exclude unrelated factors as well.

Results

We found that among the physical examination indicators of the older adults for two consecutive years, five indicators (HB, WBC, HbAlc, CB, LDL-C) showed significant differences across the population, and they had significantly different dynamic correlation patterns with six meteorological (air pressure, temperature, humidity, precipitation, wind speed, and sunshine duration) and seven air quality factors (NO2, SO2, PM10, O3-1h, O3-8h, CO, PM2.5).

Discussion

Our study has discovered for the first time the dynamic correlation between indicators in normal basic physical examinations and meteorological factors and air quality indicators, which will provide guidance for the future development of policies that care for the healthy life of the older adults.

Non-malignant occupational respiratory diseases and climate change

BACKGROUND: Respiratory diseases of infectious, allergic, neoplastic or degenerative origin are due to the interaction of environmental and occupational risk factors, individual susceptibility and other co-factors and comorbidities. Asthma and other respiratory pathologies can be worsened by climate change and exposure to other agents in occupational environments.METHODS: PubMed and Scopus, and several websites on public and occupational health were queried to find publications and documents on work-related respiratory diseases, asthma, rhinitis, chronic obstructive pulmonary disease (COPD), pneumoconiosis and allergic alveolitis in association with climate change.RESULTS: Most of the retrieved articles concerned asthma (75 in Scopus), while the other topics were less frequently covered in the scientific literature, with a maximum of 29 papers for rhinitis and 23 for COPD. The most important terms highlighted by the word clouds were 'health', 'air', 'pollution', and, only for asthma and rhinitis, 'pollen' and 'allergic/allergy'. Website data on public and occupational health, and climate change were reported.CONCLUSIONS: Assessment and management of respiratory diseases that recognise occupational exposures should be improved, and more research into integrated approaches should be favoured. Health surveillance practices for workers exposed to agents that cause respiratory diseases should be implemented. The development of biomarkers of exposure, effect and susceptibility needs further study.

Prevalence and Risk Factors of Allergic Diseases Among School Students in Tabuk: A Cross-Sectional Study

BACKGROUND

Allergic diseases such as bronchial asthma, allergic rhinitis, and atopic dermatitis are common health problems among children. The prevalence of different allergic diseases is increasing in the Kingdom of Saudi Arabia.

OBJECTIVES

This study aimed to estimate the prevalence and risk factors of allergic diseases among school students in Tabuk, Saudi Arabia.

METHODS

This cross-sectional analytical study was conducted in Tabuk city, Saudi Arabia, between the first of August and the end of September, 2022. Students from primary, intermediate, and secondary schools were included. A predesigned, structured, self-administered questionnaire in the Arabic language was used to collect data.

RESULTS

This study included 384 school students from Tabuk, Saudi Arabia. The age of the recruited students ranged from five to 19 years old. The prevalence of clinically diagnosed bronchial asthma that occurred at any time in the past was 31.8%. The prevalence of asthma symptoms was 51.0% for lifetime wheezing and 45.8% for current wheezing (in the past 12 months). The prevalence rates of clinically diagnosed allergic rhinitis and atopic dermatitis were 56.8% and 30.2%, respectively. Further, 68.2% of the school students had one or more of the diagnosed allergic diseases. The second or more childbirth orders were significantly associated with an increased risk of allergic diseases (adjusted odds ratio [AOR] = 3.140, 95% CI: 1.864-5.288). A family history of asthma or atopic conditions showed 3.118 times increased likelihood of allergic conditions (AOR = 3.118, 95% CI: 1.827-5.320). Other significant risk factors were the father's smoking (AOR = 1.698, 95% CI: 1.024-2.817) and having a dog, cat, or bird at home (AOR = 0.493, 95% CI: 0.257-0.946).

CONCLUSION

The prevalence of bronchial asthma and other allergic diseases such as allergic rhinitis and atopic dermatitis among school students in Tabuk city, Saudi Arabia, is alarmingly high. Furthermore, both genetic and environmental components of allergic disease pathogenesis have been identified as risk factors.

A Simple Method Using an Allometric Model to Quantify the Carbon Sequestration Capacity in Vineyards

Winegrapes are an important component of agroecosystems. They are endowed with great potential to sequester and store carbon to slow down greenhouse gas emissions. Herein, the biomass of grapevines was determined, and the carbon storage and distribution features of vineyard ecosystems were correspondingly analyzed using an allometric model of winegrape organs. Then, the carbon sequestration of Cabernet Sauvignon vineyard in the Helan Mountain East Region was quantified. It was found that the total carbon storage of grapevines increased with vine age. The amounts of the total carbon storage in the 5-year-old, 10-year-old, 15-year-old, and 20-year-old vineyards were 50.22 t·ha^-1, 56.73 t·ha^-1, 59.10 t·ha^-1, and 61.06 t·ha^-1, respectively. The soil held the majority of the carbon storage, which was concentrated in the top and subsurface layers (0-40 cm) of the soil. Moreover, the biomass carbon storage was mainly distributed in the perennial organs (perennial branches and roots). In young vines, carbon sequestration increased each year; however, the increased rate in carbon sequestration decreased with winegrape growth. The results indicated that vineyards have a net carbon sequestration capacity, and within certain years, the age of grapevines was found to be positively correlated with the amount of carbon sequestration. Overall, the present study provided accurate estimations of the biomass carbon storage in grapevines using the allometric model, which may help vineyards become recognized as important carbon sinks. Additionally, this research can also be used as a basis for figuring out the ecological value of vineyards on a regional scale.

The association between air pollution, meteorological factors, and daily outpatient visits for urticaria in Shijiazhuang, Hebei Province, China: a time series analysis

The associations of air pollution and meteorological factors with the outpatient visits of urticaria remain poorly studied. This study aimed to assess the association between air pollution, meteorological factors, and daily outpatient visits for urticaria in Shijiazhuang, China, during 2014-2019. Daily recordings of air pollutant concentrations, meteorological data, and outpatient visits data for urticaria were collected during the 6 years. Descriptive research methods were used to describe the distribution characteristics and demographic features of urticaria. A combination of the generalized linear regression model (GLM) and distribution lag nonlinear model (DLNM) was used to evaluate the lag association between environmental factors and daily outpatient visits for urticaria. Stratified analyses by gender (male; female) and age (< 18 years; 18-39 years; > 39 years) were further conducted. The dose-response relationship between daily urticaria visits and CO, NO₂, O₃, temperature, and relative humidity was nonlinear. High concentrations of CO, NO₂, O₃, and high temperatures increased the risk of urticaria outpatient visits. The maximum cumulative association of high concentrations of CO, NO₂, and O₃ was lag 0-14 days (CO: RR = 1.10, 95%CI: 1.06, 1.31; NO₂: RR = 1.09, 95%CI: 1.01, 1.08; O₃: RR = 1.16, 95%CI: 1.08, 1.25), and high temperatures was lag 0-7 days (RR = 1.27, 95%CI: 1.14, 1.41). Low concentrations of NO₂, O₃, and high humidity, on the other hand, act as protective factors for urticaria outpatient. The maximum cumulative association of low concentrations of NO₂ was the 0-day lag (RR = 0.97, 95%CI: 0.95, 0.99), O₃ was lag 0-5 days (RR = 0.94, 95%CI: 0.88, 0.99), and high humidity was lag 0-10 days (RR = 0.93, 95%CI: 0.89, 0.98). Stratified analyses showed that the risk of urticaria outpatient visits was higher for the males and in the < 18 years age group. In conclusion, we found that the development of urticaria in Shijiazhuang has a distinct seasonal and cyclical nature. Air pollutants and meteorological factors had varying degrees of influence on the risk of urticaria outpatient visits. This study provides indirect evidence for a link between air pollution, meteorological factors, and urticaria outpatient visits.

Climate change, human health, and the exposome: Utilizing OMIC technologies to navigate an era of uncertainty

Climate change is an anthropogenic phenomenon that is alarming scientists and non-scientists alike. The emission of greenhouse gases is causing the temperature of the earth to rise and this increase is accompanied by a multitude of climate change-induced environmental exposures with potential health impacts. Tracking human exposure has been a major research interest of scientists worldwide. This has led to the development of exposome studies that examine internal and external individual exposures over their lifetime and correlate them to health. The monitoring of health has also benefited from significant technological advances in the field of "omics" technologies that analyze physiological changes on the nucleic acid, protein, and metabolism levels, among others. In this review, we discuss various climate change-induced environmental exposures and their potential health implications. We also highlight the potential integration of the technological advancements in the fields of exposome tracking, climate monitoring, and omics technologies shedding light on important questions that need to be answered.

A comprehensive summary of disease variants implicated in metal allergy

Allergic disease represents one of the most prominent global public health crises of the 21^st century. Although many different substances are known to produce hypersensitivity responses, metals constitute one of the major classes of allergens responsible for a disproportionately large segment of the total burden of disease associated with allergy. Some of the most prevalent forms of metal allergy - including allergic contact dermatitis - are well-recognized; however, to our knowledge, a comprehensive review of the many unique disease variants implicated in human cases of metal allergy is not available within the current scientific literature. Consequently, the main goal in composing this review was to (1) generate an up-to-date reference document containing this information to assist in the efforts of lab researchers, clinicians, regulatory toxicologists, industrial hygienists, and other scientists concerned with metal allergy and (2) identify knowledge gaps related to disease. Accordingly, an extensive review of the scientific literature was performed - from which, hundreds of publications describing cases of metal-specific allergic responses in human patients were identified, collected, and analyzed. The information obtained from these articles was then used to compile an exhaustive list of distinctive dermal/ocular, respiratory, gastrointestinal, and systemic hypersensitivity responses associated with metal allergy. Each of these disease variants is discussed briefly within this review, wherein specific metals implicated in each response type are identified, underlying immunological mechanisms are summarized, and major clinical presentations of each reaction are described.Abbreviations: ACD: allergic contact dermatitis, AHR: airway hyperreactivity, ASIA: autoimmune/ autoinflammatory syndrome induced by adjuvants, BAL: bronchoalveolar lavage, CBD: chronic beryllium disease, CTCL: cutaneous T-cell lymphoma, CTL: cytotoxic T-Lymphocyte, DRESS: drug reaction with eosinophilia and systemic symptoms, GERD: gastro-esophageal reflux disease, GI: gastrointestinal, GIP: giant cell interstitial pneumonia, GM-CSF: granulocyte macrophage-colony stimulating factor, HMLD: hard metal lung disease, HMW: high molecular weight, IBS: irritable bowel syndrome, Ig: immunoglobulin, IL: interleukin, LMW: low molecular weight, PAP: pulmonary alveolar proteinosis, PPE: personal protective equipment, PRR: pathogen recognition receptor, SLE: systemic lupus erythematosus, SNAS: systemic nickel allergy syndrome, Th: helper T-cell, UC: ulcerative colitis, UV: ultraviolet.

Climate to COVID, global to local, policies to people: a biopsychosocial ecological framework for syndemic prevention and response in behavioral medicine

Land development, pollution, and waste have affected natural environments, contributing to hurricanes, wildfires, and pandemic infectious diseases like COVID-19. Globalized corporate food systems that produce ultra-refined foods with low nutritional value contribute to both environmental conditions and health conditions like obesity and undernutrition. This has the greatest impact on communities already suffering from elevated health risks driven by economic inequities rooted in racism. These interacting environmental, health, and social conditions represent a syndemic. We outline practical suggestions to address this syndemic of environmental degradation, pandemic infectious disease, chronic disease, undernutrition, and inequity through research and practice at many levels, including individual behavior, local communities, and regional, national and global policy. Collaboration with communities is central to simultaneously tackling interconnected human and environmental health threats. For example, community-led groups have increased access to healthy food in response to pandemic conditions. Building on behavioral medicine's rich foundation of ecological models, communities have partnered with local researchers to address the needs of equitable public transport and reduction of greenhouse gas emissions through multilevel research and practice. Policymakers, researchers, practitioners, and community members should collaborate with each other and across disciplines to find lasting, multiduty solutions to improve physical, psychosocial, and planetary health.

New Paradigms for Familiar Diseases: Lessons Learned on Circulatory Bacterial Signatures in Cardiometabolic Diseases

Despite the strongly accumulating evidence for microbial signatures in metabolic tissues, including the blood, suggesting a novel paradigm for metabolic disease development, the notion of a core blood bacterial signature in health and disease remains a contentious concept. Recent studies clearly demonstrate that under a strict contamination-free environment, methods such as 16 S rRNA gene sequencing, fluorescence in-situ hybridization, transmission electron microscopy, and several more, allied with advanced bioinformatics tools, allow unambiguous detection and quantification of bacteria and bacterial DNA in human tissues. Bacterial load and compositional changes in the blood have been reported for numerous disease states, suggesting that bacteria and their components may partially induce systemic inflammation in cardiometabolic disease. This concept has been so far primarily based on measurements of surrogate parameters. It is now highly desirable to translate the current knowledge into diagnostic, prognostic, and therapeutic approaches.This review addresses the potential clinical relevance of a blood bacterial signature pertinent to cardiometabolic diseases and outcomes and new avenues for translational approaches. It discusses pitfalls related to research in low bacterial biomass while proposing mitigation strategies for future research and application approaches.

An Overview of Environmental Risk Factors for Food Allergy

IgE-mediated food allergy is an increasing public health concern in many regions around the world. Although genetics play a role in the development of food allergy, the reported increase has occurred largely within a single generation and therefore it is unlikely that this can be accounted for by changes in the human genome. Environmental factors must play a key role. While there is strong evidence to support the early introduction of allergenic solids to prevent food allergy, this is unlikely to be sufficient to prevent all food allergy. The purpose of this review is to summarize the evidence on risk factors for food allergy with a focus the outdoor physical environment. We discuss emerging evidence of mechanisms that could explain a role for vitamin D, air pollution, environmental greenness, and pollen exposure in the development of food allergy. We also describe the recent extension of the dual allergen exposure hypothesis to potentially include the respiratory epithelial barrier in addition to the skin. Few existing studies have examined the relationship between these environmental factors with objective measures of IgE-mediated food allergy and further research in this area is needed. Future research also needs to consider the complex interplay between multiple environmental factors.

Pollens in therapeutic/diagnostic systems and immune system targeting

Pollen is an excellent natural substance that plays an essential role in the reproduction of plants. In this review, we explain the structure, compositions, and characteristics of pollens. We consider pollen as a multifunctional tool that can be used in therapeutic/diagnostic systems. This microcapsule can be used in the forms of the hollow microcapsule, microgel, and composite, and also can be a tool for the synthesis of micro/nanostructures in various medical applications and used for the production of genetically modified plants that affect human health. In addition, we investigate the capability of this multifunctional tool in the immune system targeting that acts as an immunomodulator. In all applications and capabilities, we explain the potential of using nanostructures as parts of these systems and as auxiliary tools for promoting the applications of pollen. It is expected that soon, with the help of pollen-based therapeutic/diagnostic systems with the ability to immune system targeting, we will achieve effective and targeted therapeutic systems for the treatment of inflammatory and autoimmune diseases. In this paper, we suggest some ideas that may be a new step for future researches.

Planetary Health, Climate Change, and Lifestyle Medicine: Threats and Opportunities

Global environmental degradation and climate change threaten the foundation of human health and well-being. In a confluence of crises, the accelerating pace of climate change and other environmental disruptions pose an additional, preventable danger to a global population that is both aging and carrying a growing burden of noncommunicable diseases (NCDs). Climate change and environmental disruption function as "threat multipliers," especially for those with NCDs, worsening the potential health impacts on those with suboptimal health. At the same time, these environmental factors threaten the basic pillars of health and prevention, increasing the risk of developing chronic disease. In the face of these threats, the core competencies of lifestyle medicine (LM) present crucial opportunities to mitigate climate change and human health impacts while also allowing individuals and communities to build resilience. LM health professionals are uniquely positioned to coach patients toward climate-healthy behavior changes that heal both people and the planet.

Targeting immunosuppressor cells with nanoparticles in autoimmunity: How far have we come to?

Autoimmunity is the assault of immune response towards self-antigens, resulting to inflammation and tissue injury. It is staged into three phases and caused by malfunction of immune tolerance. In our body, immune tolerance is synchronized by several immunosuppressor cells such as regulatory T cells and B cells as well as myeloid-derived suppressor cells, which are prominently dysregulated in autoimmunity. Hence, targeting these cell populations serve as a significant potential in the therapy of autoimmunity. Nanotechnology with its advantageous properties is shown to be a remarkable tool as drug delivery system in this field. This review focused on the development of therapeutics in autoimmune diseases utilizing various nanoparticles formulation based on two targeting approaches in autoimmunity, passive and active targeting. Lastly, this review outlined the approved present nanomedicines as well as in clinical evaluations and issues regarding the lack of translation of these nanomedicines into the market, despite the abundant of positive experimental observations.