UToledo Leads Charge to Understand Health Effects of Harmful Algal Blooms

UToledo Leads Charge to Understand Health Effects of Harmful Algal Blooms

The Power To Do Public Impact Research: Since a harmful algal bloom forced the city of Toledo to issue a "Do Not Drink" water advisory in 2014, UToledo has been working to protect water quality and the health of Lake Erie for the half million people in the region who depend on it for drinking water. This is the fourth in a five-part series detailing UToledo's water quality research efforts over the past decade.

The potential dangers of high-level microcystin exposure were made clear in the mid 1990s, when more than 100 dialysis patients in Brazil developed acute liver failure after being exposed to tainted water.

However, there was relatively little research being done on the wider public health impact of the toxins, which are produced by blooms of blue-green algae like those that crop up on Lake Erie nearly every summer.

"This absolutely hadn't hit anybody's radar," said Dr. Joan Duggan, an infectious disease specialist and professor of medicine at The University of Toledo. "It was in the lake, but it wasn't something most people - citizens and scientists alike - were thinking about."

That changed almost overnight in 2014, when a half-million people in northwest Ohio were advised not to use their tap water after high levels of the toxin were detected in both the lake and processed water.

"There has been an explosion of research in this area in the last decade," Duggan said, "and we're just starting to get our hands around a number of critical research questions for microcystin."

Many of those questions are being tackled by a multidisciplinary team of researchers at UToledo who are investigating how the toxins affect individual organ systems, potential ways to test for exposure and how various routes of exposure to harmful algal toxins may impact human health.

The name blue-green algae is a bit of a misnomer - they actually aren't algae at all. Instead, it's a type of photosynthetic bacteria called cyanobacteria, and they're found in freshwater ecosystems around the world.

Lake Erie's shallow western basin, which warms easily and has been heavily polluted by phosphorus flowing in from the Maumee River, happens to be a particularly hospitable environment for the single-celled organisms.

While many types of cyanobacteria are harmless, some can release powerful toxins including microcystins.

Dr. David Kennedy, a molecular biologist and associate professor of medicine at UToledo, said the 1996 incident in Brazil got a lot of people's attention and burnished microcystin's reputation as a liver toxin.

That wasn't the whole story.

"One of the things we've learned since then is that calling it a liver toxin doesn't really capture the true nature of microcystin," said Kennedy, whose research focus shifted to include investigation of adverse health effects of exposure to harmful algal bloom toxins following the Toledo water crisis. "Microcystin impacts so many things other than the liver. Our group has looked at the gut, the lungs, we're looking at the cardiovascular system, we're looking at neurological effects, we're looking at the skin. Those are definitely things that in 2014 we did not have good information on."

Kennedy and Dr. Steven Haller, also an associate professor of medicine, have focused on how pre-existing health conditions may make people more susceptible to harmful effects following exposure to microcystins.

Their lab experiments have shown strong evidence that suggests microcystin can worsen the severity of pre-existing colitis and exacerbate lung inflammation in asthma. They've also found that low levels of microcystin can significantly amplify non-alcoholic fatty liver disease - a condition common in individuals with diabetes.

The pair also has worked with Dr. Youngwoo Seo in the College of Engineering and Dr. Jason Huntley in the Department of Medical Microbiology and Immunology to study the potential of naturally occurring microcystin-degrading bacteria as a preventative or therapeutic solution and received a patent for a novel antibody test to confirm microcystin exposures.

More recently they have turned their focus to the potential for microcystin toxins to become airborne as algae-tainted waves crash against the Lake Erie shoreline.

Earlier this month, a research team led by Haller and Kennedy embarked on a first-of-its kind study to measure the health effects of airborne microcystin exposure in individuals who spend significant time near Lake Erie.

The Great Lakes Aerosol Monitoring Research Study, which launched this month, will follow 200 individuals from Lucas, Ottawa and Sandusky counties over the next five years.

"We've done things in experimental models and human cell lines, which are really important, but now with this community-based health study we will hopefully get directly to questions about how this is affecting the lives of people who live or work around the lake," Haller said. "We've made some significant findings in the lab, but this is really the next step in understanding the true impact harmful algal blooms have on human health."

Duggan, whose capstone project for a master's degree in public health from Yale is focused on health effects of harmful algal blooms, said UToledo's community health study is critically important.

"Most of what we know from patients is retrospective, and that makes it very hard to truly know what the harmful health effects are. That's why it's so important to go out and prospectively gather this data," she said. "We are absolutely, positively poised to be a leader in this area. We have the clinical expertise and the research expertise, and I think we can make a real difference in this area."