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Zhou S, Yan J, Song K, Ge RL. High-Altitude Hypoxia Induces Excessive Erythrocytosis in Mice via Upregulation of the Intestinal HIF2a/Iron-Metabolism Pathway. Biomedicines 2023; 11:2992. [PMID: 38001992 PMCID: PMC10669251 DOI: 10.3390/biomedicines11112992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
Excessive erythrocytosis (EE) is a preclinical form of chronic mountain sickness (CMS). The dysregulation of iron metabolism in high-altitude hypoxia may induce EE. The intestinal hypoxia-inducible factor 2 alpha (HIF2a) regulates the genes involved in iron metabolism. Considering these findings, we aimed to investigate the function and mechanism of intestinal HIF2α and the iron metabolism pathway in high-altitude EE mice. C57BL/6J mice were randomized into four groups: the low-altitude group, the high-altitude group, the high-altitude + HIF2α inhibitor group, and the high-altitude + vehicle group. In-vitro experiments were performed using the human intestinal cell line HCT116 cultured under hypoxic conditions for 24 h. Results showed that high-altitude hypoxia significantly increased the expression of intestinal HIF2α and iron metabolism-related genes, including Dmt1, Dcytb, Fpn, Tfrc, and Fth in EE mice. Genetic blockade of the intestinal HIF2α-iron metabolism pathway decreased iron availability in HCT116 cells during hypoxia. The HIF2α inhibitor PT2385 suppressed intestinal HIF2α expression, decreased iron hypermetabolism, and reduced excessive erythrocytosis in mice. These data support the hypothesis that exposure to high-altitude hypoxia can lead to iron hypermetabolism by activating intestinal HIF2α transcriptional regulation, and reduced iron availability improves EE by inhibiting intestinal HIF2α signaling.
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Affiliation(s)
- Sisi Zhou
- Research Center for High Altitude Medicine, Qinghai University, Xining 810001, China; (S.Z.); (J.Y.); (K.S.)
- Key Laboratory of High-Altitude Medicine, Ministry of Education, Xining 810001, China
- Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province, Xining 810001, China
| | - Jun Yan
- Research Center for High Altitude Medicine, Qinghai University, Xining 810001, China; (S.Z.); (J.Y.); (K.S.)
- Key Laboratory of High-Altitude Medicine, Ministry of Education, Xining 810001, China
- Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province, Xining 810001, China
| | - Kang Song
- Research Center for High Altitude Medicine, Qinghai University, Xining 810001, China; (S.Z.); (J.Y.); (K.S.)
- Key Laboratory of High-Altitude Medicine, Ministry of Education, Xining 810001, China
- Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province, Xining 810001, China
| | - Ri-Li Ge
- Research Center for High Altitude Medicine, Qinghai University, Xining 810001, China; (S.Z.); (J.Y.); (K.S.)
- Key Laboratory of High-Altitude Medicine, Ministry of Education, Xining 810001, China
- Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province, Xining 810001, China
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2
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Holthof K, Bridevaux PO, Frésard I. Underlying lung disease and exposure to terrestrial moderate and high altitude: personalised risk assessment. BMC Pulm Med 2022; 22:187. [PMID: 35534855 PMCID: PMC9088024 DOI: 10.1186/s12890-022-01979-z] [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: 12/29/2021] [Accepted: 05/03/2022] [Indexed: 11/17/2022] Open
Abstract
Once reserved for the fittest, worldwide altitude travel has become increasingly accessible for ageing and less fit people. As a result, more and more individuals with varying degrees of respiratory conditions wish to travel to altitude destinations. Exposure to a hypobaric hypoxic environment at altitude challenges the human body and leads to a series of physiological adaptive mechanisms. These changes, as well as general altitude related risks have been well described in healthy individuals. However, limited data are available on the risks faced by patients with pre-existing lung disease. A comprehensive literature search was conducted. First, we aimed in this review to evaluate health risks of moderate and high terrestrial altitude travel by patients with pre-existing lung disease, including chronic obstructive pulmonary disease, sleep apnoea syndrome, asthma, bullous or cystic lung disease, pulmonary hypertension and interstitial lung disease. Second, we seek to summarise for each underlying lung disease, a personalized pre-travel assessment as well as measures to prevent, monitor and mitigate worsening of underlying respiratory disease during travel.
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Affiliation(s)
- Kirsten Holthof
- Service de pneumologie, Centre Hospitalier du Valais Romand, Avenue du Grand-Champsec 80, 1950, Sion, Switzerland
| | - Pierre-Olivier Bridevaux
- Service de pneumologie, Centre Hospitalier du Valais Romand, Avenue du Grand-Champsec 80, 1950, Sion, Switzerland.,Service de pneumologie, Hôpitaux universitaires de Genève, 1211, Geneva 14, Switzerland.,Geneva Medical School, University of Geneva, Geneva, Switzerland
| | - Isabelle Frésard
- Service de pneumologie, Centre Hospitalier du Valais Romand, Avenue du Grand-Champsec 80, 1950, Sion, Switzerland.
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3
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Prescot A, Huber R, Kanekar S, Kondo D, Prisciandaro J, Ongur D, Renshaw PF. Effect of moderate altitude on human cerebral metabolite levels: A preliminary, multi-site, proton magnetic resonance spectroscopy investigation. Psychiatry Res Neuroimaging 2021; 314:111314. [PMID: 34098247 DOI: 10.1016/j.pscychresns.2021.111314] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 05/14/2021] [Accepted: 05/27/2021] [Indexed: 12/19/2022]
Abstract
Epidemiological studies show that altitude-of-residence is an independent risk factor for worsening rates of mood disorders, substance abuse, and suicide. Proton (1H) magnetic resonance spectroscopy (MRS) studies in rodent models of moderate-to-high altitude exposure have documented significant alterations in total creatine, glutamate, and myo-inositol, neurometabolites involved in bioenergetic homeostasis and neuronal/glial cell function. This preliminary study utilized 3 Tesla 1H MRS to study anterior cingulate cortex (ACC) and parietal-occipital cortex (POC) neurochemistry in healthy subjects residing in Utah (n = 19), Massachusetts (n = 10), and South Carolina (n = 10), to test the hypothesis that individuals residing at moderate altitude (Utah; 1,372 m) would show neurometabolite alterations vs. subjects living at sea level. Expressed as ratios to total N-acetyl aspartate (NAA), Utah participants showed lower ACC (p = 0.03) and POC (p < 0.01) total creatine, a trend towards lower ACC glutamate (p = 0.06), and lower POC myo-inositol (p = 0.02). Study limitations include small sample sizes and uncorrected multiple comparisons. To our knowledge, this is the first MRS investigation to identify potential neurochemical differences in individuals residing at moderate altitudes vs. sea level, warranting future 1H MRS studies in larger cohorts and across a range of altitudes-of-residence.
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Affiliation(s)
- Andrew Prescot
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, UT, United States.
| | - Rebekah Huber
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Shami Kanekar
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States; Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), George E. Whalen Department of Veterans Affairs Medical Center, Salt Lake City, UT, United States
| | - Douglas Kondo
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States; Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), George E. Whalen Department of Veterans Affairs Medical Center, Salt Lake City, UT, United States
| | - James Prisciandaro
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States; Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC, United States
| | - Dost Ongur
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, United States; Department of Psychiatry, Harvard Medical School, Cambridge, MA, United States
| | - Perry F Renshaw
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States; Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), George E. Whalen Department of Veterans Affairs Medical Center, Salt Lake City, UT, United States
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5
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Muckenthaler MU, Mairbäurl H, Gassmann M. Iron metabolism in high-altitude residents. J Appl Physiol (1985) 2020; 129:920-925. [PMID: 32853112 DOI: 10.1152/japplphysiol.00019.2020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Residents at high altitude cope with decreasing inspiratory oxygen partial pressure by stimulating erythropoiesis. The increase in hemoglobin levels requires high amounts of additional iron supplied from the diet. Here, we review available data on how iron metabolism adapts when living in a hypoxic environment. Our analysis reveals that long-term adaptation to high altitude enables healthy individuals to maintain their iron stores within the physiological range despite elevated requirements for erythropoiesis. However, in vulnerable populations with increased iron demand (e.g., pregnant women or exercising individuals), iron stores are less likely to be replenished quickly when living at high altitude. Future studies need to address whether different ethnicities have acquired genetic mechanisms to adapt to the elevated iron demand for erythropoiesis at high altitude.
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Affiliation(s)
- Martina U Muckenthaler
- Pediatric Oncology, Hematology & Immunology, University Hospital Heidelberg, Heidelberg, Molecular Medicine Partnership Unit, University of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research, Heidelberg, Germany
| | - Heimo Mairbäurl
- Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research, Heidelberg, Germany.,Translational Pneumology, University Hospital Heidelberg, Heidelberg, Germany
| | - Max Gassmann
- Institute of Veterinary Physiology, Vetsuisse Faculty, and Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.,Universidad Peruana Cayetano Heredia, Lima, Peru
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6
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deZoeten EF, Battista KD, Colson SB, Lovell MA, Kessler BE, Isfort RW, Fennimore BP, Onyiah JC, Kao DJ, Yeckes A, Keely S, Murray M, Hoffenberg EJ, Colgan SP, Gerich ME. Markers of Hypoxia Correlate with Histologic and Endoscopic Severity of Colitis in Inflammatory Bowel Disease. HYPOXIA (AUCKLAND, N.Z.) 2020; 8:1-12. [PMID: 32104717 PMCID: PMC7026141 DOI: 10.2147/hp.s219049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/16/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Inflammation results in significant shifts in tissue metabolism. Recent studies indicate that inflammation and hypoxia occur concomitantly. We examined whether circulating and tissue markers of hypoxia could serve as surrogate indicators of disease severity in adult and pediatric patients with inflammatory bowel disease (IBD). METHODS Serum and colonic biopsies were obtained from pediatric subjects with active IBD colitis and adult subjects with active and inactive ulcerative colitis, along with healthy non-colitis controls of all ages. Disease activity was evaluated by endoscopy and histopathology. Levels of serum hypoxia markers (macrophage inflammatory protein-3α [MIP-3α], vascular endothelial growth factor [VEGF], and erythropoietin [EPO]) were measured. RESULTS Children with active IBD colitis had higher levels of serum MIP-3α and VEGF compared to non-colitis controls (p<0.01 and p<0.05, respectively). In adult subjects with endoscopically active ulcerative colitis, serum MIP-3α and EPO were significantly elevated compared to non-colitis controls (both p<0.01). In parallel, analysis of colon tissue MIP-3α mRNA and protein in pediatric subjects revealed increased expression in those with IBD colitis compared to controls (p<0.05 and p<0.01 for mRNA and protein, respectively). Serum MIP-3α and VEGF significantly increased with histology grade. CONCLUSION Peripheral blood hypoxia markers may be useful indicators of disease activity for pediatric and adult IBD patients.
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Affiliation(s)
- Edwin F deZoeten
- Department of Pediatrics and the Digestive Health Institute, University of Colorado School of Medicine/Children’s Hospital Colorado, Aurora, CO, USA
| | - Kayla D Battista
- Department of Medicine and Mucosal Inflammation Program, Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Steven B Colson
- Department of Pediatrics and the Digestive Health Institute, University of Colorado School of Medicine/Children’s Hospital Colorado, Aurora, CO, USA
| | - Mark A Lovell
- Department of Pathology, University of Colorado School of Medicine/Children’s Hospital Colorado, Aurora, CO, USA
| | - Brittelle E Kessler
- Department of Medicine and Mucosal Inflammation Program, Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Robert W Isfort
- Department of Medicine and Mucosal Inflammation Program, Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Blair P Fennimore
- Department of Medicine and Mucosal Inflammation Program, Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Joseph C Onyiah
- Department of Medicine and Mucosal Inflammation Program, Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Daniel J Kao
- Department of Medicine and Mucosal Inflammation Program, Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Alyson Yeckes
- Department of Pediatrics and the Digestive Health Institute, University of Colorado School of Medicine/Children’s Hospital Colorado, Aurora, CO, USA
| | - Simon Keely
- Department of Pediatrics and the Digestive Health Institute, University of Colorado School of Medicine/Children’s Hospital Colorado, Aurora, CO, USA
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, Australia
| | - Monica Murray
- Department of Medicine and Mucosal Inflammation Program, Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Edward J Hoffenberg
- Department of Pediatrics and the Digestive Health Institute, University of Colorado School of Medicine/Children’s Hospital Colorado, Aurora, CO, USA
| | - Sean P Colgan
- Department of Medicine and Mucosal Inflammation Program, Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Mark E Gerich
- Department of Medicine and Mucosal Inflammation Program, Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, CO, USA
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Gassmann M, Mairbäurl H, Livshits L, Seide S, Hackbusch M, Malczyk M, Kraut S, Gassmann NN, Weissmann N, Muckenthaler MU. The increase in hemoglobin concentration with altitude varies among human populations. Ann N Y Acad Sci 2019; 1450:204-220. [PMID: 31257609 DOI: 10.1111/nyas.14136] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/02/2019] [Accepted: 05/16/2019] [Indexed: 02/06/2023]
Abstract
Decreased oxygen availability at high altitude requires physiological adjustments allowing for adequate tissue oxygenation. One such mechanism is a slow increase in the hemoglobin concentration ([Hb]) resulting in elevated [Hb] in high-altitude residents. Diagnosis of anemia at different altitudes requires reference values for [Hb]. Our aim was to establish such values based on published data of residents living at different altitudes by applying meta-analysis and multiple regressions. Results show that [Hb] is increased in all high-altitude residents. However, the magnitude of increase varies among the regions analyzed and among ethnic groups within a region. The highest increase was found in residents of the Andes (1 g/dL/1000 m), but this increment was smaller in all other regions of the world (0.6 g/dL/1000 m). While sufficient data exist for adult males and females showing that sex differences in [Hb] persist with altitude, data for infants, children, and pregnant women are incomplete preventing such analyses. Because WHO reference values were originally based on [Hb] of South American people, we conclude that individual reference values have to be defined for ethnic groups to reliably diagnose anemia and erythrocytosis in high-altitude residents. Future studies need to test their applicability for children of different ages and pregnant women.
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Affiliation(s)
- Max Gassmann
- Institute of Veterinary Physiology, Vetsuisse Faculty and Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland.,Universidad Peruana Cayetano Heredia (UPCH), Lima, Peru
| | - Heimo Mairbäurl
- Translational Lung Research Center Heidelberg (TLRC), the German Center for Lung Research (DZL), Heidelberg, Germany
| | - Leonid Livshits
- Institute of Veterinary Physiology, Vetsuisse Faculty and Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
| | - Svenja Seide
- Institute of Medical Biometry and Informatics (IMBI), University Hospital Heidelberg, Heidelberg, Germany
| | - Matthes Hackbusch
- Institute of Medical Biometry and Informatics (IMBI), University Hospital Heidelberg, Heidelberg, Germany
| | - Monika Malczyk
- Excellence Cluster Cardiopulmonary System, Justus-Liebig-University Giessen, University of Giessen and Marburg Lung Center, German Center for Lung Research (DZL), Heidelberg, Germany
| | - Simone Kraut
- Excellence Cluster Cardiopulmonary System, Justus-Liebig-University Giessen, University of Giessen and Marburg Lung Center, German Center for Lung Research (DZL), Heidelberg, Germany
| | - Norina N Gassmann
- Institute of Veterinary Physiology, Vetsuisse Faculty and Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
| | - Norbert Weissmann
- Excellence Cluster Cardiopulmonary System, Justus-Liebig-University Giessen, University of Giessen and Marburg Lung Center, German Center for Lung Research (DZL), Heidelberg, Germany
| | - Martina U Muckenthaler
- Pediatric Hematology, Oncology and Immunology, University Hospital Heidelberg, Molecular Medicine Partnership Unit, University of Heidelberg, Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research, Heidelberg, Germany
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8
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Sutehall S, Muniz-Pardos B, Lima G, Wang G, Malinsky FR, Bosch A, Zelenkova I, Tanisawa K, Pigozzi F, Borrione P, Pitsiladis Y. Altitude Training and Recombinant Human Erythropoietin: Considerations for Doping Detection. Curr Sports Med Rep 2019; 18:97-104. [PMID: 30969231 DOI: 10.1249/jsr.0000000000000577] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The benefit of training at altitude to enhance exercise performance remains equivocal although the most widely accepted approach is one where the athletes live and perform lower-intensity running at approximately 2300 m with high-intensity training at approximately 1250 m. The idea is that this method maintains maximal augmentations in total hemoglobin mass while reducing the performance impairment of high-intensity sessions performed at moderate altitude and thus preventing any detraining that can occur when athletes live and train at moderate altitude. This training regimen, however, is not universally accepted and some argue that the performance enhancement is due to placebo and training camp effects. Altitude training may affect an athlete's hematological parameters in ways similar to those observed following blood doping. Current methods of detection appear insufficient to differentiate between altitude training and blood doping making the interpretation of an athlete's biological passport difficult. Further research is required to determine the optimal method for altitude training and to enhance current detection methods to be able to differentiate better blood doping and altitude exposure.
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Affiliation(s)
- Shaun Sutehall
- Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, SOUTH AFRICA
| | - Borja Muniz-Pardos
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, SPAIN
| | - Giscard Lima
- Collaborating Centre of Sports Medicine, University of Brighton, Eastbourne, UNITED KINGDOM.,Centre for Exercise Science and Sports Medicine, University of Rome "Foro Italico", Rome, ITALY
| | - Guan Wang
- Collaborating Centre of Sports Medicine, University of Brighton, Eastbourne, UNITED KINGDOM
| | | | - Andrew Bosch
- Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, SOUTH AFRICA
| | | | - Kumpei Tanisawa
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, JAPAN
| | - Fabio Pigozzi
- Centre for Exercise Science and Sports Medicine, University of Rome "Foro Italico", Rome, ITALY
| | - Paolo Borrione
- Centre for Exercise Science and Sports Medicine, University of Rome "Foro Italico", Rome, ITALY
| | - Yannis Pitsiladis
- Collaborating Centre of Sports Medicine, University of Brighton, Eastbourne, UNITED KINGDOM
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Chandramoorthy HC, Bajunaid AM, Kariri HN, Al-Hakami A, Sham AA, Al-Shahrani MBS, Al-Humayed SM, Rajagopalan P. Feasibility of cord blood bank in high altitude Abha: preclinical impacts. Cell Tissue Bank 2018; 19:413-422. [PMID: 29460118 DOI: 10.1007/s10561-018-9687-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 02/02/2018] [Indexed: 10/18/2022]
Abstract
We explored the possibility of the cryo-storage of cord blood hematopoietic stem cells (CBHPSC) with respect to the quantity, quality and biologic efficacy of high altitude (HA) region Abha against sea level (SL) region. The results of the post-processed total nucleated cell count was 8.03 ± 0.31 × 107 and 8.44 ± 0.23 × 107 cells in the HA and SL regions respectively. The mean post processing viability of the nucleated cells was about 87.03 ± 1.39 (HA) and 88.33 ± 1.55% (SL) while post thaw cells were 85.61 ± 1.44 (HA) and 86.58 ± 1.61% (SL) after transient cryo-storage. The proliferation of CBHSCs after thawing were comparable between the HA and SL regions. The results of the colony forming unit (CFU) assays of CFU-E, CFU-GEMM, CFU-GM and BFU-E were comparable between HA and SL in both fresh and post thaw, while a declining trend with viability was significant. The differentiation capability of post thaw samples into adipocytes and osteocytes were comparable between HA and SL regions. Overall from the results, it can be evidenced that HA cord blood collection, processing or storage does not hinder the quality or biological efficacy of the CBHPSC.
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Affiliation(s)
- Harish C Chandramoorthy
- Center for Stem Cell Research, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia. .,Department of Microbiology and Clinical Parasitology, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia.
| | | | - Hussian Nasser Kariri
- Center for Stem Cell Research, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Ahmed Al-Hakami
- Center for Stem Cell Research, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia.,Department of Microbiology and Clinical Parasitology, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Abdullah Abu Sham
- Department of Obstetrics and Gynecology, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Misfer Bin Safer Al-Shahrani
- Department of Obstetrics and Gynecology, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Suliman M Al-Humayed
- Department of Internal Medicine, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Prasanna Rajagopalan
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Kingdom of Saudi Arabia
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Abstract
Running economy (RE) represents a complex interplay of physiological and biomechanical factors that is typically defined as the energy demand for a given velocity of submaximal running and expressed as the submaximal oxygen uptake (VO2) at a given running velocity. This review considered a wide range of acute and chronic interventions that have been investigated with respect to improving economy by augmenting one or more components of the metabolic, cardiorespiratory, biomechanical or neuromuscular systems. Improvements in RE have traditionally been achieved through endurance training. Endurance training in runners leads to a wide range of physiological responses, and it is very likely that these characteristics of running training will influence RE. Training history and training volume have been suggested to be important factors in improving RE, while uphill and level-ground high-intensity interval training represent frequently prescribed forms of training that may elicit further enhancements in economy. More recently, research has demonstrated short-term resistance and plyometric training has resulted in enhanced RE. This improvement in RE has been hypothesized to be a result of enhanced neuromuscular characteristics. Altitude acclimatization results in both central and peripheral adaptations that improve oxygen delivery and utilization, mechanisms that potentially could improve RE. Other strategies, such as stretching should not be discounted as a training modality in order to prevent injuries; however, it appears that there is an optimal degree of flexibility and stiffness required to maximize RE. Several nutritional interventions have also received attention for their effects on reducing oxygen demand during exercise, most notably dietary nitrates and caffeine. It is clear that a range of training and passive interventions may improve RE, and researchers should concentrate their investigative efforts on more fully understanding the types and mechanisms that affect RE and the practicality and extent to which RE can be improved outside the laboratory.
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Affiliation(s)
- Kyle R Barnes
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Level 2, AUT-Millennium Campus, 17 Antares Place, Mairangi Bay, Auckland, New Zealand,
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11
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Shi XF, Carlson PJ, Kim TS, Sung YH, Hellem TL, Fiedler KK, Kim SE, Glaeser B, Wang K, Zuo CS, Jeong EK, Renshaw PF, Kondo DG. Effect of altitude on brain intracellular pH and inorganic phosphate levels. Psychiatry Res 2014; 222:149-56. [PMID: 24768210 PMCID: PMC4699298 DOI: 10.1016/j.pscychresns.2014.04.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 03/25/2014] [Accepted: 04/04/2014] [Indexed: 11/30/2022]
Abstract
Normal brain activity is associated with task-related pH changes. Although central nervous system syndromes associated with significant acidosis and alkalosis are well understood, the effects of less dramatic and chronic changes in brain pH are uncertain. One environmental factor known to alter brain pH is the extreme, acute change in altitude encountered by mountaineers. However, the effect of long-term exposure to moderate altitude has not been studied. The aim of this two-site study was to measure brain intracellular pH and phosphate-bearing metabolite levels at two altitudes in healthy volunteers, using phosphorus-31 magnetic resonance spectroscopy ((31)P-MRS). Increased brain pH and reduced inorganic phosphate (Pi) levels were found in healthy subjects who were long-term residents of Salt Lake City, UT (4720ft/1438m), compared with residents of Belmont, MA (20ft/6m). Brain intracellular pH at the altitude of 4720ft was more alkaline than that observed near sea level. In addition, the ratio of inorganic phosphate to total phosphate signal also shifted toward lower values in the Salt Lake City region compared with the Belmont area. These results suggest that long-term residence at moderate altitude is associated with brain chemical changes.
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Affiliation(s)
- Xian-Feng Shi
- The Brain Institute, University of Utah, Salt Lake City, Utah, USA; Department of Psychiatry, University of Utah, Salt Lake City, UT, USA.
| | - Paul J. Carlson
- The Brain Institute, University of Utah, Salt Lake City, Utah, USA,Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - Tae-Suk Kim
- The Brain Institute, University of Utah, Salt Lake City, Utah, USA
| | - Young-Hoon Sung
- The Brain Institute, University of Utah, Salt Lake City, Utah, USA,Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - Tracy L. Hellem
- The Brain Institute, University of Utah, Salt Lake City, Utah, USA
| | | | - Seong-Eun Kim
- Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Breanna Glaeser
- Brain Imaging Center, McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - Kristina Wang
- Brain Imaging Center, McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - Chun S. Zuo
- Brain Imaging Center, McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - Eun-Kee Jeong
- Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Perry F. Renshaw
- The Brain Institute, University of Utah, Salt Lake City, Utah, USA,Department of Psychiatry, University of Utah, Salt Lake City, UT, USA,VISN 19 Mental Illness Research, Education and Clinical Center (MIRECC), Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Douglas G. Kondo
- The Brain Institute, University of Utah, Salt Lake City, Utah, USA,Department of Psychiatry, University of Utah, Salt Lake City, UT, USA,VISN 19 Mental Illness Research, Education and Clinical Center (MIRECC), Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
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Gore CJ, Sharpe K, Garvican-Lewis LA, Saunders PU, Humberstone CE, Robertson EY, Wachsmuth NB, Clark SA, McLean BD, Friedmann-Bette B, Neya M, Pottgiesser T, Schumacher YO, Schmidt WF. Altitude training and haemoglobin mass from the optimised carbon monoxide rebreathing method determined by a meta-analysis. Br J Sports Med 2013; 47 Suppl 1:i31-9. [PMID: 24282204 PMCID: PMC3903147 DOI: 10.1136/bjsports-2013-092840] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To characterise the time course of changes in haemoglobin mass (Hbmass) in response to altitude exposure. METHODS This meta-analysis uses raw data from 17 studies that used carbon monoxide rebreathing to determine Hbmass prealtitude, during altitude and postaltitude. Seven studies were classic altitude training, eight were live high train low (LHTL) and two mixed classic and LHTL. Separate linear-mixed models were fitted to the data from the 17 studies and the resultant estimates of the effects of altitude used in a random effects meta-analysis to obtain an overall estimate of the effect of altitude, with separate analyses during altitude and postaltitude. In addition, within-subject differences from the prealtitude phase for altitude participant and all the data on control participants were used to estimate the analytical SD. The 'true' between-subject response to altitude was estimated from the within-subject differences on altitude participants, between the prealtitude and during-altitude phases, together with the estimated analytical SD. RESULTS During-altitude Hbmass was estimated to increase by ∼1.1%/100 h for LHTL and classic altitude. Postaltitude Hbmass was estimated to be 3.3% higher than prealtitude values for up to 20 days. The within-subject SD was constant at ∼2% for up to 7 days between observations, indicative of analytical error. A 95% prediction interval for the 'true' response of an athlete exposed to 300 h of altitude was estimated to be 1.1-6%. CONCLUSIONS Camps as short as 2 weeks of classic and LHTL altitude will quite likely increase Hbmass and most athletes can expect benefit.
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Affiliation(s)
- Christopher J Gore
- Department of Physiology, Australian Institute of Sport, Canberra, Australia
- Exercise Physiology Laboratory, Flinders University, Adelaide, Australia
- University of Canberra, Canberra, Australia
| | - Ken Sharpe
- Department of Mathematics and Statistics, The University of Melbourne, Melbourne, Australia
| | - Laura A Garvican-Lewis
- Department of Physiology, Australian Institute of Sport, Canberra, Australia
- University of Canberra, Canberra, Australia
| | - Philo U Saunders
- Department of Physiology, Australian Institute of Sport, Canberra, Australia
- University of Canberra, Canberra, Australia
| | - Clare E Humberstone
- Department of Physiology, Australian Institute of Sport, Canberra, Australia
| | | | - Nadine B Wachsmuth
- Department of Sports Medicine/Sports Physiology, University of Bayreuth, Bayreuth, Germany
| | - Sally A Clark
- Department of Physiology, Australian Institute of Sport, Canberra, Australia
| | - Blake D McLean
- School of Exercise Science, Australian Catholic University, Melbourne, Australia
| | | | - Mitsuo Neya
- Singapore Sports Institute, Singapore Sports Council, Singapore, Singapore
| | | | | | - Walter F Schmidt
- Department of Sports Medicine/Sports Physiology, University of Bayreuth, Bayreuth, Germany
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Staab JE, Beidleman BA, Muza SR, Fulco CS, Rock PB, Cymerman A. Efficacy of residence at moderate versus low altitude on reducing acute mountain sickness in men following rapid ascent to 4300 m. High Alt Med Biol 2013; 14:13-8. [PMID: 23537255 DOI: 10.1089/ham.2012.1065] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
To determine if residence at moderate (~2000 m) compared to low (<50 m) altitude reduces acute mountain sickness (AMS) in men during subsequent rapid ascent to a higher altitude. Nine moderate-altitude residents (MAR) and 18 sea-level residents (SLR) completed the Environmental Symptoms Questionnaire (ESQ) at their respective baseline residence and again at 12, 24, 48, and 72 h at 4300 m to assess the severity and prevalence of AMS. AMS cerebral factor score (AMS-C) was calculated from the ESQ at each time point. AMS was judged to be present if AMS-C was ≥0.7. Resting end-tidal CO2 (PETco2) and arterial oxygen saturation (Sao2) were assessed prior to and at 24, 48, and 72 h at 4300 m. Resting venous blood samples were collected prior to and at 72 h at 4300 m to estimate plasma volume (PV) changes. MAR compared to SLR: 1) AMS severity at 4300 was lower (p<0.05) at 12 h (0.50±0.69 vs. 1.48±1.28), 24 h (0.15±0.19 vs. 1.39±1.19), 48 h (0.10±0.18 vs. 1.37±1.49) and 72 h (0.08±0.12 vs. 0.69±0.70); 2) AMS prevalence at 4300 was lower (p<0.05) at 12 h (22% vs. 72%), 24 h (0% vs. 56%), 48 h (0% vs. 56%), and 72 h (0% vs. 45%); 3) resting Sao2 (%) was lower (p<0.05) at baseline (95±1 vs. 99±1) but higher (p<0.05) at 4300 at 24 h (86±2 vs. 81±5), 48 h (88±3 vs. 83±6), and 72 h (88±2 vs. 83±5); and 4) PV (%) did not differ at 72 h at 4300 m in the MAR (4.5±6.7) but was reduced for the SLR (-8.1±10.4). These results suggest that ventilatory and hematological acclimatization acquired while living at moderate altitude, as indicated by a higher resting Sao2 and no reduction in PV during exposure to a higher altitude, is associated with greatly reduced AMS after rapid ascent to high altitude.
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Affiliation(s)
- Janet E Staab
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts 01760, USA.
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Rodway GW, Muza SR. Fighting in Thin Air: Operational Wilderness Medicine in High Asia. Wilderness Environ Med 2011; 22:297-303. [DOI: 10.1016/j.wem.2011.08.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 07/02/2011] [Accepted: 08/25/2011] [Indexed: 10/14/2022]
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Reply. Urology 2011. [DOI: 10.1016/j.urology.2011.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Lan T, Wang Y, Chen Y, Qin W, Zhang J, Wang Z, Zhang W, Zhang X, Yuan J, Wang H. Influence of Environmental Factors on Prevalence, Symptoms, and Pathologic Process of Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Northwest China. Urology 2011; 78:1142-9. [DOI: 10.1016/j.urology.2011.04.066] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Revised: 04/26/2011] [Accepted: 04/29/2011] [Indexed: 11/29/2022]
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Wise GJ. Editorial Comment. Urology 2011; 78:1149-50; author reply 1150. [DOI: 10.1016/j.urology.2011.05.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Revised: 05/18/2011] [Accepted: 05/19/2011] [Indexed: 11/28/2022]
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18
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Tang LL, Jin CZ, Wu LJ, Brockmeyer NH, Potthoff A, Wu NP. The Impact of Highly Active Antiretroviral Treatment on the Blood Profiles of Patients with Acquired Immune Deficiency Syndrome. J Int Med Res 2011; 39:1520-8. [PMID: 21986156 DOI: 10.1177/147323001103900442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study retrospectively investigated the short- and long-term impact of highly active antiretroviral treatment (HAART) on the blood profiles of patients with acquired immune deficiency syndrome (AIDS), and their relationship with disease progression. CD4+ T-cell count was measured by flow cytometry, plasma viral load of human immunodeficiency virus (HIV) RNA was detected by reverse transcription—polymerase chain reaction, and blood profile was determined by an automated analyser. CD4+ T-cell count, total lymphocyte count (TLC) and haemoglobin concentration improved gradually in patients with AIDS after the initiation of HAART. Long-term effective HAART significantly increased CD4+ T-cell counts TLC and haemoglobin concentrations, and reduced viral load to undetectable levels. An increase in haemoglobin was positively correlated with an increase in CD4+ T-cells. These findings suggest that TLC is a valuable tool for determining the initiation of HAART, and that the haemoglobin concentration could be an additional indicator for long-term monitoring of HAART in resource-limited settings.
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Affiliation(s)
- LL Tang
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - CZ Jin
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - LJ Wu
- Department of Nursing, School of Medicine, Taizhou College, Taizhou, China
| | - NH Brockmeyer
- Department of Dermatology, Allergy and STDs, Ruhr University Bochum, Bochum, Germany
| | - A Potthoff
- Department of Dermatology, Allergy and STDs, Ruhr University Bochum, Bochum, Germany
| | - NP Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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