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Wang HX, Li YD, Liang J, Xue YZ, Zhu L, Xiong TW, Chen PD, Kang X, Huang JP, Gong ZL, Sun HL. Altitude-related features and prognosis in patients with reversible splenial lesion syndrome. Ann Med 2024; 56:2401107. [PMID: 39253859 PMCID: PMC11389624 DOI: 10.1080/07853890.2024.2401107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 09/11/2024] Open
Abstract
INTRODUCTION RESLES (Reversible splenial lesion syndrome) can be observed secondary to various diseases, and intramyelinic edema may play a crucial role in the pathogenesis of SCC (Splenium of the corpus callosum). Some studies have suggested that hypoxic-ischaemic encephalopathy may constitute a risk factor for SCC lesions. However, the potential impact of high-altitude environments on SCC, especially during chronic exposure, remain obscure. METHODS Our study included 19 patients who satisfied the diagnostic criteria of RESLES at high altitudes. Ten low-altitude patients with RESLES were included as controls. All participants received MRI (Magnetic resonance imaging) scans twice. Routine blood tests, liver, kidney and thyroid function, coagulation function, electrolytes and vitamins were detected during hospitalization and before discharge. In addition, the patients were followed up in May 2023. RESULTS Hypoxic environments at high altitudes may increase the risk of RESLES. The two groups showed different clinical symptoms. High-altitude patients had significantly higher CRP levels than low-altitude patients. The lesion size in high-altitude patients showed a positive correlation with SaO2 levels. However, the patients at low altitudes had positive correlation trends between lesion size and several inflammatory markers (WBC, NEU and CRP). All patients had a benign prognosis that may not be affected by the use of prednisone acetate. CONCLUSIONS Hypoxic environments at high altitudes may play a role in the aetiology of RESLES. Additionally, RESLES is a reversible disease and the administration of glucocorticoids may be dispensable for its treatment.
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Affiliation(s)
- Hao-Xiang Wang
- Department of Neurology, Xinqiao Hospital & The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Yi-Ding Li
- Shigatse Branch, Xinqiao Hospital, Army Medical University, Shigatse, China
| | - Jun Liang
- Shigatse Branch, Xinqiao Hospital, Army Medical University, Shigatse, China
| | - Yuan-Zheng Xue
- Shigatse Branch, Xinqiao Hospital, Army Medical University, Shigatse, China
| | - Li Zhu
- Shigatse Branch, Xinqiao Hospital, Army Medical University, Shigatse, China
| | - Ting-Wei Xiong
- Department of Medical Imaging, Xinqiao Hospital & The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Peng-De Chen
- Shigatse Branch, Xinqiao Hospital, Army Medical University, Shigatse, China
| | - Xun Kang
- Shigatse Branch, Xinqiao Hospital, Army Medical University, Shigatse, China
| | - Jian-Ping Huang
- Shigatse Branch, Xinqiao Hospital, Army Medical University, Shigatse, China
| | - Zi-Li Gong
- Department of Neurology, Xinqiao Hospital & The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Hao-Lun Sun
- Shigatse Branch, Xinqiao Hospital, Army Medical University, Shigatse, China
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Guo H, Wang Q, Li T, Sun W, Chen J, Wang C, Wang C. IL-2, IL-17A and TNF-α hold potential as biomarkers for predicting acute mountain sickness prior to ascent. Cytokine 2024; 181:156694. [PMID: 39024679 DOI: 10.1016/j.cyto.2024.156694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 06/24/2024] [Accepted: 07/12/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Acute mountain sickness (AMS) is the most prevalent condition resulting from hypobaric hypoxia (HH) at high altitudes. Although evidence suggests the involvement of inflammatory cytokines in AMS development, there is currently a lack of reports on variations in cytokine levels between individuals susceptible to AMS and those resistant to AMS prior to ascending to high altitude. Thus our current study aims to assess the predictive capability for AMS occurrence by evaluating differences in cytokine levels at low altitudes. METHODS The present study recruited 48 participants, who ascended from low altitude to middle high-altitude (3700 m) and further to extreme high-altitude (5000 m). Based on Lake Louise Score (LLS) at the two high altitudes, participants were categorized into severe AMS-susceptible (sAMS), moderate AMS-susceptible (mAMS), and non-AMS groups. The Bio-Plex MAGPIX System was employed to measure plasma levels of 11 inflammatory cytokines. Cytokines at low altitude and middle high-altitude were analyzed through receiver operating characteristic (ROC) analysis to obtain area under the ROC curve (AUROC), sensitivity, and specificity. RESULTS Based on LLS at 3700 m, we initially categorized the study subjects into the sAMS group (n = 8) and the Non-AMS group (n = 40). Among individuals in the non-AMS group (n = 40) at the altitude of 3700 m, those who developed AMS at the altitude of 5000 m were assigned to the mAMS group (n = 17), whereas those who did not experience AMS were included into the non-AMS group (n = 23). The concentration of TNF-α at low altitude exhibited robust predictive performance for predicting AMS occurrence at the altitude of 3700 m. Among the non-AMS group at the altitude of 3700 m, we identified that the concentration of IL-2 and IL-17A demonstrated high efficacy in predicting the onset of AMS following ascent to 5000 m. In addition, differentially expressed cytokines including IL-17A, TNF-α and IL-2 at low altitude possessed discriminatory potential among the three groups at 5000 m.. CONCLUSION We posited that the levels of TNF-α, IL-2, IL-17A in serum of low altitude could be considered as potential biomarkers to predict the occurrence of AMS at high altitude. NEW & NOTEWORTHY Through the two comparisons at different two altitudes (baseline level and 3700 m), we provided a model to progressively screen individuals who are susceptible and resistant to different high altitudes (3700 m and 5000 m). TNF-α could firstly screen out the AMS susceptible individuals at the altitude of 3700 m. And through its combination with IL-2 and IL-17A, we could further screen out AMS susceptible individuals at the altitude of 5000 m.
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Affiliation(s)
- Haoran Guo
- Department of Laboratory Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Medical School of Chinese PLA, Beijing 100853, China
| | - Qi Wang
- Department of Orthopeadics, The Fourth Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Department of Surgery, Eastern Medical Branch of PLA General Hospital, 101199 Beijing, China
| | - Tao Li
- Chinese People's Liberation Army No. 69316 Troops, Xinjiang 844800, China
| | - Weiqiang Sun
- Chinese People's Liberation Army No. 69316 Troops, Xinjiang 844800, China
| | - Jingwen Chen
- Department of Hyperbaric Chamber, The First Medical Center of Chinese PLA General Hospital 100853, Beijing, China
| | - Chengbin Wang
- Department of Laboratory Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Medical School of Chinese PLA, Beijing 100853, China.
| | - Chi Wang
- Department of Laboratory Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Medical School of Chinese PLA, Beijing 100853, China.
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Zhao MX, Li GJ. Establishment of a nomogram model for predicting therapy complications in patients with polycythemia and deep venous thrombosis. World J Clin Cases 2024; 12:4881-4889. [DOI: 10.12998/wjcc.v12.i22.4881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/13/2024] [Accepted: 06/17/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Patients with deep venous thrombosis (DVT) residing at high altitudes can only rely on anticoagulation therapy, missing the optimal window for surgery or thrombolysis. Concurrently, under these conditions, patient outcomes can be easily complicated by high-altitude polycythemia (HAPC), which increases the difficulty of treatment and the risk of recurrent thrombosis. To prevent reaching this point, effective screening and targeted interventions are crucial. Thus, this study analyzes and provides a reference for the clinical prediction of thrombosis recurrence in patients with lower-extremity DVT combined with HAPC.
AIM To apply the nomogram model in the evaluation of complications in patients with HAPC and DVT who underwent anticoagulation therapy.
METHODS A total of 123 patients with HAPC complicated by lower-extremity DVT were followed up for 6-12 months and divided into recurrence and non-recurrence groups according to whether they experienced recurrence of lower-extremity DVT. Clinical data and laboratory indices were compared between the groups to determine the influencing factors of thrombosis recurrence in patients with lower-extremity DVT and HAPC. This study aimed to establish and verify the value of a nomogram model for predicting the risk of thrombus recurrence.
RESULTS Logistic regression analysis showed that age, immobilization during follow-up, medication compliance, compliance with wearing elastic stockings, and peripheral blood D-dimer and fibrin degradation product levels were indepen-dent risk factors for thrombosis recurrence in patients with HAPC complicated by DVT. A Hosmer-Lemeshow goodness-of-fit test demonstrated that the nomogram model established based on the results of multivariate logistic regression analysis was effective in predicting the risk of thrombosis recurrence in patients with lower-extremity DVT complicated by HAPC (χ2 = 0.873; P > 0.05). The consistency index of the model was 0.802 (95%CI: 0.799-0.997), indicating its good accuracy and discrimination.
CONCLUSION The column chart model for the personalized prediction of thrombotic recurrence risk has good application value in predicting thrombotic recurrence in patients with lower-limb DVT combined with HAPC after discharge.
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Affiliation(s)
- Ming-Xian Zhao
- Department of Vascular Surgery, Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital, Xining 810000, Qinghai Province, China
| | - Guo-Jie Li
- Department of Vascular Surgery, Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital, Xining 810000, Qinghai Province, China
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Li Y, Wang J, Zhang X, Ye Q, Yang Y, Cui X, Feng J, Li J. Correlation between serum inflammatory factors and cognitive function in patients with high-altitude polycythemia: A case-control study. Medicine (Baltimore) 2024; 103:e37983. [PMID: 38669375 PMCID: PMC11049725 DOI: 10.1097/md.0000000000037983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
The purpose of this study is to investigate the serum inflammatory factors in patients with high-altitude polycythemia (HAPC) and their correlation with cognitive function. The subjects were recruited and placed into a HAPC group and control group. Serum samples were collected, and inflammatory factors (interleukin-1beta [IL-1β], monocyte chemoattractant protein-1 [MCP-1], and tumor necrosis factor-alpha [TNF-α]) were measured using ELISA kits. The mini-mental State Examination (MMSE) was used to assess cognitive function. According to the MMSE scores, HAPC group was further divided into normal cognitive function group (HNCF) and cognitive dysfunction group (HCDF). In comparison with the control group, the MMSE scores in the HAPC group were significantly low (P < .05), whereas the serum levels of IL-1β, MCP-1, and TNF-α were significantly high (P < .01). Among the HAPC group (n = 60), 21 belonged to the HCDF and 39 belonged to the HNCF. Compared with the HNCF, the IL-1β, MCP-1, and TNF-α in the HCDF were significantly increased (P < .01). The Pearson correlation analysis showed that inflammatory factors were positively correlated with hemoglobin, and negatively correlated with MMSE. Serum inflammatory cytokines IL-1, MCP-1, and TNF-α were increased in HAPC, and HAPC exhibited cognitive dysfunction. Considering chronic hypoxia environment influences the change of the red blood cell metabolic and inflammatory factor, red blood cells and inflammatory factor in plateau is likely to be affected by patients with vascular lesions, increase cognitive impairment.
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Affiliation(s)
- Yinglan Li
- General Department, Qinghai Provincial People’s Hospital, Xining, China
| | - Jiabing Wang
- General Department, Qinghai Provincial People’s Hospital, Xining, China
| | - Xiuxin Zhang
- General Department, Qinghai Provincial People’s Hospital, Xining, China
| | - Qiong Ye
- General Department, Qinghai Provincial People’s Hospital, Xining, China
| | - Yuan Yang
- General Department, Qinghai Provincial People’s Hospital, Xining, China
| | - Xiaoshan Cui
- General Department, Qinghai Provincial People’s Hospital, Xining, China
| | - Jinhua Feng
- General Department, Qinghai Provincial People’s Hospital, Xining, China
| | - Jimei Li
- General Department, Qinghai Provincial People’s Hospital, Xining, China
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Yu S, Ye Y, Wuren T, Yi H. Alteration in the number, morphology, function, and metabolism of erythrocytes in high-altitude polycythemia. Front Physiol 2024; 15:1359357. [PMID: 38426208 PMCID: PMC10902074 DOI: 10.3389/fphys.2024.1359357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/01/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction: High-altitude polycythemia (HAPC) is a common chronic high-altitude disease characterized by significantly increased erythrocyte, hemoglobin (Hb), and hematocrit values and decreased arterial oxygen saturation. The mechanisms underlying HAPC development are unclear; we aimed to investigate this in an HAPC rat model. Methods: Twelve Sprague-Dawley rats were divided into control and HAPC groups. The HAPC group was exposed to hypobaric hypoxia. This HAPC model was assessed using routine blood tests and blood gas analyses. Bone marrow, peripheral blood reticulocytes (RETs), and peripheral blood erythrocyte apoptosis were measured using flow cytometry. Erythrocyte osmotic fragility (EOF) tests were conducted. Abnormal erythrocytes were counted using electron microscopy. Plasma-free hemoglobin, 5'-nucleotidase (CD73), adenosine, erythrocyte cytosolic adenosine, sphingosine-1-phosphate (S1P), and 2,3-bisphosphoglycerate (BPG) levels were measured using enzyme-linked immunosorbent assays. Erythrocyte metabolic pathway-related protein [adenosine A2B receptor (ADORA2B), erythrocyte equilibrative nucleoside transporter 1 (eENT1), sphingosine kinase 1 (SPHK1), phospho-SPHK1, bisphosphoglycerate mutase (BPGM), and glyceraldehyde 3-phosphate dehydrogenase (GAPDH)] levels were assessed by Western blotting. Results: The HAPC rat model was successfully established (Hb > 210 g/L). Indices of bone marrow and peripheral blood RET proportions were significantly higher in the HAPC than the control group (p = 0.04 and p < 0.001, respectively). The proportion of peripheral blood erythrocytes in early apoptosis was significantly lower in the HAPC than the control group (p < 0.001). Vesicular erythrocyte and acanthocyte proportions were significantly higher in the HAPC than the control group (p < 0.001 and p = 0.019, respectively). The EOF tests revealed that 50% erythrocyte hemolysis occurred at 4.0-4.5 and 4.5-5.0 g/L NaCl in the control and HAPC groups, respectively. Plasma-free hemoglobin, CD73, adenosine, erythrocyte cytosolic adenosine, S1P, and 2,3-BPG levels and ADORA2B, eENT1, phospho-SPHK1, S1P, BPGM, and GAPDH erythrocyte expression levels (all p ≤ 0.02) were significantly higher in the HAPC than the control group. Conclusion: In model rats, an HAPC-related erythrocyte increase was associated with enhanced bone marrow hematopoietic function and reduced erythrocyte apoptosis, whereas numerous abnormal erythrocytes, increased EOF, and reduced hemolysis resistance were associated with erythrocyte metabolism. CD73/adenosine/S1P/2,3-BPG and eENT1/adenosine/BPGM/2,3-BPG metabolic pathways in erythrocytes were activated in HAPC rats, facilitating oxygen release. These findings further reveal the intrinsic HAPC mechanism and forms a basis for future development of preventive and therapeutic strategies for HAPC.
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Affiliation(s)
- Song Yu
- College of Medicine, Southwest Jiaotong University, Chengdu, China
- Department of Hematology, Affiliated Hospital of Southwest Jiaotong University, The General Hospital of Western Theater Command, Chengdu, China
| | - Yi Ye
- Research Center for High Altitude Medicine, Qinghai University, Xining, China
| | - Tana Wuren
- Research Center for High Altitude Medicine, Qinghai University, Xining, China
| | - Hai Yi
- College of Medicine, Southwest Jiaotong University, Chengdu, China
- Department of Hematology, Affiliated Hospital of Southwest Jiaotong University, The General Hospital of Western Theater Command, Chengdu, China
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Chen X, Wang Z, Su J, Li H, Xiong J, Fu K, Wang Z, Yuan X, Shi Z, Miao X, Yang M, Yang Y, Shi Z. Altitude-dependent metabolite biomarkers reveal the mechanism of plateau pika adaptation to high altitudes. Integr Zool 2023; 18:1041-1055. [PMID: 36880690 DOI: 10.1111/1749-4877.12710] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
The harsh environment in the Tibetan plateau, the highest place in the world, poses thermoregulatory challenges and hypoxic stress to animals. The impacts of plateau environment on animal physiology and reproduction include external factors such as strong ultraviolet radiation and low temperature, and internal factors such as animal metabolites and gut microbiota. However, it remains unclear how plateau pika adapt to high altitudes through the combination of serum metabolites and gut microbiota. To this end, we captured 24 wild plateau pikas at the altitudes of 3400, 3600, or 3800 m a.s.l. in a Tibetan alpine grassland. Using the machine learning algorithms (random forest), we identified five biomarkers of serum metabolites indicative of the altitudes, that is, dihydrotestosterone, homo-l-arginine, alpha-ketoglutaric-acid, serotonin, and threonine, which were related to body weight, reproduction, and energy metabolism of pika. Those metabolic biomarkers were positively correlated with Lachnospiraceae_ Agathobacter, Ruminococcaceae, or Prevotellaceae_Prevotella, suggesting the close relationship between metabolites and gut microbiota. By identifying the metabolic biomarkers and gut microbiota analysis, we reveal the mechanisms of adaptation to high altitudes in plateau pika.
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Affiliation(s)
- Xi Chen
- State Key Laboratory of Herbage Improvement and Grassland Agro-ecosystems, Center for Grassland Microbiome, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou, China
| | - Zaiwei Wang
- State Key Laboratory of Herbage Improvement and Grassland Agro-ecosystems, Center for Grassland Microbiome, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou, China
| | - Junhu Su
- College of Grassland Science, Key Laboratory of Grassland Ecosystem (Ministry of Education), Gansu Agricultural University, Lanzhou, China
| | - Huan Li
- State Key Laboratory of Herbage Improvement and Grassland Agro-ecosystems, Center for Grassland Microbiome, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou, China
| | - Jinbo Xiong
- School of Marine Sciences, Ningbo University, Ningbo, China
| | - Keyi Fu
- State Key Laboratory of Herbage Improvement and Grassland Agro-ecosystems, Center for Grassland Microbiome, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou, China
| | - Zilong Wang
- State Key Laboratory of Herbage Improvement and Grassland Agro-ecosystems, Center for Grassland Microbiome, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou, China
| | - Xuefeng Yuan
- State Key Laboratory of Herbage Improvement and Grassland Agro-ecosystems, Center for Grassland Microbiome, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou, China
| | - Ziyue Shi
- State Key Laboratory of Herbage Improvement and Grassland Agro-ecosystems, Center for Grassland Microbiome, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou, China
| | - Xiumei Miao
- State Key Laboratory of Herbage Improvement and Grassland Agro-ecosystems, Center for Grassland Microbiome, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou, China
| | - Mei Yang
- State Key Laboratory of Herbage Improvement and Grassland Agro-ecosystems, Center for Grassland Microbiome, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou, China
| | - Yunfeng Yang
- State Key Laboratory of Herbage Improvement and Grassland Agro-ecosystems, Center for Grassland Microbiome, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou, China
- State Key Joint Laboratory of Environment Simulation and Pollution Control, School of Environment, Tsinghua University, China
| | - Zunji Shi
- State Key Laboratory of Herbage Improvement and Grassland Agro-ecosystems, Center for Grassland Microbiome, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou, China
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Aimaier S, Tao Y, Lei F, Yupeng Z, Wenhui S, Aikemu A, Maimaitiyiming D. Protective effects of the Terminalia bellirica tannin-induced Nrf2/HO-1 signaling pathway in rats with high-altitude pulmonary hypertension. BMC Complement Med Ther 2023; 23:150. [PMID: 37149589 PMCID: PMC10163731 DOI: 10.1186/s12906-023-03981-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 04/27/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Oxidative stress and endothelial cell dysfunction induced by high-altitude hypoxia have important roles in the pathological process of high-altitude pulmonary hypertension (HAPH). Tannins present in Terminalia bellirica (Gaertn.) Roxb. (TTR) have pharmacological activities that produce oxidation resistance and exert anti-inflammatory effects. Whether TTR exerts a protective effect on HAPH remains unknown. METHODS A rat model of HAPH was established. The mean pulmonary arterial pressure (mPAP) of the animals was measured, the serum levels of SOD, MDA, and GSH-Px were measured using ELISA, and the expression of Bax, Bcl-2, Nrf2, and HO-1 proteins in the lung tissue of each group of rats was measured using Western blotting. Pathological changes in the lung tissue were also observed. A model of damage to H2O2-induced pulmonary artery endothelial cells (PAECs) was generated, and cell proliferation was measured using CCK-8 assays. Flow cytometry was used to measure ROS levels in PAECs. Western blotting was used to detect the expression of Bax, Bcl-2, Nrf2, and HO-1 proteins in PAECs. RESULTS The hemodynamic and pathologic findings showed that the mPAP of HAPH rats increased markedly, and the vascular wall thickness increased (P < 0.05). TTR reduced mPAP, alleviated or slowed pulmonary arterial remodeling, increased GSH-Px and SOD activity, lowered the level of MDA (P < 0.05), and downregulated the expression of Bax in the lung tissues of HAPH rats, while the expression of Bcl-2, Nrf2, and HO-1 was upregulated (P < 0.05). The results of the cell experiments showed that TTR inhibited H2O2-induced PAEC apoptosis and ROS production (P < 0.05), downregulated the expression of Bax in PAECs, and upregulated the expression of Bcl-2, Nrf2, and HO-1 (P < 0.05). CONCLUSION The results suggest that TTR reduces pulmonary arterial pressure, decreases oxidative stress during HAPH, and exerts protective effects in rats with HAPH and that its mechanism of action is related to regulation of the Nrf2/HO-1 signaling pathway.
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Affiliation(s)
- Salamaiti Aimaier
- Heart Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China
| | - Yang Tao
- College of pharmacy, Xinjiang Medical University, Urumqi, 830011, China.
- Central Laboratory, Xinjiang Medical University, Urumqi, 830011, China.
| | - Fang Lei
- College of pharmacy, Xinjiang Medical University, Urumqi, 830011, China
| | - Zhang Yupeng
- College of pharmacy, Xinjiang Medical University, Urumqi, 830011, China
| | - Shi Wenhui
- Key Laboratory of Special Environmental Medicine of Xinjiang, General Hospital of Xinjiang Military Region of PLA, Urumqi, 830000, China
| | - Ainiwaer Aikemu
- College of pharmacy, Xinjiang Medical University, Urumqi, 830011, China
| | - Dilinuer Maimaitiyiming
- Heart Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China.
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Wang Y, Shi M, Chu Z, Yan X, You G, Chen G, Zhou H. Protective effect of bioactive iridium nanozymes on high altitude-related hypoxia-induced kidney injury in mice. Front Pharmacol 2023; 14:1115224. [PMID: 36891263 PMCID: PMC9986433 DOI: 10.3389/fphar.2023.1115224] [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: 12/03/2022] [Accepted: 02/06/2023] [Indexed: 02/22/2023] Open
Abstract
Introduction: High altitude-related hypoxia-induced organ damage significantly impacts people who are exposed to acute high-altitude environment. At present, kidney injury still lacks effective treatment strategies. Iridium nanozymes (Ir-NPs) are a nanomaterial with various enzymatic activities and are expected to be used in kidney injury treatment. Methods: In this study, we simulated a high-altitude environment (6000 m) to induce a kidney injury model, and explored the therapeutic effect of Ir-NPs in mice with kidney injury in this environment. Changes in the microbial community and metabolites were analyzed to explore the possible mechanism underlying the improvement of kidney injury during acute altitude hypoxia in mice treated with Ir-NPs. Results: It was discovered that plasma lactate dehydrogenase and urea nitrogen levels were considerably increased in mice exposed to acute altitude hypoxia compared to mice in a normal oxygen environment. Furthermore, there was a substantial increase in IL-6 expression levels in hypoxic mice; contrastingly, Ir-NPs decreased IL-6 expression levels, reduced the levels of succinic acid and indoxyl sulfate in the plasma and kidney pathological changes caused by acute altitude hypoxia. Microbiome analysis showed that bacteria, such as Lachnospiraceae_UCG_006 predominated in mice treated with Ir-NPs. Conclusion: Correlation analysis of the physiological, biochemical, metabolic, and microbiome-related parameters showed that Ir-NPs could reduce the inflammatory response and protect kidney function under acute altitude hypoxia, which may be related to intestinal flora distribution regulation and plasma metabolism in mice. Therefore, this study provides a novel therapeutic strategy for hypoxia-related kidney injury, which could be applied to other hypoxia-related diseases.
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Affiliation(s)
- Yujing Wang
- Institute of Health Service and Transfusion Medicine, Academy of Military Medical Sciences, Beijing, China
| | - Meijun Shi
- Key Laboratory of Pollution Ecology and Environmental Engineering, Institute of Applied Ecology, Chinese Academy of Sciences, Shenyang, China
| | - Zongtang Chu
- Institute of Health Service and Transfusion Medicine, Academy of Military Medical Sciences, Beijing, China
| | - Xinlin Yan
- National Engineering Research Center for the Emergency Drug, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Guoxing You
- Institute of Health Service and Transfusion Medicine, Academy of Military Medical Sciences, Beijing, China
| | - Gan Chen
- Institute of Health Service and Transfusion Medicine, Academy of Military Medical Sciences, Beijing, China
| | - Hong Zhou
- Institute of Health Service and Transfusion Medicine, Academy of Military Medical Sciences, Beijing, China
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Wang S, Ma J, Qiu H, Liu S, Zhang S, Liu H, Zhang P, Ge RL, Li G, Cui S. Plasma exosomal microRNA expression profiles in patients with high-altitude polycythemia. Blood Cells Mol Dis 2023; 98:102707. [DOI: 10.1016/j.bcmd.2022.102707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 10/19/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
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Jiang B, Li Y, Ciren D, Dawa O, Feng Y, Laba C. Supraglottic jet oxygenation and ventilation decreased hypoxemia during gastrointestinal endoscopy under deep sedation at high altitudes: a randomized clinical trial. BMC Anesthesiol 2022; 22:348. [PMCID: PMC9661813 DOI: 10.1186/s12871-022-01902-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Hypobaric hypoxia is common at high altitudes. Whether this exacerbates hypoxia during procedural sedation and whether hypoxia can be alleviated by the use of supraglottic jet oxygenation and ventilation (SJOV) are unknown. This study aimed to compare the incidence of hypoxia during gastrointestinal endoscopy under deep sedation at high altitudes with oxygen supply techniques using either a nasal cannula or SJOV.
Methods
This study was conducted from April 2022 to July 2022 in a tertiary hospital located 3650 m above sea level. Adult patients scheduled for routine gastrointestinal endoscopy under sedation were enrolled and randomized 1:1 to receive SJOV or a nasal cannula during sedation. Moderate hypoxia was the primary outcome, defined as an SPO2 of 75–89% for < 60 s. The secondary outcomes were respiratory-, cardiovascular-, and SJOV-related complications. The influence of characteristics regarding acclimatization to high altitudes (Tibetan ethnic group and erythrocytosis) on the occurrence of hypoxia was analyzed.
Results
None of the patients were lost to follow-up. A total of 72 patients were included in the analysis (36 patients in each group). There were 20 (27.8%) patients who experienced moderate hypoxia events. Significantly fewer hypoxic events occurred in the SJOV group than in the nasal cannula group [3 (8.3%) vs. 17 (47.2%), absolute risk difference (95% CI): − 38.9 (− 57.5, − 20.2) %, risk ratio (RR, 95% CI): 0.18 (0.06, 0.55), P < 0.001]. Significantly fewer patients in the SJOV group experienced mild hypoxia (P < 0.001) and severe hypoxia (P = 0.002). No serious adverse events occurred in either of the groups. The Tibetan ethnic group (P = 0.086) and erythrocytosis (P = 0.287) were not associated with the occurrence of hypoxia events.
Conclusions
The incidence of hypoxia was lower with SJOV than with nasal cannula in patients undergoing gastrointestinal endoscopy under deep sedation at high altitudes. The Tibetan ethnic group and erythrocytosis did not influence the occurrence of hypoxia.
Trial registration
This study was registered at ClinicalTrials.gov (NCT05304923) before enrollment by Dr. Yi Feng on 31/03/2022.
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Cui J, Zhaxi D, Sun X, Teng N, Wang R, Diao Y, Jin C, Chen Y, Xu X, Li X. Association of dietary pattern and Tibetan featured foods with high-altitude polycythemia in Naqu, Tibet: A 1:2 individual-matched case-control study. Front Nutr 2022; 9:946259. [PMID: 36211499 PMCID: PMC9538783 DOI: 10.3389/fnut.2022.946259] [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: 05/17/2022] [Accepted: 09/01/2022] [Indexed: 12/01/2022] Open
Abstract
This study focused on the association of dietary patterns and Tibetan featured foods with high-altitude polycythemia (HAPC) in Naqu, Tibet, to explore the risk factors of HAPC in Naqu, Tibet, to raise awareness of the disease among the population and provide evidence for the development of prevention and treatment interventions. A 1:2 individual-matched case-control study design was used to select residents of three villages in the Naqu region of Tibet as the study population. During the health examination and questionnaire survey conducted from December 2020 to December 2021, a sample of 1,171 cases was collected. And after inclusion and exclusion criteria and energy intake correction, 100 patients diagnosed with HAPC using the “Qinghai criteria” were identified as the case group, while 1,059 patients without HAPC or HAPC -related diseases were identified as the control group. Individuals were matched by a 1:2 propensity score matching according to gender, age, body mass index (BMI), length of residence, working altitude, smoking status, and alcohol status. Dietary patterns were determined by a principal component analysis, and the scores of study subjects for each dietary pattern were calculated. The effect of dietary pattern scores and mean daily intake (g/day) of foods in the Tibetan specialty diet on the prevalence of HAPC was analyzed using conditional logistic regression. After propensity score matching, we found three main dietary patterns among residents in Naqu through principal component analysis, which were a “high protein pattern,” “snack food pattern,” and “vegetarian food pattern.” All three dietary patterns showed a high linear association with HAPC (p < 0.05) and were risk factors for HAPC. In the analysis of the relationship between Tibetan featured foods and the prevalence of HAPC, the results of the multifactorial analysis following adjustment for other featured foods showed that there was a positive correlation between the average daily intake of tsampa and the presence of HAPC, which was a risk factor. Additionally, there was an inverse correlation between the average daily intake of ghee tea and the presence of HAPC, which was a protective factor.
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Affiliation(s)
- Jiaxue Cui
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Duoji Zhaxi
- Institute of High Altitude Medicine, People’s Hospital of Naqu Affiliated to Dalian Medical University, Naqu, China
| | - Xianzhi Sun
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Nan Teng
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Ruiqi Wang
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Yizhuo Diao
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Chenxin Jin
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Yongxing Chen
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Xiaoguang Xu
- Institute of High Altitude Medicine, People’s Hospital of Naqu Affiliated to Dalian Medical University, Naqu, China
- Department of Neurosurgery, Second Affiliated Hospital of Dalian Medical University, Dalian, China
- *Correspondence: Xiaoguang Xu,
| | - Xiaofeng Li
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
- Xiaofeng Li,
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Luo C, Sun G, Duan J, Han H, Zhong R, Chen L, Wangdui B, Zhu Y, Wang Z, Zhang H. Effects of high-altitude hypoxic environment on colonic inflammation, intestinal barrier and gut microbiota in three-way crossbred commercial pigs. Front Microbiol 2022; 13:968521. [PMID: 36160198 PMCID: PMC9493363 DOI: 10.3389/fmicb.2022.968521] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/15/2022] [Indexed: 11/14/2022] Open
Abstract
In recent years, the three-way crossbred commercial pigs are extensively cultured in Tibet. However, there have been few studies about the effect of high-altitude hypoxic environment on intestinal health of them. Therefore, we selected Tibetan pigs (TP) and the three-way crossbred commercial pigs (CP-H) living in the Tibet (3,500–3,700 m in altitude) as a positive control group and treatment group, respectively. The three-way crossbred commercial pigs (CP-L) living at altitudes 800–1,000 m sea level were selected as a negative control group. The colonic chyme, colonic mucosa, colonic tissue and serum samples were collected for the detection of gut microbiota and intestinal inflammation. The results showed that high-altitude hypoxic environment promoted the occurrence of colonic inflammation, disrupted the colonic barrier to some extent. And Hematoxylin–Eosin (HE) staining revealed that mild inflammatory cell infiltration was observed in colon of CP-H. 16S rRNA gene sequencing revealed that the microbial community composition of CP-H was changed compared with CP-L. Gut bacterial communities formed distinctly different clusters in principal coordinates analysis (PCoA) space, and Chao 1 index of CP-H was also decreased. At the genus level, Terrisporobacter showed greater enrichment in the CP-H than lower-altitude pigs. Colstridium-sensu-stricto-1 showed lower enrichment in the CP-H than lower-altitude pigs. However, the concentration of valeric acid in colonic chyme of CP-H was higher than CP-L and TP. Correlation analysis indicated that Terrisporobacter was positively associated with the relative mRNA expression level of IL-1β and the content of lipopolysaccharide (LPS), and was negatively correlated with the relative mRNA expression level of IL-10. The Streptococcus was positively associated with the concentrations of valerate. In summary, high-altitude hypoxic environment changed compositions of gut microbiota, promoted the occurrence of colonic inflammation, and disrupted intestinal barrier of the three-way crossbred commercial pigs.
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Affiliation(s)
- Chengzeng Luo
- College of Animal Science, Xinjiang Agricultural University, Urumqi, China
- State Key Laboratory of Animal Nutrition, Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Guangming Sun
- Institute of Animal Husbandry and Veterinary Medicine, Tibet Academy of Agriculture and Animal Husbandry Science, Lhasa, China
| | - Jiujun Duan
- State Key Laboratory of Animal Nutrition, Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Haiyu Han
- Tibet Changdu Animal Husbandry General Station, Changdu, China
| | - Ruqing Zhong
- State Key Laboratory of Animal Nutrition, Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Liang Chen
- State Key Laboratory of Animal Nutrition, Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Basang Wangdui
- Institute of Animal Husbandry and Veterinary Medicine, Tibet Academy of Agriculture and Animal Husbandry Science, Lhasa, China
| | - Yanbin Zhu
- Institute of Animal Husbandry and Veterinary Medicine, Tibet Academy of Agriculture and Animal Husbandry Science, Lhasa, China
- *Correspondence: Yanbin Zhu,
| | - Zirong Wang
- College of Animal Science, Xinjiang Agricultural University, Urumqi, China
- Zirong Wang,
| | - Hongfu Zhang
- State Key Laboratory of Animal Nutrition, Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing, China
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13
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Wang H, Liu D, Song P, Jiang F, Zhang T. Microarray-Based Prediction of Polycythemia after Exposure to High Altitudes. Genes (Basel) 2022; 13:genes13071193. [PMID: 35885976 PMCID: PMC9316656 DOI: 10.3390/genes13071193] [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: 05/17/2022] [Revised: 06/24/2022] [Accepted: 06/30/2022] [Indexed: 12/05/2022] Open
Abstract
In high-altitude environments, the prevalence of high-altitude polycythemia (HAPC) ranges between 5 and 18 percent. However, there is currently no effective treatment for this condition. Therefore, disease prevention has emerged as a critical strategy against this disease. Here, we looked into the microarray profiles of GSE135109 and GSE29977, linked to either short- or long-term exposure to the Qinghai Tibet Plateau (QTP). The results revealed inhibition in the adaptive immune response during 30 days of exposure to QTP. Following a gene set enrichment analysis (GSEA) discovered that genes associated with HAPC were enriched in Cluster1, which showed a dramatic upregulation on the third day after arriving at the QTP. We then used GeneLogit to construct a logistic prediction model, which allowed us to identify 50 genes that classify HAPC patients. In these genes, LRRC18 and HCAR3 were also significantly altered following early QTP exposure, suggesting that they may serve as hub genes for HAPC development. The in-depth study of a combination of the datasets of transcriptomic changes during exposure to a high altitude and whether diseases occur after long-term exposure in Hans can give us some inspiration about genes associated with HAPC development during adaption to high altitudes.
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Affiliation(s)
- Haijing Wang
- Key Laboratory of Adaptation and Evolution of Plateau Biota, Northwest Institute of Plateau Biology, Chinese Academy of Sciences, Xining 810001, China; (H.W.); (D.L.); (P.S.); (F.J.)
- University of Chinese Academy of Sciences, Beijing 100049, China
- Medical School, Qinghai University, Xining 810016, China
- Qinghai Provincial Key Laboratory of Animal Ecological Genomics, Xining 810008, China
| | - Daoxin Liu
- Key Laboratory of Adaptation and Evolution of Plateau Biota, Northwest Institute of Plateau Biology, Chinese Academy of Sciences, Xining 810001, China; (H.W.); (D.L.); (P.S.); (F.J.)
- University of Chinese Academy of Sciences, Beijing 100049, China
- Qinghai Provincial Key Laboratory of Animal Ecological Genomics, Xining 810008, China
- Kunlun College, Qinghai University, Xining 810016, China
| | - Pengfei Song
- Key Laboratory of Adaptation and Evolution of Plateau Biota, Northwest Institute of Plateau Biology, Chinese Academy of Sciences, Xining 810001, China; (H.W.); (D.L.); (P.S.); (F.J.)
- University of Chinese Academy of Sciences, Beijing 100049, China
- Qinghai Provincial Key Laboratory of Animal Ecological Genomics, Xining 810008, China
| | - Feng Jiang
- Key Laboratory of Adaptation and Evolution of Plateau Biota, Northwest Institute of Plateau Biology, Chinese Academy of Sciences, Xining 810001, China; (H.W.); (D.L.); (P.S.); (F.J.)
- University of Chinese Academy of Sciences, Beijing 100049, China
- Qinghai Provincial Key Laboratory of Animal Ecological Genomics, Xining 810008, China
| | - Tongzuo Zhang
- Key Laboratory of Adaptation and Evolution of Plateau Biota, Northwest Institute of Plateau Biology, Chinese Academy of Sciences, Xining 810001, China; (H.W.); (D.L.); (P.S.); (F.J.)
- University of Chinese Academy of Sciences, Beijing 100049, China
- Qinghai Provincial Key Laboratory of Animal Ecological Genomics, Xining 810008, China
- Correspondence:
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