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Wang L, Yang L, Wei B, Li H, Cai H, Huang J, Yuan X. Incorporating Exercise Efficiency to Evaluate the Accessibility and Capacity of Medical Resources in Tibet, China. CHINESE GEOGRAPHICAL SCIENCE 2022; 33:175-188. [PMID: 36405373 PMCID: PMC9641690 DOI: 10.1007/s11769-022-1321-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 08/03/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Accessibility and capacity of medical resources are key for the health care and emergency response, while the efficiency of the medical resources is very much limited by hypoxia in Tibet, China. Through introducing exercise efficiency, this study explores the accessibility of township residence to county-ship medical resources in Tibet using weighted mean travel time (WMT), and evaluates the medical capacity accordingly. The results show that: 1) the average travel time of township residence to county-level hospital is around 2 h by motor vehicle in Tibet. More than half of the population can not reach the county-ship hospital within 1 h, 33.24% of the population can not reach within 2 h, and 3.75% of the population can not reach within 6 h. 2) When considering the catchment of the medical resources and the population size, the WMT of the county-ship medical resources ranges from 0.25 h to 10.92 h. 3) After adjusted by travel time and exercise efficiency, the county-ship medical capacity became more unequal, with 38 out of 74 counties could not meet the national guideline of 1.8 medical beds per 1000. 4) In total, there are 17 counties with good WMT and sufficient medical resources, while 13 counties having very high WMT and low capacity of medical resources in Tibet. In the end, suggestions on medical resources relocation and to improve the capacity are provided. This study provides a method to incorporate exercise efficiency to access the accessibility and evaluate medical capacity that can be applied in high altitude ranges. ELECTRONIC SUPPLEMENTARY MATERIAL Supplementary material is available in the online version of this article at 10.1007/s11769-022-1321-1.
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Affiliation(s)
- Li Wang
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101 China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049 China
| | - Linsheng Yang
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101 China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049 China
| | - Binggan Wei
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101 China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049 China
| | - Hairong Li
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101 China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049 China
| | - Hongyan Cai
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101 China
| | - Jixia Huang
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101 China
- Key Laboratory for Silviculture and Conservation of Ministry of Education, Beijing Forestry University, Beijing, 100083 China
| | - Xing Yuan
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101 China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049 China
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Hydration Strategies for Physical Activity and Endurance Events at High (>2500 m) Altitude: A Practical Management Article. Clin J Sport Med 2022; 32:407-413. [PMID: 33852437 DOI: 10.1097/jsm.0000000000000919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/11/2021] [Indexed: 02/02/2023]
Abstract
A growing number of adventurous athletes are seeking new challenges through endurance events or physical activities held at high altitude (>2500 m). This coincides with a significant increase in the numbers of trekkers who ascend into the world's mountains. Altitude itself influences and complicates the athlete's effective and safe hydration. This article considers the physiology of adaptation to altitude and the effects on hydration at altitude compared with sea level, reviews the "ad libitum versus programmed hydration" controversy in conventional endurance event hydration, examines the evidence for extrapolation of sea level hydration strategies to the high-altitude environment, and synthesizes these disparate factors into a set of practical recommendations for hydration management during high-altitude physical activity. The guidelines will be relevant to participants of physical activity at altitude and health care staff who may care for them in the preparation or performance phases of their adventure.
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Drago S, Campodónico J, Sandoval M, Berendsen R, Buijze GA. Voluntary Increase of Minute Ventilation for Prevention of Acute Mountain Sickness. Int J Sports Med 2022; 43:971-977. [PMID: 35760082 DOI: 10.1055/a-1832-0279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study evaluated the feasibility and efficacy of voluntary sustained hyperventilation during rapid ascent to high altitude for the prevention of acute mountain sickness (AMS). Study subjects (n=32) were volunteer participants in a 2-day expedition to Mount Leoneras (4954 m), starting at 2800m (base camp at 4120 m). Subjects were randomized to either: 1) an intervention group using the voluntary hyperventilation (VH) technique targeting an end-tidal CO2 (ETCO2)<20 mmHg; or 2) a group using acetazolamide (AZ). During the expedition, respiratory rate (28±20 vs. 18±5 breaths/min, mean±SD, P<0.01) and SpO2 (95%±4% vs. 89%±5%, mean±SD, P<0.01) were higher, and ETCO2 (17±4 vs. 26±4 mmHg, mean±SD, P<0.01) was lower in the VH group compared to the AZ group - as repeatedly measured at equal fixed intervals during the ascent - showing the feasibility of the VH technique. Regarding efficacy, the incidence of 6 (40%) subjects registering an LLS score≥3 in the VH group was non-inferior to the 3 (18%) subjects in the acetazolamide group (P=0.16, power 28%). Voluntary increase in minute ventilation is a feasible technique, but - despite the underpowered non-inferiority in this small-scale proof-of-concept trial - it is not likely to be as effective as acetazolamide to prevent AMS.
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Affiliation(s)
- Sebastian Drago
- Orthopedic Surgery, Hospital del Trabajador, Santiago, Chile.,Faculty of Medicine, Universidad de Los Andes, Santiago, Chile
| | - Juan Campodónico
- Faculty of Medicine, Universidad de Los Andes, Santiago, Chile.,Grupo de rescate médico en montaña (GREMM), Santiago, Chile
| | - Mario Sandoval
- Sport Medicine Department; Clínica MEDS, Santiago, Chile
| | - Remco Berendsen
- Anesthesia, Leiden University Medical Center, Leiden, Netherlands
| | - Geert Alexander Buijze
- Orthopaedic Surgery and Sports Medicine, Clinique Générale, Annecy, France.,Orthopaedic Surgery, Lapeyronie Hospital, Montpellier University Medical Center, Montpellier, France.,Orthopaedic Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands
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Joyce KE, Lucas SJE, Bradwell AR. Acetazolamide can impair exercise performance; it depends upon the cohort studied. J Appl Physiol (1985) 2020; 128:1457. [PMID: 32412397 DOI: 10.1152/japplphysiol.00173.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- K E Joyce
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, United Kingdom
| | - S J E Lucas
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, United Kingdom
| | - A R Bradwell
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, United Kingdom
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Bradbury KE, Charkoudian N. Reply to Joyce et al.: Use of acetazolamide during exercise at altitude-directions for future research. J Appl Physiol (1985) 2020; 128:1458. [PMID: 32412394 DOI: 10.1152/japplphysiol.00229.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Karleigh E Bradbury
- Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Nisha Charkoudian
- Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts
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Joyce KE, Delamere J, Bradwell S, Myers SD, Ashdown K, Rue C, Lucas SJ, Thomas OD, Fountain A, Edsell M, Myers F, Malein W, Imray C, Clarke A, Lewis CT, Newman C, Johnson B, Cadigan P, Wright A, Bradwell A. Hypoxia is not the primary mechanism contributing to exercise-induced proteinuria. BMJ Open Sport Exerc Med 2020; 6:e000662. [PMID: 32341794 PMCID: PMC7173992 DOI: 10.1136/bmjsem-2019-000662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction Proteinuria increases at altitude and with exercise, potentially as a result of hypoxia. Using urinary alpha-1 acid glycoprotein (α1-AGP) levels as a sensitive marker of proteinuria, we examined the impact of relative hypoxia due to high altitude and blood pressure-lowering medication on post-exercise proteinuria. Methods Twenty individuals were pair-matched for sex, age and ACE genotype. They completed maximal exercise tests once at sea level and twice at altitude (5035 m). Losartan (100 mg/day; angiotensin-receptor blocker) and placebo were randomly assigned within each pair 21 days before ascent. The first altitude exercise test was completed within 24–48 hours of arrival (each pair within ~1 hour). Acetazolamide (125 mg two times per day) was administrated immediately after this test for 48 hours until the second altitude exercise test. Results With placebo, post-exercise α1-AGP levels were similar at sea level and altitude. Odds ratio (OR) for increased resting α1-AGP at altitude versus sea level was greater without losartan (2.16 times greater). At altitude, OR for reduced post-exercise α1-AGP (58% lower) was higher with losartan than placebo (2.25 times greater, p=0.059) despite similar pulse oximetry (SpO2) (p=0.95) between groups. Acetazolamide reduced post-exercise proteinuria by approximately threefold (9.3±9.7 vs 3.6±6.0 μg/min; p=0.025) although changes were not correlated (r=−0.10) with significant improvements in SpO2 (69.1%±4.5% vs 75.8%±3.8%; p=0.001). Discussion Profound systemic hypoxia imposed by altitude does not result in greater post-exercise proteinuria than sea level. Losartan and acetazolamide may attenuate post-exercise proteinuria, however further research is warranted.
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Affiliation(s)
- Kelsley E Joyce
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK
| | - John Delamere
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK.,Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Susie Bradwell
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK.,Medical School, East Surrey Hospital, Redhill, Surrey, UK
| | - Stephen David Myers
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK.,Occupational Performance Research Group, University of Chichester Department of Sport and Exercise Sciences, Chichester, West Sussex, UK
| | - Kimberly Ashdown
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK.,Occupational Performance Research Group, University of Chichester Department of Sport and Exercise Sciences, Chichester, West Sussex, UK
| | - Carla Rue
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK.,Occupational Performance Research Group, University of Chichester Department of Sport and Exercise Sciences, Chichester, West Sussex, UK
| | - Samuel Je Lucas
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK
| | - Owen D Thomas
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK.,Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Amy Fountain
- Research & Development, Binding Site Group Ltd, Edgbaston, Birmingham, UK
| | - Mark Edsell
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK.,St. George's University Hospital, University of London, London, UK
| | - Fiona Myers
- School of Biological Sciences, University of Portsmouth, Portsmouth, UK
| | - Will Malein
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK.,Department of Anaesthesia, Ninewells Hospital, Dundee, UK
| | - Chris Imray
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK.,Vascular Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Alex Clarke
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK.,Department of Bioengineering, Imperial College London, London, UK
| | - Chrisopher T Lewis
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK.,Academic Foundation Programme, NHS Highland, Inverness, United Kingdom
| | - Charles Newman
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK.,University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Brian Johnson
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK.,BASEM, Doncaster, UK
| | - Patrick Cadigan
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK
| | - Alexander Wright
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK.,Medical School, University of Birmingham, Birmingham, UK
| | - Arthur Bradwell
- Birmingham Medical Research Expeditionary Society, University of Birmingham, Birmingham, UK.,Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
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Bradbury KE, Yurkevicius BR, Mitchell KM, Coffman KE, Salgado RM, Fulco CS, Kenefick RW, Charkoudian N. Acetazolamide does not alter endurance exercise performance at 3,500-m altitude. J Appl Physiol (1985) 2020; 128:390-396. [PMID: 31804890 DOI: 10.1152/japplphysiol.00655.2019] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Acetazolamide (AZ) is a medication commonly used to prevent acute mountain sickness (AMS) during rapid ascent to high altitude. However, it is unclear whether AZ use impairs exercise performance; previous literature regarding this topic is equivocal. The purpose of this study was to evaluate the impact of AZ on time-trial (TT) performance during a 30-h exposure to hypobaric hypoxia equivalent to 3,500-m altitude. Ten men [sea-level peak oxygen consumption (VO2peak): 50.8 ± 6.5 mL·kg-1·min-1; body fat %: 20.6 ± 5.2%] completed 2 30-h exposures at 3,500 m. In a crossover study design, subjects were given 500 mg/day of either AZ or a placebo. Exercise testing was completed 2 h and 24 h after ascent and consisted of 15-min steady-state treadmill walking at 40%-45% sea-level VO2peak, followed by a 2-mile self-paced treadmill TT. AMS was assessed after ~12 h and 22 h at 3,500 m. The incidence of AMS decreased from 40% with placebo to 0% with AZ. Oxygen saturation was higher (P < 0.05) in AZ versus placebo trials at the end of the TT after 2 h (85 ± 3% vs. 79 ± 3%) and 24 h (86 ± 3% vs. 81 ± 4%). There was no difference in time to complete 2 miles between AZ and PL after 2 h (20.7 ± 3.2 vs. 22.7 ± 5.0 min, P > 0.05) or 24 h (21.5 ± 3.4 vs. 21.1 ± 2.9 min, P > 0.05) of exposure to altitude. Our results suggest that AZ (500 mg/day) does not negatively impact endurance exercise performance at 3,500 m.NEW & NOTEWORTHY To our knowledge, this is the first study to examine the impact of acetazolamide (500 mg/day) versus placebo on self-paced, peak-effort exercise performance using a short-duration exercise test in a hypobaric hypoxic environment with a repeated-measures design. In the present study, acetazolamide did not impact exercise performance after 2-h or 24-h exposure to 3,500-m simulated altitude.
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Affiliation(s)
- Karleigh E Bradbury
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Beau R Yurkevicius
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts.,Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Katherine M Mitchell
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Kirsten E Coffman
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts.,Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Roy M Salgado
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Charles S Fulco
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts.,Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Robert W Kenefick
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Nisha Charkoudian
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
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Burns P, Lipman GS, Warner K, Jurkiewicz C, Phillips C, Sanders L, Soto M, Hackett P. Altitude Sickness Prevention with Ibuprofen Relative to Acetazolamide. Am J Med 2019; 132:247-251. [PMID: 30419226 DOI: 10.1016/j.amjmed.2018.10.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 10/31/2018] [Accepted: 10/31/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Acute mountain sickness is a common occurrence for travel to high altitudes. Although previous studies of ibuprofen have shown efficacy for the prevention of acute mountain sickness, recommendations have been limited, as ibuprofen has not been compared directly with acetazolamide until this study. METHODS Before their ascent to 3810 m on White Mountain in California, adult volunteers were randomized to ibuprofen (600 mg, 3 times daily, started 4 hours before the ascent), or to acetazolamide (125 mg, twice daily, started the night before the ascent). The main outcome measure was acute mountain sickness incidence, using the Lake Louise Questionnaire (LLQ), with a score of >3 with headache. Sleep quality and headache severity were measured with the Groningen Sleep Quality Survey (GSQS). This trial was registered at ClinicalTrials.gov: NCT03154645 RESULTS: Ninety-two participants completed the study: 45 (49%) on ibuprofen and 47 (51%) on acetazolamide. The total incidence of acute mountain sickness was 56.5%, with the incidence for the ibuprofen group being 11% greater than that for acetazolamide, surpassing the predetermined 26% noninferiority margin (62.2% vs 51.1%; 95% confidence interval [CI], -11.1 to 33.5). No difference was found in the total LLQ scores or subgroup symptoms between drugs (P = .8). The GSQS correlated with LLQ sleep (r = 0.77; 95% CI, 0.67-0.84)=%. The acetazolamide group had higher peripheral capillary oxygen saturation than the ibuprofen group (88.5% vs 85.6%; P = .001). CONCLUSION Ibuprofen was slightly inferior to acetazolamide for acute mountain sickness prevention and should not be recommended over acetazolamide for rapid ascent. Average symptoms and severity were similar between drugs, suggesting prevention of disease.
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Affiliation(s)
- Patrick Burns
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, Calif.
| | - Grant S Lipman
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, Calif
| | - Keiran Warner
- Stanford/Kaiser Emergency Medicine Residency, Stanford University School of Medicine, Stanford, Calif
| | - Carrie Jurkiewicz
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, Calif
| | - Caleb Phillips
- Department of Computer Science, University of Colorado, Boulder
| | - Linda Sanders
- Department of Emergency Medicine, Swedish Edmonds Hospital, Edmonds, Wash
| | - Mario Soto
- Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, Wash
| | - Peter Hackett
- Altitude Research Center, Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora
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Li Y, Han J, Zhang Y, Chen Y, Zhang Y. Prophylactic effect and mechanism of p-coumaric acid against hypoxic cerebral edema in mice. Respir Physiol Neurobiol 2018; 260:95-104. [PMID: 30447305 DOI: 10.1016/j.resp.2018.11.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/11/2018] [Accepted: 11/12/2018] [Indexed: 02/08/2023]
Abstract
Our previous study found that the anti-hypoxia effect of Tibetan turnip (Brassica rapa ssp. rapa) is directly related to its p-Coumaric acid (CA) and glucoside (pCoumaric acid-beta-d-glucopyranoside, CAG) contents. The present study aimed to investigate the role and mechanism of CA against hypoxic cerebral edema. Male mice were randomly divided into one normoxia group and three hypoxia groups, which were gavaged with sterilized water, CA, or dexamethasone, respectively, once daily for 4 days. The mice were then exposed to normoxia or hypoxia (9.5% O2) for 24 h. The results showed that the brain water content (BWC) and blood-brain-barrier permeability were significantly lower in the CA treatment group than in the hypoxia vehicle group. Mice in the CA treatment group showed good blood-brain-barrier integrity; increased Na+-K+-ATPase activity and mitochondrial membrane potential; decreased oxidative stress and inflammation; and increased occludin protein levels. Prophylactic administration of CA and dexamethasone exerted similar effects against hypoxic cerebral edema. The mechanism involved improving the integrity of the blood-brain-barrier, and inhibiting oxidative stress and inflammation.
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Affiliation(s)
- Yunhong Li
- College of Biosystems Engineering and Food Science, Zhejiang Key Laboratory for Agro-Food Processing, Zhejiang Engineering Center for Food Technology and Equipment, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Jianxin Han
- College of Biosystems Engineering and Food Science, Zhejiang Key Laboratory for Agro-Food Processing, Zhejiang Engineering Center for Food Technology and Equipment, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Yujing Zhang
- College of Biosystems Engineering and Food Science, Zhejiang Key Laboratory for Agro-Food Processing, Zhejiang Engineering Center for Food Technology and Equipment, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Yufeng Chen
- College of Biosystems Engineering and Food Science, Zhejiang Key Laboratory for Agro-Food Processing, Zhejiang Engineering Center for Food Technology and Equipment, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Ying Zhang
- College of Biosystems Engineering and Food Science, Zhejiang Key Laboratory for Agro-Food Processing, Zhejiang Engineering Center for Food Technology and Equipment, Zhejiang University, Hangzhou, 310058, Zhejiang, China.
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Joyce K, Lucas S, Imray C, Balanos G, Wright AD. Advances in the available non-biological pharmacotherapy prevention and treatment of acute mountain sickness and high altitude cerebral and pulmonary oedema. Expert Opin Pharmacother 2018; 19:1891-1902. [DOI: 10.1080/14656566.2018.1528228] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- K.E. Joyce
- School of Sport, Exercise, & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - S.J.E. Lucas
- School of Sport, Exercise, & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - C.H.E. Imray
- Department of Vascular Surgery, University Hospitals of Coventry and Warwickshire; Warwick Medical School, Coventry, UK
| | - G.M Balanos
- School of Sport, Exercise, & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - A. D. Wright
- Department of Medicine, University of Birmingham, Edgbaston, UK
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