Heat stress (HS) is a common stressor that affects all biological systems. Mild to moderate HS is associated with intact baroreflex response which tries to cope up with the stress by maintaining mean arterial pressure (MAP). However, during severe HS, baroreflex response fails leading to fall in MAP which is a pathognomonic feature of heat stroke. Heat stroke can induce neuroinflammation, brain ischemia, oxidative stress and neuronal damage. Increase in ambient temperature led to activation of the thermoregulatory process in Hypothalamus (HTH) and was achieved by rise in nor-epinephrine and fall in serotonin, whereas neurotransmitter imbalance occurred during severe HS in HTH and was associated with expression of inflammatory mediators. Results of our preliminary study also suggested that neuroinflammation was associated with neurotransmitter (monoamines and glutamate) imbalance in HTH leading to thermoregulatory disruption during severe HS. Here, we also discussed that individuals predisposed to factors like chronic inflammation and other complications could decrease the threshold of heat tolerance since a short episode of even sub maximal heat exposure would precipitate the inflammatory cascade leading to thermoregulatory shutdown.
Heat StrokeExposure to high ambient temperature initiates wide physiological responses like sending afferent signals from peripheral thermoreceptors to the preoptic anterior hypothalamus (POAH) followed by efferent signals from CNS to the periphery. It results in an increase in sympathetic activity and peripheral vasodilation enabling intravascular fluid to take away the heat from core to periphery and cool down the skin by evaporation. However, HS related maladies result when the compensatory mechanisms are exhausted either due to overexposure to heat or predisposing factors that increase susceptibility to heat intolerance. In its severe form, patients cease to sweat and core temperature rises >41°C along with ataxia and altered sensorium which is a pathological condition termed as heat stroke. Uncompensated heat stroke is characterized by hyperthermia associated with the systemic inflammatory response that leads to multi organ dysfunction syndrome (MODS), in which central nervous system (CNS) dysfunctions prevail 1 . Heat stroke related deaths have increased worldwide as extreme weather events are the consequences of anthropogenic climatic changes [2][3][4][5] . Cases of dehydration, low physical fitness, obesity, lack of