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Pei Z, Xiong Y, Jiang S, Guo R, Jin W, Tao J, Zhang Z, Zhang Y, Zou Y, Gong Y, Ren J. Heavy Metal Scavenger Metallothionein Rescues Against Cold Stress-Evoked Myocardial Contractile Anomalies Through Regulation of Mitophagy. Cardiovasc Toxicol 2024; 24:85-101. [PMID: 38356081 DOI: 10.1007/s12012-023-09823-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/24/2023] [Indexed: 02/16/2024]
Abstract
Cold stress prompts an increased prevalence of cardiovascular morbidity yet the underneath machinery remains unclear. Oxidative stress and autophagy appear to contribute to cold stress-induced cardiac anomalies. Our present study evaluated the effect of heavy metal antioxidant metallothionein on cold stress (4 °C)-induced in cardiac remodeling and contractile anomalies and cell signaling involved including regulation of autophagy and mitophagy. Cold stress (3 weeks) prompted interstitial fibrosis, mitochondrial damage (mitochondrial membrane potential and TEM ultrastructure), oxidative stress (glutathione, reactive oxygen species and superoxide), lipid peroxidation, protein injury, elevated left ventricular (LV) end systolic and diastolic diameters, decreased fractional shortening, ejection fraction, Langendorff heart function, cardiomyocyte shortening, maximal velocities of shortening/relengthening, and electrically stimulated intracellular Ca2+ rise along with elongated relaxation duration and intracellular Ca2+ clearance, the responses of which were overtly attenuated or mitigated by metallothionein. Levels of apoptosis, cell death (Bax and loss of Bcl2, IL-18), and autophagy (LC3BII-to-LC3BI ratio, Atg7 and Beclin-1) were overtly upregulated with comparable p62 under cold stress. Cold stress also evoked elevated mitophagy (decreased TOM20, increased Parkin and FUNDC1 with unaltered BNIP3). Cold stress overtly dampened phosphorylation of autophagy/mitophagy inhibitory molecules Akt and mTOR, stimulated and suppressed phosphorylation of ULK1 and eNOS, respectively, in the absence of altered pan protein levels. Cold stress-evoked responses in cell death, autophagy, mitophagy and their regulatory domains were overtly attenuated or ablated by metallothionein. Suppression of autophagy and mitophagy with 3-methyladenine, bafilomycin A1, cyclosporine A, and liensinine rescued hypothermia-instigated cardiomyocyte LC3B puncta formation and mechanical anomalies. Our findings support a protective nature for metallothionein in deep hypothermia-evoked cardiac abnormalities associated with regulation of autophagy and mitophagy.
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Affiliation(s)
- Zhaohui Pei
- The Second Department of Cardiology, Nanchang City Renmin Hospital, Nanchang, 3330009, China.
| | - Yayuan Xiong
- The First Department of Cardiology, Nanchang City Renmin Hospital, Nanchang, 3330009, China
| | - Shasha Jiang
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
| | - Rui Guo
- College of Life Sciences, Institute of Life Science and Green Development, Hebei University, Baoding, China
- The Key Laboratory of Zoological Systematics and Application, College of Life Sciences, Hebei University, Baoding, China
| | - Wei Jin
- The Second Department of Cardiology, Nanchang City Renmin Hospital, Nanchang, 3330009, China
| | - Jun Tao
- Department of Cardiovascular Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510000, China
| | - Zhenzhong Zhang
- Shanghai Institute for Cardiovascular Diseases, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Yingmei Zhang
- Shanghai Institute for Cardiovascular Diseases, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
- Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, 200032, China
| | - Yunzeng Zou
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
- Shanghai Institute for Cardiovascular Diseases, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
- Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, 200032, China
| | - Yan Gong
- The Second Department of Cardiology, Nanchang City Renmin Hospital, Nanchang, 3330009, China
| | - Jun Ren
- Shanghai Institute for Cardiovascular Diseases, Shanghai, 200032, China.
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China.
- Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, 200032, China.
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Xu Z, Watzek JT, Phung D, Oberai M, Rutherford S, Bach AJE. Heat, heatwaves, and ambulance service use: a systematic review and meta-analysis of epidemiological evidence. Int J Biometeorol 2023; 67:1523-1542. [PMID: 37495745 PMCID: PMC10457246 DOI: 10.1007/s00484-023-02525-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/01/2023] [Accepted: 07/14/2023] [Indexed: 07/28/2023]
Abstract
Ambulance data has been reported to be a sensitive indicator of health service use during hot days, but there is no comprehensive summary of the quantitative association between heat and ambulance dispatches. We conducted a systematic review and meta-analysis to retrieve and synthesise evidence published up to 31 August 2022 about the association between heat, prolonged heat (i.e. heatwaves), and the risk of ambulance dispatches. We initially identified 3628 peer-reviewed papers and included 48 papers which satisfied the inclusion criteria. The meta-analyses showed that, for each 5 °C increase in mean temperature, the risk of ambulance dispatches for all causes and for cardiovascular diseases increased by 7% (95% confidence interval (CI): 5%, 10%) and 2% (95% CI: 1%, 3%), respectively, but not for respiratory diseases. The risk of ambulance dispatches increased by 6% (95% CI: 4%, 7%), 7% (95% CI: 5%, 9%), and 18% (95% CI: 12%, 23%) under low-intensity, severe, and extreme heatwaves, respectively. We observed two potential sources of bias in the existing literature: (1) bias in temperature exposure measurement; and (2) bias in the ascertainment of ambulance dispatch causes. This review suggests that heat exposure is associated with an increased risk of ambulance dispatches, and there is a dose-response relationship between heatwave intensity and the risk of ambulance dispatches. For future studies assessing the heat-ambulance association, we recommend that (1) using data on spatially refined gridded temperature that is either very well interpolated or derived from satellite imaging may be an alternative to reduce exposure measurement bias; and (2) linking ambulance data with hospital admission data can be useful to improve health outcome classification.
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Affiliation(s)
- Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia.
- Cities Research Institute, Griffith University, Gold Coast, Australia.
| | - Jessica T Watzek
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia
| | - Dung Phung
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Mehak Oberai
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia
| | - Shannon Rutherford
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia
- Cities Research Institute, Griffith University, Gold Coast, Australia
| | - Aaron J E Bach
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia.
- Cities Research Institute, Griffith University, Gold Coast, Australia.
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Yong KH, Teo YN, Azadbakht M, Phung H, Chu C. The Scorching Truth: Investigating the Impact of Heatwaves on Selangor's Elderly Hospitalisations. Int J Environ Res Public Health 2023; 20:ijerph20105910. [PMID: 37239636 DOI: 10.3390/ijerph20105910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/06/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
Global climate change has contributed to the intensity, frequency, and duration of heatwave events. The association between heatwaves and elderly mortality is highly researched in developed countries. In contrast, heatwave impact on hospital admissions has been insufficiently studied worldwide due to data availability and sensitivity. In our opinion, the relationship between heatwaves and hospital admissions is worthwhile to explore as it could have a profound impact on healthcare systems. Therefore, we aimed to investigate the associations between heatwaves and hospitalisations for the elderly by age group in Selangor, Malaysia, from 2010 to 2020. We further explored the impact of heatwaves on the risks of cause-specific hospital admissions across age groups within the elderly. This study applied generalized additive models (GAMs) with the Poisson family and distributed lag models (DLMs) to estimate the effect of heatwaves on hospitalisations. According to the findings, there was no significant increase in hospitalisations for those aged 60 and older during heatwaves; however, a rise in mean apparent temperature (ATmean) by 1 °C significantly increased the risk of hospital admission by 12.9%. Heatwaves had no immediate effects on hospital admissions among elderly patients, but significant delay effects were identified for ATmean with a lag of 0-3 days. The hospital admission rates of the elderly groups started declining after a 5-day average following the heatwave event. Females were found to be relatively more vulnerable than males during heatwave periods. Consequently, these results can provide a reference to improve public health strategies to target elderly people who are at the greatest risk of hospitalisations due to heatwaves. Development of early heatwave and health warning systems for the elderly would assist with preventing and reducing health risks while also minimising the burden on the whole hospital system in Selangor, Malaysia.
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Affiliation(s)
- Kun Hing Yong
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4111, Australia
| | - Yen Nee Teo
- Institute of Malaysian and International Studies, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Mohsen Azadbakht
- Department of Infrastructure Engineering, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Hai Phung
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4111, Australia
| | - Cordia Chu
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4111, Australia
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