impact of climate change on the dynamic of disease

7/24/2019 Impact of Climate Change on the Dynamic of Disease

1/30

Impact of Climate Change on the Dynamic of Disease

EBV, Cancer, Malaria

and Climate Change : pulling the trigger

Sofia Mubarika HaryanaFaculty of Medicine

Universitas Gadjah Mada

2829 October 2015


2/30

Outline

1. Post MDGs 2015SDGs 2030

2. The effect of climate change to health:

3. Viral related cancerclimate effect4. Future works :joint forces to better world


3/30

United Nations Development Programme

1. Post-2015 SDGs 2030

THE WORLD WE WANT

(status: 20 February 2012)

Equity, accesibility, peace, better life and ecosystem


4/30

Where is health in the SDGs?

SDGs3: Ensure healthy lives and promote

wellbeing for all at all ages: 9 targets that

cover a wide range of health issues, from

maternal and child health to environmental

health

SDG s 7: greater access to energy , increasethe services hospitals and community health

centers

SDGs 13: climate change that change

ecosystems and increase vector bornediseases.

SDGs 16: Peace and stability will impact the

mental and physical health of communities


5/30

Heat & cold waves:5,671

climate

15,000 excess deaths in France, 35,000 elsewhere in Europe, triggered

by two weeks of heatwave. Sixty percent of deaths were >75 years(IPCC, 2007)

2. Climate Change to Health.....


6/30

Climate - Vector-borne threats Europe

Disease Vector Notes

African horse

sickness,bluetongue

Biting midges Europe 1998-2010

Canine

leishmanosis

Sand flies Belgium 2005

(vectors)

Dengue fever Asian tigermosquito

France 2010

Chikungunya

Fever

Asian tiger

mosquito

Italy 2007

West Nile fever Culicidmosquitoes

Mediterranean basin: 1990s to

present

Crimean Congo

haemorrhagic fever

Ticks Spreading in the Balkans


7/30

Vector-borne Disease

What is VBD?

Types of VBD transmission:Human-vector-human

(Anth ropo not ic Infect ions)

Vector

Humans

Humans

Vector

Malaria

Dengue

Yellow fever

Animal-vector-human

(Zoon otic Infect io ns)

Vector Vector

Animals

Animals

Humans Lyme diseaseHantaviral disease

Most arboviral diseases (e.g., WNV)


8/30

Vector-borne Disease Dynamics

Susceptiblepopulation

Migration (forced)

Vector environment

Vector

Survival, lifespan

Reproduction/breeding patterns

Biting behavior

Pathogen

Survival

Transmission

Replication in host


9/30

Direct Effects of Climate Change on Vector-borne Disease

Climate change has the potential to Increase range or abundance of animal reservoirs

and/or arthropod vectors

(e.g., Malaria, Schistosomiasis, Lyme)

Enhance transmission (e.g., West Nile virus and other arboviruses)

Increase importation of vectors or pathogens (e.g., Dengue, Chikungunya, West Nile virus)

Increase animal disease risk and potential humanrisk (e.g., Trypanosomiasis)

Greer et al., 2008


10/30

Case Study I: Malaria


11/30

40% world population at risk

500 million severely ill

Climate sensitive disease1

No transmission where mosquitoes

cannot survive Anopheles: optimal adult

development 28-32C

P falciparum transmission: 16-33C

Highland malaria2

Areas on the edges of endemic

regions

Global warming El Nio3

Outbreaks

Estimated incidence of clinical malaria episodes (WHO)

1 Khasnis and Nettleman 2005; 2 Patz and Olson 2006; 3 Haines and Patz,2004

McDonald et al., 1957

Case Study I: Malaria (cont.)


12/30

WHO, 2008b

Malaria Transmission Map


13/30

Climate change and malariascenario

Hugo Ahlenius, UNEP/GRID-Arendal, 2005


14/30

Summary of Climate ChangeEffects

Climate change has the potential to Increase range or abundance of animal reservoirs

and/or arthropod vectors Lyme, Malaria, Schistosomiasis

Prolong transmission cycle Malaria, West Nile virus, and other arboviruses

Increase importation of vectors or animalreservoirs Dengue, Chikungunya, West Nile virus

Increase animal disease risk and potential humanrisk African trypanosomiasis


15/30

Viral related cancers

1. Epstein Barr Virus (EBV)Nasopharyngeal Cancer,Lymphoma, Non Hodgkinlymphoma, B Cell

Lymphoma, Gastric carcinoma - SALIVA

2. Human Papilloma Virus (HPV) Cervical Cancer - STD

3. HIVsarcoma - STD

4. Hepatitis B virus ( HBV / HCV)Hepatocellular

carcinoma - SALIVA

5. TB / HPV Lung Cancer - STD

http:/www.med.sc.edu:85/virol/herpes.htm


16/30

Globocan 2012Cancer incidence and mortality

HPV

EBV + Helicobacter Pylorii

HPV + EBV

HPV

HPV + EBV

HBV

EBV

EBV


17/30

Cancer FactsGlobocan 2012

> 70% death

International Agency for Research on Cancer


18/30

Epstein Barr VirusNPC

Infect > 90 % population worldwide - Kissingdisease .

DNA virus ( herpes Virus)once infect will

reside the whole life in the infected individu Infect Epithel oropharynx through gp 21 ( also

express on B lymphocytes)IgG and IgA

Screening strategyELISA


19/30

Etiology of NPC

NPC

Epstein-Barr virus

Ethnicity

DietTobacco

(Immuno)genetic

factors

GenderHerbal

Drugs/

oils

Environmental

factors

100%
http://images.google.nl/imgres?imgurl=www.cdc.gov/diabetes/pubs/images/bathroom.gif&imgrefurl=http://www.cdc.gov/diabetes/pubs/tcyd/ktrack.htm&h=163&w=158&prev=/images?q=FEMALE+MALE++SIGN&svnum=10&hl=nl&lr=&ie=UTF-8&oe=UTF-8http://images.google.nl/imgres?imgurl=astronomy.swin.edu.au/~pbourke/texture/flag/china.gif&imgrefurl=http://astronomy.swin.edu.au/~pbourke/texture/flag/&h=217&w=325&prev=/images?q=china&svnum=10&hl=nl&lr=&ie=UTF-8&oe=UTF-8http://www.mobot.org/MOBOT/research/library/kohler/1761_089.jpghttp://images.google.nl/imgres?imgurl=stagnes.dio.org/images/chili%20pepper.gif&imgrefurl=http://stagnes.dio.org/parish_bulletin.htm&h=338&w=481&prev=/images?q=chili+pepper&svnum=10&hl=nl&lr=&ie=UTF-8&oe=UTF-8http://images.google.nl/imgres?imgurl=www.chez.com/frenzy/images/cigarette.jpg&imgrefurl=http://www.chez.com/frenzy/horreur_noire.htm&h=180&w=300&prev=/images?q=cigarette&svnum=10&hl=nl&lr=&ie=UTF-8&oe=UTF-8


20/30

EBV - Nasopharyngeal carcinoma (NPC)

Tumor arising from the epithelial cells covering nasopharyngeal

surface.

Remarkable geographical incidence; frequently occurs in a well-defined regions.

Absolut association to Epstein-Barr virus (EBV) infection - > 90%

population infected worldwide

Non specific symptoms

https://reader009.{domain}/reader009/html5/0319/5aaf0dd22083b/5aaf0ddbcc984.jpg; IARC publication; Chang ET & Adami HO. Cancer Epid Biomarkers Prev. 2006.
http://nasopharyngealcancer.com/images/head.jpghttp://nasopharyngealcancer.com/images/head.jpg


21/30

( C)


22/30

Nasopharyngeal carcinoma (NPC) in Indonesia:

3%

0%

11%

30%

21%

35%

0%

Stage I Stage II A Stage II B Stage III Stage IV A Stage IV B

0

10

20

30

40

50

60

70

01-

10

yrs

11-

20

yrs

21-

30

yrs

31-

40

yrs

41-

50

yrs

51-

60

yrs

61-

70

yrs

71-

80

yrs

>80

yrs

Male

Female

Sardjito hospital Yogyakarta : the 1st cancer in man

Non-specific symptoms at early stage

85% late stage

(III/IV)


23/30

Figure 10-3 part 1 of 3


24/30

The regulation of B cell activation by complement receptor

Binding of complement proteins (C3d) to antigens directly or via attached antibodies leads tocoligation of antigen receptors (Ig) and complement receptors (CR2, CD21) on antigen-specificB cells. This enhances the Ig-mediated signal and the subsequent B cell response.

The complement receptors (CR2/CD21)are the EBV receptors on B cells

The EBV viral envelope protein gp350/200, which shares a regionof sequence similarity with C3d, can interact with CR2/CD21


25/30


26/30

Date1: 12-09-20012: 03-12-2001

3: 15-03-2002

4: 17-10-2002

5: 16-12-2002

6: 01-05-2003

7: 02-07-20038: 05-11-2003

9: 19-11-2003*

Days1: 02: 82

3: 184 CR

4: 400

5: 460

6: 596

7: 6588: 784

9: 798* Mx

EBV IgA ELISA

0,0

0,5

1,0

1,5

2,0

2,5

3,0

3,5

1 2 3 4 5 6 7 8 9

Sample number

ELISAO

D4

50valu VCA-p18 peptide

EAd-extract

* Lung metastasis (CT/MRI)

1 2 3 4 5 6 7 8 9*

BFRF3 (18 kD)

BZLF1 (36+38 kD)

BdRF1 (40 kD)

BALF2 (138 kD)

BKRF1 (72 kD)BXLF1 (68 kD)

BMRF1 (47/54 kD)

BGLF5 (58 kD)

Immunoblot

Case: Female caucasian (age 16): T4N1M0Treatment Chemoradiation + IFN- > 2 years follow-up

R.Mertens et al. Cancer. (1997);80(5):951-9.

EBV-serology predictive

at >6 months pre-metastasis

Note: No increased EBV-DNA in circulation


27/30

Best practices ....In Taiwan

In year 2002EBV/ NPC is the highest in

Taiwan and China

In Year 2012EBV /NPC is very low ( 2nd

lowest ) WHY ??

Taiwan : good hygieneclean water , healthy

life style


28/30

IGR KI VUMC AvL UGM

From Basic to Clinic Advocacy

Multidiscipline Integrated

tr nsl tion l ppro ch

From bench to precision medicine

UNHAS USU UNUD UNAIR UI UNPAD UNDIP UB

Best Practices : To be C oE in EBVNasopharyngeal carcinoma

diagnosisi, treatment band prevention in Indonesia

Asia Link (EU ) : 20032006

KWF : 2006 - nowRistek Dikti/ PUPT : 2012 - now


29/30

Future works

EBVcancer - high burden : EBV + Malaria ( Co-

infection? Joint forces muliti and transdiscipiin

Early screening : Dip stickimmunohromatography

based - Early Stage Minimal Invasive : Cancer Biomarkers ( NPC, Breast,

Ovarial, HCC)

Translational reserach From genomic to proteomics

EBV genomeHost genome

Clean water , healthy life style are required :CAMPAIGN


30/30

FM UGM established 5 March 1946

UGM established on 19 December 1949

through synergy to better world..........

Merci ...

Kop kun kap...

Thank you ...

Terima kasih...

Matur nuwun...

impact of climate change on the dynamic of disease

Documents