Wednesday, January 17, 2024

 ANOTHER REASON TO SAY NO DEEP SEA MINING

URI professor leads effort demonstrating success of new technology in conducting deep-sea research on fragile organisms


Multi-institution team uses quantitative imaging technology, innovative robotic device to capture tissue in minutes, preserve for advanced genomic study


Peer-Reviewed Publication

UNIVERSITY OF RHODE ISLAND

RAD-2 encapsulates a marine worm 

VIDEO: 

A ROTARY ACTUATED DODECAHEDRON (RAD-2) ENCAPSULATES A HOLOPLANKTONIC POLYCHAETE (TOMOPTERIS, A MARINE WORM). VIDEO FROM REMOTELY OPERATED VEHICLE (ROV), SUBASTIAN SCIENCE CAMERA, SCHMIDT OCEAN INSTITUTE.

 

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CREDIT: SCHMIDT OCEAN INSTITUTE




KINGSTON, R.I. – Jan. 17, 2024 – A University of Rhode Island professor of Ocean Engineering and Oceanography, along with a multidisciplinary research team from multiple institutions, successfully demonstrated new technologies that can obtain preserved tissue and high-resolution 3D images within minutes of encountering some of the most fragile animals in the deep ocean.

URI Professor Brennan Phillips, the principal investigator on the project, and a team of 15 researchers from six institutions, including URI, have shown that it is possible to shave years from the process of determining whether a new or rare species has been discovered. The results of their work are published today in the journal Science Advances. An advanced copy of the article and press package are available

Roboticists, ocean engineers, bioengineers, and marine and molecular biologists from URI’s Department of Ocean Engineering; the Bigelow Laboratory for Ocean Sciences in East Boothbay, Maine; the School of Engineering and Applied Sciences at Harvard University; Monterey Bay Aquarium Research Institute (MBARI) in California; PA Consulting, a worldwide firm that focuses on innovation; and the Department of Natural Sciences at Baruch College, City University of New York, made up the team. The paper represents five years of research.

Revolutionary advancements in underwater imaging, robotics, and genomic sequencing have reshaped marine exploration, the study reads. The research shows that within minutes of an encounter with a deep-sea animal, it is possible to capture detailed measurements and motion of the animal, obtain an entire genome, and generate a comprehensive list of genes being expressed that point to their physiological status in the deep ocean. The result of this rich digital data is a ‘cybertype’ of a single animal, rather than a physical ‘holotype’ that is traditionally found in museum collections.

“Currently, if researchers want to describe what they believe is a new species, they face an arduous process,” Phillips said. “The way it is done now is you capture a specimen, which is very difficult because a lot of these animals are so delicate and tissue-thin, and it’s likely you may not be able to collect them at all. But if you successfully collect an animal, you then preserve it in a jar. Then begins a long process of physically bringing that specimen to different collections around the world where it is compared to existing organisms. After a long time, sometimes up to 21 years, scientists may reach consensus that this is a new species. 

“Again, these are deep-sea, thin little wisps of animals. The current workflow is not appropriate. It’s a major reason why we have so many undescribed species in the ocean.”

Information gained from the study—and others that follow—could be useful for extinction  prevention studies, as it provides a wealth of information from a single specimen gained during a single encounter. The work also responds to the growing call among researchers for compassionate collection, which minimizes harm to animals by using advanced technologies to collect information. Future studies and development could allow for complete scans and inventories of life in the deep sea within a catch-and-release framework.

“The vision was: How might a marine biologist work to better understand and connect to deep-sea life decades or centuries into the future?” said David Gruber, Distinguished Professor of Biology at Baruch College, City University of New York, and an Explorer with National Geographic Society. “This is a demonstration on how an interdisciplinary team could work collaboratively to provide an enormous amount of new information on deep-sea life after one brief encounter. The ultimate goal is to continue down this path and refine the technology to be as minimally-invasive as possible—akin to a doctor's check-up in the deep sea! This approach is becoming increasingly important with current extinction being 100 times higher than background extinction rates.”

Phillips said because collecting these samples has always been hard, there are many deep-sea species that have yet to be identified. “When you look at climate change and deep-sea mining and their potential effects, it is unsettling,” Phillips said. “You realize you don’t have a full baseline of species, and you may not know what you’ve lost before it’s too late. If you want to know what has been there before it’s gone, this is a new way to do that.” 

The mission, which was funded by the Schmidt Ocean Institute and its Designing the Future program, and conducted on its research vessel Falkor, included two expeditions off the coast of Hawaii and San Diego in 2019 and 2021. The team collected as many as 14 preserved tissue samples a day, along with terabytes of quantitative digital imagery. Together, the study provided: 

  • The first complete assembled and annotated transcriptome (genes being made in the animals’ habitat) of Pegea tunicate, a marine invertebrate animal;
  • Details of the molecular basis of environmental sensing of a holoplanktonic Tomopteris polychaete (marine worm), which spends its entire life in the water column;
  • Details of the full transcriptomes of two siphonophores, (gelatinous zooplankton composed of specialized parts growing together in a chain) Erenna sp. and Marrus claudanielis, as well as the Pegea tunicate and Tomopteris polychaete;
  • Full morphological (form and structure) characterizations using digital imaging of each animal while at depth.

The lead author of the paper, John Burns, a senior research scientist at Bigelow Laboratory, conducted the genomic analysis on four animals sampled at depths of almost 4,000 feet.

“What we were able to achieve with these animals is remarkable,” Burns said. “For me, this is best seen in the sequence data we generated for the Tomopteris worm: We captured it while it was exploring its environment and were able to infer that it was scanning the water using two long sensory whiskers near its head for ‘sweet’ tastes: likely sugars associated with prey, and possibly for ammonia: a waste product of its typical prey.

“With that information, we can envision how it hunts by following chemical trails in its open water habitat,” Burns said. “I don’t think that would have been possible without the innovative technology invented and employed by the engineers on the team that allowed complete preservation of the information from the animals within minutes of an encounter.”

Burns said another study with Gruber looked at how capture methods affect jellyfish ribonucleic acid, known as RNA, one of the building blocks of life. That sequence of information can start to change after about 10 minutes of stressful conditions, even with gentle collection. The Designing the Future technologies overcome this by preserving the information before the animal’s cells start to respond to stress, according to Burns.

“We also discovered that three of the animals we captured have huge genomes: each having nearly 10 times the DNA in a cell compared to us humans!” Burns said. “For the fourth, with a more modestly sized genome (about 3% the size of a human genome) we were able to use cutting edge sequencing methods to build the most cohesive and complete genome of a salp to date.”

Harvard and URI brought to the mission a rotary-actuated folding dodecahedron (RAD-2), an innovative origami-inspired robotic encapsulation device, which collected animal tissue samples and almost instantaneously preserved that tissue at depth. 

“We are seeing the impact of new types of marine robots for midwater and deep-sea exploration,” said roboticist Robert Wood, the Harry Lewis and Marlyn McGrath Professor of Engineering and Applied Sciences at Harvard University. “Not only are robots going places that are difficult or impossible for humans to reach, our devices investigate, interact with, and collect specimens using a gentle touch… or no touch at all.”

Imaging systems from MBARI’s Bioinspiration Lab that included a laser-scanning imaging device called DeepPIV and a three-dimensional lightfield camera called EyeRIS enabled the measurement and reconstruction of three-dimensional morphology, or body shape, of the animals in their natural environment.

“We cannot protect what we do not yet fully understand. Advanced imaging technologies can accelerate our efforts to document the diversity of life in the ocean. The faster we can catalog marine life, the better we can assess and track the impact of human actions like climate change and mining on ocean environments,” said Kakani Katija, bioengineer and principal engineer of the Bioinspiration Lab at MBARI. 

“We have these remotely operated vehicles out there with advanced imaging systems, which can create a three-dimensional model after only a few minutes,” Phillips said. “We were able to approach a tiny jellyfish in a matter of seconds, collect high-resolution 3D images to the control room, and our team was able to tell in a matter of minutes that the tentacles were exactly 5 millimeters long. Then, we had extremely well-preserved tissue samples of the same animal within a matter of minutes.”

 

Composite image of gelatinous deep-sea animals observed and sampled in the study.  Clockwise starting from upper left: the holoplanktonic polychaete Tomopteris sp., the siphonophore Marrus claudanielis, the siphonophore Erenna sp., and the salp Pegea sp. Photos courtesy of ROV SuBastian science camera, Schmidt Ocean Institute.

CREDIT

Schmidt Ocean Institute

The ROV SuBastian with rotary actuated dodecahedron (RAD-2) mounted on the front and about to be lowered into the sea. Photo courtesy of Brennan Phillips

CREDIT

Photo courtesy Brennan Phillips

Preparations 

 

Woolly mammoth movements tied to earliest Alaska hunting camps

Peer-Reviewed Publication

UNIVERSITY OF ALASKA FAIRBANKS

Mammoth_Art_JuliusCsotonyi.jpg 

IMAGE: 

ARTWORK SHOWS THREE MAMMOTHS BEING WATCHED BY A FAMILY OF ANCIENT ALASKANS FROM THE DUNES NEAR THE SWAN POINT ARCHAEOLOGICAL SITE, A SEASONAL HUNTING CAMP OCCUPIED 14,000 YEARS AGO.

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CREDIT: IMAGE BY JULIUS CSOSTONYI

Researchers have linked the travels of a 14,000-year-old woolly mammoth with the oldest known human settlements in Alaska, providing clues about the relationship between the iconic species and some of the earliest people to travel across the Bering Land Bridge.

Scientists made those connections by using isotope analysis to study the life of a female mammoth, named Élmayųujey'eh, by the Healy Lake Village Council. A tusk from Elma was discovered at the Swan Point archaeological site in Interior Alaska. Samples from the tusk revealed details about Elma and the roughly 1,000-kilometer journey she took through Alaska and northwestern Canada during her lifetime.

Isotopic data, along with DNA from other mammoths at the site and archaeological evidence, indicates that early Alaskans likely structured their settlements to overlap with areas where mammoths congregated. Those findings, highlighted in the new issue of the journal Science Advances, provide evidence that mammoths and early hunter-gatherers shared habitat in the region. The long-term predictable presence of woolly mammoths would have attracted humans to the area.

“She wandered around the densest region of archaeological sites in Alaska,” said Audrey Rowe, a University of Alaska Fairbanks Ph.D. student and lead author of the paper. “It looks like these early people were establishing hunting camps in areas that were frequented by mammoths.”

The mammoth tusk was excavated and identified in 2009 by Charles Holmes, affiliate research professor of anthropology at UAF, and François Lanoë, research associate in archaeology at the University of Alaska Museum of the North. They found Elma’s tusk and the remains of two related juvenile mammoths, along with evidence of campfires, the use of stone tools, and butchered remains of other game. All of this “indicates a pattern consistent with human hunting of mammoths,” said Ben Potter, an archaeologist and professor of anthropology at UAF.

Researchers at UAF’s Alaska Stable Isotope Facility then analyzed thousands of samples from Elma’s tusk to recreate her life and travels. Isotopes provide chemical markers of an animal’s diet and location. The markers are then recorded in the bones and tissues of animals and remain even after they die. 

Mammoth tusks are well-suited to isotopic study because they grew throughout the ancient animals’ lives, with clearly visible layers appearing when split lengthwise. Those growth bands give researchers a way to collect a chronological record of a mammoth’s life by studying isotopes in samples along the tusk.

Much of Elma’s journey overlapped with that of a previously studied male mammoth who lived 3,000 years earlier, demonstrating long-term movement patterns by mammoths over several millennia. In Elma’s case, they also indicated she was a healthy 20-year-old female.

“She was a young adult in the prime of life. Her isotopes showed she was not malnourished and that she died in the same season as the seasonal hunting camp at Swan Point where her tusk was found,” said senior author Matthew Wooller, who is director of the Alaska Stable Isotope Facility and a professor at UAF’s College of Fisheries and Ocean Sciences.

The era in which Elma lived may have compounded the challenges posed by the relatively recent appearance of humans. The grass- and shrub-dominated steppe landscape that had been common in Interior Alaska was beginning to shift toward more forested terrain.

“Climate change at the end of the ice age fragmented mammoths’ preferred open habitat, potentially decreasing movement and making them more vulnerable to human predation,” Potter said.

Other contributors to the study included the University of Alaska Anchorage, University of Ottawa, McMaster University, University of Alaska Museum of the North, University of Michigan Museum of Paleontology, Adelphi University, University of Arizona, Hakai Institute and the Healy Lake Village Council.


Matthew Wooller, a professor in the UAF College of Fisheries and Ocean Sciences, sits among mammoth tusks in the collection at the University of Alaska Museum of the North.

CREDIT

UAF photo by JR Ancheta

University of Alaska Fairbanks Ph.D. student Audrey Rowe works on a project near the Swan Point archaeological site, where a mammoth tusk she studied was found.

CREDIT

Photo by Matthew Wooller



 U$A

Higher infant mortality rates associated with restrictive abortion laws


Research reported in the American Journal of Preventive Medicine provides evidence that states with the most restrictive abortion laws saw 16% more infant deaths in 2014–2018 than in states offering access to comprehensive reproductive healthcare


Peer-Reviewed Publication

ELSEVIER

Higher Infant Mortality Rates Associated With Restrictive Abortion Laws 

IMAGE: 

MAP OF NUMBER OF RESTRICTIVE ABORTION LAWS PER STATE, US, (A) 2014, (B) 2018, AND (C) 2022.

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CREDIT: AMERICAN JOURNAL OF PREVENTIVE MEDICINE





Ann Arbor, January 17, 2024 – Contrary to professed intent, the states where abortion access was most restricted experienced the highest levels of infant mortality in the United States from 2014–2018, according to new research in the American Journal of Preventive Medicine, published by Elsevier. The findings showed that states with the most restrictive laws (11-12 laws) had a 16% increased infant mortality rate (IMR) compared to states with the least number of restrictive abortion laws (1-5 laws).

Lead investigator Lois K. Lee, MD, MPH, Division of Emergency Medicine, Boston Children’s Hospital, and Departments of Pediatrics and Emergency Medicine, Harvard Medical School, explained, “As pediatricians and obstetricians, we are concerned about how threats to comprehensive reproductive care affect our patients and their infants. Given the current changing legal landscape in the US regarding reproductive health policy, it is essential that we consider the larger impacts of restricting access to abortion, not just to birthing individuals, but also on infant births.”

In order to examine the association of abortion access not just on birthing individuals, but also on infant births, the research team performed a national ecologic study using county-level birth cohort linked files (linking maternal and infant data) on infant mortality from the National Center for Health Statistics for 2014–2018 (before the SCOTUS decision on Dobbs v. Jackson Women’s Health Organization). While previous studies had primarily examined state-level infant mortality rates, these data are novel because of the more granular analysis of county-level infant mortality.

Investigators categorized 48 states (excluding Hawaii and Alaska) by the number of restrictive abortion laws and factored in driving distance to an abortion facility, key demographic characteristics, and state Medicaid expansion status.

In addition to the impact of restrictive abortion laws, demographic characteristics such as Black ethnicity of the birthing parent, high school education attainment or less, smoking during pregnancy, and inadequate prenatal care were associated with elevated IMR.

The investigators were surprised to find that increased driving distance to an abortion facility was not statistically associated with an increased county-level IMR, as had been determined by previous studies. This may be because prenatal care access is more of a contributor to infant mortality than abortion facility access.

The investigators stressed that if pregnant women with limited financial means have increasingly limited access to comprehensive reproductive healthcare, including contraception and pre-conception planning, the long-term health and wellbeing outcomes for these individuals and their children may affect future population health.

Dr. Lee elaborated, “Maternal health directly influences infant and child health—and ultimately population health. From our study findings, it is important to understand that limiting access to abortion as part of comprehensive reproductive care not only affects birthing individuals, but also their infants. Without the implementation of more equitable access to comprehensive reproductive care, there will be continued disparities in access to care and health outcomes, varying especially by geography in the US.”

She added, “It will take years to truly understand the long-term public health impact of the SCOTUS decision on Dobbs v. Jackson Women’s Health Organization and other challenges to comprehensive reproductive health care services. Given the well-established disparities in maternal and infant mortality by race and geography, we are concerned more restrictions on comprehensive reproductive care will exacerbate these disparities, especially among lower-income individuals.”

 

 

 

 

Stalagmites as climate archive


Researchers from Heidelberg and Karlsruhe use stalagmite to reconstruct regional and global climate history


Peer-Reviewed Publication

HEIDELBERG UNIVERSITY

Stalagmites 

IMAGE: 

ACTIVE DRIPSTONE FORMATION IN A SIDE AREA OF THE “KLEINE TEUFELSHÖHLE”.

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CREDIT: KIT (TAKEN AS PART OF THE HEIKA PROJECT CHECK EXTREMA)





When combined with data from tree-ring records, stalagmites can open up a unique archive to study natural climate fluctuations across hundreds of years, a research team including geoscientists from Heidelberg University and the Karlsruhe Institute of Technology have demonstrated. The researchers analysed the isotopic composition of oxygen in a stalagmite formed from calcareous water in a cave in southern Germany. In conjunction with the data acquired from tree rings, they were able to reconstruct short-term climate fluctuations over centuries and correlate them with historically documented environmental events.

Until now, short-term climate fluctuations over hundreds of years could be analysed only by means of tree-ring records by combining independent measurements from a number of studies, explains geoscientist Dr Tobias Kluge of the Karlsruhe Institute of Technology (KIT). The size of the tree rings, which varies by a few millimetres, provides information on the dynamics of seasonal precipitation, in turn pointing to climatic conditions in the specific growth period. According to Dr Kluge, summers with heavy rainfall are expected particularly in cold years, whereas very wet winters are expected in warm years.

In contrast to tree rings, stalagmites have only been used in exceptional cases to systematically measure climate data and their annual variations. The decisive factor is the rainwater infiltrating a cave, whose dissolved lime forms the stalagmites. This water comes from local precipitation in the cold and warm seasons, and each is characterised by a special isotopic composition of oxygen. From this, analyses can be derived indicating whether and in which years winter or summer precipitation dominated.

The researchers from Heidelberg and Karlsruhe studied a stalagmite – a dripstone that grows upward from the floor of a cave – from the “Kleine Teufelshöhle” in Franconian Switzerland. With a growth rate of one to four centimetres per millennium, or an annual growth rate of about the width of a single hair, this stalagmite grew much more slowly than comparable ones. The growth zones of the stalagmite are a hundred times thinner than a tree ring, so just a few centimetres can provide data on the climatic conditions over a thousand years. The composition of oxygen isotopes was measured using the ion probe at the Institute of Earth Sciences of Heidelberg University. “The analyses required precise measurements within the annual growth zones of just a few micrometres, which is possible only with this type of large-scale research device,” explains Prof. Dr Mario Trieloff, head of the Heidelberg Ion Probe laboratory.

The researchers report that the climate data acquired from the “Kleine Teufelshöhle” stalagmite revealed regional as well as global environmental events. The unusually cold year of 1816, which went down in history as the Year Without a Summer, stemmed from an eruption of the Tambora volcano in Indonesia in April of 1815, possibly exacerbated by a hitherto unknown volcanic eruption six years before. The data from the stalagmite measurements show that summers were cold and winters very wet during this time, which combined with year-round flooding led to poor harvests and famine.

The information stored in the stalagmite also provides evidence on long-term climate fluctuations such as the Little Ice Age, whose core period began at the end of the 16th century and lasted until the late 17th century. According to the researchers, this period was marked by frequent flooding, which is historically documented in the city of Nuremberg not far from the “Teufelshöhle”. The climate data from the cave was verified using a tree-ring archive from the vicinity. The data point to cold dry winters that delayed the annual ice and snow melts, leading to major short-term floods with catastrophic consequences, explains Dr Kluge from the Institute of Applied Geosciences at the KIT.

The research results were published in the journal Earth and Planetary Science Letters. Along with the scientists from Heidelberg and Karlsruhe, researchers from Berlin, Hohenheim, and Mannheim participated in the investigations.

 

Chronic inflammation and poverty are a ‘double whammy’ for mortality risk


Peer-Reviewed Publication

UNIVERSITY OF FLORIDA




A new study led by a University of Florida College of Public Health and Health Professions researcher finds that people with chronic inflammation living in poverty have more than double the risk of dying from heart disease and nearly triple the risk of dying from cancer within the next 15 years. The findings are based on data representing 95 million Americans ages 40 and over.

While chronic inflammation and poverty are each known to increase mortality risk, when combined, the two factors appear to have a synergistic effect, producing a greater increase in risk than if the individual effects of the two factors were merely added together, the study authors say. Their findings appear in the journal Frontiers in Medicine.

“There is a lot of existing evidence that chronic inflammation can lead to disease,” said lead author Arch Mainous III, Ph.D., a professor in the department of health services research, management and policy in the UF College of Public Health and Health Professions. “We became interested in the potential interplay of chronic inflammation with poverty, which tends to increase inflammation in its own right through factors such as chronic stress. We found that poverty and high levels of inflammation act synergistically, giving people with both factors basically a double whammy. It makes them far more likely to die and in a relatively short period of time, just 15 years.”

Acute inflammation is part of the body’s healthy short-term immune response to fighting infection, toxins or other foreign substances that may enter the body. Chronic inflammation, however, lasts for months or years and has been shown to increase the risk for developing conditions such as cancer, heart disease, Type 2 diabetes and kidney disease. Another new study led by Mainous indicates that 34.6% of U.S. adults have systemic inflammation.

Chronic inflammation can be caused by a host of lifestyle, physiological and environmental factors, such as poor diet, stress, lack of physical activity, smoking, aging, obesity, autoimmune disorders and exposure to toxins in the environment.

The findings from the UF study highlight the need for routine chronic inflammation screenings in vulnerable populations to limit what are, in many cases, preventable deaths, said Mainous, also the vice chair for research in the UF College of Medicine’s department of community health and family medicine. Currently, there are no clinical guidelines for chronic inflammation screening.

“Investigators have been studying chronic inflammation for 25 years and we have a lot of data on its role in the disease pathway and mortality,” Mainous said. “We know it’s a problem, but we don’t do anything about it. We need to translate the basic science on chronic inflammation to the doctor’s office through the creation of screening guidelines so physicians can identify chronic inflammation in their patients and work to treat the underlying causes.”

For the UF study, researchers evaluated data from the National Health and Nutrition

Examination Survey, a nationally representative survey conducted by the National Center for Health Statistics that combines survey questions with laboratory testing. The team analyzed data collected from adults ages 40 and older whose household income fell below the U.S. poverty line and whose lab tests showed elevated levels of C-reactive protein, an indicator of chronic inflammation. Records were linked to the National Death Index to track mortality over a 15-year period.

Those individuals living with both chronic inflammation and poverty had a 127% increased risk for dying from heart disease and a 196% increased risk for dying from cancer. People living with chronic inflammation or poverty, but not both factors, had about a 50% increase in mortality risk over the same period.

“It is time to move beyond documenting the health problems that inflammation can cause to trying to fix these problems,” Mainous said.

In addition to Mainous, the UF study team included members of the department of community health and family medicine at the College of Medicine: Frank A. Orlando, M.D., a clinical associate professor; Lu Yin, Ph.D., a data management analyst; Velyn L. Wu, M.D., an assistant clinical professor; and Aaron A. Saguil, M.D., a professor and of the department chair; as well as Pooja Sharma, a doctoral student in health services research at the College of Public Health and Health Professions.

A new study led by a University of Florida College of Public Health and Health Professions researcher finds that people with chronic inflammation living in poverty have more than double the risk of dying from heart disease and nearly triple the risk of dying from cancer within the next 15 years. The findings are based on data representing 95 million Americans ages 40 and over.

While chronic inflammation and poverty are each known to increase mortality risk, when combined, the two factors appear to have a synergistic effect, producing a greater increase in risk than if the individual effects of the two factors were merely added together, the study authors say. Their findings appear in the journal Frontiers in Medicine.

“There is a lot of existing evidence that chronic inflammation can lead to disease,” said lead author Arch Mainous III, Ph.D., a professor in the department of health services research, management and policy in the UF College of Public Health and Health Professions. “We became interested in the potential interplay of chronic inflammation with poverty, which tends to increase inflammation in its own right through factors such as chronic stress. We found that poverty and high levels of inflammation act synergistically, giving people with both factors basically a double whammy. It makes them far more likely to die and in a relatively short period of time, just 15 years.”

Acute inflammation is part of the body’s healthy short-term immune response to fighting infection, toxins or other foreign substances that may enter the body. Chronic inflammation, however, lasts for months or years and has been shown to increase the risk for developing conditions such as cancer, heart disease, Type 2 diabetes and kidney disease. Another new study led by Mainous indicates that 34.6% of U.S. adults have systemic inflammation.

Chronic inflammation can be caused by a host of lifestyle, physiological and environmental factors, such as poor diet, stress, lack of physical activity, smoking, aging, obesity, autoimmune disorders and exposure to toxins in the environment.

The findings from the UF study highlight the need for routine chronic inflammation screenings in vulnerable populations to limit what are, in many cases, preventable deaths, said Mainous, also the vice chair for research in the UF College of Medicine’s department of community health and family medicine. Currently, there are no clinical guidelines for chronic inflammation screening.

“Investigators have been studying chronic inflammation for 25 years and we have a lot of data on its role in the disease pathway and mortality,” Mainous said. “We know it’s a problem, but we don’t do anything about it. We need to translate the basic science on chronic inflammation to the doctor’s office through the creation of screening guidelines so physicians can identify chronic inflammation in their patients and work to treat the underlying causes.”

For the UF study, researchers evaluated data from the National Health and Nutrition

Examination Survey, a nationally representative survey conducted by the National Center for Health Statistics that combines survey questions with laboratory testing. The team analyzed data collected from adults ages 40 and older whose household income fell below the U.S. poverty line and whose lab tests showed elevated levels of C-reactive protein, an indicator of chronic inflammation. Records were linked to the National Death Index to track mortality over a 15-year period.

Those individuals living with both chronic inflammation and poverty had a 127% increased risk for dying from heart disease and a 196% increased risk for dying from cancer. People living with chronic inflammation or poverty, but not both factors, had about a 50% increase in mortality risk over the same period.

“It is time to move beyond documenting the health problems that inflammation can cause to trying to fix these problems,” Mainous said.

In addition to Mainous, the UF study team included members of the department of community health and family medicine at the College of Medicine: Frank A. Orlando, M.D., a clinical associate professor; Lu Yin, Ph.D., a data management analyst; Velyn L. Wu, M.D., an assistant clinical professor; and Aaron A. Saguil, M.D., a professor and of the department chair; as well as Pooja Sharma, a doctoral student in health services research at the College of Public Health and Health Professions.

JOURNAL

DOI

METHOD OF RESEARCH

SUBJECT OF RESEARCH

ARTICLE TITLE

ARTICLE PUBLICATION DATE


Living in poverty with chronic inflammation significantly increases heart disease and cancer mortality risk, study finds


Combined effect of poverty and inflammation on mortality is worse than expected from separate effects


Peer-Reviewed Publication

FRONTIERS





In the US, approximately 37.9 million people, or 11.4% of the population, lived below the poverty line in 2022. It has been well demonstrated that poverty negatively affects physical and mental health. For example, people living in poverty run a greater risk of mental illness, heart disease, hypertension, and stroke, and have a higher mortality and lower life expectancy. The mechanisms by which poverty impacts on health outcomes are manifold: for example, people experiencing poverty have reduced access to healthy food, clean water, safe housing, education, and healthcare.

Now, researchers have shown for the first time that the effects of poverty may combine in a synergistic manner with another risk factor, chronic inflammation, to reduce health and life expectancy even further. They found that health outcomes for Americans living in poverty and with chronic inflammation are significantly worse than expected from their separate health effects. The results are published in Frontiers in Medicine.

“Here we show that clinicians need to consider the effect of inflammation on people’s health and longevity, especially on those experiencing poverty,” said lead author Dr Arch Mainous, a professor at the University of Florida.

Inflammation is a natural physiological reaction to infections or injuries, essential for healing. But chronic inflammation – caused by exposure to environmental toxins, certain diets, autoimmune disorders such as arthritis, or other chronic diseases like Alzheimer’s – is a known risk factor for disease and mortality, just like poverty.

NHANES

Mainous and colleagues analyzed data from adults aged 40 and older, enrolled between 1999 and 2002 in the National Health and Nutrition Examination Survey (NHANES), and followed them until 31 December 2019. The NHANES, conducted since 1971 by the National Center for Health Statistics, tracks the health and nutritional status of US adults and children. The NHANES allows for estimates of the US population represented by the cohort, and this study represented nearly 95 million adults. The authors combined NHANES data with records from the National Death Index, to calculate mortality rates over a period of 15 years after enrollment.

Among other demographics, NHANES records the household income. The authors divided this by the official poverty threshold to calculate the ‘poverty index ratio’, a standard measure of poverty.

Chronic inflammation

Whether participants suffered from severe inflammation was deduced from their plasma concentration of high sensitivity C-reactive protein (hs-CRP), produced by the liver in response to the secretion of interleukins by immune and fat cells. The concentration of hs-CRP, included among NHANES data, is a readily available, informative, and well-studied measure of inflammation: for example, elevated concentrations are known to increase the risk of cardiovascular disease and all-cause mortality.

Typically, a concentration of greater than 0.3 mg/dl hs-CRP is taken to indicate chronic systemic inflammation, but Mainous et al. also considered the more stringent threshold of 1.0 mg/dl in a separate analysis.

The authors classified participants in four groups: with or without chronic inflammation, and living below the poverty line or not. By comparing the 15-year mortality rate between these, they could thus study the effects of poverty and inflammation separately and jointly.

Synergistic effect

“We found that participants with either inflammation or poverty alone each had about a 50% increased risk in all-cause mortality. In contrast, individuals with both inflammation and poverty had a 127% increased heart disease mortality risk and a 196% increased cancer mortality risk,” said Dr Frank A. Orlando, an associate professor at the University of Florida and the study’s second author.

“If the effects of inflammation and poverty on mortality were additive, you’d expect a 100% increase in mortality for people where both apply. But since the observed 127% and 196% increases are much greater than 100%, we conclude that the combined effect of inflammation and poverty on mortality is synergistic.”

Routine screening for both risk factors?

A wide variety of treatments for systemic inflammation exists, ranging from diet and exercise to nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids. The present results suggest that clinicians might consider screening socially disadvantaged people – already a medically vulnerable group – for chronic inflammation, and if necessary treat them with such anti-inflammatory drugs. However, steroids and NSAIDS aren’t without risks when taken long-term. More research will thus be needed before patients are routinely prescribed them in clinical practice to decrease systemic inflammation.

“It’s important for guidelines panels to take up this issue to help clinicians integrate inflammation screening into their standard of care, particularly for patients who may have factors that place them at risk for chronic inflammation, including living in poverty. It is time to move beyond documenting the health problems that inflammation can cause, to trying to fix these problems,” concluded Mainous.