emerging infectious diseases - Dx caused by newly evolved strains or organisms - Dx caused by pathogens endemic in other species that enter human popupalation - Dx caused by pathogens present in human populations but show recent increase in incidence

Environmental and Nutritional Diseases I Flashcards by Matt Stanton

single leading global cause of heath loss

undernutrition

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leading cause of death in developed countries

ischemic heart disease and cerebrovascular disease

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half leading cause of death in developing countries

infectious disease

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EIDs

emerging infectious diseases

Dx caused by newly evolved strains or organisms
Dx caused by pathogens endemic in other species that enter human popupalation
Dx caused by pathogens present in human populations but show recent increase in incidence

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highest mortality of children under 5

malnutrition and infections in east, central, western africa

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infections leading to childhood deaths

pneumonia
diarrhea
malaria
measles
neonatal

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diarrhea

leading cause of death in africa
-loss of water

E.coli
campilobacter
rotavirus

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greenhouse gases

carbon dioxide
methane
ozone

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toxicology

science of poisons

-includes radiation and heat

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definition of poison

quantitative concept dependent on dosage

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xenobiotics

exogenous chemicals in env in air, water, food, that may be absorbed into body through inhalation, ingestion, skin contact

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detoxification

metabolized to inactive water-soluble products

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phase 1 reactions

hydrolysis, oxidation, reduction

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phase 2 reactions

glucuronidation, sulfation, methylation, conjugation with gultathione

form water-soluble compounds that are readily excreted

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cytochrome p450

CYP
-important catalysis of phase 1 reactions

ER of liver

heme-containing enzyme

either activate or detoxify xenobiotics
-ROS as byproduct

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CCl4

carbon tetrachloride

-CYP convert to toxic trichloromethyl free radical

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benzo-alpha-pyrene

carcinogen in cigarette smoke

CYP converts to DNA-binding metabolite

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CYP inducers

environmental chemicals
drugs
smoking
alcohol
hormones

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activity of CYP inducers

binding nuclear receptors that heterodimerize with RXR

-associates with promoter elements in 5’ region of CYP gene

receptors:
aryl hydrocarbon
PPA
CA
PX

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CYP activity

variation among individuals

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outdoor air pollutants

ozone
nitrogen dioxide
sulfur dioxide
acid aerosols
particulates

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smog

consists of the 6 outdoor air pollutants

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ozone

high in atmosphere - absorbs dangerous UV

ground level is a pollutant

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ground level ozone

formed from nitrogen oxides and organic compounds in sunlight

toxicity mediated by free radicals

injure respiratory tract - type I alveolar cells

dangerous for those with asthma and emphysema

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source of sulfur dioxide

power plants burning coal, oil, copper smelting, paper mills -converted to sulfuric acid and sulfuric trioxide - burning sensation in nose and throat

particulate matter

soot -from oil fired power plants and diesel exhaust London in 50s

size of dangerous particulates

less than 10 um in diameter - inhaled into alveoli and phagoctosed - release of mediators for inflammation

carbon monoxide

incomplete oxidation of carbonaceous materials -systemic asphyxiant 200x greater affinity for hemoglobin than O2

systemic hypoxia and CO poisoning

20-30% Hg saturated

unconscious/death and CO poisoning

60-70% Hg saturated

Dx of CO poisoning

measure carboxyHg levels in blood

acute CO poisoning

generalized cherry-red color of the skin

most common indoor air pollutant

tobacco smoke

wood smoke

irritant, predispose to lung infection, may contain carcinogenic polycyclic aromatic hydrocarbons

bioaerosols

microbial agents that cause infection -legionaires, viral pneumonia, common cold allergens -dust mite, fungi, molds

radon

radioactive has from uranium -in soil and in homes -lung ca in uranium miners

formaldehyde

manufacture of building materials | -refugees of environmental disasters

low levels of lead

in children significant negative effects

heavy metals

lead arsenic mercury cadmium

subclinical lead poisoning

less than 10 ug/dL low intellectual capacity behavioral problems hyperactivity organization skills

half life of lead

in bone 20-30 years

neurotoxicity of lead

inhibit neurotransmitters - disrupt Ca homeostasis

Pb and decreased Hg synthesis

Pb and death

150

Pb and encephalopathy, nephropathy, frank anemia

around 100

Pb and changes in nerve conductdion

Pb inhibits two enzymes

delta-aminolevulinic acid and ferrochelatase

ferrochelatase

incorporation of iron into protoporphyrin (-) by lead results in microcytic, hypochromic anemia

Hg and Pb

microcytic, hypochromic anemia

diagnosis of lead poisoning

blood levels of lead and free red cell protoporphyrin

ringed sideroblasts

Pb inhibition of ferrochelatse | -results in red cell precursors with iron-laden mitochondria detected with prussian blue stain

Pb and brain

demyelination edema astroctyte proliferation necrosis of cortical neurons

peripheral demyelinating neuropathy

from lead poisoning extensor mm first (wrist drop) followed by peroneal mm (foot drop)

Pb and kidneys

chronic interstitial fibrosis | -saturnine gout

basophilc stipling

often with Pb intoxication

forms of mercury

metallic (elemental) inorganic (mercuric chloride) organic (methyl)

main source of mercury exposure

contaminated fish -methyl mercury and vapors from metallic mercury in dental amalgams

skin cancers and hyperpigmentation

with arsenic squamous and basal cell carcinomas not sun exposed surfaces -pals of hands and soles of feet

cadmium intoxication

food exposure itai-itai (ouch ouch) - in rice in Japan -osteoporosis and osteomalacia not directly genotoxic - but produces ROS

arsenic

royal poison soil and water, herbicides

most toxic arsenic

arsenic trioxide

arsenic ingestion

GI, cardiovascular, CNS problems | -interfers with Ox Phos