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Burtscher J, Pasha Q, Chanana N, Millet GP, Burtscher M, Strasser B. Immune consequences of exercise in hypoxia: A narrative review. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:297-310. [PMID: 37734549 PMCID: PMC11116970 DOI: 10.1016/j.jshs.2023.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/14/2023] [Accepted: 08/23/2023] [Indexed: 09/23/2023]
Abstract
Immune outcomes are key mediators of many health benefits of exercise and are determined by exercise type, dose (frequency/duration, intensity), and individual characteristics. Similarly, reduced availability of ambient oxygen (hypoxia) modulates immune functions depending on the hypoxic dose and the individual capacity to respond to hypoxia. How combined exercise and hypoxia (e.g., high-altitude training) sculpts immune responses is not well understood, although such combinations are becoming increasingly popular. Therefore, in this paper, we summarize the impact on immune responses of exercise and of hypoxia, both independently and together, with a focus on specialized cells in the innate and adaptive immune system. We review the regulation of the immune system by tissue oxygen levels and the overlapping and distinct immune responses related to exercise and hypoxia, then we discuss how they may be modulated by nutritional strategies. Mitochondrial, antioxidant, and anti-inflammatory mechanisms underlie many of the adaptations that can lead to improved cellular metabolism, resilience, and overall immune functions by regulating the survival, differentiation, activation, and migration of immune cells. This review shows that exercise and hypoxia can impair or complement/synergize with each other while regulating immune system functions. Appropriate acclimatization, training, and nutritional strategies can be used to avoid risks and tap into the synergistic potentials of the poorly studied immune consequences of exercising in a hypoxic state.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, Lausanne 1015, Switzerland
| | - Qadar Pasha
- Institute of Hypoxia Research, New Delhi 110067, India
| | - Neha Chanana
- Department of Biochemistry, Jamia Hamdard, New Delhi 110062, India
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne 1015, Switzerland
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck 6020, Austria.
| | - Barbara Strasser
- Faculty of Medicine, Sigmund Freud Private University, Vienna 1020, Austria; Ludwig Boltzmann Institute for Rehabilitation Research, Vienna 1100, Austria
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Nieman DC. Exercise immunology: Novel insights. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:277-279. [PMID: 38278352 PMCID: PMC11117002 DOI: 10.1016/j.jshs.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 01/18/2024] [Indexed: 01/28/2024]
Affiliation(s)
- David C Nieman
- Human Performance Laboratory,Appalachian State University, North Carolina Research Campus, Kannapolis, NC 28081, USA.
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Maksiutenko EM, Merkureva V, Barbitoff YA, Tsay VV, Aseev MV, Glotov AS, Glotov OS. Exome sequencing in extreme altitude mountaineers identifies pathogenic variants in RTEL1 and COL6A1 previously associated with respiratory failure. Physiol Rep 2024; 12:e16015. [PMID: 38653581 PMCID: PMC11039409 DOI: 10.14814/phy2.16015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/02/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
Adaptation of humans to challenging environmental conditions, such as extreme temperature, malnutrition, or hypoxia, is an interesting phenomenon for both basic and applied research. Identification of the genetic factors contributing to human adaptation to these conditions enhances our understanding of the underlying molecular and physiological mechanisms. In our study, we analyzed the exomes of 22 high altitude mountaineers to uncover genetic variants contributing to hypoxic adaptation. To our surprise, we identified two putative loss-of-function variants, rs1385101139 in RTEL1 and rs1002726737 in COL6A1 in two extremely high altitude (personal record of more than 8500 m) professional climbers. Both variants can be interpreted as pathogenic according to medical geneticists' guidelines, and are linked to inherited conditions involving respiratory failure (late-onset pulmonary fibrosis and severe Ullrich muscular dystrophy for rs1385101139 and rs1002726737, respectively). Our results suggest that a loss of gene function may act as an important factor of human adaptation, which is corroborated by previous reports in other human subjects.
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Affiliation(s)
- Evgeniia M. Maksiutenko
- Department of Genomic MedicineD.O. Ott Research Institute of Obstetrics, Gynaecology, and ReproductologySt. PetersburgRussia
| | - Valeriia Merkureva
- Department of Genomic MedicineD.O. Ott Research Institute of Obstetrics, Gynaecology, and ReproductologySt. PetersburgRussia
- CerbaLab Ltd.St. PetersburgRussia
| | - Yury A. Barbitoff
- Department of Genomic MedicineD.O. Ott Research Institute of Obstetrics, Gynaecology, and ReproductologySt. PetersburgRussia
- Department of Genetics and BiotechnologySt. Petersburg State UniversitySt. PetersburgRussia
| | - Victoria V. Tsay
- Department of Genomic MedicineD.O. Ott Research Institute of Obstetrics, Gynaecology, and ReproductologySt. PetersburgRussia
- CerbaLab Ltd.St. PetersburgRussia
- Department of Experimental Medical VirologyMolecular Genetics and Biobanking of Pediatric Research and Clinical Center for Infectious DiseasesSt. PetersburgRussia
| | - Mikhail V. Aseev
- Department of Genomic MedicineD.O. Ott Research Institute of Obstetrics, Gynaecology, and ReproductologySt. PetersburgRussia
- CerbaLab Ltd.St. PetersburgRussia
| | - Andrey S. Glotov
- Department of Genomic MedicineD.O. Ott Research Institute of Obstetrics, Gynaecology, and ReproductologySt. PetersburgRussia
- Department of Genetics and BiotechnologySt. Petersburg State UniversitySt. PetersburgRussia
| | - Oleg S. Glotov
- Department of Genomic MedicineD.O. Ott Research Institute of Obstetrics, Gynaecology, and ReproductologySt. PetersburgRussia
- Department of Experimental Medical VirologyMolecular Genetics and Biobanking of Pediatric Research and Clinical Center for Infectious DiseasesSt. PetersburgRussia
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Abstract
The timing of life on Earth is remarkable: between individuals of the same species, a highly similar temporal pattern is observed, with shared periods of activity and inactivity each day. At the individual level, this means that over the course of a single day, a person alternates between two states. They are either upright, active, and communicative or they lie down in a state of (un)consciousness called sleep where even the characteristic of neuronal signals in the brain shows distinctive properties. The circadian clock governs both of these time stamps-activity and (apparent) inactivity-making them come and go consistently at the same approximate time each day. This behavior thus represents the meeting of two pervasive systems: the circadian clock and metabolism. In this article, we will describe what is known about how the circadian clock anticipates daily changes in oxygen usage, how circadian clock regulation may relate to normal physiology, and to hypoxia and ischemia that can result from pathologies such as myocardial infarction and stroke.
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Affiliation(s)
- Francesca Sartor
- Institute of Medical Psychology, Medical Faculty, LMU Munich, Germany (F.S., B.F.-B., M.M.)
| | - Borja Ferrero-Bordera
- Institute of Medical Psychology, Medical Faculty, LMU Munich, Germany (F.S., B.F.-B., M.M.)
| | - Jeffrey Haspel
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO (J.H.)
| | - Markus Sperandio
- Institute for Cardiovascular Physiology and Pathophysiology, Walter Brendel Center for Experimental Medicine, and the Biomedical Center (BMC), Medical Faculty, LMU Munich, Germany (M.S.)
| | - Paul M Holloway
- Radcliffe Department of Medicine, University of Oxford, United Kingdom (P.M.H.)
| | - Martha Merrow
- Institute of Medical Psychology, Medical Faculty, LMU Munich, Germany (F.S., B.F.-B., M.M.)
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Lei H. Hypoxia and Activation of Neutrophil Degranulation-Related Genes in the Peripheral Blood of COVID-19 Patients. Viruses 2024; 16:201. [PMID: 38399976 PMCID: PMC10891603 DOI: 10.3390/v16020201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 01/20/2024] [Accepted: 01/21/2024] [Indexed: 02/25/2024] Open
Abstract
Severe COVID-19 is characterized by systematic hyper-inflammation and subsequent damage to various organs. Therefore, it is critical to trace this cascade of hyper-inflammation. Blood transcriptome has been routinely utilized in the interrogation of host immune response in COVID-19 and other infectious conditions. In this study, consensus gene dysregulation in the blood was obtained from 13 independent transcriptome studies on COVID-19. Among the up-regulated genes, the most prominent functional categories were neutrophil degranulation and cell cycle, which is clearly different from the classical activation of interferon signaling pathway in seasonal flu. As for the potential upstream causal factors of the atypical gene dysregulation, systemic hypoxia was further examined because it is much more widely reported in COVID-19 than that in seasonal flu. It was found that both physiological and pathological hypoxia can induce activation of neutrophil degranulation-related genes in the blood. Furthermore, COVID-19 patients with different requirement for oxygen intervention showed distinctive levels of gene expression related to neutrophil degranulation in the whole blood, which was validated in isolated neutrophils. Thus, activation of neutrophil degranulation-related genes in the blood of COVID-19 could be partially attributed to hypoxia. Interestingly, similar pattern was also observed in H1N1 infection (the cause of Spanish flu) and several other severe respiratory viral infections. As for the molecular mechanism, both HIF-dependent and HIF-independent pathways have been examined. Since the activation of neutrophil degranulation-related genes is highly correlated with disease severity in COVID-19, early detection of hypoxia and active intervention may prevent further activation of neutrophil degranulation-related genes and other harmful downstream hyper-inflammation. This common mechanism is applicable to current and future pandemic as well as the severe form of common respiratory infection.
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Affiliation(s)
- Hongxing Lei
- CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, and China National Center for Bioinformation, Beijing 100101, China; ; Tel.: +86-010-84097276
- Cunji Medical School, University of Chinese Academy of Sciences, Beijing 101408, China
- Center of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing 100069, China
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Yu Z, Zhang EE. Disrupted circadian rhythms in the plateau pika. Trends Neurosci 2023; 46:1005-1007. [PMID: 37802756 DOI: 10.1016/j.tins.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 09/12/2023] [Indexed: 10/08/2023]
Abstract
The plateau pika (Ochotona curzoniae) is the most populous mammal on the 'third pole', the Qinghai-Tibet Plateau, and is presumed to have inhabited the region before the plateau rose up from sea level. Herein we discuss the disrupted circadian rhythm in the plateau pika and the gene polymorphism behind this phenotype, placing these findings in the broader context of circadian rhythms under extreme conditions.
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Affiliation(s)
- Ziqing Yu
- National Institute of Biological Sciences, Beijing 102206, China
| | - Eric Erquan Zhang
- National Institute of Biological Sciences, Beijing 102206, China; Tsinghua Institute of Multidisciplinary Biomedical Research, Tsinghua University, Beijing 102206, China.
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Kumar R, Chanana N, Sharma K, Palmo T, Lee M, Mishra A, Nolan K, Fonseca Balladares DC, Mickael C, Gupta M, Thinlas T, Pasha Q, Graham B. Dexamethasone prophylaxis protects from acute high-altitude illness by modifying the peripheral blood mononuclear cell inflammatory transcriptome. Biosci Rep 2023; 43:BSR20231561. [PMID: 37975243 PMCID: PMC10695741 DOI: 10.1042/bsr20231561] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/25/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023] Open
Abstract
Acute high-altitude (HA) exposure can induce several pathologies. Dexamethasone (DEX) can be taken prophylactically to prevent HA disease, but the mechanism by which it acts in this setting is unclear. We studied the transcriptome of peripheral blood mononuclear cells (PBMCs) from 16 subjects at low altitude (LA, 225 m) and then 3 days after acute travel to HA (3500 m) during the India-Leh-Dexamethasone-Expedition-2020 (INDEX2020). Half of the participants received oral DEX prophylaxis 4 mg twice daily in an unblinded manner, starting 1 day prior to travel to HA, and 12 h prior to the first PBMC collection. PBMC transcriptome data were obtained from 16 subjects, half of whom received DEX. The principal component analysis demonstrated a clear separation of the groups by altitude and treatment. HA exposure resulted in a large number of gene expression changes, particularly in pathways of inflammation or the regulation of cell division, translation, or transcription. DEX prophylaxis resulted in changes in fewer genes, particularly in immune pathways. The gene sets modulated by HA and DEX were distinct. Deconvolution analysis to assess PBMC subpopulations suggested changes in B-cell, T-cell, dendritic cell, and myeloid cell numbers with HA and DEX exposures. Acute HA travel and DEX prophylaxis induce significant changes in the PBMC transcriptome. The observed benefit of DEX prophylaxis against HA disease may be mediated by suppression of inflammatory pathways and changing leukocyte population distributions.
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Affiliation(s)
- Rahul Kumar
- Department of Medicine, University of California San Francisco, San Francisco, CA, U.S.A
- Lung Biology Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, U.S.A
| | - Neha Chanana
- Genomics and Molecular Medicine, CSIR-Institute of Genomics and Integrative Biology, Delhi, India
| | - Kavita Sharma
- Genomics and Molecular Medicine, CSIR-Institute of Genomics and Integrative Biology, Delhi, India
| | - Tsering Palmo
- Genomics and Molecular Medicine, CSIR-Institute of Genomics and Integrative Biology, Delhi, India
| | - Michael H. Lee
- Department of Medicine, University of California San Francisco, San Francisco, CA, U.S.A
- Lung Biology Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, U.S.A
| | - Aastha Mishra
- Cardiorespiratory Disease Unit, CSIR-Institute of Genomics and Integrative Biology, Delhi, India
| | - Kevin Nolan
- Department of Medicine, University of California San Francisco, San Francisco, CA, U.S.A
- Lung Biology Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, U.S.A
| | - Dara C. Fonseca Balladares
- Department of Medicine, University of California San Francisco, San Francisco, CA, U.S.A
- Lung Biology Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, U.S.A
| | - Claudia Mickael
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, CO, U.S.A
| | - Mohit D. Gupta
- Department of Cardiology, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Tashi Thinlas
- Department of Medicine, Sonam Norboo Memorial Hospital, Leh, Ladakh, India
| | - Qadar Pasha
- Genomics and Molecular Medicine, CSIR-Institute of Genomics and Integrative Biology, Delhi, India
- Institute of Hypoxia Research, New Delhi, India
| | - Brian B. Graham
- Department of Medicine, University of California San Francisco, San Francisco, CA, U.S.A
- Lung Biology Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, U.S.A
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Liu B, Xu G, Sun B, Wu G, Chen J, Gao Y. Clinical and biochemical indices of people with high-altitude experience linked to acute mountain sickness. Travel Med Infect Dis 2023; 51:102506. [PMID: 36410656 DOI: 10.1016/j.tmaid.2022.102506] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/02/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Acute mountain sickness (AMS) is a major health issue for people travelling to high altitudes. This study was designed to comprehensively evaluate the changes in clinical characteristics and biochemical indices of high-altitude travelers and determine whether these changes were associated with AMS. METHODS A total of 14 clinical indices and 52 biochemical indices were determined in 22 subjects before and during acute high-altitude exposure. Six hours after passive ascent to 3648 m (Lhasa, China), the Lake Louise Scoring (LLS) system 2018 was used to assess AMS, which was defined as headache with a total LLS ≥3. RESULTS Before travelling to high altitudes, uric acid (UA), platelet distribution width (PDW), mitral peak E velocity (MVE), and ejection fraction (EF) were significantly higher in AMS-resistant individuals than in AMS-susceptible ones (all p < 0.05). A good predictive value of UA (0.817, 95% CI: 0.607-1.000) and PDW (0.844, 95% CI: 0.646-1.000) for AMS-susceptible subjects was found. With high-altitude experience, 14 subjects were diagnosed as having AMS. Compared with non-AMS, the changes in UA and number of neutrophils in AMS presented a significant difference (all p < 0.05). The high-altitude-induced changes in UA, area under the curve, specificity, and sensitivity for identifying AMS were 0.883 (95% CI: 0.738-1.000), 83.30%, and 90.00%, respectively. CONCLUSION Human presents a compensatory physiological and biochemical response to high-altitude travel at early phase. The UA concentration before travel and its trend with high-altitude experience exhibited good performance for identifying AMS.
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Affiliation(s)
- Bao Liu
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, 400038, China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, 400038, China.
| | - Gang Xu
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, 400038, China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, 400038, China.
| | - Bingda Sun
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, 400038, China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, 400038, China.
| | - Gang Wu
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, 400038, China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, 400038, China.
| | - Jian Chen
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, 400038, China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, 400038, China.
| | - Yuqi Gao
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, 400038, China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, 400038, China.
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