Climate change and lung health

“As temperatures rise around the world due to climate change, so does the level of air pollution."

The KHP Cardiovascular & Respiratory Partnership Programme spoke with Dr Annika Warnatsch from the King’s Centre for Lung Health to learn about the centre’s research on the impact of air pollution in vulnerable populations. 

The King's Centre for Lung Health focuses on innovative ways to promote lung health throughout the lifetime through preventing, diagnosing and treating lung disease. By driving excellence in discovery and applied science, and working with scientists, healthcare professionals, patients, and communities the centre aims to help solve the most pressing lung health problems.  

Although the King’s Centre for Lung Health only launched in June 2022, the team has already led many influential projects, including working with collaborators to pioneer clinical trials and patient centred outcomes; innovating diagnostics for lung health and illness; and investigating new treatments for acute illness in patients with asthma and chronic obstructive lung disease.  

One of the main focuses for the centre is on a novel study to investigate the impact of particulate matter (PM) (a mixture of solid particles and liquid droplets found in the air) on airway health, particularly in vulnerable populations.  

We caught up with Dr Annika Warnatsch, group leader at the King’s Centre for Lung Health, to learn more about the centre’s research, and the bold action that needs to be taken to protect vulnerable people from the stark effects of air pollution.  

What’s the relationship between climate change and lung health?  

“As temperatures rise around the world due to climate change, so does the level of air pollution. This vicious cycle intensifies the greenhouse effect, contributing towards global warming. However, air pollution is also a health emergency. The relationship between climate change and lung health is a matter of grave concern, reaching far beyond environmental degradation.  

“The World Health Organization (WHO) report that 99% of the human population live in areas where air quality fails to meet safety guidelines. The consequences of pollution affect millions globally and is a driving factor of respiratory diseases, lung cancer, heart disease, and strokes; contributing towards millions of premature deaths annually.   

“Air pollution can cause new respiratory conditions, as well as serve as a trigger to worsen existing illnesses like asthma or chronic obstructive pulmonary disease (COPD). It additionally weakens the body’s ability to combat viral infections, leaving people more vulnerable to respiratory illnesses. Alarmingly, it can harm the growth of children’s lungs, with potentially irreversible consequences. So, if we want to learn more about how to protect our vulnerable communities from air pollution, we need a deeper understanding of the connection between climate change and lung health.”  

There is also a lesser-known yet equally pressing concern of the environmental footprint of medical interventions, as Annika explains:  

“Inhalers, which are essential for managing respiratory conditions, pose a dual threat. Firstly, once they are disposed of, they contribute to landfills. Secondly, a single inhaler equates to the environmental impact of a lengthy car journey, significantly adding to our carbon footprint. Considering the staggering number of asthma sufferers worldwide, estimated at 232 million, reducing inhaler usage could yield substantial sustainability benefits, both for individual health and the planet's well-being.” 

Elsewhere in the partnership, work is under way to support high value sustainable inhaler practice and responsible respiratory prescribing.  

Tell us about the grant that has been awarded to look at the effects of air pollution on lungs?  

“Our team has been awarded the prestigious King’s Climate and Sustainability Seed Funding Award totalling over £54,000. The funding has enabled cross-partner site collaboration -combining expertise in immunology, respiratory medicine, environmental science, molecular biology, and pharmacology.  

“Not only does our team encompass expertise across specialities, including proof-of-concept experimental studies; environmental exposure; combustion and forest fires; air pollution; and molecular signalling pathways, we have also partnered with four institutions in India and Thailand: the St John’s Research Institute in Bangalore; and in Thailand Chulalongkorn University in Bangkok; Khon Kaen University; and Chiang Mai University. 

“These two countries are heavily impacted by air pollution, and so, we can leverage these partnerships to provide diverse real-world air pollution samples.” 

What have you set out to achieve? 

“Our aim is to understand the impacts of real-world PM on airway health, particularly the effects on vulnerable populations, including those that already have COPD. Most other studies have not used real-world air pollution, which is highly variable, particularly with the time and season. We will be taking a closer look at real-world air-pollution samples from forest fires, combustion, and other environmental exposures in Thailand and India.  

“With the help of these real-world air pollution samples, our pioneer data so far indicates that different types of air pollution, such as from forest fires and combustion, across various locations can trigger unique inflammatory reactions in biological systems. Neutrophils, the most abundant white blood cells, arrive rapidly at sites of infection. They are equipped with a multitude of powerful anti-microbial defence mechanisms and secrete mediators that recruit and activate local cells. If they are unregulated, these functions can cause collateral damage and contribute to disease pathology.    

“Our findings suggest that exposure to PM pollution can activate various responses in neutrophils, and the specific reactions depend on where the pollution comes from and what it's made of. We will investigate neutrophil responses from healthy donors and COPD patients by exposing them to varied PM samples. The team will also examine detrimental inflammatory responses, including how to block meanwhile allowing beneficial responses.” 

What has inspired you to pursue your work in this area? 

“Since 2019, my lab’s work has focused on neutrophil responses in the lung, including the role of neutrophils and the cytotoxic mediators they produce during respiratory virus infections. So, this is a relevant and exciting piece of research to be involved with. Catherine Hawrylowicz, Professor of Immune Regulation in Allergic Disease, is pivotal to this research, and she has a long-standing background in air pollution, including how PM and vitamin D affect respiratory health immunity.”  

How do you see the future of this research?  

“In collaboration with our clinical colleagues, we aim to identify interventions that can protect at-risk people with respiratory conditions who are particularly vulnerable during episodes of heightened pollution. This research could result in the design of neutrophil targeted treatments, and strategies to alleviate the impact of PM-induced changes on antiviral responses. Ultimately, we hope to advance precision medicine to protect airway health and combat the devastating impact of PM exposure.  

“The team are now looking for further funding to support the continuation of this vital and important work.” 

For further information about the research, please contact Annika.Warnatsch <at> kcl.ac.uk.  

To find out more about the King’s Centre for Lung Health, visit its website here.