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Yang C, Tuo Y, Shi X, Duo J, Liu X, Zhang F, Feng X. Prevalence, risk factors, and clinical characteristics of pulmonary embolism in patients with acute exacerbation of COPD in Plateau regions: a prospective cohort study. BMC Pulm Med 2024; 24:102. [PMID: 38413975 PMCID: PMC10900782 DOI: 10.1186/s12890-024-02915-z] [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: 12/03/2023] [Accepted: 02/19/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND AND OBJECTIVE To investigate pulmonary thromboembolism (PE) in acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) patients in plateau regions, we performed a prospective cohort study to evaluate the prevalence, risk factors and clinical characteristics of PE in the cohort of hospitalized patients at high altitude. METHODS We did a prospective study with a total of 636 AE-COPD patients in plateau regions. Demographic and clinical data, laboratory data, including ultrasound scans of the lower extremities and cardiac ultrasound, and computed tomographic pulmonary angiography (CTPA) variables were obtained, and comparisons were made between groups with and without PE. We also conducted logistic regression to explore the risk factors of PE. RESULTS Of the 636 patients hospitalized with AE-COPD (age 67.0 ± 10.7 years, 445[70.0%] male), 188 patients developed PE (29.6% [95% CI: 26.0%, 33.1%]). Multivariable logistic regression showed that ethnic minorities, D-dimer > 1 mg/L, AST > 40 U/L, chest pain, cardiac insufficiency or respiratory failure, Padua score > 3, and DVT were associated with a higher probability of PE. CONCLUSIONS The prevalence of PE is high and those with a higher Padua score, the occurrence of deep venous thrombosis, higher neutrophil count, chest pain, cardiac insufficiency or respiratory failure, higher levels of AST, and a higher level of D-dimer had a higher risk of PE. The analysis of AE-COPD may help to provide more accurate screening for PE and improve clinical outcomes of patients with AE-COPD in plateau regions.
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Affiliation(s)
- Chenlu Yang
- Department of Epidemiology and Biostatistics, School of Basic Medicine, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yajun Tuo
- Department of Respiratory and Critical Care Medicine, Qinghai Provincial People's Hospital, Qinghai, China
| | - Xuefeng Shi
- Department of Respiratory and Critical Care Medicine, Qinghai Provincial People's Hospital, Qinghai, China
| | - Jie Duo
- Department of Respiratory and Critical Care Medicine, Qinghai Provincial People's Hospital, Qinghai, China
| | - Xin Liu
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
| | - Fang Zhang
- Department of Respiratory and Critical Care Medicine, Qinghai Provincial People's Hospital, Qinghai, China
| | - Xiaokai Feng
- Department of Respiratory and Critical Care Medicine, Qinghai Provincial People's Hospital, Qinghai, China.
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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Chen Y, Zhang X, Ye Q, Zhang X, Cao N, Li SY, Yu J, Zhao ST, Zhang J, Xu XM, Shi YK, Yang LX. Machine learning-based prediction model for myocardial ischemia under high altitude exposure: a cohort study. Sci Rep 2024; 14:686. [PMID: 38182722 PMCID: PMC10770400 DOI: 10.1038/s41598-024-51202-8] [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: 09/15/2023] [Accepted: 01/02/2024] [Indexed: 01/07/2024] Open
Abstract
High altitude exposure increases the risk of myocardial ischemia (MI) and subsequent cardiovascular death. Machine learning techniques have been used to develop cardiovascular disease prediction models, but no reports exist for high altitude induced myocardial ischemia. Our objective was to establish a machine learning-based MI prediction model and identify key risk factors. Using a prospective cohort study, a predictive model was developed and validated for high-altitude MI. We consolidated the health examination and self-reported electronic questionnaire data (collected between January and June 2022 in 920th Joint Logistic Support Force Hospital of china) of soldiers undergoing high-altitude training, along with the health examination and second self-reported electronic questionnaire data (collected between December 2022 and January 2023) subsequent to their completion on the plateau, into a unified dataset. Participants were subsequently allocated to either the training or test dataset in a 3:1 ratio using random assignment. A predictive model based on clinical features, physical examination, and laboratory results was designed using the training dataset, and the model's performance was evaluated using the area under the receiver operating characteristic curve score (AUC) in the test dataset. Using the training dataset (n = 2141), we developed a myocardial ischemia prediction model with high accuracy (AUC = 0.86) when validated on the test dataset (n = 714). The model was based on five laboratory results: Eosinophils percentage (Eos.Per), Globulin (G), Ca, Glucose (GLU), and Aspartate aminotransferase (AST). Our concise and accurate high-altitude myocardial ischemia incidence prediction model, based on five laboratory results, may be used to identify risks in advance and help individuals and groups prepare before entering high-altitude areas. Further external validation, including female and different age groups, is necessary.
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Affiliation(s)
- Yu Chen
- Department of Cardiology, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China
| | - Xin Zhang
- Department of Pulmonary and Critical Care Medicine, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China
| | - Qing Ye
- Department of Radiation Oncology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xin Zhang
- Department of Radiology, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China
| | - Ning Cao
- Department of Neurosurgery, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China
| | - Shao-Ying Li
- Department of Pulmonary and Critical Care Medicine, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China
| | - Jie Yu
- Department of Thoracocardiac Surgery, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China
| | - Sheng-Tao Zhao
- Department of Pulmonary and Critical Care Medicine, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China
| | - Juan Zhang
- Department of Pulmonary and Critical Care Medicine, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China
| | - Xin-Ming Xu
- Department of Quality Control, 920th Hospital of Joint Logistics Support Force, PLA, No. 212 Daguan Rd, Kunming, 650032, Yunnan, China.
| | - Yan-Kun Shi
- Department of Cardiology, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China.
| | - Li-Xia Yang
- Department of Cardiology, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China.
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Liao Y, Chen Z, Yang Y, Shen D, Chai S, Ma Y, Ge R, Wang X, Wang S, Liu S. Antibiotic intervention exacerbated oxidative stress and inflammatory responses in SD rats under hypobaric hypoxia exposure. Free Radic Biol Med 2023; 209:70-83. [PMID: 37806597 DOI: 10.1016/j.freeradbiomed.2023.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/28/2023] [Accepted: 10/03/2023] [Indexed: 10/10/2023]
Abstract
The gut microbiota plays a crucial role in maintaining host nutrition, metabolism, and immune homeostasis, particularly in extreme environmental conditions. However, the regulatory mechanisms of the gut microbiota in animal organisms hypobaric hypoxia exposure require further study. We conducted a research by comparing SD rats treated with an antibiotic (ABX) cocktail and untreated SD rats that were housed in a low-pressure oxygen chamber (simulating low pressure and hypoxic environment at 6000 m altitude) for 30 days. After the experiment, blood, feces, and lung tissues from SD rats were collected for analysis of blood, 16S rRNA amplicon sequencing, and non-targeted metabolomics. The results demonstrated that the antibiotic cocktail-treated SD rats exhibited elevated counts of neutrophil (Neu) and monocyte (Mon) cells, an enrichment of sulfate-reducing bacteria (SBC), reduced levels of glutathione, and accumulated phospholipid compounds. Notably, the accumulation of phospholipid compounds, particularly lysophosphatidic acid (LPA), lipopolysaccharide (LPS), and lysophosphatidylcholine (LPC), along with the aforementioned changes, contributed to heightened oxidative stress and inflammation in the organism. In addition, we explored the resistance mechanisms of SD rats in low-oxygen and low-pressure environments and found that increasing the quantity of the Prevotellaceae and related beneficial bacteria (especially Lactobacillus) could reduce oxidative stress and inflammation. These findings offer valuable insights into enhancing the adaptability of low-altitude animals under hypobaric hypoxia exposure.
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Affiliation(s)
- Yang Liao
- College of Animal Husbandry and Veterinary Sciences, Qinghai University, Xining, 810016, China
| | - Zheng Chen
- College of Animal Husbandry and Veterinary Sciences, Qinghai University, Xining, 810016, China
| | - Yingkui Yang
- College of Animal Husbandry and Veterinary Sciences, Qinghai University, Xining, 810016, China
| | - Di Shen
- College of Animal Husbandry and Veterinary Sciences, Qinghai University, Xining, 810016, China
| | - Shatuo Chai
- College of Animal Husbandry and Veterinary Sciences, Qinghai University, Xining, 810016, China
| | - Yan Ma
- Research Center for High Altitude Medicine, Medical College of Qinghai University, Xining, 810001, China
| | - Rili Ge
- Research Center for High Altitude Medicine, Medical College of Qinghai University, Xining, 810001, China
| | - Xun Wang
- College of Animal Husbandry and Veterinary Sciences, Qinghai University, Xining, 810016, China
| | - Shuxiang Wang
- College of Animal Husbandry and Veterinary Sciences, Qinghai University, Xining, 810016, China.
| | - Shujie Liu
- College of Animal Husbandry and Veterinary Sciences, Qinghai University, Xining, 810016, China.
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4
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Yang Y, Cheng J, Peng Y, Luo Y, Zou D, Yang Y, Ma Y. Clinical features of patients with cerebral venous sinus thrombosis at plateau areas. Brain Behav 2023; 13:e2998. [PMID: 37095720 PMCID: PMC10275515 DOI: 10.1002/brb3.2998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 04/26/2023] Open
Abstract
OBJECTIVE Cerebral venous sinus thrombosis (CVST) is believed to be associated with high-altitude exposure and has worse clinical prognosis in plateau areas than in plain areas, although this needs to be further verified. This retrospective study aims to compare the clinical differences of patients with CVST in plateau and plain areas and further ascertain the role of high-altitude exposure in the etiology of aggravating predisposition toward CVST. METHODS Twenty-four symptomatic CVST patients occurring at plateau areas (altitude ≥ 4000 m), in corresponding with 24 CVST patients occurring at plain areas (altitude ≤ 1000 m), were recruited according to the inclusion and exclusion criteria from June 2020 to December 2021. The collected data and compared parameters include clinical features, neuroimaging findings, hematology profile, lipid profile, and coagulation profile within 24 h of hospital admission, as well as the treatment method and final outcome. RESULTS There were no obvious differences of demographic characteristics, including gender, age, height, and weight between patients with CVST in plateau and plain areas, as well as medical history, neuroimaging findings, treatment protocols, and clinical outcome (all p > .05). Compared to patients with CVST at plain areas, time before hospital admission was longer and heartbeat was slower in patients with CVST at plateau areas (all p < .05). More importantly, elevated red blood cells counts, hemoglobin level, and altered coagulation function were found in patients with CVST at plateau areas (all p < .05). CONCLUSION CVST patients in plateau areas presented with altered clinical characteristics, altered coagulation function, and aggravated predisposition toward venous thromboembolism compared with CVST patients in plain areas. Future prospective studies will be needed to further elucidate the influences of a high altitude on the pathogenesis of CVST.
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Affiliation(s)
- Yongxiang Yang
- Department of NeurosurgeryThe General Hospital of Western Theater CommandChengduChina
| | - Jingmin Cheng
- Department of NeurosurgeryThe General Hospital of Western Theater CommandChengduChina
| | - Yuping Peng
- Department of NeurosurgeryThe General Hospital of Western Theater CommandChengduChina
| | - Yan Luo
- Department of OncologyThe General Hospital of Western Theater CommandChengduChina
| | - Dongbo Zou
- Department of NeurosurgeryThe General Hospital of Western Theater CommandChengduChina
| | - Yongjian Yang
- Department of CardiologyThe General Hospital of Western Theater CommandChengduChina
| | - Yuan Ma
- Department of NeurosurgeryThe General Hospital of Western Theater CommandChengduChina
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5
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Zhao CC, Chen LY, Chen CJ, Wang QR, Li QH, Kang PD. Does living at high altitude increase the risk of bleeding events after total knee arthroplasty? A retrospective cohort study. INTERNATIONAL ORTHOPAEDICS 2023; 47:67-74. [PMID: 36318309 DOI: 10.1007/s00264-022-05614-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Post-operative bleeding after total knee arthroplasty (TKA) is a frequent cause of post-operative complications. This study compared blood loss and indicators of coagulation and fibrinolysis between TKA patients living at low or high altitudes. METHODS We retrospectively analyzed 120 patients at our institution who underwent primary TKA from May 2019 to March 2020, and we divided them into those living in areas about 500 m or > 3000 m above sea level. We compared the primary outcome of total blood loss between them. We also compared them in terms of several secondary outcomes: coagulation and fibrinolysis parameters, platelet count, reduction in hemoglobin, hidden blood loss, intra-operative blood loss, transfusion rate, and incidence of thromboembolic events and other complications. RESULTS Total blood loss was significantly higher in the high-altitude group than in the low-altitude group (mean, 748.2 mL [95% CI, 658.5-837.9] vs 556.6 mL [95% CI, 496.0-617.1]; p = 0.001). The high-altitude group also showed significantly longer activated partial thromboplastin time, prothrombin time, and thrombin time before surgery and on post-operative day one, as well as increased levels of fibrinogen/fibrin degradation product on post-operative days one and three. Ecchymosis was significantly more frequent in the high-altitude group (41.7 vs 21.7%; relative risk (RR) = 1.923 [95% CI, 1.091-3.389]; p = 0.019). The two groups showed similar transfusion rates, and none of the patients experienced venous thromboembolism, pulmonary embolism, or infection. CONCLUSION High altitude may alter coagulation and fibrinolysis parameters in a way that increases risk of blood loss after TKA. Such patients may benefit from special management to avoid bleeding events.
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Affiliation(s)
- Cheng-Cheng Zhao
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, People's Republic of China
| | - Li-Yile Chen
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, People's Republic of China
| | - Chang-Jun Chen
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, People's Republic of China
| | - Qiu-Ru Wang
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, People's Republic of China
| | - Qian-Hao Li
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, People's Republic of China
| | - Peng-de Kang
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, People's Republic of China.
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6
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Li M, Tang X, Liao Z, Shen C, Cheng R, Fang M, Wang G, Li Y, Tang S, Xie L, Zhang Z, Kamau PM, Mwangi J, Lu Q, Li Y, Wang Y, MacKeigan DT, Cerenzia EG, Ni H, Lai R. Hypoxia and low temperature upregulate transferrin to induce hypercoagulability at high altitude. Blood 2022; 140:2063-2075. [PMID: 36040436 PMCID: PMC10653030 DOI: 10.1182/blood.2022016410] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 08/16/2022] [Indexed: 11/20/2022] Open
Abstract
Studies have shown significantly increased thromboembolic events at high altitude. We recently reported that transferrin could potentiate blood coagulation, but the underlying mechanism for high altitude-related thromboembolism is still poorly understood. Here, we examined the activity and concentration of plasma coagulation factors and transferrin in plasma collected from long-term human residents and short-stay mice exposed to varying altitudes. We found that the activities of thrombin and factor XIIa (FXIIa) along with the concentrations of transferrin were significantly increased in the plasma of humans and mice at high altitudes. Furthermore, both hypoxia (6% O2) and low temperature (0°C), 2 critical high-altitude factors, enhanced hypoxia-inducible factor 1α (HIF-1α) levels to promote the expression of the transferrin gene, whose enhancer region contains HIF-1α binding site, and consequently, to induce hypercoagulability by potentiating thrombin and FXIIa. Importantly, thromboembolic disorders and pathological insults in mouse models induced by both hypoxia and low temperature were ameliorated by transferrin interferences, including transferrin antibody treatment, transferrin downregulation, and the administration of our designed peptides that inhibit the potentiation of transferrin on thrombin and FXIIa. Thus, low temperature and hypoxia upregulated transferrin expression-promoted hypercoagulability. Our data suggest that targeting the transferrin-coagulation pathway is a novel and potentially powerful strategy against thromboembolic events caused by harmful environmental factors under high-altitude conditions.
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Affiliation(s)
- Meiquan Li
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences/Key Laboratory of Bioactive Peptides of Yunnan Province, Kunming Institute of Zoology-The Chinese University of Hong Kong Joint Laboratory of Bioresources and Molecular Research in Common Diseases, National Resource Center for Non-Human Primates, Kunming Primate Research Center, National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Sino-African Joint Research Center, and Engineering Laboratory of Peptides, Kunming Institute of Zoology, Kunming, China
- College of Agriculture and Life Sciences, Kunming University, Kunming, China
| | - Xiaopeng Tang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences/Key Laboratory of Bioactive Peptides of Yunnan Province, Kunming Institute of Zoology-The Chinese University of Hong Kong Joint Laboratory of Bioresources and Molecular Research in Common Diseases, National Resource Center for Non-Human Primates, Kunming Primate Research Center, National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Sino-African Joint Research Center, and Engineering Laboratory of Peptides, Kunming Institute of Zoology, Kunming, China
- Institutes for Drug Discovery and Development, Chinese Academy of Sciences, Shanghai, China
| | - Zhiyi Liao
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences/Key Laboratory of Bioactive Peptides of Yunnan Province, Kunming Institute of Zoology-The Chinese University of Hong Kong Joint Laboratory of Bioresources and Molecular Research in Common Diseases, National Resource Center for Non-Human Primates, Kunming Primate Research Center, National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Sino-African Joint Research Center, and Engineering Laboratory of Peptides, Kunming Institute of Zoology, Kunming, China
- Kunming College of Life Science, University of Chinese Academy of Sciences, Beijing, China
| | - Chuanbin Shen
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, St. Michael’s Hospital and Toronto Platelet Immunobiology Group, Toronto, ON, Canada
| | - Ruomei Cheng
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences/Key Laboratory of Bioactive Peptides of Yunnan Province, Kunming Institute of Zoology-The Chinese University of Hong Kong Joint Laboratory of Bioresources and Molecular Research in Common Diseases, National Resource Center for Non-Human Primates, Kunming Primate Research Center, National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Sino-African Joint Research Center, and Engineering Laboratory of Peptides, Kunming Institute of Zoology, Kunming, China
- Kunming College of Life Science, University of Chinese Academy of Sciences, Beijing, China
| | - Mingqian Fang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences/Key Laboratory of Bioactive Peptides of Yunnan Province, Kunming Institute of Zoology-The Chinese University of Hong Kong Joint Laboratory of Bioresources and Molecular Research in Common Diseases, National Resource Center for Non-Human Primates, Kunming Primate Research Center, National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Sino-African Joint Research Center, and Engineering Laboratory of Peptides, Kunming Institute of Zoology, Kunming, China
- Kunming College of Life Science, University of Chinese Academy of Sciences, Beijing, China
| | - Gan Wang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences/Key Laboratory of Bioactive Peptides of Yunnan Province, Kunming Institute of Zoology-The Chinese University of Hong Kong Joint Laboratory of Bioresources and Molecular Research in Common Diseases, National Resource Center for Non-Human Primates, Kunming Primate Research Center, National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Sino-African Joint Research Center, and Engineering Laboratory of Peptides, Kunming Institute of Zoology, Kunming, China
- Institutes for Drug Discovery and Development, Chinese Academy of Sciences, Shanghai, China
| | - Ya Li
- Department of Clinical Laboratory, Yunnan Key Laboratory of Laboratory Medicine, Yunnan Innovation Team of Clinical Laboratory and Diagnosis, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Shuzhen Tang
- Department of Clinical Laboratory, the People’s Hospital of Diqing Tibetan Autonomous Prefecture, Shangri-La, China
| | - Li Xie
- Department of Clinical Laboratory, the Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zhiye Zhang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences/Key Laboratory of Bioactive Peptides of Yunnan Province, Kunming Institute of Zoology-The Chinese University of Hong Kong Joint Laboratory of Bioresources and Molecular Research in Common Diseases, National Resource Center for Non-Human Primates, Kunming Primate Research Center, National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Sino-African Joint Research Center, and Engineering Laboratory of Peptides, Kunming Institute of Zoology, Kunming, China
- Institutes for Drug Discovery and Development, Chinese Academy of Sciences, Shanghai, China
| | - Peter Muiruri Kamau
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences/Key Laboratory of Bioactive Peptides of Yunnan Province, Kunming Institute of Zoology-The Chinese University of Hong Kong Joint Laboratory of Bioresources and Molecular Research in Common Diseases, National Resource Center for Non-Human Primates, Kunming Primate Research Center, National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Sino-African Joint Research Center, and Engineering Laboratory of Peptides, Kunming Institute of Zoology, Kunming, China
- Kunming College of Life Science, University of Chinese Academy of Sciences, Beijing, China
| | - James Mwangi
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences/Key Laboratory of Bioactive Peptides of Yunnan Province, Kunming Institute of Zoology-The Chinese University of Hong Kong Joint Laboratory of Bioresources and Molecular Research in Common Diseases, National Resource Center for Non-Human Primates, Kunming Primate Research Center, National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Sino-African Joint Research Center, and Engineering Laboratory of Peptides, Kunming Institute of Zoology, Kunming, China
- Kunming College of Life Science, University of Chinese Academy of Sciences, Beijing, China
| | - Qiumin Lu
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences/Key Laboratory of Bioactive Peptides of Yunnan Province, Kunming Institute of Zoology-The Chinese University of Hong Kong Joint Laboratory of Bioresources and Molecular Research in Common Diseases, National Resource Center for Non-Human Primates, Kunming Primate Research Center, National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Sino-African Joint Research Center, and Engineering Laboratory of Peptides, Kunming Institute of Zoology, Kunming, China
- Institutes for Drug Discovery and Development, Chinese Academy of Sciences, Shanghai, China
| | - Yaxiong Li
- Department of Cardiovascular Surgery, Yan’an Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yuming Wang
- Department of Clinical Laboratory, the Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Daniel Thomas MacKeigan
- Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, St. Michael’s Hospital and Toronto Platelet Immunobiology Group, Toronto, ON, Canada
- Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Eric G. Cerenzia
- Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, St. Michael’s Hospital and Toronto Platelet Immunobiology Group, Toronto, ON, Canada
- Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Heyu Ni
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, St. Michael’s Hospital and Toronto Platelet Immunobiology Group, Toronto, ON, Canada
- Department of Physiology, University of Toronto, Toronto, ON, Canada
- Canadian Blood Services Centre for Innovation, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ren Lai
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences/Key Laboratory of Bioactive Peptides of Yunnan Province, Kunming Institute of Zoology-The Chinese University of Hong Kong Joint Laboratory of Bioresources and Molecular Research in Common Diseases, National Resource Center for Non-Human Primates, Kunming Primate Research Center, National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Sino-African Joint Research Center, and Engineering Laboratory of Peptides, Kunming Institute of Zoology, Kunming, China
- Institutes for Drug Discovery and Development, Chinese Academy of Sciences, Shanghai, China
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Zhu J, Duan Y, Duo D, Yang J, Bai X, Liu G, Wang Q, Wang X, Qu N, Zhou Y, Li X. High-altitude Hypoxia Influences the Activities of the Drug-Metabolizing Enzyme CYP3A1 and the Pharmacokinetics of Four Cardiovascular System Drugs. Pharmaceuticals (Basel) 2022; 15:ph15101303. [PMID: 36297415 PMCID: PMC9612038 DOI: 10.3390/ph15101303] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/11/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: High-altitude hypoxia has been shown to affect the pharmacokinetic properties of drugs. Although there is a high incidence of cardiovascular disease among individuals living in high-altitude areas, studies on the effect of high-altitude hypoxia on the pharmacokinetic properties of cardiovascular drugs are limited. (2) Methods: The aim of this study was to evaluate the pharmacokinetics of nifedipine, bosentan, simvastatin, sildenafil, and their respective main metabolites, dehydronifedipine, hydroxybosentan, simvastatin hydroxy acid, and N-desmethyl sildenafil, in rats exposed to high-altitude hypoxia. Additionally, the protein and mRNA expression of cytochrome P450 3A1 (CYP3A1), a drug-metabolizing enzyme, were examined. (3) Results: There were significant changes in the pharmacokinetic properties of the drugs in rats exposed to high-altitude hypoxia, as evidenced by an increase in the area under the curve (AUC) and the half-life (t1/2z) and a decrease in total plasma clearance (CLz/F). However, most of these changes were reversed when the rats returned to a normoxic environment. Additionally, there was a significant decrease in CYP3A1 expression in rats exposed to high-altitude hypoxia at both the protein and mRNA levels. (4) Conclusions: High-altitude hypoxia suppressed the metabolism of the drugs, indicating that the pharmacokinetics of the drugs should be re-examined, and the optimal dose should be reassessed in patients living in high-altitude areas.
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Affiliation(s)
- Junbo Zhu
- Research Center for High Altitude Medicine, Qinghai University Medical College, Xining 810000, China
- State Key Laboratory of Plateau Ecology and Agriculture, Qinghai University, Xining 810000, China
| | - Yabin Duan
- Department of Clinical Pharmacy, Qinghai University Affiliated Hospital, Xining 810000, China
| | - Delong Duo
- Research Center for High Altitude Medicine, Qinghai University Medical College, Xining 810000, China
| | - Jianxin Yang
- Research Center for High Altitude Medicine, Qinghai University Medical College, Xining 810000, China
| | - Xue Bai
- Research Center for High Altitude Medicine, Qinghai University Medical College, Xining 810000, China
| | - Guiqin Liu
- Research Center for High Altitude Medicine, Qinghai University Medical College, Xining 810000, China
| | - Qian Wang
- Research Center for High Altitude Medicine, Qinghai University Medical College, Xining 810000, China
| | - Xuejun Wang
- Department of Anesthesiology, Red Cross Hospital of Qinghai, Xining 810000, China
| | - Ning Qu
- Department of Anesthesiology, Qinghai Hospital of Traditional Chinese Medicine, Xining 810000, China
| | - Yang Zhou
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Provincial Key Laboratory of Pharmaceutics, Guizhou Medical University, Guiyang 550004, China
- Correspondence: (Y.Z.); (X.L.)
| | - Xiangyang Li
- Research Center for High Altitude Medicine, Qinghai University Medical College, Xining 810000, China
- State Key Laboratory of Plateau Ecology and Agriculture, Qinghai University, Xining 810000, China
- Correspondence: (Y.Z.); (X.L.)
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Yang H, Yang G, Xu M, Zhao Y, He S, Wang Q, Wen Y, Huang C, Wu J, Ren C, Yang Y, He S. Impact of high altitude on the incidence of postoperative venous thromboembolism and its genetic susceptibility: A meta-analysis and systematic review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156632. [PMID: 35691358 DOI: 10.1016/j.scitotenv.2022.156632] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 06/07/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The effect of high-altitude (HA) on venous thromboembolism (VTE) and its mechanism remains ambiguous. To clarify this, we aimed to conduct a meta-analysis and systematic review to evaluate the incidence of VTE at HA and comparatively low altitude (LA) and figure out the intrinsic risk factors such as susceptibility genes of patients with VTE at HA. METHODS We selected studies that explored the risk factors for HA and VTE by searching PubMed, Embase, and Web of Science to analyze the impact of HA on VTE. All relevant studies before August 2021 were screened using the terms ([high altitude] OR [plateau] OR [mountain]) AND ([venous thromboembolism] OR [deep vein thrombosis] OR [pulmonary embolism]). Latest studies on the gene of HA-VTE patients were also summarized and analyzed. RESULTS Fifteen studies were eventually assessed, and the overall numbers of subjects with and without VTE were 1475 and 286,926 respectively. The overall incidence of VTE, deep vein thrombosis (DVT) and pulmonary embolism (PE) in the HA group was significantly higher than that in the LA group (P < 0.01). The overall incidence of VTE, DVT and PE in the HA group was significantly higher than that in the LA group at 30 days post operation (P < 0.05, P < 0.05 and P < 0.01, respectively). At 90 days post operation, incidence of VTE and PE in the HA group was higher than that in the LA group (P < 0.01and P < 0.01, respectively), but there was no difference in the incidence of DVT (P = 0.07). Regarding endogenous factors, the analysis of genes in patients with HA-VTE revealed numerous targeted genes such as ANG, ACE, lncRNA-LINC00 659/UXT-AS1 and GP4. CONCLUSIONS We observed a significant association between HA and the overall incidence of VTE and that at 30/90 days post operation, indicating that HA may be a risk factor for VTE.
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Affiliation(s)
- Haihong Yang
- Department of Anesthesiology, The General Hospital of Western Theater Command, Chengdu 610083, China
| | - Guan Yang
- Department of Pain, The General Hospital of Western Theater Command, Chengdu 610083, China
| | - Meiling Xu
- Department of Geriatrics, The General Hospital of Western Theater Command, Chengdu 610083, China
| | - Yuanyuan Zhao
- The General Hospital of Western Theater Command, Chengdu 610083, China
| | - Shengdong He
- The General Hospital of Western Theater Command, Chengdu 610083, China
| | - Qiwu Wang
- The General Hospital of Western Theater Command, Chengdu 610083, China
| | - Yi Wen
- The General Hospital of Western Theater Command, Chengdu 610083, China
| | - Chen Huang
- The General Hospital of Western Theater Command, Chengdu 610083, China
| | - Jianping Wu
- Department of Neurosurgery, The General Hospital of Western Theater Command, Chengdu 610083, China
| | - Chao Ren
- The General Hospital of Western Theater Command, Chengdu 610083, China
| | - Yongxiang Yang
- Department of Neurosurgery, The General Hospital of Western Theater Command, Chengdu 610083, China.
| | - Siyi He
- Department of Cardiovascular Surgery, The General Hospital of Western Theater Command, Chengdu 610083, China.
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Guo Y, Liu X, Zihao Z, Zhang Q, Shi Z, Zhang N. Blood routine reference value range should be adjusted according to regional and ethnic characteristics. Front Public Health 2022; 10:934101. [PMID: 35968454 PMCID: PMC9372343 DOI: 10.3389/fpubh.2022.934101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/01/2022] [Indexed: 11/26/2022] Open
Abstract
Objective To further understand the influence of regional and ethnic factors on blood routine indicators. Methods The routine blood test (RBT) results of 617 healthy men aged 18–45 years old of the Li, Tibet, and Han nationalities living in the city of Sanya, Hainan Province (200 m), the city of Xining, Qinghai Province (2,300 m), and Maduo County of Qinghai Province (4,300 m) for a long time were studied. Eight indexes, such as the red blood cell (RBC), hemoglobin (Hb), and platelet (PLT) counts, were compared and analyzed. Results With an increase in altitude, the RBT index values and change trends of the different ethnic groups were different. When the altitude increased by 2,000 m, the RBC and Hb increased by 6.6 and 8.1%, respectively, and the PLT decreased by 16.8%. However, the RBC, Hb, and PLT of the Tibetan subjects decreased by 7.4, 5.1, and 3.0%, respectively. In the same region, there were also significant differences in the RBT index values among the ethnic groups. The RBC increased, Hb decreased, and PLT did not change in the Li nationality in Sanya compared with the Han nationality. The RBC, Hb, and PLT of Tibetans in the Xining area were significantly higher than those of the Han population. Referring to the current RBT reference value range in China, the abnormal rates of the various RBT index values of the enrolled population were high. By utilizing Hb as an example, 27.7% of the Li nationality in Sanya was low, 67.0% of the Tibetan nationality in Xining was high, and 89.4% of the Maduo Han nationality was high. The PLT was lower in the Sanya Li nationality (13.8%) and the Maduo Han nationality (88.3%). Conclusion Regional and ethnic factors have a significant impact on the RBT, and the current range of normal values of the RBT in China needs to be revised and adjusted.
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Affiliation(s)
- Yan Guo
- Graduate school, Medical College of Soochow University, Suzhou, China
- Department of Pathology, Qinghai Provincial People's Hospital, Xining, China
| | - Xiao Liu
- Department of Basic Medical Sciences, The 960th Hospital of PLA, Jinan, China
| | - Zhang Zihao
- Department of Experimental Medicine, Hainan Hospital of PLA General Hospital, Sanya, China
| | - Qiang Zhang
- Department of Neurosurgery, Qinghai Provincial People's Hospital, Xining, China
| | - Zhongshan Shi
- Department of Intensive Care Medicine, Ge er mu People's Hospital, Ge er mu, China
| | - Na Zhang
- Department of Respiratory, Qinghai Provincial People's Hospital, Xining, China
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10
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Sharma V, Varshney R, Sethy NK. Human adaptation to high altitude: a review of convergence between genomic and proteomic signatures. Hum Genomics 2022; 16:21. [PMID: 35841113 PMCID: PMC9287971 DOI: 10.1186/s40246-022-00395-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 06/17/2022] [Indexed: 12/29/2022] Open
Abstract
Both genomics- and proteomics-based investigations have identified several essential genes, proteins, and pathways that may facilitate human adaptive genotype/phenotype in a population-specific manner. This comprehensive review provides an up-to-date list of genes and proteins identified for human adaptive responses to high altitudes. Genomics studies for indigenous high-altitude populations like Tibetans, Andeans, Ethiopians, and Sherpas have identified 169 genes under positive natural selection. Similarly, global proteomics studies have identified 258 proteins (± 1.2-fold or more) for Tibetan, Sherpa, and Ladakhi highlanders. The primary biological processes identified for genetic signatures include hypoxia-inducible factor (HIF)-mediated oxygen sensing, angiogenesis, and erythropoiesis. In contrast, major biological processes identified for proteomics signatures include 14–3-3 mediated sirtuin signaling, integrin-linked kinase (ILK), phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT), and integrin signaling. Comparing genetic and protein signatures, we identified 7 common genes/proteins (HBB/hemoglobin subunit beta, TF/serotransferrin, ANGPTL4/angiopoietin-related protein 4, CDC42/cell division control protein 42 homolog, GC/vitamin D-binding protein, IGFBP1/insulin-like growth factor-binding protein 1, and IGFBP2/insulin-like growth factor-binding protein 2) involved in crucial molecular functions like IGF-1 signaling, LXR/RXR activation, ferroptosis signaling, iron homeostasis signaling and regulation of cell cycle. Our combined multi-omics analysis identifies common molecular targets and pathways for human adaptation to high altitude. These observations further corroborate convergent positive selection of hypoxia-responsive molecular pathways in humans and advocate using multi-omics techniques for deciphering human adaptive responses to high altitude.
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Affiliation(s)
- Vandana Sharma
- Peptide and Proteomics Division, Defence Institute of Physiology and Allied Sciences (DIPAS), Defence Research and Development Organisation (DRDO), Lucknow Road, Timarpur, Delhi, 110054, India
| | - Rajeev Varshney
- Peptide and Proteomics Division, Defence Institute of Physiology and Allied Sciences (DIPAS), Defence Research and Development Organisation (DRDO), Lucknow Road, Timarpur, Delhi, 110054, India
| | - Niroj Kumar Sethy
- Peptide and Proteomics Division, Defence Institute of Physiology and Allied Sciences (DIPAS), Defence Research and Development Organisation (DRDO), Lucknow Road, Timarpur, Delhi, 110054, India.
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11
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Hypoxia and hemorheological properties in older individuals. Ageing Res Rev 2022; 79:101650. [PMID: 35597435 DOI: 10.1016/j.arr.2022.101650] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/20/2022] [Accepted: 05/13/2022] [Indexed: 12/17/2022]
Abstract
Hypoxia is caused by insufficient oxygen availability for the organism leading to reduced oxygen delivery to tissues and cells. It has been regarded as a severe threat to human health and it is indeed implicated in pathophysiological mechanisms involved in the development and progression of many diseases. Nevertheless, the potential of controlled hypoxia interventions (i.e. hypoxia conditioning) for improving cardio-vascular health is gaining increased attention. However, blood rheology is often a forgotten factor for vascular health while aging and hypoxia exposure are both suspected to alter hemorheological properties. These changes in blood rheology may influence the benefits-risks balance of hypoxia exposure in older individuals. The benefits of hypoxia exposure for vascular health are mainly reported for healthy populations and the combined impact of aging and hypoxia on blood rheology could therefore be deleterious in older individuals. This review discusses evidence of hypoxia-related and aging-related changes in blood viscosity and its determinants. It draws upon an extensive literature search on the effects of hypoxia/altitude and aging on blood rheology. Aging increases blood viscosity mainly through a rise in plasma viscosity, red blood cell (RBC) aggregation and a decrease in RBC deformability. Hypoxia also causes an increase in RBC aggregation and plasma viscosity. In addition, hypoxia exposure may increase hematocrit and modulate RBC deformability, depending on the hypoxic dose, i.e, beneficial effect of intermittent hypoxia with moderate dose vs deleterious effect of chronic continuous or intermittent hypoxia or if the hypoxic dose is too high. Special attention is directed toward the risks vs. benefits of hemorheological changes during hypoxia exposure in older individuals, and its clinical relevance for vascular disorders.
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12
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Yang Y, Peng Y, He S, Wu J, Xie Q, Ma Y. The Clinical Differences of Patients With Traumatic Brain Injury in Plateau and Plain Areas. Front Neurol 2022; 13:848944. [PMID: 35547378 PMCID: PMC9081812 DOI: 10.3389/fneur.2022.848944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Traumatic brain injury (TBI) is a leading cause of death and disability, which tends to have a worse clinical recovery if it occurs in plateau areas than in plain areas. To explore the underlying cause of this outcome preliminarily, this retrospective study was conducted to compare the clinical differences of patients with TBI in plateau and plain areas. Methods In this study, 32 patients with TBI in plateau areas (altitude ≥ 4,000 m) and 32 in plain areas (altitude ≤ 1,000 m) were recruited according to the inclusion and exclusion criteria from June 2020 to December 2021. The collected data and compared parameters include clinical features, head CT presentations and Marshall classifications, hematology profile, lipid profile, coagulation profile, and multiorgan (cardiac, liver, renal) function within 24 h of hospital admission, as well as the treatment method and final outcome. Results There were no obvious differences in demographic characteristics, including gender, age, height, and weight, between patients with TBI in plateau and plain areas (all P > 0.05). Compared to patients with TBI in plain areas, the time before hospital admission was longer, heartbeat was slower, systolic blood pressure (SBP) was lower, and hospital stays were longer in patients with TBI in plateau areas (all P < 0.05). More importantly, elevated red blood cells (RBCs) count and hemoglobin (HGB) level, enhanced coagulation function, and higher rates of multiorgan (cardiac, liver, and renal) injury were found in patients with TBI in plateau areas (all P < 0.05). Conclusion Patients with TBI in plateau areas presented with altered clinical characteristics, enhanced coagulation function, and aggravated predisposition toward multiorgan (cardiac, liver, and renal) injury, compared to patients with TBI in plain areas. Future prospective studies are needed to further elucidate the influences of high altitude on the disease course of TBI.
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Affiliation(s)
- Yongxiang Yang
- Department of Neurosurgery, General Hospital of Western Theater Command, Chengdu, China
| | - Yuping Peng
- Department of Neurosurgery, General Hospital of Western Theater Command, Chengdu, China.,Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Siyi He
- Department of Cardiovascular Surgery, General Hospital of Western Theater Command, Chengdu, China
| | - Jianping Wu
- Department of Neurosurgery, General Hospital of Western Theater Command, Chengdu, China
| | - Qingyun Xie
- Department of Orthopedic, General Hospital of Western Theater Command, Chengdu, China
| | - Yuan Ma
- Department of Neurosurgery, General Hospital of Western Theater Command, Chengdu, China
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Abstract
Wang, Yuliang, Xuewen Huang, Weibo Yang, and Qingxian Zeng. Platelets and high-altitude exposure: a meta-analysis. High Alt Med Biol. 23:43-56, 2022. Background: How high-altitude hypoxia influences platelets is controversial. We attempted to quantify the impact of high-altitude exposure on platelets through meta-analysis. Methods: We systematically searched electronic databases (PubMed, Embase, Web of Science, VIP, Wanfang, and CNKI) and identified articles reporting an association between platelet count (PC) or platelet indices (platelet distribution width, mean platelet volume [MPV], and plateletcrit) and high-altitude exposure. The mean and standard deviation were extracted, and the standard mean difference (SMD) was estimated using random-effects models. Stata 15.3 was used to analyze statistical data. Results: Thirty-two studies were ultimately included. For acute high-altitude hypoxia (1-14 days), no significant difference was detected, even in patients with acute mountain disease. For the chronic high-altitude hypoxia (≥1 month) group, a significant decrease in PC (SMD [95% confidence interval, CI] = -0.34 [-0.63 to -0.04]) and increase in MPV (SMD [95% CI] = 1.55 [0.60 to 2.49]) were detected compared with those in the control group. Subgroup analysis showed that the tendency was more obvious in the group with longer exposure (≥1 year). Moreover, the PC of the chronic mountain sickness group was less compared with the healthy altitude control group (SMD [95% CI] = -1.82 [-2.74 to -0.91]). Conclusion: A reduced PC and an increased MPV are associated with chronic exposure to high-altitude hypoxia. Moreover, acute high-altitude exposure has no significant influence on platelets.
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Affiliation(s)
- Yuliang Wang
- Department of High Altitude Disease, Xizang Military General Hospital, Xizang Province, Lhasa City, China
| | - Xuewen Huang
- Department of High Altitude Disease, Xizang Military General Hospital, Xizang Province, Lhasa City, China
| | - Weibo Yang
- Department of High Altitude Disease, Xizang Military General Hospital, Xizang Province, Lhasa City, China
| | - Qingxian Zeng
- Department of High Altitude Disease, Xizang Military General Hospital, Xizang Province, Lhasa City, China
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14
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Kour A, Niranjan SK, Malayaperumal M, Surati U, Pukhrambam M, Sivalingam J, Kumar A, Sarkar M. Genomic Diversity Profiling and Breed-Specific Evolutionary Signatures of Selection in Arunachali Yak. Genes (Basel) 2022; 13:genes13020254. [PMID: 35205299 PMCID: PMC8872319 DOI: 10.3390/genes13020254] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/09/2022] [Accepted: 01/13/2022] [Indexed: 02/04/2023] Open
Abstract
Arunachali yak, the only registered yak breed of India, is crucial for the economic sustainability of pastoralist Monpa community. This study intended to determine the genomic diversity and to identify signatures of selection in the breed. Previously available double digest restriction-site associated DNA (ddRAD) sequencing data of Arunachali yak animals was processed and 99,919 SNPs were considered for further analysis. The genomic diversity profiled based on nucleotide diversity, π (π = 0.041 in 200 bp windows), effective population size, Ne (Ne = 83) and Runs of homozygosity (ROH) (predominance of shorter length ROHs) was found to be optimum. Subsequently, 207 regions were identified to be under selective sweeps through de-correlated composite of multiple signals (DCMS) statistic which combined three individual test statistics viz. π, Tajima’s D and |iHS| in non-overlapping 100 kb windows. Mapping of these regions revealed 611 protein-coding genes including KIT, KITLG, CDH12, FGG, FGA, FGB, PDGFRA, PEAR1, STXBP3, olfactory receptor genes (OR5K3, OR5H6 and OR1E1) and taste receptor genes (TAS2R1, TAS2R3 and TAS2R4). Functional annotation highlighted that biological processes like platelet aggregation and sensory perception were the most overrepresented and the associated regions could be considered as breed-specific signatures of selection in Arunachali yak. These findings point towards evolutionary role of natural selection in environmental adaptation of Arunachali yak population and provide useful insights for pursuing genome-wide association studies in future.
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Affiliation(s)
- Aneet Kour
- ICAR-National Research Centre on Yak, Dirang 790101, Arunachal Pradesh, India; (M.P.); (M.S.)
- Correspondence:
| | - Saket Kumar Niranjan
- ICAR-National Bureau of Animal Genetic Resources, Karnal 132001, Haryana, India; (S.K.N.); (A.K.)
| | - Mohan Malayaperumal
- ICAR-National Dairy Research Institute, Karnal 132001, Haryana, India; (M.M.); (U.S.)
| | - Utsav Surati
- ICAR-National Dairy Research Institute, Karnal 132001, Haryana, India; (M.M.); (U.S.)
| | - Martina Pukhrambam
- ICAR-National Research Centre on Yak, Dirang 790101, Arunachal Pradesh, India; (M.P.); (M.S.)
| | | | - Amod Kumar
- ICAR-National Bureau of Animal Genetic Resources, Karnal 132001, Haryana, India; (S.K.N.); (A.K.)
| | - Mihir Sarkar
- ICAR-National Research Centre on Yak, Dirang 790101, Arunachal Pradesh, India; (M.P.); (M.S.)
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15
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A dry immersion model of microgravity modulates platelet phenotype, miRNA signature, and circulating plasma protein biomarker profile. Sci Rep 2021; 11:21906. [PMID: 34753989 PMCID: PMC8578674 DOI: 10.1038/s41598-021-01335-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/26/2021] [Indexed: 11/08/2022] Open
Abstract
Ground based research modalities of microgravity have been proposed as innovative methods to investigate the aetiology of chronic age-related conditions such as cardiovascular disease. Dry Immersion (DI), has been effectively used to interrogate the sequelae of physical inactivity (PI) and microgravity on multiple physiological systems. Herein we look at the causa et effectus of 3-day DI on platelet phenotype, and correlate with both miRomic and circulating biomarker expression. The miRomic profile of platelets is reflective of phenotype, which itself is sensitive and malleable to the exposome, undergoing responsive transitions in order to fulfil platelets role in thrombosis and haemostasis. Heterogeneous platelet subpopulations circulate at any given time, with varying degrees of sensitivity to activation. Employing a DI model, we investigate the effect of acute PI on platelet function in 12 healthy males. 3-day DI resulted in a significant increase in platelet count, plateletcrit, platelet adhesion, aggregation, and a modest elevation of platelet reactivity index (PRI). We identified 15 protein biomarkers and 22 miRNA whose expression levels were altered after DI. A 3-day DI model of microgravity/physical inactivity induced a prothrombotic platelet phenotype with an unique platelet miRNA signature, increased platelet count and plateletcrit. This correlated with a unique circulating protein biomarker signature. Taken together, these findings highlight platelets as sensitive adaptive sentinels and functional biomarkers of epigenetic drift within the cardiovascular compartment.
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16
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Zhang J, Dawa J, Suolang D, Lei Y, Wang J, Basang D. The Application of Preoperative Three-Dimensional Reconstruction Visualization Digital Technology in the Surgical Treatment of Hepatic Echinococcosis in Tibet. Front Surg 2021; 8:715005. [PMID: 34490337 PMCID: PMC8417046 DOI: 10.3389/fsurg.2021.715005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/26/2021] [Indexed: 01/17/2023] Open
Abstract
Objective: The present study aims to explore the application value of three-dimensional (3D) reconstruction technology in the preoperative evaluation of patients with complicated hepatic echinococcosis in Tibet. Methods: A total of 200 patients with complicated hepatic echinococcosis, admitted to our hospital between May 2019 and December 2020, who underwent radical hepatectomy, were enrolled in the present study. The patients were randomly divided into a preoperative computer tomography group and a preoperative 3D reconstruction group. According to the imaging results, a surgical plan was formulated. A comparison was made between the two groups of the coincidence rate of the surgical plan and intraoperative and postoperative complications. Results: The patients with hepatic echinococcosis who underwent 3D visualization reconstruction before surgery had a high compliance rate with the surgical plans and the operating time, the number of cases with blood flow blockage, the blood flow blockage time, intraoperative hemorrhage, and postoperative biliary fistulas were significantly lower. Conclusion: The application of preoperative 3D visualization reconstruction in patients with complicated hepatic echinococcosis in Tibet could effectively improve surgical safety.
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Affiliation(s)
- Jun Zhang
- Department of General Surgery, Peking University First Hospital, Beijing, China
| | - Jinmei Dawa
- Department of General Surgery, Peking University First Hospital, Beijing, China.,Department of General Surgery, People's Hospital of Tibet Autonomous Region, Lhasa, China
| | - Duojie Suolang
- Department of General Surgery, Peking University First Hospital, Beijing, China.,Department of General Surgery, People's Hospital of Tibet Autonomous Region, Lhasa, China
| | - Yanming Lei
- Department of General Surgery, Peking University First Hospital, Beijing, China.,Department of Imaging, People's Hospital of Tibet Autonomous Region, Lhasa, China
| | - Jiayun Wang
- Department of General Surgery, Peking University First Hospital, Beijing, China.,Department of Clinical Medicine, Capital Medical University, Beijing, China
| | - Dunzhu Basang
- Department of General Surgery, Peking University First Hospital, Beijing, China.,Department of General Surgery, People's Hospital of Tibet Autonomous Region, Lhasa, China
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17
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Feriel J, Tchipeva D, Depasse F. Effects of circadian variation, lifestyle and environment on hematological parameters: A narrative review. Int J Lab Hematol 2021; 43:917-926. [PMID: 34019728 DOI: 10.1111/ijlh.13590] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/06/2021] [Accepted: 04/27/2021] [Indexed: 12/28/2022]
Abstract
The complete blood count (CBC) is the most widely prescribed laboratory test. It plays a key role in screening, diagnosing, and monitoring a variety of medical disorders. Preanalytical and analytical variables are responsible for more than 50% of laboratory errors that may lead to spurious CBC results. The effects of blood sampling, transport, storage, and analytical errors on hematological parameters have been well described. Circadian variation and changes in lifestyle and environment can also affect blood cells. It has been extensively studied in the past, but highly variable methodology and the presence of confounding factors have provided scattered and inconsistent results. We have investigated the literature to define the impact of circadian variation, modification of the sleep-wake cycle, acute and chronic exercise, eating habits, alcohol, tobacco, drugs of abuse, high-altitude, heat/cold exposure, and air pollution on CBC results. The affected cell type along with the intensity and duration of changes are detailed for each condition. We aim at providing a comprehensive overview of which situations may induce clinically significant changes and have to be taken into account by healthcare professionals before considering a hematological parameter as pathological and requesting complementary tests.
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18
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Friedrich L, Levin G, Maixner N, Bart Y, Tsur A, Yinon Y, Meyer R. Hematologic adaptation to mask-wearing among pregnant women and obstetrical outcome during the coronavirus disease 2019 pandemic. Int J Gynaecol Obstet 2021; 154:297-303. [PMID: 33872397 PMCID: PMC9087669 DOI: 10.1002/ijgo.13715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/16/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the effect of the coronavirus disease 2019 (COVID-19) mask-wearing on hematological laboratory components and obstetrical outcomes among women delivering during the COVID-19 pandemic. METHODS Laboratory results and obstetrical outcomes of women with singleton gestations, admitted for delivery during the COVID-19 mask-wearing period (April-June 2020) were compared with those of women delivering during the parallel period in 2019 and with a larger cohort derived from nine pre-pandemic years (March 2011-April 2020). RESULTS Overall, 1838 women delivered during the COVID-19 pandemic. Compared with the pre-pandemic period, mean hemoglobin and fibrinogen levels were significantly higher during the mask-wearing period (12.15 ± 1.1 vs 11.96 ± 1.2, P < 0.001 and 472 ± 103.6 vs 448 ± 85.1 mg/dl, P < 0.001, respectively). Platelet levels were lower (200 ± 56.0 vs 206 ± 57.5 K/µl, P < 0.001). The rate of delivery at <34 weeks of gestation was lower during the mask-wearing period (1.1% vs 2%, odds ratio [OR] 0.57, 95% confidence intervals [CI] 0.37-0.88, P = 0.01), whereas cesarean delivery and postpartum hemorrhage rates were higher (26.7% vs 24.4%, OR 1.13, 95% CI 1.02-1.25, P = 0.022 and 4.1% vs 2.8%, OR 1.5, 95% CI 1.2-1.8, P = 0.001, respectively). CONCLUSION A hard-to-ventilate space created by wearing a mask during the COVID-19 era may be the underlying cause of the observed higher hemoglobin level among pregnant women, possibly affecting obstetrical outcomes.
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Affiliation(s)
- Lior Friedrich
- Faculty of Health Sciences, The Joyce & Irving Goldman Medical School, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Gabriel Levin
- The Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.,The Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Nitzan Maixner
- Faculty of Health Sciences, The Joyce & Irving Goldman Medical School, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Yossi Bart
- The Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel.,The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Abraham Tsur
- The Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel.,The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yoav Yinon
- The Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel.,The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Raanan Meyer
- The Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel.,The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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19
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Abdelsalam M, Althaqafi RMM, Assiri SA, Althagafi TM, Althagafi SM, Fouda AY, Ramadan A, Rabah M, Ahmed RM, Ibrahim ZS, Nemenqani DM, Alghamdi AN, Al Aboud D, Abdel-Moneim AS, Alsulaimani AA. Clinical and Laboratory Findings of COVID-19 in High-Altitude Inhabitants of Saudi Arabia. Front Med (Lausanne) 2021; 8:670195. [PMID: 34055842 PMCID: PMC8149591 DOI: 10.3389/fmed.2021.670195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 03/23/2021] [Indexed: 01/08/2023] Open
Abstract
Background: SARS-CoV-2, the causative agent of COVID-19, continues to cause a worldwide pandemic, with more than 147 million being affected globally as of this writing. People's responses to COVID-19 range from asymptomatic to severe, and the disease is sometimes fatal. Its severity is affected by different factors and comorbidities of the infected patients. Living at a high altitude could be another factor that affects the severity of the disease in infected patients. Methods: In the present study, we have analyzed the clinical, laboratory, and radiological findings of COVID-19-infected patients in Taif, a high-altitude region of Saudi Arabia. In addition, we compared matched diseased subjects to those living at sea level. We hypothesized that people living in high-altitude locations are prone to develop a more severe form of COVID-19 than those living at sea level. Results: Age and a high Charlson comorbidity score were associated with increased numbers of intensive care unit (ICU) admissions and mortality among COVID-19 patients. These ICU admissions and fatalities were found mainly in patients with comorbidities. Rates of leukocytosis, neutrophilia, higher D-dimer, ferritin, and highly sensitive C-reactive protein (CRP) were significantly higher in ICU patients. CRP was the most independent of the laboratory biomarkers found to be potential predictors of death. COVID-19 patients who live at higher altitude developed a less severe form of the disease and had a lower mortality rate, in comparison to matched subjects living at sea level. Conclusion: CRP and Charlson comorbidity scores can be considered predictive of disease severity. People living at higher altitudes developed less severe forms of COVID-19 disease than those living at sea level, due to a not-yet-known mechanism.
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Affiliation(s)
- Mostafa Abdelsalam
- Alameen Hospital, Taif, Saudi Arabia.,Mansoura Nephrology and Dialysis Unit, Internal Medicine Department, College of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Sara A Assiri
- College of Medicine, Taif University, Taif, Saudi Arabia
| | | | - Saleh M Althagafi
- General Department of Medical Services, Security Forces Hospital, Mecca, Saudi Arabia
| | - Ahmed Y Fouda
- Alameen Hospital, Taif, Saudi Arabia.,Anesthesiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed Ramadan
- Alameen Hospital, Taif, Saudi Arabia.,Radiology Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mohammed Rabah
- Alameen Hospital, Taif, Saudi Arabia.,Radiology Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Reham M Ahmed
- Alameen Hospital, Taif, Saudi Arabia.,Albbassia Chest Hospital, Cairo, Egypt
| | - Zein S Ibrahim
- Department of Physiology, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | | | | | | | | | | |
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20
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Li Y, Ma Y, Wang K, Zhang M, Wang Y, Liu X, Hao M, Yin X, Liang M, Zhang H, Wang X, Chen X, Zhang Y, Duan W, Kang L, Qiao B, Wang J, Jin L. Using Composite Phenotypes to Reveal Hidden Physiological Heterogeneity in High-Altitude Acclimatization in a Chinese Han Longitudinal Cohort. PHENOMICS (CHAM, SWITZERLAND) 2021; 1:3-14. [PMID: 36939745 PMCID: PMC9584130 DOI: 10.1007/s43657-020-00005-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 10/16/2020] [Accepted: 10/26/2020] [Indexed: 11/30/2022]
Abstract
Altitude acclimatization is a human physiological process of adjusting to the decreased oxygen availability. Since several physiological processes are involved and their correlations are complicated, the analyses of single traits are insufficient in revealing the complex mechanism of high-altitude acclimatization. In this study, we examined these physiological responses as the composite phenotypes that are represented by a linear combination of physiological traits. We developed a strategy that combines both spectral clustering and partial least squares path modeling (PLSPM) to define composite phenotypes based on a cohort study of 883 Chinese Han males. In addition, we captured 14 composite phenotypes from 28 physiological traits of high-altitude acclimatization. Using these composite phenotypes, we applied k-means clustering to reveal hidden population physiological heterogeneity in high-altitude acclimatization. Furthermore, we employed multivariate linear regression to systematically model (Models 1 and 2) oxygen saturation (SpO2) changes in high-altitude acclimatization and evaluated model fitness performance. Composite phenotypes based on Model 2 fit better than single trait-based Model 1 in all measurement indices. This new strategy of using composite phenotypes may be potentially employed as a general strategy for complex traits research such as genetic loci discovery and analyses of phenomics.
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Affiliation(s)
- Yi Li
- State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, 200438 China
- Institute for Six-Sector Economy, Fudan University, Shanghai, 200433 China
| | - Yanyun Ma
- Ministry of Education Key Laboratory of Contemporary Anthropology, Department of Anthropology and Human Genetics, School of Life Sciences, Fudan University, Shanghai, 200438 China
- Institute for Six-Sector Economy, Fudan University, Shanghai, 200433 China
| | - Kun Wang
- Ministry of Education Key Laboratory of Contemporary Anthropology, Department of Anthropology and Human Genetics, School of Life Sciences, Fudan University, Shanghai, 200438 China
| | - Menghan Zhang
- State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, 200438 China
| | - Yi Wang
- Ministry of Education Key Laboratory of Contemporary Anthropology, Department of Anthropology and Human Genetics, School of Life Sciences, Fudan University, Shanghai, 200438 China
| | - Xiaoyu Liu
- State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, 200438 China
| | - Meng Hao
- Ministry of Education Key Laboratory of Contemporary Anthropology, Department of Anthropology and Human Genetics, School of Life Sciences, Fudan University, Shanghai, 200438 China
| | - Xianhong Yin
- State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, 200438 China
| | - Meng Liang
- Ministry of Education Key Laboratory of Contemporary Anthropology, Department of Anthropology and Human Genetics, School of Life Sciences, Fudan University, Shanghai, 200438 China
| | - Hui Zhang
- State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, 200438 China
| | - Xiaofeng Wang
- State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, 200438 China
| | - Xingdong Chen
- State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, 200438 China
- Fudan-Taizhou Institute of Health Sciences, Taizhou, 225300 China
| | - Yao Zhang
- Key Laboratory of High Altitude Environment and Genes Related To Diseases of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, 712082 China
| | - Wenyuan Duan
- Institute of Cardiovascular Disease, Shandong Provincial Western Hospital, Jinan, Shandong 250022 China
| | - Longli Kang
- Key Laboratory of High Altitude Environment and Genes Related To Diseases of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, 712082 China
| | - Bin Qiao
- Institute of Cardiovascular Disease, Shandong Provincial Western Hospital, Jinan, Shandong 250022 China
| | - Jiucun Wang
- State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, 200438 China
- Institute for Six-Sector Economy, Fudan University, Shanghai, 200433 China
- Research Unit of Dissecting the Population Genetics and Developing New Technologies for Treatment and Prevention of Skin Phenotypes and Dermatological Diseases (2019RU058), Chinese Academy of Medical Sciences, Beijing, 100730 China
| | - Li Jin
- State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, 200438 China
- Institute for Six-Sector Economy, Fudan University, Shanghai, 200433 China
- Research Unit of Dissecting the Population Genetics and Developing New Technologies for Treatment and Prevention of Skin Phenotypes and Dermatological Diseases (2019RU058), Chinese Academy of Medical Sciences, Beijing, 100730 China
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21
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Venous thrombosis at altitude presents with distinct biochemical profiles: a comparative study from the Himalayas to the plains. Blood Adv 2020; 3:3713-3723. [PMID: 31765479 DOI: 10.1182/bloodadvances.2018024554] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 10/22/2019] [Indexed: 11/20/2022] Open
Abstract
High-altitude (HA) hypoxia exposure is believed to induce venous thromboembolism (VTE) in otherwise healthy individuals, although this needs to be fully established. The present study aims to ascertain the role of HA exposure in aggravating any predisposition toward VTE and to explore whether the etiology of HA-induced VTE is different from that of VTE closer to sea level. We compared manifestation-matched male VTE patients from HA (HAPs) and VTE patients from the plains closer to sea level (SLPs) for 54 parameters, including coagulation-related, fibrinolytic, and thrombophilic variables, as well as markers for stress and inflammatory response and platelet and endothelial activation. Our results established an association between HA hypoxia and VTE in alterations of primarily hemostatic variables. Approximately 96% of HAPs presented with ≥10 altered parameters out of 54 studied compared with 7% of SLPs. Elevated platelet count, von Willebrand factor, and clotting factors and altered coagulation exhibited significant associations with VTE events and altitude exposure (all P < .05). Additionally, most VTEs at HA were associated with younger age groups, unlike those on the plains. A receiver operator characteristic curve analysis revealed differences between HAPs and SLPs for CD40 ligand (area under the curve [AUC], 0.90; 95% confidence interval [CI], 0.84-0.96]), P-selectin (0.79; 0.70-0.88), platelet factor-4 (0.90; 0.84-0.96), intracellular adhesion molecule-1 (0.86; 0.79-0.93), vascular cell adhesion molecule-1 (0.97; 0.95-0.99), vascular endothelial growth factor (0.87; 0.8-0.94), FLT4 (0.94; 0.89-0.99), and Toll-like receptor-2 (0.98; 0.96-1.0) (all P < .05). In conclusion, this study suggests that HA exposure perturbs the molecules associated with vascular integrity and contributes to the early onset of VTE.
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22
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Evaluation of Oxidative Stress in Patients with Difficult-to-Heal Skin Wounds Treated with Hyperbaric Oxygen. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:1835352. [PMID: 32802258 PMCID: PMC7415099 DOI: 10.1155/2020/1835352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 07/16/2020] [Indexed: 01/16/2023]
Abstract
Objective To determine the concentration of thiobarbituric acid reactive substances (TBARS) in erythrocytes and blood plasma, and the activities of selected antioxidant enzymes: catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx) in erythrocytes in patients receiving hyperbaric oxygen (HBO) treatment due to difficult-to-heal “skin wounds”. Material and Methods. Indices of oxidative stress were assessed in venous blood taken from 23 patients three times: immediately before HBO procedure, approx. 5 minutes after leaving the hyperbaric chamber, and after 25 HBO procedures. Moreover, selected blood counts were measured in the collected material two times: prior to treatment and after 25 HBO procedures. Results A statistically significant positive correlation between the CAT activity and the TBARS concentration in the erythrocytes of patients was found before treatment in the hyperbaric chamber (r = 0.394; P ≤ 0.05). No statistically significant changes in the TBARS concentration in erythrocytes and blood plasma were observed both after the first HBO procedure and after 25 procedures. No statistically significant changes in the activities of CAT, SOD, and GPx were noted. Platelet count decreased by 18.7% (P ≤ 0.05) after 25 HBO procedures. Granulocyte count decreased by approx. 21% (P ≤ 0.05), and granulocyte percentage by 11.8% (P ≤ 0.01). In turn, the percentage of lymphocytes and monocytes increased after the treatment by 16.6% (P < 0.05) and 16.4% (P < 0.05), respectively. Conclusions Exposure to HBO due to difficult-to-heal skin wounds does not significantly affect the levels of oxidative stress in the peripheral blood of patients and, from the point of view of oxidation–reduction processes, appears to be a safe therapeutic method for the treatment of chronic wounds.
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23
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Deng B, Liu W, Pu L, Wang X, Duan R, Wang T, Wang Z, Du L, Gao Z, Chen Z. Quantitative Proteomics Reveals the Effects of Resveratrol on High-Altitude Polycythemia Treatment. Proteomics 2020; 20:e1900423. [PMID: 32468662 DOI: 10.1002/pmic.201900423] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 05/18/2020] [Indexed: 12/17/2022]
Abstract
High-altitude polycythemia (HAPC) is a common plateau chronic disease in which red blood cells are compensatory hyperproliferative due to high altitude hypoxic environment. HAPC severely affects the physical and mental health of populations on the plateau. However, the pathogenesis and treatment of HAPC has been rarely investigated. Here, the hypoxia-induced HAPC model of rat is established, in which hemoglobin concentration significantly increases and platelets clearly decrease. The effect of resveratrol upon hypoxia enables HAPC remission and makes hemoglobin and platelet tend to a normal level. Furthermore, quantitative proteomics is applied to investigate the plasma proteome variation and the underlying molecular regulation during HAPC occurrence and treatment with resveratrol. Hypoxia promotes erythrocyte developing and differentiating and disrupts cytoskeleton organization. Notably, the resveratrol administration reverses the proteome change pattern due to hypoxia and contributes to plateau adaption. Quantitative verification of differentially expressed proteins confirms the roles of resveratrol in HAPC. Resveratrol is expected to be useful for HAPC treatment.
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Affiliation(s)
- Bingnan Deng
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
| | - Weili Liu
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
| | - Lingling Pu
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
| | - Xinxing Wang
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
| | - Ruifeng Duan
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
| | - Tianhui Wang
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
| | - Zirou Wang
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
| | - Lianqun Du
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
| | - Zhixian Gao
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
| | - Zhaoli Chen
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
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24
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Raberin A, Nader E, Ayerbe JL, Mucci P, Connes P, Durand F. Evolution of blood rheology and its relationship to pulmonary hemodynamic during the first days of exposure to moderate altitude. Clin Hemorheol Microcirc 2020; 74:201-208. [PMID: 31476150 DOI: 10.3233/ch-190671] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Blood rheology and hemodynamic parameters have never been explored together during acclimatization to altitude. This study aimed to investigate changes in blood rheology parameters and pulmonary hemodynamics during the first days of real moderate altitude exposure.Seventeen athletes were tested at sea-level, 20 hours after their arrival at 2,400 meters of altitude (H1) and five days later (H2). Blood was sampled to analyze red blood cell (RBC) aggregation, blood viscosity and hematocrit. Pulmonary arterial pressure (PAP), pulmonary capillary pressure (Pcap) and pulmonary vascular resistance (PVR) were assessed by echocardiography.We observed a rise in hematocrit, blood viscosity, RBC aggregation, PAP, Pcap and PVR between sea-level and H1. In H2, RBC aggregation, hematocrit, PAP, Pcap and PVR remained different compared to sea-level and no difference was observed between H1 and H2. Blood viscosity decreased in H2 and returned to sea-level values.Our results suggest that hemoconcentration occurring within the first hours of altitude exposure increased blood viscosity, which contributed to the changes in pulmonary hemodynamic. When blood viscosity decreased in H2, no change occurred in pulmonary hemodynamic parameters suggesting that hypoxic pulmonary vasoconstriction was still present. The elevated RBC aggregation observed after in H2 could participate in the increase of Pcap.
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Affiliation(s)
- Antoine Raberin
- Laboratoire Européen Performance Santé Altitude (LEPSA), EA 4604, Université de Perpignan Via Domitia, Font Romeu, France
| | - Elie Nader
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team laquo Vascular Biology and Red Blood Cell raquo, Université Claude Bernard Lyon 1, Université de Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | | | - Patrick Mucci
- Unité de recherche Pluridisciplinaire Sport Santé Société (URePSSS), EA 7369, Université Lille, Université Artois, Université Littoral Côte d'Opale, Lille, France
| | - Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team laquo Vascular Biology and Red Blood Cell raquo, Université Claude Bernard Lyon 1, Université de Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Fabienne Durand
- Laboratoire Européen Performance Santé Altitude (LEPSA), EA 4604, Université de Perpignan Via Domitia, Font Romeu, France
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25
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Yang W, Zhao S, Liu D, Su G, Zhang D, Lagui, Deng Y, Guan X. Establishment of Reference Intervals for Blood Cell Analysis of Adult Tibetan Farmers and Herdsmen Over 4100 Meters Above Sea Level in Tibet Based on a Health Survey. High Alt Med Biol 2020; 21:223-231. [PMID: 32498572 DOI: 10.1089/ham.2020.0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Yang, Wei, Song Zhao, Dan Liu, Guangming Su, Dongwei Zhang, Gui La, Yu Deng, Pian Ni, and Xiuru Guan. Establishment of reference intervals for blood cell analysis of adult Tibetan farmers and herdsmen over 4100 meters above sea level in Tibet based on a health survey. High Alt Med Biol. 21:223-231, 2020. Background: High altitude has substantial influence on reference intervals (RIs) for blood cell analysis. However, the currently used RIs for blood cell analysis in China have not been investigated in people from high-altitude areas, which may potentially cause confusion regarding disease diagnosis and treatment of Tibetan farmers and herdsmen from high-altitude areas. Therefore, it is necessary to establish blood cell analysis RIs that are suitable for people in high-altitude areas. Methods: In total, 1145 healthy Tibetan farmers and herdsmen were recruited who have lived at an altitude from 4100 to 5280 m in Kangma, Tibet, for a long time. The C28-A3 guideline from the Clinical and Laboratory Standards Institute was used to establish the RIs for hemoglobin (HGB) concentrations and red blood cell (RBC), white blood cell (WBC), and platelet (PLT) counts from the blood results of Tibetan participants. Results: There were significant gender differences in blood cell RIs for Tibetan farmers and herdsmen who lived above 4100 m above sea level in Kangma, Tibet. Compared with currently used RIs in China, RIs for HGB concentrations and RBCs in Kangma were significantly higher, whereas WBCs were similar and PLT count was lower. Conclusions: The currently used RIs in China may not be applicable to adult Tibetan farmers and herdsmen above 4100 m in Tibet. The newly obtained RIs can supplement the currently used RIs.
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Affiliation(s)
- Wei Yang
- Department of Laboratory Diagnostics, The First Affiliated Hospital of Harbin Medical University, Harbin, P.R. China
| | - Song Zhao
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, P.R. China
| | - Dan Liu
- Department of Laboratory Diagnostics, The First Affiliated Hospital of Harbin Medical University, Harbin, P.R. China
| | - Guangming Su
- Department of Laboratory Diagnostics, The First Affiliated Hospital of Harbin Medical University, Harbin, P.R. China
| | - Dongwei Zhang
- Department of Laboratory Diagnostics, The First Affiliated Hospital of Harbin Medical University, Harbin, P.R. China
| | - Lagui
- Departments of Medical Treatment, The Kangma County Hospital, Tibet, P.R. China
| | - Yu Deng
- Departments of Medical Treatment, The Kangma County Hospital, Tibet, P.R. China
| | - Xiuru Guan
- Department of Laboratory Diagnostics, The First Affiliated Hospital of Harbin Medical University, Harbin, P.R. China
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26
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Features and incidence of thromboembolic disease: A comparative study between high and low altitude dwellers in Saudi Arabia. Saudi J Biol Sci 2020; 27:1632-1636. [PMID: 32489304 PMCID: PMC7253901 DOI: 10.1016/j.sjbs.2020.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 11/21/2022] Open
Abstract
To estimate and compare the incidence of thromboembolic disease among patients who are clinically suspected for VTE among high and low altitude dwellers in Saudi Arabia. A prospective study conducted over two years (2011–2013) conducted in two different geographical areas in Saudi Arabia; Abha City and Riyadh City. Patients clinically suspected with deep vein thrombosis and pulmonary embolism was recruited to the study. A detailed social, medical and laboratory investigations were taken from all patients including lifestyle, occupation and smoking. A total of 234 patients participated in the study. There were 146 (62.4%) females and 88 (37.6%) males. Mean age was 51.7 years. A 56.8% incidence of DVT was seen among high altitude dwellers compared to 13.0% among low altitude dwellers. Also, a 12.6% incidence of PE was documented among high altitude dwellers, compared to 4.1% of the low altitude dwellers. VTE was significantly more among high altitude dwellers (81.9%) compared to low altitude dwellers (21.9%). Mean WBC count was significantly higher among the high altitude dwellers (10.8 ± 9.7 vs. 8.2 ± 3.4, p = 0.043). Mean platelet count was significantly higher among the high altitude dwellers compared to the low altitude dwellers (327.4 ± 162.4 vs. 212.0 ± 158.9, p = 0.005). The likelihood of developing VTE is greater among people who resided at moderate to high altitude for prolonged periods of time. The changes in the factors for coagulation including platelet counts may not reflect the true status of hypercoagulability especially if patients have stayed longer in high altitudes because of physiological adaptation to the environment.
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27
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Srivastava S, Garg I, Kumari B, Rai C, Singh Y, Kumar V, Yanamandra U, Singh J, Bansal A, Kumar B. Diagnostic potential of circulating micro RNA hsa-miR-320 in patients of high altitude induced deep vein thrombosis: An Indian study. GENE REPORTS 2019. [DOI: 10.1016/j.genrep.2019.100550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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28
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Serebrovska ZO, Serebrovska TV, Kholin VA, Tumanovska LV, Shysh AM, Pashevin DA, Goncharov SV, Stroy D, Grib ON, Shatylo VB, Bachinskaya NY, Egorov E, Xi L, Dosenko VE. Intermittent Hypoxia-Hyperoxia Training Improves Cognitive Function and Decreases Circulating Biomarkers of Alzheimer's Disease in Patients with Mild Cognitive Impairment: A Pilot Study. Int J Mol Sci 2019; 20:E5405. [PMID: 31671598 PMCID: PMC6862463 DOI: 10.3390/ijms20215405] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 10/23/2019] [Accepted: 10/24/2019] [Indexed: 12/15/2022] Open
Abstract
Alzheimer's disease (AD) affects not only the central nervous system, but also peripheral blood cells including neutrophils and platelets, which actively participate in pathogenesis of AD through a vicious cycle between platelets aggregation and production of excessive amyloid beta (Aβ). Platelets adhesion on amyloid plaques also increases the risk of cerebral microcirculation disorders. Moreover, activated platelets release soluble adhesion molecules that cause migration, adhesion/activation of neutrophils and formation of neutrophil extracellular traps (NETs), which may damage blood brain barrier and destroy brain parenchyma. The present study examined the effects of intermittent hypoxic-hyperoxic training (IHHT) on elderly patients with mild cognitive impairment (MCI), a precursor of AD. Twenty-one participants (age 51-74 years) were divided into three groups: Healthy Control (n = 7), MCI+Sham (n = 6), and MCI+IHHT (n = 8). IHHT was carried out five times per week for three weeks (total 15 sessions). Each IHHT session consisted of four cycles of 5-min hypoxia (12% FIO2) and 3-min hyperoxia (33% FIO2). Cognitive parameters, Aβ and amyloid precursor protein (APP) expression, microRNA 29, and long non-coding RNA in isolated platelets as well as NETs in peripheral blood were investigated. We found an initial decline in cognitive function indices in both MCI+Sham and MCI+IHHT groups and significant correlations between cognitive test scores and the levels of circulating biomarkers of AD. Whereas sham training led to no change in these parameters, IHHT resulted in the improvement in cognitive test scores, along with significant increase in APP ratio and decrease in Aβ expression and NETs formation one day after the end of three-week IHHT. Such effects on Aβ expression and NETs formation remained more pronounced one month after IHHT. In conclusion, our results from this pilot study suggested a potential utility of IHHT as a new non-pharmacological therapy to improve cognitive function in pre-AD patients and slow down the development of AD.
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Affiliation(s)
- Zoya O Serebrovska
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, Kyiv 01024, Ukraine.
| | | | - Viktor A Kholin
- Department of Age Physiology and Pathology of Nervous System, Chebotarev Institute of Gerontology NAMS of Ukraine, Kyiv 04114, Ukraine.
| | - Lesya V Tumanovska
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, Kyiv 01024, Ukraine.
| | - Angela M Shysh
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, Kyiv 01024, Ukraine.
| | - Denis A Pashevin
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, Kyiv 01024, Ukraine.
| | - Sergii V Goncharov
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, Kyiv 01024, Ukraine.
| | - Dmytro Stroy
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, Kyiv 01024, Ukraine.
| | - Oksana N Grib
- Department of Clinical Physiology and Pathology of Internal Organs, Chebotarev Institute of Gerontology NAMS of Ukraine, Kyiv 04114, Ukraine.
| | - Valeriy B Shatylo
- Department of Clinical Physiology and Pathology of Internal Organs, Chebotarev Institute of Gerontology NAMS of Ukraine, Kyiv 04114, Ukraine.
| | - Natalia Yu Bachinskaya
- Department of Age Physiology and Pathology of Nervous System, Chebotarev Institute of Gerontology NAMS of Ukraine, Kyiv 04114, Ukraine.
| | - Egor Egorov
- CellAir Constructions GmbH, Schorndorf 73614, Germany.
| | - Lei Xi
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA 23298-0204, USA.
| | - Victor E Dosenko
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, Kyiv 01024, Ukraine.
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29
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Gupta N, Zhao YY, Evans CE. The stimulation of thrombosis by hypoxia. Thromb Res 2019; 181:77-83. [DOI: 10.1016/j.thromres.2019.07.013] [Citation(s) in RCA: 342] [Impact Index Per Article: 68.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 06/19/2019] [Accepted: 07/14/2019] [Indexed: 11/28/2022]
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30
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Zhang R, Yu X, Shen Y, Yang C, Liu F, Ye S, Du X, Ma L, Cao H, Wang Z, Li C. Correlation between RBC changes and coagulation parameters in high altitude population. ACTA ACUST UNITED AC 2019; 24:325-330. [PMID: 30669960 DOI: 10.1080/16078454.2019.1568658] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To explore the correlations between RBCs indexes and the basic coagulation parameters, and provide data for further studies on high altitude-induced thrombotic disease. METHODS A total of eligible 433 volunteers were divided into different groups according to HGB concentration and HCT, respectively. PT, APTT, TT and Fbg were measured by clotting assays. HGB content, HCT and PLT count were assessed by automated hematology analyzer. RESULTS APTT and PT were significantly higher in group 4 (high HGB or HCT groups) (p < 0.05 for all comparison) and PLT count was significantly lower in group 4 than in other groups (p < 0.01 for all comparison). APTT and PT showed negative correlations with HGB concentration (r = -0.168 and -0.165 resp.; both p < 0.01), whereas positive correlations were found between APTT and HCT, PT and HCT (r = 0.225 and 0.258, resp.; both p < 0.01). PLT, TT and Fbg showed no correlation with HGB and HCT. CONCLUSIONS HGB and HCT may not correlate with basic coagulation parameters in high altitude population, their predictive value for high altitude-induced thrombotic disease may relatively independent and this remain to be determined in further studies.
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Affiliation(s)
- Rong Zhang
- a Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College , Chengdu , People's Republic of China
| | - Xiaochuan Yu
- b People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture , Sichuan , People's Republic of China
| | - Yuanzhen Shen
- b People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture , Sichuan , People's Republic of China
| | - Chunhui Yang
- a Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College , Chengdu , People's Republic of China
| | - Fengjuan Liu
- a Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College , Chengdu , People's Republic of China
| | - Shengliang Ye
- a Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College , Chengdu , People's Republic of China
| | - Xi Du
- a Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College , Chengdu , People's Republic of China
| | - Li Ma
- a Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College , Chengdu , People's Republic of China
| | - Haijun Cao
- a Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College , Chengdu , People's Republic of China
| | - Zongkui Wang
- a Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College , Chengdu , People's Republic of China
| | - Changqing Li
- a Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College , Chengdu , People's Republic of China
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Shang C, Wuren T, Ga Q, Bai Z, Guo L, Eustes AS, McComas KN, Rondina MT, Ge R. The human platelet transcriptome and proteome is altered and pro-thrombotic functional responses are increased during prolonged hypoxia exposure at high altitude. Platelets 2019; 31:33-42. [PMID: 30721642 DOI: 10.1080/09537104.2019.1572876] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Exposure to hypoxia, through ascension to high altitudes (HAs), air travel, or human disease, is associated with an increased incidence of thrombosis in some settings. Mechanisms underpinning this increased thrombosis risk remain incompletely understood, and the effects of more sustained hypoxia on the human platelet molecular signature and associated functional responses have never been examined. We examined the effects of prolonged (≥2 months continuously) hypobaric hypoxia on platelets isolated from subjects residing at HA (3,700 meters) and, for comparison, matched subjects residing under normoxia conditions at sea level (50 meters). Using complementary transcriptomic, proteomic, and functional methods, we identified that the human platelet transcriptome is markedly altered under prolonged exposure to hypobaric hypoxia at HA. Among the significantly, differentially expressed genes (mRNA and protein), were those having canonical roles in platelet activation and thrombosis, including membrane glycoproteins (e.g. GP4, GP6, GP9), integrin subunits (e.g. ITGA2B), and alpha-granule chemokines (e.g. SELP, PF4V1). Platelets from subjects residing at HA were hyperactive, as demonstrated by increased engagement and adhesion to fibrinogen, fewer alpha granules by transmission electron microscopy, increased circulating PF4 and ADP, and significantly enhanced clot retraction. In conclusion, we identify that prolonged hypobaric hypoxia exposure due to HA alters the platelet transcriptome and proteome, triggering increased functional activation responses that may contribute to thrombosis. Our findings may also have relevance across a range of human diseases where chronic hypoxia, platelet activation, and thrombosis are increased.
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Affiliation(s)
- Chunxiang Shang
- Research Center for High Altitude Medicine, Qinghai University, Xining, Qinghai, China.,Oncology Department, The Fifth Hospital of Qinghai Provinces, Xining, Qinghai, China
| | - Tana Wuren
- Research Center for High Altitude Medicine, Qinghai University, Xining, Qinghai, China.,Departments of Internal Medicine and Pathology, University of Utah, Salt Lake City, UT, USA
| | - Qing Ga
- Research Center for High Altitude Medicine, Qinghai University, Xining, Qinghai, China
| | - Zhenzhong Bai
- Research Center for High Altitude Medicine, Qinghai University, Xining, Qinghai, China
| | - Li Guo
- The University of Utah Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
| | - Alicia S Eustes
- Departments of Internal Medicine and Pathology, University of Utah, Salt Lake City, UT, USA.,The University of Utah Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
| | - Kyra N McComas
- Departments of Internal Medicine and Pathology, University of Utah, Salt Lake City, UT, USA
| | - Matthew T Rondina
- Departments of Internal Medicine and Pathology, University of Utah, Salt Lake City, UT, USA.,The University of Utah Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA.,Hematological Department, George E. Wahlen VAMC GRECC, Salt Lake City, UT, USA
| | - Rili Ge
- Research Center for High Altitude Medicine, Qinghai University, Xining, Qinghai, China
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Jakubowski M, Szahidewicz-Krupska E, Doroszko A. The Human Carbonic Anhydrase II in Platelets: An Underestimated Field of Its Activity. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4548353. [PMID: 30050931 PMCID: PMC6046183 DOI: 10.1155/2018/4548353] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 05/24/2018] [Indexed: 12/15/2022]
Abstract
Carbonic anhydrases constitute a group of enzymes that catalyse reversible hydration of carbon dioxide leading to the formation of bicarbonate and proton. The platelet carbonic anhydrase II (CAII) was described for the first time in the '80s of the last century. Nevertheless, its direct role in platelet physiology and pathology still remains poorly understood. The modulation of platelet CAII action as a therapeutic approach holds promise as a novel strategy to reduce the impact of cardiovascular diseases. This short review paper summarises the current knowledge regarding the role of human CAII in regulating platelet function. The potential future directions considering this enzyme as a potential drug target and important pathophysiological chain in platelet-related disorders are described.
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Affiliation(s)
- Maciej Jakubowski
- Department of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Ewa Szahidewicz-Krupska
- Department of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Adrian Doroszko
- Department of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
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Enawgaw B, Birhan W, Abebe M, Terefe B, Baynes HW, Deressa T, Melku M. Haematological and immunological reference intervals for adult population in the state of Amhara, Ethiopia. Trop Med Int Health 2018; 23:765-773. [PMID: 29752840 DOI: 10.1111/tmi.13071] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Reference intervals (RIs) currently being used in Ethiopia are derived from western populations. Thus, this study aimed to establish locally derived haematological and immunological RIs. METHOD The study was conducted in Amhara State, Ethiopia with a total of 967 (55.2% males) participants. 56.9% of males and 43.1% of females were eligible for haematological and immunological RI determination. A non-parametric test was used for the determination of upper (97.5th percentile) and lower (2.5th percentile) reference interval limits with 95% CI. The Harris and Boyd Rule was used to determine the need of partitioning of reference intervals based on gender. RESULT The established 95% reference intervals (2.5th-97.5th percentile) were: for WBC: 3-11.2 × 109 /l; for platelet: 90-399 × 109 /l; for RBC: 4-6 × 1012 /l for males and 3.5-5.6 × 1012 /l for females; for haemoglobin: (Hgb) 12-18.9 g/dl for males and 10.7-17.5 g/dl for females; for PCV: 35.7-55.3% for males and 32.2-50.1% for females; for CD4: 400-1430 × 109 /l for males and 466-1523 × 109 /l for females; for CD4 percentage: 18-49.1% for males and 21.3-52.9% for females; for MCV: 81-100 fl; for MCH: 25.3-34.6 pg; MCHC: 28.8-36.9%; for RDW: 11.6-15.4% and for MPV: 8-12.3 fl. Males had significantly higher RBC, Hgb and PCV than females. CD4 counts and CD4 percentage were significantly higher in females. CONCLUSION The reference intervals established in this study differ from others and thus should be used for the interpretation of laboratory results in diagnosis and safety monitoring in clinical trials in Amhara.
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Affiliation(s)
- Bamlaku Enawgaw
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wubet Birhan
- Department of Immunology & Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Molla Abebe
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Betelihem Terefe
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habtamu Wondifraw Baynes
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tekalign Deressa
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Melku
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Zhao J, You G, Yin Y, Zhang Y, Wang Y, Chen G, Zhao L, Zhou H. Acute high-altitude exposure shortens survival after uncontrolled hemorrhagic shock in rats. J Surg Res 2018; 226:150-156. [PMID: 29661281 DOI: 10.1016/j.jss.2018.01.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 11/30/2017] [Accepted: 01/17/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Uncontrolled hemorrhage (UH) remains the most common cause of death on the battlefield. This study examined the pathophysiological characteristics of UH in rats acutely exposed to high altitude. MATERIAL AND METHODS Rats raised at sea level were randomly divided into two groups. Rats in the high-altitude group were exposed to hypobaric hypoxia in a hypobaric chamber (simulating 4000 m above sea level) for 2 d and then were performed a hemorrhagic shock protocol in the hypobaric chamber. Rats that underwent the same hemorrhage procedure at sea level were used as control. Anesthetized rats were bled to maintain their mean arterial pressure at 45 mmHg for 1 h. The distal quarter of the tail was amputated to allow free blood loss. After 1 h, the tail cut was ligated to induce hemostasis. mean arterial pressure, acid-base balance, blood loss, and survival were recorded. Rats were killed, and tissues were obtained for histological analysis. RESULTS Rats in the high-altitude group suffered less uncontrolled blood loss, more severe acidosis (lower pH and base excess), and inferior tissue oxygen supply (lower oxygen saturation and higher arterial lactate concentration) during the hemorrhage periods compared with the control group. Survival rates were significantly lower in the high-altitude group than those in the control group (P < 0.05), which was consistent with the results of pathological tissue injury. CONCLUSIONS In this rat model of hemorrhagic shock, acute high-altitude exposure resulted in decreased UH but more serious hemorrhagic shock injuries than that at sea level.
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Affiliation(s)
- Jingxiang Zhao
- Department of Blood Products and Substitutes, Institute of Transfusion Medicine, Academy of Military Medical Science, HaiDian, Beijing, China
| | - Guoxing You
- Department of Blood Products and Substitutes, Institute of Transfusion Medicine, Academy of Military Medical Science, HaiDian, Beijing, China
| | - Yujing Yin
- Department of Blood Products and Substitutes, Institute of Transfusion Medicine, Academy of Military Medical Science, HaiDian, Beijing, China
| | - Yuha Zhang
- Department of Blood Products and Substitutes, Institute of Transfusion Medicine, Academy of Military Medical Science, HaiDian, Beijing, China
| | - Ying Wang
- Department of Blood Products and Substitutes, Institute of Transfusion Medicine, Academy of Military Medical Science, HaiDian, Beijing, China
| | - Gan Chen
- Department of Blood Products and Substitutes, Institute of Transfusion Medicine, Academy of Military Medical Science, HaiDian, Beijing, China
| | - Lian Zhao
- Department of Blood Products and Substitutes, Institute of Transfusion Medicine, Academy of Military Medical Science, HaiDian, Beijing, China
| | - Hong Zhou
- Department of Blood Products and Substitutes, Institute of Transfusion Medicine, Academy of Military Medical Science, HaiDian, Beijing, China.
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Wang Z, Liu H, Dou M, Du X, Hu J, Su N, Wang Y, Zhang R, Li C. The quality changes in fresh frozen plasma of the blood donors at high altitude. PLoS One 2017; 12:e0176390. [PMID: 28430802 PMCID: PMC5400266 DOI: 10.1371/journal.pone.0176390] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 04/10/2017] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE According to the international guidelines, fresh frozen plasma (FFP) is unanimously used to treat coagulation disorders. The quality of FFP is critical for the clinical transfusion. Till now, few studies have integratedly evaluated the differences of FFP from blood donors at between high altitude (HA) and low altitude (LA). Besides, there were no special quality standards for HA FFP in China. MATERIALS AND METHODS Up to 41 HA (Lhasa, 3700 m) and 46 LA (Chengdu, 500 m) blood donors were included in our study to estimate the differences of FFP from HA and LA blood donors. The concentration of total plasma proteins, prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), fibrinogen (Fbg), factor (F) II, FV, FVII, FVIII, FIX, FX, FXI, FXII, D-dimer, protein C (PC), protein S (PS), antithrombin III (ATIII) and von Willebrand factor antigen (vWF:Ag) were determined, respectively. RESULTS As compared with FFP of LA blood donors, the total protein content of HA blood donors showed a significant decrease (65.2±8.9 vs.57.2±6.3 g/L; p<0.001); PT, aPTT, TT were significantly increased (p<0.001); the levels of FII, FV, FVII, FVIII, FIX, FX, FXI, FXII and vWF:Ag were notably decreased (all p<0.05), whereas Fbg and D-dimer were dramaticly increased (p = 0.038). Additionly, in HA blood donors, vWF: Ag and FVIII:C of O-group was significantly lower (p<0.05) than that of non-O-group. It should be noted that FVIII:C of HA blood donors (0.64±0.10 IU/mL) was lower than the current Chinese quality requirements for FFP (≥ 0.7 IU/ml). No significant differences were observed in PC, PS and ATIII. CONCLUSION In general, our findings showed that the quality of FFP was significantly different between HA and LA blood donors, and the current Chinese quality requirements of FFP are not suitable for HA FFP. Therefore, setting up a special quality requirement for HA is quite necessary and meaningful.
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Affiliation(s)
- Zongkui Wang
- Institute of Blood Transfusion, Chinese Academy of Medical Science, Chengdu, China
| | - Hua Liu
- Tibet Autonomous Region Blood Center, Lhasa, Tibet
| | - Miaomiao Dou
- Institute of Blood Transfusion, Chinese Academy of Medical Science, Chengdu, China
| | - Xi Du
- Institute of Blood Transfusion, Chinese Academy of Medical Science, Chengdu, China
| | - Jijun Hu
- Guizhou Taibang Biological Products Co., Ltd, Guiyang, Guizhou
| | - Na Su
- Institute of Blood Transfusion, Chinese Academy of Medical Science, Chengdu, China
| | - Ya Wang
- Institute of Blood Transfusion, Chinese Academy of Medical Science, Chengdu, China
| | - Rong Zhang
- Institute of Blood Transfusion, Chinese Academy of Medical Science, Chengdu, China
- * E-mail: (RZ); (CL)
| | - Changqing Li
- Institute of Blood Transfusion, Chinese Academy of Medical Science, Chengdu, China
- * E-mail: (RZ); (CL)
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Abstract
PURPOSE OF REVIEW The relationship of altitude and cold to cardiovascular risk is complex. Cold is hard to separate from altitude. This review highlights the latest information on cardiovascular disease associated with high altitude and cold; both represent unique clinical situations. RECENT FINDINGS Evolution and genetics are relevant to high altitude, with much new information available. Specific physiology explains some congenital heart disease at altitude. New reports of hematological changes associated with altitude and cold help clarify thrombosis, which is relevant to reports of very late in-stent thrombosis at altitude. Multiple cardiovascular risk factors are affected by altitude and cold, and an increased incidence of myocardial infarction occurs. There is new research on acute mountain sickness associated with inflammation with relevance for clinical study of pulmonary edema. Socioeconomics plays a part in altitude and cold effects on cardiovascular disease. In addition to acute disease, high altitude involves chronic mountain sickness with new knowledge of associated cardiovascular endothelial abnormalities. SUMMARY High altitude and cold involve acute disease, chronic disease, and public health issues. Continued research is essential to enable the best clinical management in this era of rapid worldwide travel.
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Qian G, Ran X, Zhou CX, Deng DQ, Zhang PL, Guo Y, Luo JH, Zhou XH, Xie H, Cai M. Systemic lupus erythematosus patients in the low-latitude plateau of China: altitudinal influences. Lupus 2014; 23:1537-45. [PMID: 25059490 DOI: 10.1177/0961203314544186] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The current study was to investigate the features of hospitalized patients with systemic lupus erythematosus (SLE) at different altitudes. The correlation between SLE activity and altitudinal variations was also explored. Medical records of 1029 patients were retrospectively reviewed. Activity of SLE in each organ system was recorded using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). There was no significant correlation between SLE activity and altitudes (r = 0.003, p = 0.159). Age at onset for SLE patients at high altitudes was significantly younger than that at low and moderate altitudes (p = 0.022 and p = 0.004, respectively). Age at SLE admission at low altitudes was significant older than those at moderate and high altitudes (p = 0.011 and p < 0.001, respectively). Patients at high altitudes had shorter duration from disease onset to admission than those at moderate altitudes (p = 0.009). Incidence of Sm antibodies-positive for resident patients at high altitudes was 36.4%, which were higher than that at moderate altitudes (p = 0.003). We found increasing trends of CNS activity in active patients; immunological and renal activities in inactive patients were correlated with elevated altitudes (p = 0.024, p = 0.004, p = 0.005), while arthritis scores in active patients showed the tendency of decreasing with the rise of elevation (p = 0.002). Hemoglobin level, red blood cell and platelet counts at high altitudes were significantly lower than those at low altitudes (p < 0.05, respectively). There was no significant difference in hemoglobin level between moderate- and low-altitude groups (p > 0.05). No significant difference in platelet counts between moderate- and high-altitude groups was observed (p > 0.05). Our findings suggest that some clinical features, laboratory tests and activity of main organs in SLE are influenced by altitudes. Furthermore, organ activities of active and inactive SLE patients have different patterns of altitudinal variations. These distinctive variations likely reveal that peculiar environmental factors at high altitudes can affect the development of SLE.
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Affiliation(s)
- G Qian
- Department of Dermatology & Rheumatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - X Ran
- Department of Dermatology & Rheumatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - C X Zhou
- Department of Dermatology & Rheumatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - D Q Deng
- Department of Dermatology & Rheumatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - P L Zhang
- Department of Dermatology & Rheumatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Y Guo
- Department of Dermatology & Rheumatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - J H Luo
- Department of Epidemiology, School of Public Health, Kunming Medical University, Kunming, China
| | - X H Zhou
- Department of Dermatology & Rheumatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - H Xie
- Department of Dermatology & Rheumatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - M Cai
- Department of Dermatology & Rheumatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
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Karabacak M, Varol E, Türkdogan KA, Duman A, Akpinar O, Karabacak P. Mean Platelet Volume in Patients With Carbon Monoxide Poisoning. Angiology 2013; 65:252-6. [DOI: 10.1177/0003319713497422] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Carbon monoxide (CO) poisoning is frequent and can lead to high morbidity and mortality. Some studies have indicated increased platelet activation and aggregation in CO poisoning. Thus, we investigated mean platelet volume (MPV), an indicator of platelet activation, in patients with CO poisoning. We included 193 (117 women) patients who presented with a diagnosis of CO poisoning between June 2011 and March 2013. Control group was composed of 39 (15 women) patients. Troponin and creatine kinase MB levels were significantly higher in the CO poisoning group. Platelet counts were significantly higher in patients with CO poisoning (281 ± 76 vs 248 ± 65 × 109, respectively; P = .01). Similarly, MPV was significantly higher in the CO poisoning group (8.9 ± 0.8 vs 7.9 ± 0.9 fL, respectively; P < .001). Elevated MPV values may indicate that patients with CO poisoning have a higher risk of thromboembolic and cardiovascular complications due to platelet activation.
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Affiliation(s)
| | - Ercan Varol
- Department of Cardiology, Medical Faculty, Suleyman Demirel University, Isparta, Turkey
| | | | - Ali Duman
- Department of Emergency Medicine, Isparta State Hospital, Isparta, Turkey
| | - Orhan Akpinar
- Department of Emergency Medicine, Isparta State Hospital, Isparta, Turkey
| | - Pinar Karabacak
- Resident, Department of Anesthesia and Reanimation, Medical Faculty, Suleyman Demirel University, Isparta, Turkey
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Abstract
Altitude physiology began with Paul Bert in 1878. Chronic mountain sickness (CMS) was defined by Carlos Monge in the 1940s in the Peruvian Andes as consisting of excess polycythemia. Hurtado et al performed studies in the Peruvian Andes in the 1950s to 1960s which defined acclimatization in healthy altitude natives, including polycythemia, moderate pulmonary hypertension, and low systemic blood pressure (BP). Electrocardiographic changes of right ventricular hypertrophy (RVH) were noted. Acclimatization of newcomers to altitude involves hyperventilation stimulated by hypoxia and is usually benign. Acute mountain sickness (AMS) in travelers to altitude is characterized by hypoxia-induced anorexia, dyspnea, headache, insomnia, and nausea. The extremes of AMS are high-altitude cerebral edema and high-altitude pulmonary edema. The susceptible high-altitude resident can lose their tolerance to altitude and develop CMS, also referred to as Monge disease. The CMS includes extreme polycythemia, severe RVH, excess pulmonary hypertension, low systemic BP, arterial oxygen desaturation, and hypoventilation.
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Affiliation(s)
- Thomas F Whayne
- Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, KY, USA
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Respiratory syncytial virus infection is strongly correlated with decreased mean platelet volume. Int J Infect Dis 2013; 17:e678-80. [PMID: 23485431 DOI: 10.1016/j.ijid.2013.01.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 12/03/2012] [Accepted: 01/14/2013] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND To date, infections have usually been associated with elevations of the mean platelet volume. We correlated infection with respiratory syncytial virus (RSV) with changes in mean platelet volume (MPV). METHODS A consecutive series of patients with positive and negative rapid RSV assays and viral cultures, as well as children under 10 years of age with bronchoscopy for pneumonia or airway obstruction, were compared. RESULTS The MPV was significantly lower in patients with positive versus negative rapid RSV assays (9.7±0.8 vs. 10.5±0.9 fl, p<0.001), as well as viral cultures (9.9±1.0 vs. 10.5±1.0 fl, p<0.001). Children with RSV undergoing bronchoscopy (n=7) also had significantly lower MPV than children without RSV (n=79) (8.8±1.0 vs. 10.2±1.1 fl, p<0.004). An MPV <8.9 fl had a sensitivity of 71% and specificity of 49% for RSV in children undergoing bronchoscopy. CONCLUSIONS We conclude that infection with RSV is associated with decreased MPV and this may be clinically useful in children undergoing bronchoscopy.
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Thrombocytopenia and erythrocytosis in mice with a mutation in the gene encoding the hemoglobin β minor chain. Proc Natl Acad Sci U S A 2011; 109:576-81. [PMID: 22203977 DOI: 10.1073/pnas.1119146109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Diverse mutations in the genes encoding hemoglobin (Hb) have been characterized in human disease. We describe here a mutation in the mouse Hbb-b2 gene, denoted Plt12, that precisely mimics the human hemoglobin Hotel Dieu variant. The mutation results in increased affinity of Hb for oxygen and Plt12 mutant mice exhibited reduced partial pressure of O(2) in the blood, accompanied by erythrocytosis characterized by elevated erythropoietin levels and splenomegaly with excess erythropoiesis. Most homozygous Hbb-b2(Plt12/Plt12) mice succumbed to early lethality associated with emphysema, cardiac abnormalities, and liver degeneration. Survivors displayed a marked thrombocytopenia without significant deficiencies in the numbers of megakaryocytes or megakaryocyte progenitor cells. The lifespan of platelets in the circulation of Hbb-b2(Plt12/Plt12) mice was normal, and splenectomy did not correct the thrombocytopenia, suggesting that increased sequestration was unlikely to be a major contributor. These data, together with the observation that megakaryocytes in Hbb-b2(Plt12/Plt12) mice appeared smaller and deficient in cytoplasm, support a model in which hypoxia causes thrombocytopenia as a consequence of an inability of megakaryocytes, once formed, to properly mature and produce sufficient platelets. The Plt12 mouse is a model of high O(2)-affinity hemoglobinopathy and provides insights into hematopoiesis under conditions of chronic hypoxia.
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Abstract
Hypobaric hypoxia is associated with an increase in erythropoesis and an increased thrombotic risk. This is true of long haul air travel, mountaineering expeditions and longer stays at altitude. Studies looking at clotting on mountaineering expeditions are further complicated by the effects of exercise, plasma volume changes and the catecholamine response to hypoxia. This review examines the evidence for changes in clotting factors and functional clotting at altitude and considers the implications of altitude travel for those with pre-existing medical conditions.
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Affiliation(s)
- K Wheatley
- ST3 in Infectious Diseases, Chelsea and Westminster Hospital, Fulham Road, London
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Simeoni S, Biselli R, D'Amelio R, Rocca B, Lattanzio S, Mucci L, Davì G, Patacchioli FR. Stress-induced salivary cortisol secretion during hypobaric hypoxia challenge and in vivo urinary thromboxane production in healthy male subjects. Stress 2011; 14:282-9. [PMID: 21434833 DOI: 10.3109/10253890.2010.545458] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Few studies have assessed the effects of stress on in vivo platelet activation. In the present study, hypobaric hypoxia induced by rapid decompression during high-altitude simulated flight in a hypobaric chamber was used to evaluate the effects of environmental stress on salivary cortisol and urinary thromboxane metabolite (TXM) excretion, a noninvasive marker of in vivo platelet function. Twenty-one male aviators (mean ± SD age = 36 ± 7 years) experiencing hypoxia by removing their oxygen mask for 4-5 min during a simulated flight to 25,000 ft (7,620 m; pO(2) = 59.17 mmHg) and a matched control group of thirteen flying instructors wearing oxygen masks during the challenge, were studied. Hypobaric hypoxia induced a transient significant increase (P < 0.001) in the aviators' salivary cortisol concentration; the overall pattern of diurnal cortisol fluctuation was maintained in both groups. Urinary TXM showed a significant ∼30% reduction (P < 0.01) after the chamber session in aviators exposed to hypobaric hypoxia, but not in controls. A significant inverse correlation was found between salivary cortisol and urinary TXM in aviators (r = - 0.64, P = 0.0015). Salivary cortisol was a significant predictor (P < 0.001) for urinary TXM concentrations in aviators. In conclusion, here we observed that an acute stress-induced salivary cortisol increase was associated with reduced urinary thromboxane biosynthesis, providing the first indirect evidence for an inhibitory effect of acute stress on in vivo platelet function.
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Affiliation(s)
- Simona Simeoni
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
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Albayrak Y, Albayrak A, Albayrak F, Yildirim R, Aylu B, Uyanik A, Kabalar E, Güzel IC. Mean platelet volume: a new predictor in confirming acute appendicitis diagnosis. Clin Appl Thromb Hemost 2010; 17:362-6. [PMID: 20460349 DOI: 10.1177/1076029610364520] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
UNLABELLED The purpose of this study was to investigate the diagnostic value of mean platelet volume (MPV) in acute appendicitis (AA). METHODS Our study was carried out in 206 healthy control groups and 226 patients who had a preliminary diagnosis of AA. RESULTS A statistically significant decrease in MPV was noted in patients with AA compared with healthy controls (P < .001). The best MPV level cutoff point for AA was 7.6 fL, with a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 73%, 84%, 84%, and 74%, respectively. CONCLUSIONS As the MPV value is included in the complete blood count (CBC) analysis, it increases the sensitivity and NPVs of white blood cell (WBC) in AA diagnosis without the need for extra analyses, loss of time, or cost increase. Therefore, we believe that the MPV value should also be taken into consideration along with the WBC in every patient with suspected AA.
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Affiliation(s)
- Yavuz Albayrak
- Department of General Surgery and Burn Unit, Erzurum Region Education and Research Hospital, Erzurum, Turkey.
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Severinghaus JW. [Not Available]. High Alt Med Biol 2010; 11:5-8. [PMID: 20367481 DOI: 10.1089/ham.2010.11103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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