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Zhang H, Wang X, Liu J, Zhang Y, Ka M, Ma Y, Xu J, Zhang W. Role of neutrophil myeloperoxidase in the development and progression of high-altitude pulmonary edema. Biochem Biophys Res Commun 2024; 703:149681. [PMID: 38382360 DOI: 10.1016/j.bbrc.2024.149681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/28/2024] [Accepted: 02/12/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Neutrophil infiltration and hypoxic pulmonary vasoconstriction induced by hypobaric hypoxic stress are vital in high-altitude pulmonary edema (HAPE). Myeloperoxidase (MPO), an important enzyme in neutrophils, is associated with inflammation and oxidative stress and is also involved in the regulation of nitric oxide synthase (NOS), an enzyme that catalyzes the production of the vasodilatory factor nitric oxide (NO). However, the role of neutrophil MPO in HAPE's progression is still uncertain. Therefore, we hypothesize that MPO is involved in the development of HAPE via NOS. METHODS In Xining, China (altitude: 2260 m), C57BL/6 N wild-type and mpo-/- mice served as normoxic controls, while a hypobaric chamber simulated 7000 m altitude for hypoxia. L-NAME, a nitric oxide synthase (NOS) inhibitor to inhibit NO production, was the experimental drug, and D-NAME, without NOS inhibitory effects, was the control. After measuring pulmonary artery pressure (PAP), samples were collected and analyzed for blood neutrophils, oxidative stress, inflammation, vasoactive substances, pulmonary alveolar-capillary barrier permeability, and lung tissue morphology. RESULTS Wild-type mice's lung injury scores, permeability, and neutrophil counts rose at 24 and 48 h of hypoxia exposure. Under hypoxia, PAP increased from 12.89 ± 1.51 mmHg under normoxia to 20.62 ± 3.33 mmHg significantly in wild-type mice and from 13.24 ± 0.79 mmHg to 16.50 ± 2.07 mmHg in mpo-/- mice. Consistent with PAP, inducible NOS activity, lung permeability, lung injury scores, oxidative stress response, and inflammation showed more significant increases in wild-type mice than in mpo-/- mice. Additionally, endothelial NOS activity and NO levels decreased more pronouncedly in wild-type mice than in mpo-/- mice. NOS inhibition during hypoxia led to more significant increases in PAP, permeability, and lung injury scores compared to the drug control group, especially in wild-type mice. CONCLUSION MPO knockout reduces oxidative stress and inflammation to preserve alveolar-capillary barrier permeability and limits the decline in endothelial NOS activity to reduce PAP elevation during hypoxia. MPO inhibition emerges as a prospective therapeutic strategy for HAPE, offering avenues for precise interventions.
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Affiliation(s)
- Huan Zhang
- Research Center for High Altitude Medicine, Qinghai University, Xining, Qinghai, 810001, China; Key Laboratory of High Altitude Medicine (Ministry of Education), 810000, China; Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province (Qinghai-Utah Joint Research Key Lab for High Altitude Medicine), Qinghai University, Xining, Qinghai, 810001, China; Department of Pathology, The Second Affiliated Hospital of Xi'an Jiaotong University, 710004, China.
| | - Xiaojun Wang
- Department of Basic Medicine, Medical College of Qinghai University, Xining, Qinghai, 810001, China.
| | - Jie Liu
- Department of Pathology, Xi'an Chest Hospital, Xian, Shaanxi, 710000, China.
| | - Yu Zhang
- Department of Basic Medicine, Medical College of Qinghai University, Xining, Qinghai, 810001, China.
| | - Maojia Ka
- Research Center for High Altitude Medicine, Qinghai University, Xining, Qinghai, 810001, China; Key Laboratory of High Altitude Medicine (Ministry of Education), 810000, China; Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province (Qinghai-Utah Joint Research Key Lab for High Altitude Medicine), Qinghai University, Xining, Qinghai, 810001, China.
| | - Yi Ma
- Research Center for High Altitude Medicine, Qinghai University, Xining, Qinghai, 810001, China; Key Laboratory of High Altitude Medicine (Ministry of Education), 810000, China; Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province (Qinghai-Utah Joint Research Key Lab for High Altitude Medicine), Qinghai University, Xining, Qinghai, 810001, China.
| | - Jiaolong Xu
- Department of Basic Medicine, Medical College of Qinghai University, Xining, Qinghai, 810001, China; Linyi Central Hospital, Linyi, Shandong, 276400, China.
| | - Wei Zhang
- Research Center for High Altitude Medicine, Qinghai University, Xining, Qinghai, 810001, China; Key Laboratory of High Altitude Medicine (Ministry of Education), 810000, China; Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province (Qinghai-Utah Joint Research Key Lab for High Altitude Medicine), Qinghai University, Xining, Qinghai, 810001, China.
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Tenzing D, Suolang P, Gesang D, Suolang D, Duan G, Ciren W, Wang Y, Ni T. Effect of furosemide in the treatment of high-altitude pulmonary edema. BMC Pulm Med 2024; 24:109. [PMID: 38438895 PMCID: PMC10913242 DOI: 10.1186/s12890-024-02933-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/26/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND High-altitude pulmonary edema (HAPE) refers to the onset of breathlessness, cough, and fever at rest after arriving at high altitudes. It is a life-threatening illness caused by rapid ascent to high altitudes. Furosemide is controversial in HAPE treatment but is routinely used in China. Further research is needed to assess its efficacy and impact on HAPE management and prognosis. The aim of this study is to determine the effectiveness of furosemide for HAPE. METHODS A retrospective was conducted to analysis of patients with HAPE admitted to the People's Hospital of Shigatse City from January 2018 to September 2023. Patients were divided into furosemide group and non-furosemide group for further analysis. Clinical variables including demographic information, comorbidities, vital signs, inflammatory markers, biochemical analysis, CT severity score and prognostic indicators were collected. RESULTS A total of 273 patients were enrolled, with 209 patients in the furosemide group and 64 patients in the non-furosemide group. The furosemide group showed a significantly decrease in CT severity scores compared to the non-furosemide group. Subgroup analysis showed that the longer the duration of furosemide use, the more pronounced the improvement in lung CT severity scores. But there were no significant differences in length of hospital stay and in-hospital mortality between the two groups. CONCLUSION Furosemide helps alleviate pulmonary edema in HAPE patients, but further research is needed to clarify its impact on prognosis.
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Affiliation(s)
- Dava Tenzing
- Department of Emergency, People's Hospital of Shigatse City, No. 1 Daqing East Road, Sangzhuzi District, Shigatse City, Tibet, China
| | - Pianduo Suolang
- Department of Emergency, People's Hospital of Shigatse City, No. 1 Daqing East Road, Sangzhuzi District, Shigatse City, Tibet, China
| | - Deji Gesang
- Department of Emergency, People's Hospital of Shigatse City, No. 1 Daqing East Road, Sangzhuzi District, Shigatse City, Tibet, China
| | - Duoji Suolang
- Department of Emergency, People's Hospital of Shigatse City, No. 1 Daqing East Road, Sangzhuzi District, Shigatse City, Tibet, China
| | - Gaozhan Duan
- Department of Emergency, People's Hospital of Shigatse City, No. 1 Daqing East Road, Sangzhuzi District, Shigatse City, Tibet, China
| | - Wangmu Ciren
- Department of Emergency, People's Hospital of Shigatse City, No. 1 Daqing East Road, Sangzhuzi District, Shigatse City, Tibet, China
| | - Yihui Wang
- Department of Emergency, People's Hospital of Shigatse City, No. 1 Daqing East Road, Sangzhuzi District, Shigatse City, Tibet, China.
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin er Road, Huangpu District, 200025, Shanghai, China.
| | - Tongtian Ni
- Department of Emergency, People's Hospital of Shigatse City, No. 1 Daqing East Road, Sangzhuzi District, Shigatse City, Tibet, China.
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin er Road, Huangpu District, 200025, Shanghai, China.
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Wang J, Hu Y, Xu Y, Long Q, Gu C, Tang C, Wang R, Yong S. Phospholipase D regulates ferroptosis signal transduction in mouse spleen hypoxia response. Braz J Med Biol Res 2024; 57:e13218. [PMID: 38451609 PMCID: PMC10913393 DOI: 10.1590/1414-431x2023e13218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/28/2023] [Indexed: 03/08/2024] Open
Abstract
High-altitude hypoxia exposure can lead to phospholipase D-mediated lipid metabolism disorder in spleen tissues and induce ferroptosis. Nonetheless, the key genes underlying hypoxia-induced splenic phospholipase D and the ferroptosis pathway remain unclear. This study aimed to establish a hypoxia animal model. Combined transcriptomic and proteomic analyses showed that 95 predicted target genes (proteins) were significantly differentially expressed under hypoxic conditions. Key genes in phospholipase D and ferroptosis pathways under hypoxic exposure were identified by combining Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis techniques. Gene set enrichment analysis (GSEA) showed that the differential gene sets of the phospholipase D and ferroptosis signaling pathways were upregulated in the high-altitude hypoxia group. The genes in the phospholipase D signalling pathway were verified, and the expression levels of KIT and DGKG were upregulated in spleen tissues under hypoxic exposure. Subsequently, the mRNA and protein expression levels of genes from the exogenous pathway such as TFRC, SLC40A1, SLC7A11, TRP53, and FTH1 and those from the endogenous pathway such as GPX4, HMOX1, and ALOX15 differentials in the ferroptosis signalling pathway were verified, and the results indicated significant differential expression. In summary, exposure to high-altitude hypoxia mediated phospholipid metabolism disturbance through the phospholipase D signalling pathway and further induced ferroptosis, leading to splenic injury.
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Affiliation(s)
- Jiayang Wang
- Department of Basic Medicine, School of Medicine, Qinghai University, Xining, Qinghai Province, China
| | - Ying Hu
- Department of Basic Medicine, School of Medicine, Qinghai University, Xining, Qinghai Province, China
| | - Yuzhen Xu
- Department of Basic Medicine, School of Medicine, Qinghai University, Xining, Qinghai Province, China
| | - Qifu Long
- Department of Basic Medicine, School of Medicine, Qinghai University, Xining, Qinghai Province, China
| | - Cunlin Gu
- Department of Basic Medicine, School of Medicine, Qinghai University, Xining, Qinghai Province, China
| | - Chaoqun Tang
- Department of Basic Medicine, School of Medicine, Qinghai University, Xining, Qinghai Province, China
| | - Ru Wang
- Department of Basic Medicine, School of Medicine, Qinghai University, Xining, Qinghai Province, China
| | - Sheng Yong
- Department of Basic Medicine, School of Medicine, Qinghai University, Xining, Qinghai Province, China
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Li Y, Huang Q, Zeng X, Wang R, Li W. Population Pharmacokinetics of Atorvastatin in High-Altitude and Plain Patients with Hyperlipidemic. J Clin Pharmacol 2024; 64:345-352. [PMID: 37864509 DOI: 10.1002/jcph.2376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/12/2023] [Indexed: 10/23/2023]
Abstract
The pharmacokinetic (PK) characteristics of drugs were altered under high-altitude hypoxia. We aim to describe the population PK of atorvastatin (ATV) to identify patient characteristics that are predictive of variability in the PK parameters of the ATV and investigate the effects of high-altitude hypoxia on the blood concentration of ATV in patients with hyperlipidemia. A total of 160 plasma concentrations were collected from 40 patients with hyperlipidemia in plateau areas and 40 in plain areas. The population pharmacokinetic model of patients with hyperlipidemia in plateau and plain areas of China was established by a nonlinear mixed-effects model. The PK of ATV were described by a 1-compartment model with first-order elimination. The main PK parameters of ATV were the first-order absorption rate (0.76 hour-1 fixed); clearance (174.22 L/h) and apparent volume of distribution (1119.62 L). The values of area and age were identified as significant covariates for the clearance, area, age, and urea for the volume of distribution. The steady-state peak concentration in the plateau area was higher than that in the plain area. This study may suggest dose reduction is necessary for patients with hyperlipidemia in high altitudes.
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Affiliation(s)
- Yu Li
- Department of Pharmacy, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, China
- School of Pharmacy, Ningxia Medical University, Ningxia, China
| | - Qin Huang
- Department of Pharmacy, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, China
| | - Xianghai Zeng
- Department of Pharmacy, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, China
- School of Pharmacy, Ningxia Medical University, Ningxia, China
| | - Rong Wang
- Department of Pharmacy, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, China
| | - Wenbin Li
- Department of Pharmacy, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, China
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Zhong Y, Liu F, Zhang X, Guo Q, Wang Z, Wang R. Research progress on reproductive system damage caused by high altitude hypoxia. Endocrine 2024; 83:559-570. [PMID: 38170433 DOI: 10.1007/s12020-023-03643-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE The high altitude area is characterized by low pressure and hypoxia, and rapidly entering the high altitude area will cause a series of damage to the body. Some studies have shown that hypoxia can cause damage to the reproductive system. In recent years, researchers have been paying attention to the effects of hypoxia on hormone level, ovarian reserve, embryonic development, testicular development, sperm motility level, and have begun to explore its injury mechanism, but its mechanism is not clear. In this paper, the mechanism of hypoxia on the reproductive system is reviewed, which is expected to provide a new idea for solving the problem of the low fertility rate of humans and animals at high altitudes. METHODS A comprehensive PubMed search was conducted, selecting all relevant peer-reviewed English papers published before January 2022. Other relevant papers were selected from the list of references. RESULTS Studies have shown that the complete fertility rate of people living at low altitudes is 7.7, and the complete fertility rate of people living at high altitudes is 4.77, and the hypoxic environment at high altitudes reduces fertility. At the same time, high-altitude, low-oxygen environments are associated with increased infant mortality and post-neonatal mortality. To date, most studies seem to point to a correlation between anoxic exposure at high altitudes and low fertility in humans and animals. CONCLUSION Although the molecular mechanisms are not fully understood, the effects of hypoxia at high altitude on hormonal level, ovarian reserve, embryonic development, testicular development, and sperm motility and levels require further research to investigate this complex topic.
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Affiliation(s)
- Yan Zhong
- School of Pharmacy, Gansu University of Traditional Chinese Medicine, Lanzhou, China.
- Pharmacy of the 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, China.
| | - Feifei Liu
- School of Pharmacy, Gansu University of Traditional Chinese Medicine, Lanzhou, China
- Pharmacy of the 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, China
| | - Xiaojing Zhang
- Pharmacy of the 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, China.
| | - Qianwen Guo
- Pharmacy of the 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, China
| | - Zihan Wang
- Pharmacy of the 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, China
| | - Rong Wang
- Pharmacy of the 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, China.
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Westwood J, Mayhook-Walker I, Simpkins C, Darby-Smith A, Morris D, Normando E. Retinal Vascular Changes in Response to Hypoxia: A High-Altitude Expedition Study. High Alt Med Biol 2024; 25:49-59. [PMID: 38011631 DOI: 10.1089/ham.2023.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
Westwood, Jessica, India Mayhook-Walker, Ciaran Simpkins, Andrew Darby-Smith, Dan Morris, and Eduardo Normando. Retinal vascular changes in response to hypoxia: a high-altitude expedition study. High Alt Med Biol. 25:49-59, 2024. Background: Increased tortuosity and engorgement of retinal vasculature are recognized physiological responses to hypoxia. This can lead to high-altitude retinopathy (HAR), but incidence reports are highly variable, and our understanding of the etiological mechanisms remains incomplete. This study quantitatively evaluated retinal vascular changes during an expedition to 4,167 m. Methods: Ten healthy participants summited Mount Toubkal, Morocco. Fundus images were taken predeparture, daily throughout the expedition, and 1 month postreturn. Diameter and tortuosity of four vessels were assessed, in addition to vessel density and features of HAR. Results: Significant (p ≤ 0.05) increases in tortuosity and diameter were observed in several vessels on high-altitude exposure days. There was a strong correlation between altitude and supratemporal retinal artery diameter on days 2, 3, and 6 of the expedition (r = 0.7707, 0.7951, 0.7401, respectively; p < 0.05). There was a significant increase in median vessel density from 6.7% at baseline to 10.0% on summit day. Notably there were no incidences of HAR. Conclusion: Physiological but not pathological changes were seen in this cohort, which gives insight into the state of the cerebral vasculature throughout this expedition. These results are likely attributable to relatively low altitude exposure, a conservative ascent profile, and the cohort's demographic. Future study must include daily retinal images at higher altitudes and take steps to mitigate environmental confounders. This study is relevant to altitude tourists, patients with diabetic retinopathy or retinal vein occlusion, and critically ill patients.
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Affiliation(s)
- Jessica Westwood
- Imperial College London Ophthalmology Research Group, Western Eye Hospital, London, United Kingdom
| | - India Mayhook-Walker
- Imperial College London Ophthalmology Research Group, Western Eye Hospital, London, United Kingdom
| | - Ciaran Simpkins
- Imperial College London Ophthalmology Research Group, Western Eye Hospital, London, United Kingdom
| | - Andrew Darby-Smith
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Dan Morris
- Cardiff Eye Unit, University Hospital of Wales, Cardiff, United Kingdom
| | - Eduardo Normando
- Imperial College London Ophthalmology Research Group, Western Eye Hospital, London, United Kingdom
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Zhang X, Zhang Y, Si Y, Gao N, Zhang H, Yang H. A high altitude respiration and SpO2 dataset for assessing the human response to hypoxia. Sci Data 2024; 11:248. [PMID: 38413602 PMCID: PMC10899206 DOI: 10.1038/s41597-024-03065-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 02/13/2024] [Indexed: 02/29/2024] Open
Abstract
This report presents the Harespod dataset, an open dataset for high altitude hypoxia research, which includes respiration and SpO2 data. The dataset was collected from 15 college students aged 23-31 in a hypobaric oxygen chamber, during simulated altitude changes and induced hypoxia. Real-time physiological data, such as oxygen saturation waveforms, oxygen saturation, respiratory waveforms, heart rate, and pulse rate, were obtained at 100 Hz. Approximately 12 hours of valid data were collected from all participants. Researchers can easily identify the altitude corresponding to physiological signals based on their inherent patterns. Time markers were also recorded during altitude changes to facilitate realistic annotation of physiological signals and analysis of time-difference-of-arrival between various physiological signals for the same altitude change event. In high altitude scenarios, this dataset can be used to enhance the detection of human hypoxia states, predict respiratory waveforms, and develop related hardware devices. It will serve as a valuable and standardized resource for researchers in the field of high altitude hypoxia research, enabling comprehensive analysis and comparison.
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Affiliation(s)
- Xi Zhang
- School of Life Sciences, Northwestern Polytechnical University, Xi'an, 710072, China
- Engineering Research Center of Chinese Ministry of Education for Biological Diagnosis, Treatment and Protection Technology and Equipment, Northwestern Polytechnical University, Xi'an, 710072, China
| | - Yu Zhang
- School of Computer Science, Northwestern Polytechnical University, Xi'an, 710129, China.
| | - Yingjun Si
- School of Life Sciences, Northwestern Polytechnical University, Xi'an, 710072, China
- Engineering Research Center of Chinese Ministry of Education for Biological Diagnosis, Treatment and Protection Technology and Equipment, Northwestern Polytechnical University, Xi'an, 710072, China
| | - Nan Gao
- Department of Computer Science and Technology, Tsinghua University, Beijing, 100084, China
| | - Honghao Zhang
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, 710072, China
| | - Hui Yang
- School of Life Sciences, Northwestern Polytechnical University, Xi'an, 710072, China.
- Engineering Research Center of Chinese Ministry of Education for Biological Diagnosis, Treatment and Protection Technology and Equipment, Northwestern Polytechnical University, Xi'an, 710072, China.
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Li S, Lyu Q, Shi Q, Bai Y, Ren X, Ma J. Intermittent short-duration reoxygenation relieves high-altitude pulmonary hypertension via NOX4/H2O2/PPAR-γ axis. Clin Sci (Lond) 2024; 138:103-115. [PMID: 38237016 PMCID: PMC10830432 DOI: 10.1042/cs20231508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/03/2024]
Abstract
High-altitude pulmonary hypertension (HAPH) is a severe and progressive disease that can lead to right heart failure. Intermittent short-duration reoxygenation at high altitude is effective in alleviating HAPH; however, the underlying mechanisms are unclear. In the present study, a simulated 5,000-m hypoxia rat model and hypoxic cultured pulmonary artery smooth muscle cells (PASMCs) were used to evaluate the effect and mechanisms of intermittent short-duration reoxygenation. The results showed that intermittent 3-h/per day reoxygenation (I3) effectively attenuated chronic hypoxia-induced pulmonary hypertension and reduced the content of H2O2 and the expression of NADPH oxidase 4 (NOX4) in lung tissues. In combination with I3, while the NOX inhibitor apocynin did not further alleviate HAPH, the mitochondrial antioxidant MitoQ did. Furthermore, in PASMCs, I3 attenuated hypoxia-induced PASMCs proliferation and reversed the activated HIF-1α/NOX4/PPAR-γ axis under hypoxia. Targeting this axis offset the protective effect of I3 on hypoxia-induced PASMCs proliferation. The present study is novel in revealing a new mechanism for preventing HAPH and provides insights into the optimization of intermittent short-duration reoxygenation.
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Affiliation(s)
- Shaohua Li
- Department of Aerospace Physiology, Air Force Medical University, Xi’an 710032, China
| | - Qiang Lyu
- Department of Nephrology, Chinese PLA General Hospital, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing 100853, China
| | - Qixin Shi
- Department of Aerospace Physiology, Air Force Medical University, Xi’an 710032, China
| | - Yungang Bai
- Department of Aerospace Physiology, Air Force Medical University, Xi’an 710032, China
| | - Xinling Ren
- Department of Respiratory and Critical Care Medicine, Shenzhen University General Hospital, Shenzhen 518071, China
| | - Jin Ma
- Department of Aerospace Physiology, Air Force Medical University, Xi’an 710032, China
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Richalet JP, Hermand E, Lhuissier FJ. Cardiovascular physiology and pathophysiology at high altitude. Nat Rev Cardiol 2024; 21:75-88. [PMID: 37783743 DOI: 10.1038/s41569-023-00924-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 10/04/2023]
Abstract
Oxygen is vital for cellular metabolism; therefore, the hypoxic conditions encountered at high altitude affect all physiological functions. Acute hypoxia activates the adrenergic system and induces tachycardia, whereas hypoxic pulmonary vasoconstriction increases pulmonary artery pressure. After a few days of exposure to low oxygen concentrations, the autonomic nervous system adapts and tachycardia decreases, thereby protecting the myocardium against high energy consumption. Permanent exposure to high altitude induces erythropoiesis, which if excessive can be deleterious and lead to chronic mountain sickness, often associated with pulmonary hypertension and heart failure. Genetic factors might account for the variable prevalence of chronic mountain sickness, depending on the population and geographical region. Cardiovascular adaptations to hypoxia provide a remarkable model of the regulation of oxygen availability at the cellular and systemic levels. Rapid exposure to high altitude can have adverse effects in patients with cardiovascular diseases. However, intermittent, moderate hypoxia might be useful in the management of some cardiovascular disorders, such as coronary heart disease and heart failure. The aim of this Review is to help physicians to understand the cardiovascular responses to hypoxia and to outline some recommendations that they can give to patients with cardiovascular disease who wish to travel to high-altitude destinations.
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Affiliation(s)
- Jean-Paul Richalet
- Hypoxie et Poumon, Université Sorbonne Paris Nord, INSERM U1272, Paris, France.
| | - Eric Hermand
- Unité de Recherche Pluridisciplinaire Sport Santé Société, ULR 7369-URePSSS, Université Littoral Côte d'Opale, Université Artois, Université Lille, CHU Lille, Dunkirk, France
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Li H, Liu S, Dai W, Yao B, Zhou Y, Si S, Yu H, Zhao R, Jin F, Jiang L. Pressure-sensitive multivesicular liposomes as a smart drug-delivery system for high-altitude pulmonary edema. J Control Release 2024; 365:301-316. [PMID: 38007195 DOI: 10.1016/j.jconrel.2023.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023]
Abstract
Changes in bodily fluid pressures, such as pulmonary artery pressure, play key roles in high-altitude pulmonary edema (HAPE) and other disorders. Smart delivery systems releasing a drug in response to these pressures might facilitate early medical interventions. However, pressure-responsive delivery systems are unavailable. We here constructed hydrostatic pressure-sensitive multivesicular liposomes (PSMVLs) based on the incomplete filling of the internal vesicle space with neutral lipids. These liposomes were loaded with amlodipine besylate (AB), a next-generation calcium channel inhibitor, to treat HAPE on time. AB-loaded PSMVLs (AB-PSMVLs) were destroyed, and AB was released through treatment under hydrostatic pressure of at least 25 mmHg. At 25 mmHg, which is the minimum pulmonary artery pressure value in HAPE, 38.8% of AB was released within 1 h. In a mouse HAPE model, AB-PSMVLs concentrated in the lung and released AB to diffuse into the vascular wall. Intravenously injected AB-PSMVLs before HAPE modeling resulted in a stronger protection of lung tissues and respiratory function and lower occurrence of pulmonary edema than treatment with free drug or non-pressure-sensitive AB-loaded liposomes. This study offers a new strategy for developing smart drug delivery systems that respond to changes in bodily fluid pressures.
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Affiliation(s)
- Huiyang Li
- School of pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Shuo Liu
- School of pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Wenjin Dai
- School of pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Bingmei Yao
- School of pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Yong Zhou
- School of pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu Province, China; Guanyun People's Hospital, Lianyungang, Jiangsu Province, China
| | - Sujia Si
- School of pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Hairong Yu
- Huaihai Hospital Affiliated to Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Riguang Zhao
- Huaihai Hospital Affiliated to Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Fang Jin
- School of pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Liqun Jiang
- School of pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu Province, China.
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Louis A, Pröpper C, Savina Y, Tanne C, Duperrex G, Robach P, Zellner P, Doutreleau S, Boulet JM, Frey A, Pillard F, Pistea C, Poussel M, Thuet T, Richalet JP, Lecoq-Jammes F. The Impact of COVID-19 on the Response to Hypoxia. High Alt Med Biol 2023; 24:321-328. [PMID: 37843910 DOI: 10.1089/ham.2022.0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
Louis, Alexandre, Charlotte Pröpper, Yann Savina, Corentin Tanne, Guy Duperrex, Paul Robach, Pascal Zellner, Stéphane Doutreleau, Jean-Michel Boulet, Alain Frey, Fabien Pillard, Cristina Pistea, Mathias Poussel, Thomas Thuet, Jean-Paul Richalet, and François Lecoq-Jammes. The impact of COVID-19 on the response to hypoxia. High Alt Med Biol. 24:321-328, 2023. Background: Severe high-altitude illness (SHAI) and coronavirus disease 2019 (COVID-19), while differing in most aspects of pathophysiology, both involve respiratory capacity. We examined the long-term impact of COVID-19 on response to hypoxia in individuals free of symptoms but having tested positive during the pandemic. The need for recommendations for such individuals planning a stay at high altitude are discussed. Methods: This multicenter study recruited participants from the multiSHAI cohort, all of whom had previously undergone a hypoxic exercise test. These participants were classified into two groups depending on whether they had since suffered mild-to-moderate COVID-19 (COVID+) or not (Control) and then asked to retake the test. Primary outcomes were: desaturation induced by hypoxia at exercise (ΔSpE), hypoxic cardiac response at exercise, hypoxic ventilatory response at exercise, and SHAI risk score. Results: A total of 68 participants retook the test, 36 classified in the COVID+ group. Analyses of primary outcomes showed no significant differences between groups. However, the COVID+ group showed significantly increased ventilation (VE) parameters during both hypoxic (p = 0.003) and normoxic exercise (p = 0.007). However, only the VE/oxygen consumption relationship during hypoxic exercise was significantly different. Conclusion: This study demonstrates no negative impact of COVID-19 on response to hypoxia as evaluated by the Richalet test. Clinical Trial Registration: NTC number: NCT05167357.
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Affiliation(s)
- Alexandre Louis
- IFREMMONT (Training and Research Institute of Mountain Medicine), Chamonix-Mont-Blanc, France
| | | | - Yann Savina
- IFREMMONT (Training and Research Institute of Mountain Medicine), Chamonix-Mont-Blanc, France
- UPR-4278 Laboratoire de Physiologie Expérimentale Cardiovasculaire (LaPEC)-Avignon Université, Avignon, France
| | - Corentin Tanne
- IFREMMONT (Training and Research Institute of Mountain Medicine), Chamonix-Mont-Blanc, France
- Pediatric Service, Metropole Savoie Hospital Center, Chambéry, France
| | - Guy Duperrex
- IFREMMONT (Training and Research Institute of Mountain Medicine), Chamonix-Mont-Blanc, France
| | - Paul Robach
- National School for Mountain Sports, Site of the National School for Skiing and Mountaineering (ENSA), Chamonix, France
| | - Pascal Zellner
- IFREMMONT (Training and Research Institute of Mountain Medicine), Chamonix-Mont-Blanc, France
| | | | | | - Alain Frey
- Sports Medicine Department, CHI Poissy/St Germain, Poissy, France
| | - Fabien Pillard
- Sports Medicine Department, University Sports Clinic, Pierre Paul Riquet University Hospital, Toulouse, France
| | - Cristina Pistea
- Mitochondria, Oxidative Stress, and Muscle Protection, University of Strasbourg, Strasbourg, France
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, CHU, Strasbourg, France
| | - Mathias Poussel
- Department of Pulmonary Function Testing and Exercise Physiology, Nancy University Hospital, Nancy, France
| | - Thomas Thuet
- Sports Medicine Department, CHI Poissy/St Germain, Poissy, France
| | - Jean-Paul Richalet
- INSERM U1272, University Sorbonne Paris Nord, Bobigny, France
- Medical Pole, INSEP, Paris, France
| | - François Lecoq-Jammes
- IFREMMONT (Training and Research Institute of Mountain Medicine), Chamonix-Mont-Blanc, France
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12
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Bhandari SS. Letter to the Editor: Sensitivity and Specificity of the Lake Louise Score: What Should We Focus On? High Alt Med Biol 2023; 24:337-338. [PMID: 37578468 DOI: 10.1089/ham.2023.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
Affiliation(s)
- Sanjeeb S Bhandari
- Mountain Medicine Society of Nepal, Kathmandu, Nepal
- Collaboration for Emergency Care, Kathmandu, Nepal
- Emergency Department, UPMC Western Maryland Health, Cumberland, Maryland, USA
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13
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O'Connor AE, Hatzenbiler DM, Flom LT, Bobadilla AC, Bruns DR, Schmitt EE. Physiological and Morphometric Differences in Resident Moderate-Altitude vs. Sea-Level Mice. Aerosp Med Hum Perform 2023; 94:887-893. [PMID: 38176033 PMCID: PMC10826331 DOI: 10.3357/amhp.6234.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
INTRODUCTION: High-altitude [>2400 m (7874 ft)] acclimatization has been well studied with physiological adaptations like reductions in body weight and exercise capacity. However, despite the significance of moderate altitude [MA, 1524-2438 m (5000-8000 ft)], acclimatization at this elevation is not well described. We aimed to investigate differences in mice reared at MA compared to sea level (SL). We hypothesized that MA mice would be smaller and leaner and voluntarily run less than SL mice.METHODS: C57BL/6 mice reared for at least three generations in Laramie, WY [2194 m (7198 ft), MA], were compared to C57BL/6J mice from Bar Harbor, ME [20 m (66 ft), SL]. We quantified body composition and exercise outputs as well as cardiopulmonary morphometrics. Subsets of MA and SL mice were analyzed to determine differences in neuronal activation after exercise.RESULTS: When body weight was normalized to tibia length, SL animals weighed 1.30 g ⋅ mm-1 while MA mice weighed 1.13 g · mm-1. Total fat % and trunk fat % were higher in MA mice with values of 41% and 39%, respectively, compared to SL mice with values of 28% and 26%, respectively. However, no differences were noted in leg fat %. MA animals had higher heart mass (119 mg) and lower lung mass (160 mg) compared to SL mice heart mass (100 mg) and lung mass (177 mg). MA mice engaged in about 40% less voluntary wheel-running activity than SL animals.DISCUSSION: Physiological differences are apparent between MA and SL mice, prompting a need to further understand larger scale implications of residence at moderate altitude.O'Connor AE, Hatzenbiler DM, Flom LT, Bobadilla A-C, Bruns DR, Schmitt EE. Physiological and morphometric differences in resident moderate-altitude vs. sea-level mice. Aerosp Med Hum Perform. 2023; 94(12):887-893.
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Horakova L, Paal P, Pichler Hefti J, Andjelkovic M, Beidleman BA, Derstine M, Hillebrandt D, Jean D, Mateikaitė-Pipirienė K, Rosier AJ, Kriemler S, Keyes LE. Women's Health at High Altitude: An Introduction to a 7-Part Series by the International Climbing and Mountaineering Federation Medical Commission. High Alt Med Biol 2023; 24:243-246. [PMID: 37862559 DOI: 10.1089/ham.2023.0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023] Open
Abstract
Horakova, Lenka, Peter Paal, Jacqueline Pichler Hefti, Marija Andjelkovic, Beth A. Beidleman, Mia Derstine, David Hillebrandt, Dominique Jean, Kastė Mateikaitė-Pipirienė, Alison J. Rosier, Susi Kriemler, and Linda E. Keyes. Women's health at high altitude: An introduction to a 7-part series by the International Climbing and Mountaineering Federation Medical Commission. High Alt Med Biol. 24:243-246, 2023. Background: Women have been traveling to high altitude since the inception of modern mountaineering. Although there are distinct female-specific features such as menstruation and menopause relevant to adaptation to and performance at high altitude, very little data exist on women's high-altitude health. To summarize what is known to date, the Medical Commission of the International Climbing and Mountaineering Federation (UIAA) has created a series of articles on women's health, high altitude illness, and performance at high altitude. Methods: Assembling an international author team, two types of manuscripts were developed: (1) reviews on female-specific topics such as pregnancy; (2) reviews on sex differences in high-altitude related illnesses, nutrition, cold injuries, and mortality. Results: The literature search yielded 7,165 articles, with 482 studies meeting the inclusion criteria for full-text review. The authors of individual chapters reviewed these articles and performed additional hand searches. Conclusions: Some important questions on women sojourning and exercising at high altitude have been studied, but many are still awaiting a qualified and evidence-based response. Our seven reviews, to be published in future issues of this journal, summarize what is known about lowland women sojourning at high altitude, provide recommendations, and highlight knowledge gaps in high altitude women's medicine.
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Affiliation(s)
- Lenka Horakova
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
| | - Peter Paal
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Anaesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelsus Medical University, Salzburg, Austria
| | | | - Marija Andjelkovic
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Pharmacy, Singidunum University, Belgrade, Serbia
| | - Beth A Beidleman
- US Army Research Institute of Environmental Medicine, Military Performance Division, Natick, Massachusetts, USA
| | - Mia Derstine
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
| | - David Hillebrandt
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- General Medical Practitioner, Holsworthy, Devon
| | - Dominique Jean
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Paediatrics, Infectious Diseases and Altitude Medicine, Grenoble, France
| | - Kastė Mateikaitė-Pipirienė
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Diaverum Dialysis Clinic, Elektrėnai, Lithuania
| | - Alison J Rosier
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
| | - Linda E Keyes
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
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Li X, Ma H, Ding X, Jiang H, Zhang X. Impaired Neurological Activity in the Mental Rotation Ability of Tibetan Indigenous Residents After Chronic Exposure to High Altitude. Neuroscience 2023; 532:1-13. [PMID: 37739028 DOI: 10.1016/j.neuroscience.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 09/24/2023]
Abstract
Mental rotation is a core indicator of spatial ability, and a threshold for cognitive impairment may exist at approximately 4,000 m above sea level, but the specific thresholds for the severity of hypoxia in Tibetan indigenous populations in mental rotation ability remain largely unknown. To determine whether a threshold for mental rotation impairment exists in indigenous residents, we related a mental rotation task to inter-individual differences in a range of behavioral performance and neuropsychological characteristics across 51 indigenous Tibetan highlanders and 34 matched controls at three different altitudes (sea level, 2,900 m, and 4,200 m). Analyses of reaction time showed delayed behavioral responses in the 4,200 m altitude group. Further analyses of rotation-related negativity (RRN) revealed that the RRN was significantly more negative and the differences disappeared gradually for different angles among individuals exposed to an altitude of 4,200 m. Moreover, a time-frequency analysis showed significantly enhanced alpha- and beta-band power values for the 4,200 m altitude participants after stimulus presentation. The impairment in mental rotation ability is related to hypoxia and can be attributed to the absence of sufficient cognitive resources, which demonstrates the existence of a threshold for the effects of high altitude on the brain's mental rotation ability. Taken together, our findings have important implications for exploring the altitude threshold for the influence of high-altitude exposure on brain function, as well as for guiding the development of innovative strategies to optimize the response of the organism against chronic hypoxia-induced under extreme environments.
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Affiliation(s)
- Xiaoyan Li
- School of Psychology, Northwest Normal University, Lanzhou 730000, China; Plateau Brain Science Research Center, Tibet University, Lhasa 850000, China
| | - Hailin Ma
- Plateau Brain Science Research Center, Tibet University, Lhasa 850000, China.
| | - Xiaobin Ding
- School of Psychology, Northwest Normal University, Lanzhou 730000, China.
| | - Heng Jiang
- Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuro-information, University of Electronic Science and Technology of China, Chengdu 610000, China
| | - Xuemei Zhang
- Shanghai Pudong Development Bank of Tibet, Lhasa 850000, China.
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Fayazi B, Tadibi V, Ranjbar K. The role of hypoxia related hormones responses in acute mountain sickness susceptibility individuals unaccustomed to high altitude. PLoS One 2023; 18:e0292173. [PMID: 37796960 PMCID: PMC10553285 DOI: 10.1371/journal.pone.0292173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 09/14/2023] [Indexed: 10/07/2023] Open
Abstract
Acute mountain sickness (AMS) is caused by rapid ascent to altitude (>2500 m) and remains a poorly understood pathophysiological condition. Accordingly, we investigated the relationship between acute exposure to high altitude and hypoxia related biochemical proteins. 21 healthy subjects (Female (8) and male (13), Age: 36.7±8.5, BMI: 23.2±3.1) volunteers participated in this project and fasting blood samples were taken before (sea level) and after 1 and 24-h exposure to high altitude (3,550 m). Blood oxygen saturation (SpO2), AMS status (Lake Louise Score) and serum HIF-1, Endothelin-1, VEGF and Orexin-A were measured (via ELISA) at 1, 6 and 24 h after exposure to high altitude. Pre-ascent measurement of hypoxia related proteins (Orexin-A, HIF-1, VEGF and Endothelin-1) where all significantly (<0.05) higher in the AMS-resistant individuals (No-AMS) when compared to AMS susceptible individuals (AMS+). Upon ascent to high altitude, 11 out of 21 volunteers had AMS (10.1±0.6 in AMS+ vs. 0.9±0.6 in No-AMS, P<0.05) and presented with lower resting SpO2 levels (77.7±0.4 vs. 83.5±0.3 respectively, p<0.05). Orexin-A, HIF-1, VEGF and Endothelin-1, significantly increased 24 hrs after exposure to high altitude in both AMS+ and No-AMS. The response of Orexin-A was similar between two groups, also, HIF-1 elevation 24 hrs after exposure to altitude was more in AMS+ (13% vs. 19%), but the increase of VEGF and Endothelin-1, 1 and 24 hrs after exposure to altitude in No-AMS was double that of AMS+. Hypoxia related proteins include Orexin-A, HIF-1, VEGF and Endothelin-1 may play a pathophysiological role in those who are susceptible to AMS.
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Affiliation(s)
- Bayan Fayazi
- Department of Exercise Physiology, Faculty of Sport Sciences, Razi University, Kermanshah, Iran
| | - Vahid Tadibi
- Department of Exercise Physiology, Faculty of Sport Sciences, Razi University, Kermanshah, Iran
| | - Kamal Ranjbar
- Department of Exercise Physiology, Faculty of Sport Sciences, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran
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17
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Xu Y, Li H, Sun N, Yao B, Dai W, Wang J, Si S, Liu S, Jiang L. Dry Powder Formulations for Inhalation Require a Smaller Aerodynamic Diameter for Usage at High Altitude. J Pharm Sci 2023; 112:2655-2666. [PMID: 37595750 DOI: 10.1016/j.xphs.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 08/14/2023] [Accepted: 08/14/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND High Altitude Pulmonary Edema (HAPE) seriously threatens the health of people at high altitudes. There are drug treatments for HAPE, and dry powder formulations (DPFs) represent a rapid and accessible delivery vehicle for these drugs. However, there are presently no reports on the inhalability of DPFs in low-pressure environments. Given the reduced atmospheric pressure typical at high altitudes, conventional DPFs might not be suitable for inhalation. Therefore, it is necessary to elucidate the deposition behaviors of dry powder in the respiratory tract at low pressure, as well as to improve their pulmonary deposition efficiency via adjustments to their formulation and design. METHODS The effect of air pressure, inspiratory velocity, and particle properties (such as size, density, and aerodynamic diameter) on pulmonary deposition of DPFs was calculated by a computational fluid dynamics (CFD)-coupled discrete phase model. DPFs of various aerodynamic diameters were prepared by spray drying, and the inhalability of these DPFs in a low-pressure environment was evaluated in mice. Finally, a mouse model of HAPE was established, and the treatment of HAPE by nifedipine-loaded DPFs with small aerodynamic diameter was validated. RESULTS CFD results showed that low pressure decreased the deposition of DPFs in the lungs. At 0.5 standard atmosphere, DPFs with aerodynamic diameter of ∼2.0 μm could not enter the lower respiratory tract; however, a decrease in the physical diameter, density, and, consequently, the aerodynamic diameter of the DPFs was able to enhance pulmonary deposition of these powders. To validate the CFD results, three kinds of dry powder with aerodynamic diameters of 0.66, 0.98, and 2.00 μm were prepared by spray drying. Powders with smaller aerodynamic diameter could be inhaled into the lungs of mice more effectively, and, consequently could ameliorate the progression of HAPE more effectively than conventional powders. These results were consistent with the CFD results. CONCLUSIONS Low atmospheric pressure can prevent the pulmonary deposition of DPFs at high altitudes. Compared with conventional DPFs, powders with smaller aerodynamic diameter can be effectively inhaled at these pressures and thus might be more suitable for the treatment the HAPE.
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Affiliation(s)
- Ya Xu
- School of Pharmacy, Xuzhou Medical University, Xuzhou 221009, China
| | - Huiyang Li
- School of Pharmacy, Xuzhou Medical University, Xuzhou 221009, China
| | - Nan Sun
- School of Pharmacy, Xuzhou Medical University, Xuzhou 221009, China; The Affiliated Lianyungang Oriental Hospital of Xuzhou Medical University, Lianyungang 222042, China
| | - Bingmei Yao
- School of Pharmacy, Xuzhou Medical University, Xuzhou 221009, China
| | - Wenjin Dai
- School of Pharmacy, Xuzhou Medical University, Xuzhou 221009, China
| | - Jian Wang
- School of Pharmacy, Xuzhou Medical University, Xuzhou 221009, China
| | - Sujia Si
- School of Pharmacy, Xuzhou Medical University, Xuzhou 221009, China
| | - Shuo Liu
- School of Pharmacy, Xuzhou Medical University, Xuzhou 221009, China
| | - Liqun Jiang
- School of Pharmacy, Xuzhou Medical University, Xuzhou 221009, China.
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Wu X, Liu Z, Hao D, Zhao Q, Li W, Xie M, Feng X, Liao X, Chen S, Wang S, Zhou C, Long W, Zhong Y, Li S, Cao Y, Wang H, Wang A, Xu Y, Huang M, Liu J, Zhong R, Wu Y, He Z. Tyrosine phosphorylation of band 3 impairs the storage quality of suspended red blood cells in the Tibetan high-altitude polycythemia population. J Transl Med 2023; 21:676. [PMID: 37770909 PMCID: PMC10540337 DOI: 10.1186/s12967-023-04428-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/05/2023] [Indexed: 09/30/2023] Open
Abstract
Due to environmental hypoxia on the Tibetan Plateau, local residents often exhibit a compensative increase in hemoglobin concentration to maintain the body's oxygen supply. However, increases in hemoglobin and hematocrit (Hct) pose a serious challenge to the quality of stored suspended red blood cells (SRBCs) prepared from the blood of high-hemoglobin populations, especially populations at high altitude with polycythemia in Tibet. To explore the difference in storage quality of SRBCs prepared from plateau residents with a high hemoglobin concentration, blood donors were recruited from Tibet (> 3600 m) and Chengdu (≈ 500 m) and divided into a high-altitude control (HAC) group, high-altitude polycythemia (HAPC) group and lowland control (LLC) group according to their hemoglobin concentration and altitude of residence. The extracellular acidification rate (ECAR), pyruvate kinase (PK) activity and band 3 tyrosine phosphorylation were analyzed on the day of blood collection. Then, whole-blood samples were processed into SRBCs, and storage quality parameters were analyzed aseptically on days 1, 14, 21 and 35 of storage. Overall, we found that tyrosine 21 phosphorylation activated glycolysis by releasing glycolytic enzymes from the cytosolic domain of band 3, thus increasing glucose consumption and lactate accumulation during storage, in the HAPC group. In addition, band 3 tyrosine phosphorylation impaired erythrocyte deformability, accompanied by the highest hemolysis rate in the HAPC group, during storage. We believe that these results will stimulate new ideas to further optimize current additive solutions for the high-hemoglobin population in Tibet and reveal new therapeutic targets for the treatment of HAPC populations.
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Affiliation(s)
- Xiaodong Wu
- Department of Critical Care Medicine, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, 610041, People's Republic of China
| | - Zhijuan Liu
- Department of Blood Transfusion, People's Hospital of Tibet Autonomous Region, Lhasa, 851400, Tibet, People's Republic of China
| | - Doudou Hao
- Department of Biobank, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Ximianqiao Rd #20, Wuhou District, Chengdu, 610041, People's Republic of China
| | - Qin Zhao
- Department of Biobank, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Ximianqiao Rd #20, Wuhou District, Chengdu, 610041, People's Republic of China
| | - Wanjing Li
- Center of Biomedical Engineering, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Huacai Rd #26, Chenghua District, Chengdu, 610052, People's Republic of China
| | - Maodi Xie
- Laboratory of Mitochondria and Metabolism, Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Xia Feng
- Department of Critical Care Medicine, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, 610041, People's Republic of China
| | - Xia Liao
- Department of Critical Care Medicine, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, 610041, People's Republic of China
| | - Siyuan Chen
- Department of Biobank, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Ximianqiao Rd #20, Wuhou District, Chengdu, 610041, People's Republic of China
| | - Siyu Wang
- Department of Biobank, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Ximianqiao Rd #20, Wuhou District, Chengdu, 610041, People's Republic of China
| | - Chaohua Zhou
- Department of Biobank, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Ximianqiao Rd #20, Wuhou District, Chengdu, 610041, People's Republic of China
| | - Wenchun Long
- Department of Endocrinology and Metabolism, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Ximianqiao Rd #20, Wuhou District, Chengdu, 610041, People's Republic of China
| | - Yajun Zhong
- Department of Endocrinology and Metabolism, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Ximianqiao Rd #20, Wuhou District, Chengdu, 610041, People's Republic of China
| | - Shen Li
- Center of Biomedical Engineering, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Huacai Rd #26, Chenghua District, Chengdu, 610052, People's Republic of China
| | - Ye Cao
- Center of Biomedical Engineering, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Huacai Rd #26, Chenghua District, Chengdu, 610052, People's Republic of China
| | - Hong Wang
- Center of Biomedical Engineering, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Huacai Rd #26, Chenghua District, Chengdu, 610052, People's Republic of China
| | - Aiping Wang
- Department of Blood Transfusion, People's Hospital of Tibet Autonomous Region, Lhasa, 851400, Tibet, People's Republic of China
| | - Yuehong Xu
- Department of Blood Transfusion, People's Hospital of Tibet Autonomous Region, Lhasa, 851400, Tibet, People's Republic of China
| | - Min Huang
- Department of Blood Transfusion, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, 610041, People's Republic of China
| | - Jiaxin Liu
- Center of Biomedical Engineering, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Huacai Rd #26, Chenghua District, Chengdu, 610052, People's Republic of China.
| | - Rui Zhong
- Center of Biomedical Engineering, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Huacai Rd #26, Chenghua District, Chengdu, 610052, People's Republic of China.
| | - Yunhong Wu
- Department of Endocrinology and Metabolism, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Ximianqiao Rd #20, Wuhou District, Chengdu, 610041, People's Republic of China.
| | - Zeng He
- Department of Biobank, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Ximianqiao Rd #20, Wuhou District, Chengdu, 610041, People's Republic of China.
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Masè M, Viziano A, Strapazzon G, Alessandrini M, Micarelli A. Auditory function in humans at high altitude. A scoping review. PLoS One 2023; 18:e0291919. [PMID: 37733697 PMCID: PMC10513325 DOI: 10.1371/journal.pone.0291919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/09/2023] [Indexed: 09/23/2023] Open
Abstract
PURPOSE High-altitude (HA) affects sensory organ response, but its effects on the inner ear are not fully understood. The present scoping review aimed to collect the available evidence about HA effects on the inner ear with focus on auditory function. METHODS The scoping review was conducted following the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews. PubMed, Scopus, and Web of Science electronic databases were systematically searched to identify studies conducted in the last 20 years, which quantified in healthy subjects the effects of HA on auditory function. RESULTS The systematic search identified 17 studies on a total population of 888 subjects (88.7% male, age: 27.8 ± 4.1 years; median sample size of 15 subjects). Nine studies were conducted in a simulated environment and eight during real expeditions at HA. To quantify auditory function, six studies performed pure tone audiometry, four studies measured otoacoustic emissions (OAE) and eight studies measured auditory evoked responses (AER). Study protocols presented heterogeneity in the spatio-temporal patterns of HA exposure, with highly varying maximal altitudes and exposure durations. CONCLUSION Most studies reported a reduction of auditory function with HA in terms of either elevation of auditory thresholds, lengthening of AER latencies, reduction of distortion-product and transient-evoked OAEs. Future studies in larger populations, using standardized protocols and multi-technique auditory function evaluation, are needed to further characterize the spatio-temporal pattern of HA effects along the auditory pathways and clarify the pathophysiological implications and reversibility of the observed changes.
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Affiliation(s)
- Michela Masè
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Laboratory of Biophysics and Translational Cardiology, Department of Cellular, Computational and Integrative Biology–CIBIO, University of Trento, Trento, Italy
| | - Andrea Viziano
- Department of Clinical Sciences and Translational Medicine, ENT Unit, University of Rome Tor Vergata, Rome, Italy
| | - Giacomo Strapazzon
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Marco Alessandrini
- Department of Clinical Sciences and Translational Medicine, ENT Unit, University of Rome Tor Vergata, Rome, Italy
| | - Alessandro Micarelli
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Unit of Neuroscience, Rehabilitation and Sensory Organs, UNITER ONLUS, Rome, Italy
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Wang YM, Zhou YK, Han CS, Chen LJ, Zhuang ZM, Yang RL, Li WR. Stem Cells from Human Exfoliated Deciduous Teeth Alleviate High-Altitude Cerebral Oedema by Shifting Microglial M1/M2 Polarisation. Chin J Dent Res 2023; 26:153-162. [PMID: 37732681 DOI: 10.3290/j.cjdr.b4330807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
OBJECTIVE To explore the high-efficiency and low-risk prevention and treatment strategies for stem cells from human exfoliated deciduous teeth (SHED) for high-altitude cerebral oedema. METHODS A low-pressure and low-oxygen tank mimicking high-altitude conditions was used to establish the high-altitude cerebral oedema animal model. The preventive effects of SHED for cerebral oedema were then evaluated by haematoxylin and eosin (H&E) and histological staining. In vitro, SHED was co-cultured with BV-2 to analyse the effects of SHED by western blot and immunofluorescence staining. RESULTS SHED can prevent and treat cerebral oedema in a high altitude rat animal model. Mechanistically, SHED treatment can protect brain cells from apoptosis induced by high altitude condition. Moreover, SHED treatment can inhibit M1-type polarisation and promote M2-type polarisation of microglia cells via the suppression of hypoxia inducible factor (HIF)- 1α-mediated extracellular signal-regulated kinase (ERK) signalling activated in high altitude condition. CONCLUSION SHED treatment can relieve high-altitude cerebral oedema via inhibiting HIF- 1α-mediated ERK signalling, which indicates that SHED is a promising alternative strategy to prevent and treat high-altitude cerebral oedema.
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21
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Burtscher J, Hohenauer E, Burtscher M, Millet GP, Egg M. Environmental and behavioral regulation of HIF-mitochondria crosstalk. Free Radic Biol Med 2023; 206:63-73. [PMID: 37385566 DOI: 10.1016/j.freeradbiomed.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/05/2023] [Accepted: 06/19/2023] [Indexed: 07/01/2023]
Abstract
Reduced oxygen availability (hypoxia) can lead to cell and organ damage. Therefore, aerobic species depend on efficient mechanisms to counteract detrimental consequences of hypoxia. Hypoxia inducible factors (HIFs) and mitochondria are integral components of the cellular response to hypoxia and coordinate both distinct and highly intertwined adaptations. This leads to reduced dependence on oxygen, improved oxygen supply, maintained energy provision by metabolic remodeling and tapping into alternative pathways and increased resilience to hypoxic injuries. On one hand, many pathologies are associated with hypoxia and hypoxia can drive disease progression, for example in many cancer and neurological diseases. But on the other hand, controlled induction of hypoxia responses via HIFs and mitochondria can elicit profound health benefits and increase resilience. To tackle pathological hypoxia conditions or to apply health-promoting hypoxia exposures efficiently, cellular and systemic responses to hypoxia need to be well understood. Here we first summarize the well-established link between HIFs and mitochondria in orchestrating hypoxia-induced adaptations and then outline major environmental and behavioral modulators of their interaction that remain poorly understood.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.
| | - Erich Hohenauer
- Rehabilitation and Exercise Science Laboratory (RES Lab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Switzerland; International University of Applied Sciences THIM, Landquart, Switzerland; Department of Neurosciences and Movement Science, University of Fribourg, Fribourg, Switzerland; Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Margit Egg
- Institute of Zoology, University of Innsbruck, Innsbruck, Austria
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22
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Li L, Lin L, Wen B, Zhao PC, Liu DS, Pang GM, Wang ZR, Tan Y, Lu C. Promising Natural Medicines for the Treatment of High-Altitude Illness. High Alt Med Biol 2023; 24:175-185. [PMID: 37504973 PMCID: PMC10516238 DOI: 10.1089/ham.2022.0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 06/27/2023] [Indexed: 07/29/2023] Open
Abstract
Li Li, Lin Lin, Bo Wen, Peng-cheng Zhao, Da-sheng Liu, Guo-ming Pang, Zi-rong Wang, Yong Tan, and Cheng Lu. Promising natural medicines for the treatment of high-altitude illness. High Alt Med Biol. 24:175-185, 2023.-High-altitude illness (HAI) is a dangerous disease characterized by oxidative stress, inflammatory damage and hemodynamic changes in the body that can lead to severe damage to the lungs, heart, and brain. Natural medicines are widely known for their multiple active ingredients and pharmacological effects, which may be important in the treatment of HAI. In this review, we outline the specific types of HAI and the underlying pathological mechanisms and summarize the currently documented natural medicines applied in the treatment of acute mountain sickness and high-altitude cerebral edema, high-altitude pulmonary edema, chronic mountain sickness, and high-altitude pulmonary hypertension. Their sources, types, and medicinal sites are summarized, and their active ingredients, pharmacological effects, related mechanisms, and potential toxicity are discussed. In conclusion, natural medicines, as an acceptable complementary and alternative strategy with fewer side effects and more long-term application, can provide a reference for developing more natural antialtitude sickness medicines in the future and have good application prospects in HAI treatment.
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Affiliation(s)
- Li Li
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lin Lin
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Bo Wen
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Peng-cheng Zhao
- School of Life Science, Northwestern Polytechnical University, Xi'an, China
| | - Da-sheng Liu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Guo-ming Pang
- Kaifeng Traditional Chinese Medicine Hospital, Kaifeng, China
| | - Zi-rong Wang
- Logistics Support Division, National Immigration Administration, Beijing, China
| | - Yong Tan
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Cheng Lu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
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23
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Patrician A, Willie C, Hoiland RL, Gasho C, Subedi P, Anholm JD, Tymko MM, Ainslie PN. Manipulation of iron status on cerebral blood flow at high altitude in lowlanders and adapted highlanders. J Cereb Blood Flow Metab 2023; 43:1166-1179. [PMID: 36883428 PMCID: PMC10291452 DOI: 10.1177/0271678x231152734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/27/2023] [Accepted: 12/05/2022] [Indexed: 03/09/2023]
Abstract
Cerebral blood flow (CBF) increases during hypoxia to counteract the reduction in arterial oxygen content. The onset of tissue hypoxemia coincides with the stabilization of hypoxia-inducible factor (HIF) and transcription of downstream HIF-mediated processes. It has yet to be determined, whether HIF down- or upregulation can modulate hypoxic vasodilation of the cerebral vasculature. Therefore, we examined whether: 1) CBF would increase with iron depletion (via chelation) and decrease with repletion (via iron infusion) at high-altitude, and 2) explore whether genotypic advantages of highlanders extend to HIF-mediated regulation of CBF. In a double-blinded and block-randomized design, CBF was assessed in 82 healthy participants (38 lowlanders, 20 Sherpas and 24 Andeans), before and after the infusion of either: iron(III)-hydroxide sucrose, desferrioxamine or saline. Across both lowlanders and highlanders, baseline iron levels contributed to the variability in cerebral hypoxic reactivity at high altitude (R2 = 0.174, P < 0.001). At 5,050 m, CBF in lowlanders and Sherpa were unaltered by desferrioxamine or iron. At 4,300 m, iron infusion led to 4 ± 10% reduction in CBF (main effect of time p = 0.043) in lowlanders and Andeans. Iron status may provide a novel, albeit subtle, influence on CBF that is potentially dependent on the severity and length-of-stay at high altitude.
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Affiliation(s)
- Alexander Patrician
- Centre for Heart, Lung, & Vascular Health, School of Health and Exercise Sciences, University of British Columbia – Okanagan, Kelowna, BC, Canada
| | - Christopher Willie
- Centre for Heart, Lung, & Vascular Health, School of Health and Exercise Sciences, University of British Columbia – Okanagan, Kelowna, BC, Canada
| | - Ryan L Hoiland
- Centre for Heart, Lung, & Vascular Health, School of Health and Exercise Sciences, University of British Columbia – Okanagan, Kelowna, BC, Canada
- Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada
- Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Christopher Gasho
- Pulmonary/Critical Care Section, VA Loma Linda Healthcare System and Department of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Prajan Subedi
- Pulmonary/Critical Care Section, VA Loma Linda Healthcare System and Department of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - James D Anholm
- Pulmonary/Critical Care Section, VA Loma Linda Healthcare System and Department of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Michael M Tymko
- Centre for Heart, Lung, & Vascular Health, School of Health and Exercise Sciences, University of British Columbia – Okanagan, Kelowna, BC, Canada
| | - Philip N Ainslie
- Centre for Heart, Lung, & Vascular Health, School of Health and Exercise Sciences, University of British Columbia – Okanagan, Kelowna, BC, Canada
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24
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Qile M, Xu Q, Ye Y, Liu H, Gomchok D, Liu J, Wuren T, Ge RL. Erythrocytes Display Metabolic Changes in High-Altitude Polycythemia. High Alt Med Biol 2023; 24:104-109. [PMID: 37195723 DOI: 10.1089/ham.2022.0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
Qile, Muge, Qiying Xu, Yi Ye, Huifang Liu, Drolma Gomchok, Juanli Liu, Tana Wuren, and Ri-Li Ge. Erythrocytes display metabolic changes in high-altitude polycythemia. High Alt Med Biol. 24:104-109, 2023. Background: Sphingosine-1-phosphate (S1P) levels are increased after acute exposure to high altitude; however, whether this effect is observed in chronic high-altitude hypoxia is unknown. Methods: We studied erythrocyte S1P levels in 13 subjects with high-altitude polycythemia (HAPC) and 13 control subjects and also used a mouse model of HAPC. HAPC subjects lived in Maduo (4,300 m altitude) for 10 years, whereas control subjects lived permanently in Xining (2,260 m). The mouse model of HAPC was established by stimulating an altitude of 5,000 m in a hypobaric chamber for 30 days. Hematology and S1P, CD73, 2,3-bisphosphoglycerate (2,3-BPG), and reticulocyte levels were measured. Results: The hemoglobin concentration and number of red blood cells were significantly elevated in human and mouse HAPC groups. Blood S1P levels in HAPC subjects and mice were higher than those in control groups (p < 0.05 and p < 0.001, respectively). 2,3-BPG and CD73 levels in HAPC subjects were significantly higher than those in control subjects (p < 0.05). No significant changes in reticulocyte levels were observed. Conclusions: The critical altitude-induced metabolic changes such as S1P retained high levels even after prolonged exposure, and it may inspire future research into therapeutic strategies for hypoxia-associated illnesses.
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Affiliation(s)
- Muge Qile
- Research Center for High-Altitude Medicine, Qinghai University Medical School, Xining, Qinghai, China
| | - Qiying Xu
- Research Center for High-Altitude Medicine, Qinghai University Medical School, Xining, Qinghai, China
| | - Yi Ye
- Research Center for High-Altitude Medicine, Qinghai University Medical School, Xining, Qinghai, China
| | - Huifang Liu
- Research Center for High-Altitude Medicine, Qinghai University Medical School, Xining, Qinghai, China
| | - Drolma Gomchok
- Research Center for High-Altitude Medicine, Qinghai University Medical School, Xining, Qinghai, China
| | - Juanli Liu
- Research Center for High-Altitude Medicine, Qinghai University Medical School, Xining, Qinghai, China
| | - Tana Wuren
- Research Center for High-Altitude Medicine, Qinghai University Medical School, Xining, Qinghai, China
| | - Ri-Li Ge
- Research Center for High-Altitude Medicine, Qinghai University Medical School, Xining, Qinghai, China
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25
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Gao C, Yang B, Li Y, Pei W. Monocarboxylate transporter-dependent mechanism is involved in the adaptability of the body to exercise-induced fatigue under high-altitude hypoxia environment. Brain Res Bull 2023; 195:78-85. [PMID: 36804772 DOI: 10.1016/j.brainresbull.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/28/2023] [Accepted: 02/14/2023] [Indexed: 02/17/2023]
Abstract
Under high-altitude hypoxia environment, the body is more prone to fatigue, which occurs in both peripheral muscles and the central nervous system (CNS). The key factor determining the latter is the imbalance of brain energy metabolism, which makes it difficult to maintain the central nervous system to send peripheral nerve impulse continuously. During strenuous exercise, lactate released from astrocytes is taken up by neurons stored for energy to maintain synaptic transmission, a process mediated by monocarboxylate transporters (MCTs) in CNS. The present study investigated the correlation among the adaptability to exercise-induced fatigue, brain lactate metabolism and neuronal hypoxia injury under high-altitude hypoxia environment. Rats were subjected to exhaustive incremental load treadmill exercise under either normal pressure and normoxic conditions or simulated high-altitude low pressure and hypoxic conditions, with subsequent evaluation of the average exhaustive time as well as the expression of monocarboxylate transporters 2 (MCT2), MCT4, the average neuronal density in the cerebral motor cortex, and the lactate content in rat brain. At the early stage of simulated high-altitude environment, the average exhaustive time and neuronal density of rats decreased rapidly, then gradually recovered to some extent with the extension of altitude acclimatization time. The expression of MCT2, MCT4 and the lactate content in rat brain also increased gradually with the extension of altitude acclimatization time. After the application of lactate transport inhibitor, the recovery of exercise capacity of rats after altitude acclimatization was quickly blocked, and the neuronal injury in the cerebral motor cortex of rats was also significantly aggravated. These findings demonstrate that MCT-dependent mechanism is involved in the adaptability of the body to central fatigue, and provide a potential basis for medical intervention for exercise-induced fatigue under high-altitude hypoxia environment.
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Affiliation(s)
- Chen Gao
- Department of General Practice, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou 730050, China.
| | - Binni Yang
- Department of General Practice, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou 730050, China
| | - Yurong Li
- Department of General Practice, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou 730050, China
| | - Wenjuan Pei
- Department of General Practice, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou 730050, China
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26
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Li L, Zhou Y, Zou S, Wang Y. The Effects of High-Altitude Mountaineering on Cognitive Function in Mountaineers: A Meta-Analysis. Int J Environ Res Public Health 2023; 20:5101. [PMID: 36982007 PMCID: PMC10049572 DOI: 10.3390/ijerph20065101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/04/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Nowadays, with the convenience of international traveling and driven by many individuals' fond dreams of challenging high-altitude exercises, high-altitude mountaineering is becoming increasingly popular worldwide. Therefore, we performed a meta-analysis to determine the effects of high-altitude mountaineering on cognitive functions in mountaineers before and after climbing. METHODS After a thorough electronic literature search and selection, eight studies were included in this meta-analysis, and the conducted test cycles ranged from 8 to 140 days. Eight variables were included in this meta-analysis: the Trail-Making Test (TMB), Digit Span-Forward (DSF), Digit Span-Backward (DSB), Finger Tapping Test-Right (FTR) Finger Tapping Test-Left (FTL), Wechsler Memory Scale Visual (WMSV), the Aphasia Screening Test (Verbal Items) (AST-Ver), and the Aphasia Screening Test (Visual Motor Errors) (AST-Vis). The effect sizes (ES) and forest plots of these eight variables were generated. RESULTS Five variables (TMB, ES = 0.39; DSF, ES = 0.57; FTR, ES = 0.50; FTL, ES = 0.16; WMSV, ES = 0.63) out of eight were significantly improved after high-altitude mountaineering, whereas the ES values of DSB, AST-Ver, and AST-Vis did not show significant improvement after climbing. CONCLUSION Despite two limitations, namely, methodological issues inherent in the meta-analysis and the inability to explain high heterogeneity between studies, this study is the first meta-analysis that has attempted to specify and compare the cognitive functions of mountaineers before and after high-altitude mountaineering. Furthermore, as a short-term plateau exercise, high-altitude mountaineering has no significant negative impacts on the cognitive functions of climbers. Future research is needed for a long period of high-altitude mountaineering.
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Affiliation(s)
- Lun Li
- College of Physical Education, China University of Geosciences (Wuhan), Wuhan 430074, China; (L.L.)
| | - Yun Zhou
- College of Physical Education, China University of Geosciences (Wuhan), Wuhan 430074, China; (L.L.)
| | - Shisi Zou
- College of Physical Education, China University of Geosciences (Wuhan), Wuhan 430074, China; (L.L.)
| | - Yongtai Wang
- College of Health Sciences and Technology, Rochester Institute of Technology, Rochester, NY 14623, USA
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27
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Stacey BS, Hoiland RL, Caldwell HG, Howe CA, Vermeulen T, Tymko MM, Vizcardo‐Galindo GA, Bermudez D, Figueroa‐Mujíica RJ, Gasho C, Tuaillon E, Hirtz C, Lehmann S, Marchi N, Tsukamoto H, Villafuerte FC, Ainslie PN, Bailey DM. Lifelong exposure to high-altitude hypoxia in humans is associated with improved redox homeostasis and structural-functional adaptations of the neurovascular unit. J Physiol 2023; 601:1095-1120. [PMID: 36633375 PMCID: PMC10952731 DOI: 10.1113/jp283362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 12/20/2022] [Indexed: 01/13/2023] Open
Abstract
High-altitude (HA) hypoxia may alter the structural-functional integrity of the neurovascular unit (NVU). Herein, we compared male lowlanders (n = 9) at sea level (SL) and after 14 days acclimatization to 4300 m (chronic HA) in Cerro de Pasco (CdP), Péru (HA), against sex-, age- and body mass index-matched healthy highlanders (n = 9) native to CdP (lifelong HA). Venous blood was assayed for serum proteins reflecting NVU integrity, in addition to free radicals and nitric oxide (NO). Regional cerebral blood flow (CBF) was examined in conjunction with cerebral substrate delivery, dynamic cerebral autoregulation (dCA), cerebrovascular reactivity to carbon dioxide (CVRCO2 ) and neurovascular coupling (NVC). Psychomotor tests were employed to examine cognitive function. Compared to lowlanders at SL, highlanders exhibited elevated basal plasma and red blood cell NO bioavailability, improved anterior and posterior dCA, elevated anterior CVRCO2 and preserved cerebral substrate delivery, NVC and cognition. In highlanders, S100B, neurofilament light-chain (NF-L) and T-tau were consistently lower and cognition comparable to lowlanders following chronic-HA. These findings highlight novel integrated adaptations towards regulation of the NVU in highlanders that may represent a neuroprotective phenotype underpinning successful adaptation to the lifelong stress of HA hypoxia. KEY POINTS: High-altitude (HA) hypoxia has the potential to alter the structural-functional integrity of the neurovascular unit (NVU) in humans. For the first time, we examined to what extent chronic and lifelong hypoxia impacts multimodal biomarkers reflecting NVU structure and function in lowlanders and native Andean highlanders. Despite lowlanders presenting with a reduction in systemic oxidative-nitrosative stress and maintained cerebral bioenergetics and cerebrovascular function during chronic hypoxia, there was evidence for increased axonal injury and cognitive impairment. Compared to lowlanders at sea level, highlanders exhibited elevated vascular NO bioavailability, improved dynamic regulatory capacity and cerebrovascular reactivity, comparable cerebral substrate delivery and neurovascular coupling, and maintained cognition. Unlike lowlanders following chronic HA, highlanders presented with lower concentrations of S100B, neurofilament light chain and total tau. These findings highlight novel integrated adaptations towards the regulation of the NVU in highlanders that may represent a neuroprotective phenotype underpinning successful adaptation to the lifelong stress of HA hypoxia.
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Affiliation(s)
- Benjamin S. Stacey
- Neurovascular Research Laboratory, Faculty of Life Sciences and EducationUniversity of South WalesPontypriddUK
| | - Ryan L. Hoiland
- Department of Anaesthesiology, Pharmacology and Therapeutics, Vancouver General HospitalUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Department of Cellular and Physiological Sciences, Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Hannah G. Caldwell
- Centre for Heart, Lung and Vascular HealthUniversity of British Columbia‐Okanagan CampusKelownaBritish ColumbiaCanada
| | - Connor A. Howe
- Centre for Heart, Lung and Vascular HealthUniversity of British Columbia‐Okanagan CampusKelownaBritish ColumbiaCanada
| | - Tyler Vermeulen
- Centre for Heart, Lung and Vascular HealthUniversity of British Columbia‐Okanagan CampusKelownaBritish ColumbiaCanada
| | - Michael M. Tymko
- Centre for Heart, Lung and Vascular HealthUniversity of British Columbia‐Okanagan CampusKelownaBritish ColumbiaCanada
- Faculty of Kinesiology, Sport, and RecreationUniversity of AlbertaEdmontonAlbertaCanada
- Department of Medicine, Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Gustavo A. Vizcardo‐Galindo
- Laboratorio de Fisiología Comparada, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y FilosofíaUniversidad Peruana Cayetano HerediaLima 31Peru
| | - Daniella Bermudez
- Laboratorio de Fisiología Comparada, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y FilosofíaUniversidad Peruana Cayetano HerediaLima 31Peru
| | - Rómulo J. Figueroa‐Mujíica
- Laboratorio de Fisiología Comparada, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y FilosofíaUniversidad Peruana Cayetano HerediaLima 31Peru
| | - Christopher Gasho
- Division of Pulmonary and Critical CareLoma Linda University School of MedicineLoma LindaCAUSA
| | - Edouard Tuaillon
- Department of Infectious DiseasesUniversity of MontpellierMontpellierFrance
| | - Christophe Hirtz
- LBPC‐PPCUniversité de Montpellier, IRMB CHU de Montpellier, INM INSERMMontpellierFrance
| | - Sylvain Lehmann
- LBPC‐PPCUniversité de Montpellier, IRMB CHU de Montpellier, INM INSERMMontpellierFrance
| | - Nicola Marchi
- Laboratory of Cerebrovascular and Glia Research, Department of Neuroscience, Institute of Functional GenomicsUniversity of MontpellierMontpellierFrance
| | - Hayato Tsukamoto
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
| | - Francisco C. Villafuerte
- Laboratorio de Fisiología Comparada, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y FilosofíaUniversidad Peruana Cayetano HerediaLima 31Peru
| | - Philip N. Ainslie
- Neurovascular Research Laboratory, Faculty of Life Sciences and EducationUniversity of South WalesPontypriddUK
- Centre for Heart, Lung and Vascular HealthUniversity of British Columbia‐Okanagan CampusKelownaBritish ColumbiaCanada
| | - Damian M. Bailey
- Neurovascular Research Laboratory, Faculty of Life Sciences and EducationUniversity of South WalesPontypriddUK
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Zhang L, Liu X, Wei Q, Zou L, Zhou L, Yu Y, Wang D. Arginine attenuates chronic mountain sickness in rats via microRNA-144-5p. Mamm Genome 2023; 34:76-89. [PMID: 36763178 DOI: 10.1007/s00335-023-09980-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/30/2023] [Indexed: 02/11/2023]
Abstract
Hypobaric hypoxia is an environmental stress leading to high-altitude pulmonary hypertension. While high-altitude pulmonary hypertension has been linked to high hematocrit findings (chronic mountain sickness; CMS). The present study is designed to investigate the effect of arginine (ARG) on hypobaric hypoxia-induced CMS of rats. Hypobaric hypoxia resulted in lower body weight, decreased appetite, increased pulmonary artery pressure, and deteriorated lung tissue damage in rats. Red blood cells (RBC), hemoglobin, hematocrit, mean corpuscular volume, and mean corpuscular hemoglobin values and blood viscosity were increased in rats, which were alleviated by ARG. microRNA (miRNA) microarray analysis was used to filter differentially expressed miRNAs after ARG in rats. miR-144-5p was reduced under hypobaric hypoxia and upregulated by ARG. miR-144-5p silencing aggravated the erythrocytosis and hyperviscosity in rats, and also accentuated tissue damage and excessive accumulation of RBC. The role of miR-144-5p in rats with CMS was achieved by blocking erythropoietin (EPO)/erythropoietin receptor (EPOR). In conclusion, ARG alleviated CMS symptoms in rodents exposed to hypobaric hypoxia by decreasing EPO/EPOR via miR-144-5p.
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Affiliation(s)
- Leiying Zhang
- Chinese PLA Medical School, Beijing, 100039, People's Republic of China
- Department of Blood Transfusion, The First Medical Center of Chinese, PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, 100039, People's Republic of China
| | - Xiaomin Liu
- Chinese PLA Medical School, Beijing, 100039, People's Republic of China
- Department of Blood Transfusion, The First Medical Center of Chinese, PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, 100039, People's Republic of China
| | - Qingxia Wei
- Beijing Key Laboratory of Chronic Heart Failure Precision Medicine, Chinese PLA General Hospital, Beijing, 100039, People's Republic of China
| | - Liyang Zou
- Chinese PLA Medical School, Beijing, 100039, People's Republic of China
- Department of Blood Transfusion, The First Medical Center of Chinese, PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, 100039, People's Republic of China
| | - Lingling Zhou
- Chinese PLA Medical School, Beijing, 100039, People's Republic of China
- Department of Blood Transfusion, The First Medical Center of Chinese, PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, 100039, People's Republic of China
| | - Yang Yu
- Chinese PLA Medical School, Beijing, 100039, People's Republic of China.
- Department of Blood Transfusion, The First Medical Center of Chinese, PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, 100039, People's Republic of China.
| | - Deqing Wang
- Chinese PLA Medical School, Beijing, 100039, People's Republic of China.
- Department of Blood Transfusion, The First Medical Center of Chinese, PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, 100039, People's Republic of China.
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Liu F, Hu C, Ding J, Fu C, Wang S, Li T. GATA-1 Promotes Erythroid Differentiation Through the Upregulation of miR-451a and miR-210-3p Expressions in CD34 + Cells in High-Altitude Polycythemia. High Alt Med Biol 2023; 24:59-67. [PMID: 36749159 DOI: 10.1089/ham.2022.0095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Liu, Fang, Caiyan Hu, Jin Ding, Chengbing Fu, Shuqiong Wang, and Tiantian Li. GATA-1 promotes erythroid differentiation through the upregulation of miR-451a and miR-210-3p expression in CD34+ cells in high-altitude polycythemia. High Alt Med Biol. 24:59-67, 2023. Background: The clinical manifestations of high-altitude polycythemia (HAPC) include excessive accumulation of erythrocytes, and its pathogenesis is not yet clear. Methods: Peripheral blood was collected from 10 HAPC patients (HAPC group) and normal individuals (control group) each. CD34+ cells were sorted using immunomagnetic beads and differentiated into erythroid cells for 7, 11, and 15 days. Changes in GATA-binding protein 1 (GATA-1), miR-451a, and miR-210-3p expression and their possible regulatory relationships were investigated. Results: Under hypoxia, GATA-1 expression on day 15 was about 2.4 times that on day 7 in the control group and about 1.3 times that on day 7 in the HAPC group, which was significantly lower compared with the control group. miR-451a and miR-210-3p expressions in the HAPC group were 2.6 and 1.8 times that in the control group, respectively, and were significantly increased. When GATA-1 was inhibited, miR-451a and miR-210-3p expressions were significantly decreased by 0.43 and 0.39 times, respectively, compared with those in the control group. Conclusions: Hypoxia stimulated the upregulation of GATA-1 level and accelerated the change of expression, which promoted miR-451a and miR-210-3p expressions and shortened the time taken by cells to enter end-stage differentiation, so as to enhance erythroid differentiation, which may be a pathogenetic mechanism underlying HAPC polycytosis.
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Affiliation(s)
- Fang Liu
- Department of Biochemistry, Qing Hai University Medical College, Xi Ning, China
| | - Caiyan Hu
- Baoding First Central Hospital, Bao Ding, China
| | - Jin Ding
- Xi' an Central Blood Bank, Xi' an, China
| | - Chengbing Fu
- Department of Biochemistry, Qing Hai University Medical College, Xi Ning, China
| | - Shuqiong Wang
- Department of Biochemistry, Qing Hai University Medical College, Xi Ning, China
| | - Tiantian Li
- Department of Biochemistry, Qing Hai University Medical College, Xi Ning, China
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Viscor G, Corominas J, Carceller A. Nutrition and Hydration for High-Altitude Alpinism: A Narrative Review. Int J Environ Res Public Health 2023; 20:3186. [PMID: 36833880 PMCID: PMC9965509 DOI: 10.3390/ijerph20043186] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
This report aims to summarise the scientific knowledge around hydration, nutrition, and metabolism at high altitudes and to transfer it into the practical context of extreme altitude alpinism, which, as far as we know, has never been considered before in the literature. Maintaining energy balance during alpine expeditions is difficult for several reasons and requires a deep understanding of human physiology and the biological basis for altitude acclimation. However, in these harsh conditions it is difficult to reconcile our current scientific knowledge in sports nutrition or even for mountaineering to high-altitude alpinism: extreme hypoxia, cold, and the logistical difficulties intrinsic to these kinds of expeditions are not considered in the current literature. Requirements for the different stages of an expedition vary dramatically with increasing altitude, so recommendations must differentiate whether the alpinist is at base camp, at high-altitude camps, or attempting the summit. This paper highlights nutritional recommendations regarding prioritising carbohydrates as a source of energy and trying to maintain a protein balance with a practical contextualisation in the extreme altitude environment in the different stages of an alpine expedition. More research is needed regarding specific macro and micronutrient requirements as well as the adequacy of nutritional supplementations at high altitudes.
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Affiliation(s)
- Ginés Viscor
- Secció de Fisiologia, Departament de Biologia Cel·Lular, Fisiologia i Immunologia, Facultat de Biologia, Universitat de Barcelona, 08028 Barcelona, Spain
| | - Jordi Corominas
- International Federation of Mountain Guide Associations (UIAGM/IFMGA), CH-1920 Bern, Switzerland
| | - Anna Carceller
- Secció de Fisiologia, Departament de Biologia Cel·Lular, Fisiologia i Immunologia, Facultat de Biologia, Universitat de Barcelona, 08028 Barcelona, Spain
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Wang YH, Chien WC, Chung CH, Her YN, Yao CY, Lee BL, Li FL, Wan FJ, Tzeng NS. Acute Mountain Sickness and the Risk of Subsequent Psychiatric Disorders-A Nationwide Cohort Study in Taiwan. Int J Environ Res Public Health 2023; 20:2868. [PMID: 36833565 PMCID: PMC9957283 DOI: 10.3390/ijerph20042868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
We aim to explore if there is a relationship between acute mountain sickness (AMS) and the risk of psychiatric disorders in Taiwan by using the National Health Insurance Research Database for to the rare studies on this topic. We enrolled 127 patients with AMS, and 1270 controls matched for sex, age, monthly insured premiums, comorbidities, seasons for medical help, residences, urbanization level, levels of care, and index dates were chosen from 1 January 2000 to 31 December 2015. There were 49 patients with AMS and 140 controls developed psychiatric disorders within the 16-year follow-up. The Fine-Gray model analyzed that the patients with AMS were prone to have a greater risk for the development of psychiatric disorders with an adjusted sub-distribution hazard ratio (sHRs) of 10.384 (95% confidence interval [CI]: 7.267-14.838, p < 0.001) for psychiatric disorders. The AMS group was associated with anxiety disorders, depressive disorders, bipolar disorder, sleep disorders, posttraumatic stress disorder/acute stress disorder, psychotic disorder, and substance-related disorder (SRD). The relationship between anxiety, depression, sleep disorders, SRD, and AMS still persisted even after we excluded the psychiatric disorders within the first five years after AMS. There was an association between AMS and the rising risk of psychiatric disorders in the 16 years of long-term follow-up research.
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Affiliation(s)
- Ya-Hsuan Wang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei City 11490, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei City 11490, Taiwan
- School of Public Health, National Defense Medical Center, Taipei City 11490, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei City 11490, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei City 11490, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei City 11490, Taiwan
- School of Public Health, National Defense Medical Center, Taipei City 11490, Taiwan
| | - Yu-Ning Her
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei City 11490, Taiwan
| | - Chia-Yi Yao
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei City 11490, Taiwan
| | - Biing-Luen Lee
- Department of Plastic Surgery, Yonghe Cardinal Tien Hospital, New Taipei City 23148, Taiwan
| | - Fang-Ling Li
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei City 11490, Taiwan
- Department of Medical Research, Tri-Service General Hospital, Beitou Branch, National Defense Medical Center, Taipei City 11243, Taiwan
| | - Fang-Jung Wan
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei City 11490, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei City 11490, Taiwan
- Student Counseling Center, National Defense Medical Center, Taipei City 11490, Taiwan
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Reiser AE, Furian M, Lichtblau M, Buergin A, Schneider SR, Appenzeller P, Mayer L, Muralt L, Mademilov M, Abdyraeva A, Aidaralieva S, Muratbekova A, Akylbekov A, Sheraliev U, Shabykeeva S, Sooronbaev TM, Ulrich S, Bloch KE. Effect of acetazolamide on visuomotor performance at high altitude in healthy people 40 years of age or older-RCT. PLoS One 2023; 18:e0280585. [PMID: 36662903 PMCID: PMC9858039 DOI: 10.1371/journal.pone.0280585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/04/2023] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Altitude travel is increasingly popular also for middle-aged and older tourists and professionals. Due to the sensitivity of the central nervous system to hypoxia, altitude exposure may impair visuomotor performance although this has not been extensively studied. Therefore, we investigated whether a sojourn at moderately high altitude is associated with visuomotor performance impairments in healthy adults, 40y of age or older, and whether this adverse altitude-effect can be prevented by acetazolamide, a drug used to prevent acute mountain sickness. METHODS In this randomized placebo-controlled parallel-design trial, 59 healthy lowlanders, aged 40-75y, were assigned to acetazolamide (375 mg/day, n = 34) or placebo (n = 25), administered one day before ascent and while staying at high altitude (3100m). Visuomotor performance was assessed at 760m and 3100m after arrival and in the next morning (post-sleep) by a computer-assisted test (Motor-Task-Manager). It quantified deviation of a participant-controlled cursor affected by rotation during target tracking. Primary outcome was the directional error during post-sleep recall of adaptation to rotation estimated by multilevel linear regression modeling. Additionally, adaptation, immediate recall, and correct test execution were evaluated. RESULTS Compared to 760m, assessments at 3100m with placebo revealed a mean (95%CI) increase in directional error during adaptation and immediate recall by 1.9° (0.2 to 3.5, p = 0.024) and 1.1° (0.4 to 1.8, p = 0.002), respectively. Post-sleep recall remained unchanged (p = NS), however post-sleep correct test execution was 14% less likely (9 to 19, p<0.001). Acetazolamide improved directional error during post-sleep recall by 5.6° (2.6 to 8.6, p<0.001) and post-sleep probability of correct test execution by 36% (30 to 42, p<0.001) compared to placebo. CONCLUSION In healthy individuals, 40y of age or older, altitude exposure impaired adaptation to and immediate recall and correct execution of a visuomotor task. Preventive acetazolamide treatment improved visuomotor performance after one night at altitude and increased the probability of correct test execution compared to placebo. CLINICALTRIALS.GOV IDENTIFIER ClinicalTrials.gov NCT03536520.
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Affiliation(s)
- Aurelia E. Reiser
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
| | - Michael Furian
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
| | - Mona Lichtblau
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
| | - Aline Buergin
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
| | - Simon R. Schneider
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
| | - Paula Appenzeller
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
| | - Laura Mayer
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
| | - Lara Muralt
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
| | - Maamed Mademilov
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
- Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyz Republic
| | - Ainura Abdyraeva
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
- Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyz Republic
| | - Shoira Aidaralieva
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
- Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyz Republic
| | - Aibermet Muratbekova
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
- Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyz Republic
| | - Azamat Akylbekov
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
- Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyz Republic
| | - Ulan Sheraliev
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
- Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyz Republic
| | - Saltanat Shabykeeva
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
- Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyz Republic
| | - Talant M. Sooronbaev
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
- Department of Respiratory Medicine, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyz Republic
| | - Silvia Ulrich
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
| | - Konrad E. Bloch
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic
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Kutz CJ, Kirby IJ, Grover IR, Tanaka HL. Aviation Decompression Sickness in Aerospace and Hyperbaric Medicine. Aerosp Med Hum Perform 2023; 94:11-17. [PMID: 36757235 DOI: 10.3357/amhp.6113.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION: The U.S. Navy experienced a series of physiological events in aircrew involving primarily the F/A-18 airframe related to rapid decompression of cabin pressures, of which aviation decompression sickness (DCS) was felt to contribute. The underlying pathophysiology of aviation DCS is the same as that of diving-related. However, based on the innate multifactorial circumstances surrounding hypobaric DCS, in clinical practice it continues to be unpredictable and less familiar as it falls at the intersect of aerospace and hyperbaric medicine. This retrospective study aimed to review the case series diagnosed as aviation DCS in a collaborative effort between aerospace specialists and hyperbaricists to increase appropriate identification and treatment of hypobaric DCS.METHODS: We identified 18 cases involving high-performance aircraft emergently treated as aviation DCS at a civilian hyperbaric chamber. Four reviewers with dual training in aviation and hyperbaric medicine retrospectively reviewed cases and categorized presentations as "DCS" or "Alternative Diagnosis".RESULTS: Reviewers identified over half of presenting cases could be attributed to an alternative diagnosis. In events that occurred at flight altitudes below 17,000 ft (5182 m) or with rapid decompression pressure changes under 0.3 atm, DCS was less likely to be the etiology of the presenting symptoms.CONCLUSIONS: Aviation physiological events continue to be difficult to diagnose. This study aimed to better understand this phenomenon and provide additional insight and key characteristics for both flight physicians and hyperbaric physicians. As human exploration continues to challenge the limits of sustainable physiology, the incidence of aerospace DCS may increase and underscores our need to recognize and appropriately treat it.Kutz CJ, Kirby IJ, Grover IR, Tanaka HL. Aviation decompression sickness in aerospace and hyperbaric medicine. Aerosp Med Hum Perform. 2023; 94(1):11-17.
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Zila-Velasque JP, Grados-Espinoza P, Morán-Mariños C, Morales Pocco KO, Capcha-Jimenez US, Ortiz-Benique ZN. Adaptation and altitude sickness: A 40-year bibliometric analysis and collaborative networks. Front Public Health 2023; 11:1069212. [PMID: 36935697 PMCID: PMC10018125 DOI: 10.3389/fpubh.2023.1069212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/06/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction We analyze the scientific production and collaboration networks of studies based on adaptation and altitude diseases in the period 1980-2020. Methods The publications were extracted from journals indexed in Scopus. The bibliometric analysis was used to analyze the scientific production, including the number of annual publications, the documents, and the characteristics of the publications. With the VOSviewer software, the analysis of collaborative networks, productivity of the countries, as well as the analysis of the co-occurrence of keywords were visualized. Results 15,240 documents were registered, of which 3,985 documents were analyzed. A significant trend was observed in the number of publications (R 2: 0.9847; P: < 0.001), with annual growth of 4.6%. The largest number of publications were original articles (77.8%), these published more frequently in the journal "Altitude Medicine and Biology". The largest number of countries were from Europe and Asia; however, the largest collaboration network was with the United States. Of the countries with high altitudes, China and Peru ranked first in scientific productivity. The research priorities were on the adaptation mechanism (37.1%), mainly anoxia and respiratory function. Acute mountain sickness (18.4%) and pulmonary edema (14.7%) were the most reported diseases. Of the top 10 institutions, "University of Colorado" and "Universidad Peruana Cayetano Heredia" contributed more than 100 publications. Conclusions Scientific production on adaptation and altitude illnesses continues to grow. The United States and United Kingdom present collaborative networks with high-altitude countries. The research is aimed at studying the mechanisms of adaptation to altitude and acute mountain sickness.
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Affiliation(s)
- J. Pierre Zila-Velasque
- Red Latinoamericana de Medicina en la Altitud e Investigación, Pasco, Peru
- Facultad de Medicina Humana, Universidad Nacional Daniel Alcides Carrión, Pasco, Peru
- Unidad de Investigación en Bibliometría, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
| | - Pamela Grados-Espinoza
- Red Latinoamericana de Medicina en la Altitud e Investigación, Pasco, Peru
- Facultad de Medicina Humana, Universidad Nacional Daniel Alcides Carrión, Pasco, Peru
| | - Cristian Morán-Mariños
- Unidad de Investigación en Bibliometría, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
- Servicio de Neumología, Hospital Nacional Dos de Mayo, Lima, Peru
- Red de Eficacia Clinica y Sanitaria (REDECS), Lima, Peru
- *Correspondence: Cristian Morán-Mariños
| | - Kevin O. Morales Pocco
- Red Latinoamericana de Medicina en la Altitud e Investigación, Pasco, Peru
- Universidad Nacional del Altiplano Puno, Puno, Peru
- Asociación Científica de Estudiantes de Medicina – UNAP, Puno, Peru
| | - Uriel S. Capcha-Jimenez
- Red Latinoamericana de Medicina en la Altitud e Investigación, Pasco, Peru
- Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
- Sociedad Científica de San Fernando, Lima, Peru
| | - Zhamanda N. Ortiz-Benique
- Red Latinoamericana de Medicina en la Altitud e Investigación, Pasco, Peru
- Facultad de Medicina, Universidad Nacional de San Agustín, Arequipa, Peru
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Cates VC, Bruce CD, Marullo AL, Isakovich R, Saran G, Leacy JK, O′Halloran KD, Brutsaert TD, Sherpa MT, Day TA. Steady-state chemoreflex drive captures ventilatory acclimatization during incremental ascent to high altitude: Effect of acetazolamide. Physiol Rep 2022; 10:e15521. [PMID: 36461658 PMCID: PMC9718940 DOI: 10.14814/phy2.15521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 11/03/2022] [Indexed: 06/17/2023] Open
Abstract
Ventilatory acclimatization (VA) is important to maintain adequate oxygenation with ascent to high altitude (HA). Transient hypoxic ventilatory response tests lack feasibility and fail to capture the integrated steady-state responses to chronic hypoxic exposure in HA fieldwork. We recently characterized a novel index of steady-state respiratory chemoreflex drive (SSCD), accounting for integrated contributions from central and peripheral respiratory chemoreceptors during steady-state breathing at prevailing chemostimuli. Acetazolamide is often utilized during ascent for prevention or treatment of altitude-related illnesses, eliciting metabolic acidosis and stimulating respiratory chemoreceptors. To determine if SSCD reflects VA during ascent to HA, we characterized SSCD in 25 lowlanders during incremental ascent to 4240 m over 7 days. We subsequently compared two separate subgroups: no acetazolamide (NAz; n = 14) and those taking an oral prophylactic dose of acetazolamide (Az; 125 mg BID; n = 11). At 1130/1400 m (day zero) and 4240 m (day seven), steady-state measurements of resting ventilation (V̇I ; L/min), pressure of end-tidal (PET )CO2 (Torr), and peripheral oxygen saturation (SpO2 ; %) were measured. A stimulus index (SI; PET CO2 /SpO2 ) was calculated, and SSCD was calculated by indexing V̇I against SI. We found that (a) both V̇I and SSCD increased with ascent to 4240 m (day seven; V̇I : +39%, p < 0.0001, Hedges' g = 1.52; SSCD: +56.%, p < 0.0001, Hedges' g = 1.65), (b) and these responses were larger in the Az versus NAz subgroup (V̇I : p = 0.02, Hedges' g = 1.04; SSCD: p = 0.02, Hedges' g = 1.05). The SSCD metric may have utility in assessing VA during prolonged stays at altitude, providing a feasible alternative to transient chemoreflex tests.
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Affiliation(s)
- Valerie C. Cates
- Department of Biology, Faculty of Science and TechnologyMount Royal UniversityCalgaryAlbertaCanada
| | - Christina D. Bruce
- Department of Biology, Faculty of Science and TechnologyMount Royal UniversityCalgaryAlbertaCanada
| | - Anthony L. Marullo
- Department of Biology, Faculty of Science and TechnologyMount Royal UniversityCalgaryAlbertaCanada
- Department of Physiology. School of MedicineUniversity Cork CollegeCorkIreland
| | - Rodion Isakovich
- Department of Biology, Faculty of Science and TechnologyMount Royal UniversityCalgaryAlbertaCanada
| | - Gurkarn Saran
- Department of Biology, Faculty of Science and TechnologyMount Royal UniversityCalgaryAlbertaCanada
| | - Jack K. Leacy
- Department of Biology, Faculty of Science and TechnologyMount Royal UniversityCalgaryAlbertaCanada
- Department of Physiology. School of MedicineUniversity Cork CollegeCorkIreland
| | - Ken D. O′Halloran
- Department of Physiology. School of MedicineUniversity Cork CollegeCorkIreland
| | | | | | - Trevor A. Day
- Department of Biology, Faculty of Science and TechnologyMount Royal UniversityCalgaryAlbertaCanada
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Fallahi S, Houck JA, Euser AG, Julian CG, Moore LG, Lorca RA. High altitude differentially modulates potassium channel-evoked vasodilatation in pregnant human myometrial arteries. J Physiol 2022; 600:5353-5364. [PMID: 36286320 PMCID: PMC9772154 DOI: 10.1113/jp283741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/12/2022] [Indexed: 01/05/2023] Open
Abstract
High-altitude (>2500 m or 8200 ft) residence reduces uterine artery blood flow during pregnancy, contributing to an increased incidence of preeclampsia and intrauterine growth restriction. However, not all pregnancies are affected by the chronic hypoxic conditions of high-altitude residence. K+ channels play important roles in the uterine vascular adaptation to pregnancy, promoting a reduction in myogenic tone and an increase in blood flow. We hypothesized that, in pregnancies with normal fetal growth at high altitude, K+ channel-dependent vasodilatation of myometrial arteries is increased compared to those from healthy pregnant women at a lower altitude (∼1700 m). Using pharmacological modulation of two K+ channels, ATP-sensitive (KATP ) and large-conductance Ca2+ -activated (BKCa ) K+ channels, we assessed the vasodilatation of myometrial arteries from appropriate for gestational age (AGA) pregnancies in women living at high or low altitudes. In addition, we evaluated the localization of these channels in the myometrial arteries using immunofluorescence. Our results showed an endothelium-dependent increase in KATP -dependent vasodilatation in myometrial arteries from high versus low altitude, whereas vasodilatation induced by BKCa activation was reduced in these vessels. Additionally, KATP channel co-localization with endothelial markers was reduced in the high-altitude myometrial arteries, which suggested that the functional increase in KATP activity may be by mechanisms other than regulation of channel localization. These observations highlight an important contribution of K+ channels to the human uterine vascular adaptation to pregnancy at high altitude serving to maintain normal fetal growth under conditions of chronic hypoxia. KEY POINTS: High-altitude (>2500 m or 8200 ft) residence reduces uterine blood flow during pregnancy and fetal growth. Animal models of high altitude/chronic hypoxia suggest that these reductions are partially due to reduced vascular K+. channel responses, such as those elicited by large conductance Ca2+ -activated (BKCa ) and ATP-sensitive (KATP ) K+ channel activation. We found that women residing at high versus low altitude during pregnancy showed diminished myometrial artery vasodilatory responses to endothelium-independent BKCa channel activation but greater responses to endothelium-dependent KATP channel activation. Our observations indicate that KATP channels play an adaptive role in maintaining myometrial artery vasodilator sensitivity under chronic hypoxic conditions during pregnancy. Thus, KATP channels represent potential therapeutic targets for augmenting uteroplacental blood flow and, in turn, preserving fetal growth in cases of uteroplacental hypoperfusion.
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Affiliation(s)
- Sahand Fallahi
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado Denver-Anschutz Medical Campus, Aurora, CO 80045
| | - Julie A. Houck
- Department of Biomedical Informatics, University of Colorado Denver-Anschutz Medical Campus, Aurora, CO 80045
| | - Anna G. Euser
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado Denver-Anschutz Medical Campus, Aurora, CO 80045
| | - Colleen G. Julian
- Department of Biomedical Informatics, University of Colorado Denver-Anschutz Medical Campus, Aurora, CO 80045
| | - Lorna G. Moore
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado Denver-Anschutz Medical Campus, Aurora, CO 80045
| | - Ramón A. Lorca
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado Denver-Anschutz Medical Campus, Aurora, CO 80045
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Guo Y, Yong S, Xu Y, Hu Y, Li J, Long Q, Wang X, Gu C, Miao Z. Integrative Analysis of Proteomics and Metabolism Reveals the Potential Roles of Arachidonic Acid Metabolism in Hypoxia Response in Mouse Spleen. Molecules 2022; 27:molecules27228102. [PMID: 36432203 PMCID: PMC9696392 DOI: 10.3390/molecules27228102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 11/23/2022]
Abstract
High altitude hypoxia stress is the key cause of high-altitude pulmonary edema and spleen contraction. The molecular mechanism of immune response of various tissue systems to hypoxia stress remains lacking. In this study, we applied proteomics combined with metabolomics to explore the key molecular profilings involved in high altitude hypoxia response in the spleen of mice. The results showed that 166 proteins were significantly up-regulated, and only 39 proteins were down-regulated. Bioinformatics analysis showed that mineral absorption, neuroactive ligand-receptor interaction, arachidonic acid metabolism, IL-17 signaling pathway and NOD-like preceptor signaling pathway were significantly enriched in the list of 166 upregulated differentially expressed proteins (DEPs). Among these metabolic pathways, the former three pathways were co-identified in KEGG terms from LC-MS/MS based metabolic analysis. We further found that both arachidonate 15-lipoxygenase and hematopoietic prostaglandin D synthase were upregulated by around 30% and 80% for their protein levels and mRNA levels, respectively. Most downstream metabolites were upregulated accordingly, such as prostaglandin A2 and D2. This study provides important evidence that arachidonic acid metabolism potentially promotes spleen hypoxia response through a combined analysis of proteomics and metabolism, which could bring new insights for the spleen targeted rational design upon arachidonic acid metabolism of new therapies.
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Gasser B. Deathly Accidents While High-Altitude Mountaineering in the Swiss Alps-An Observational Analysis from 2009 to 2021. Int J Environ Res Public Health 2022; 19:12498. [PMID: 36231795 PMCID: PMC9566316 DOI: 10.3390/ijerph191912498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/22/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND High-altitude mountaineering has become more and more popular. While many enjoy the beauty of the highest parts of Switzerland, there are considerable risks, which can even result in death. This study analyzed fatal events while high-altitude mountaineering in the Swiss Alps. MATERIALS AND METHODS In this study, cases of emergencies while high-altitude mountaineering in the Swiss Alps were analyzed in the period from 2009 to 2021 from the Swiss Alpine Club (SAC) emergency registry. Fatal emergencies were identified and analyzed in detail. RESULTS In total, 5020 emergency cases were analyzed, and among them 303 deathly events where detected. Of the fatal emergencies, 261 cases (86.1%) were male and 42 (13.9%) were female. The average age was 53.2 ± 19.1 years. More than half of the emergencies were on a route to a classic four-thousander. Fatal events were most common on the Matterhorn, with 40 cases (13.2%); on the Mönch, with 18 cases (5.9%); and on the Piz Bernina, with 10 cases (3.3%). In 245 of the fatal emergencies (80.9%), a fall was the cause. The second most prominent cause was rockfalls, with 16 cases (5.3%), followed by stranding, with 10 cases (3.3%), and avalanches, with 9 cases (3%). Illnesses and crevasse accidents counted together for less than 5% of the fatal cases. Almost two-thirds of fatal falls occurred while descending. Concerning nationality, 30% were from Switzerland and more than three-fourths of victims were from the countries of the Alps. DISCUSSION We found that falls were the most common cause of fatal emergencies in the Swiss Alps. Concerning the fact that most of these emergencies occurred during descents, fatigue and inadequate focus (forgetting the risks of the descent after successfully reaching the peak) are potential reasons for the fatal events. This potentially resulted from a lack of acclimatization, insufficient physical fitness, and inadequate tour planning. Since most victims were from the countries of the Alps, training tours may be possible as a recommended preparation for more difficult four-thousander peaks.
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Affiliation(s)
- Benedikt Gasser
- Departement für Sport, Bewegung und Gesundheit-Abteilung Rehabilitative und Regenerative Sportmedizin-Universität Basel-Grosse Allee 6, CH-4052 Basel, Switzerland
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Qin N, Xie H, Zhao A, Zhang X, Sun Y, Li W, Wang R. Effects of salidroside on exercise tolerance of mice under high altitude hypoxia environment. Zhejiang Da Xue Xue Bao Yi Xue Ban 2022; 51:397-404. [PMID: 37202096 PMCID: PMC10264981 DOI: 10.3724/zdxbyxb-2022-0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/05/2022] [Indexed: 05/20/2023]
Abstract
OBJECTIVE To investigate the effect of salidroside on the exercise tolerance of mice under high altitude hypoxia environment. METHODS C57BL/6J healthy male mice were randomly divided into normoxia control group, model control group, Rhodiola rosea capsule group and salidroside low-dose (5 mg/kg), medium-dose (10 mg/kg) and high-dose (20 mg/kg) groups, with 15 mice in each group. After 3 days, all groups (except the normoxia control group) entered a plateau with an altitude of 4010 m. After 1 day of hypoxia exposure, the exhausted swimming test was performed to determine the exhaustive time of mice; the pathological changes of liver and muscle tissue were observed with hematoxylin and eosin staining. The levels of malondialdehyde (MDA), hydrogen peroxide (H 2O 2), glutathione (GSH), total superoxide dismutase (T-SOD), glycogen, lactate and ATPase were measured and compared among groups. RESULTS Compared with the normoxia control group, the exhaustive swimming time of the model control group was shortened ( P<0.05), the liver tissue and muscle tissue were pathologically damaged, the level of oxidative stress was significantly increased, the levels of sodium potassium ATPase and calcium magnesium ATPase were significantly increased. Compared with the model control group, the exhaustive swimming time of the mice in the Rhodiola rosea capsule group and salidroside groups was significantly prolonged ( P<0.05). The oxidative stress injury was alleviated, the contents of MDA, H 2O 2 and lactic acid in liver and muscle tissues decreased, the contents of GSH, liver glycogen and muscle glycogen increased, and the activities of T-SOD and ATPase increased (all P<0.05). CONCLUSION Salidroside has significant anti-fatigue activity, and its anti-fatigue effect is related to the reduction of oxidative stress damage, the reduction of the accumulation of undesirable metabolites and the increase in the reserve of energy substances.
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Affiliation(s)
- Ningning Qin
- 1. Department of Pharmacy, the 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Key Laboratory of the Plateau Medicine, Lanzhou 730050, China
- 2. School of Pharmacy, Lanzhou University, Lanzhou 730000, China
| | - Hua Xie
- 1. Department of Pharmacy, the 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Key Laboratory of the Plateau Medicine, Lanzhou 730050, China
| | - Anpeng Zhao
- 1. Department of Pharmacy, the 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Key Laboratory of the Plateau Medicine, Lanzhou 730050, China
- 2. School of Pharmacy, Lanzhou University, Lanzhou 730000, China
| | - Xiaojing Zhang
- 1. Department of Pharmacy, the 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Key Laboratory of the Plateau Medicine, Lanzhou 730050, China
| | - Yuemei Sun
- 1. Department of Pharmacy, the 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Key Laboratory of the Plateau Medicine, Lanzhou 730050, China
| | - Wenbin Li
- 1. Department of Pharmacy, the 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Key Laboratory of the Plateau Medicine, Lanzhou 730050, China
| | - Rong Wang
- 1. Department of Pharmacy, the 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Key Laboratory of the Plateau Medicine, Lanzhou 730050, China
- 2. School of Pharmacy, Lanzhou University, Lanzhou 730000, China
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Huang L, Zhang X, Luo L, Mu H, Li W, Wang R. Effects of high-altitude environment on pharmacokinetic parameters of gliquidone in rats. Zhejiang Da Xue Xue Bao Yi Xue Ban 2022; 51:389-396. [PMID: 37202102 PMCID: PMC10264973 DOI: 10.3724/zdxbyxb-2022-0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/30/2022] [Indexed: 05/20/2023]
Abstract
OBJECTIVE To investigate the effect of high-altitude hypoxia on the pharmacokinetics parameters of gliquidone. METHODS Twelve healthy male Wistar rats were randomly divided into plain group and high-altitude group with 6 rats in each group. Blood samples were collected after intragastric administration of gliquidone (6.3 mg/kg). Ultra-fast liquid chromatography-tandem mass spectrometry (UFLC-MS/MS) was used to determine the concentration of gliquidone in rat plasma samples. And the expression of CYP2C9 in rat liver tissues was determined by Western blotting. RESULTS Compared with the plain group, the peak concentration of gliquidone in the high-altitude rats was significantly increased, the absorption rate constant was decreased, the elimination rate constant and the absorption half-life were increased, the elimination half-life was shortened, the mean residence time and apparent volume of distribution were decreased (all P<0.05). Western blotting showed that the expression of CYP2C9 was significantly up-regulated in the liver tissues of high altitude group rats, compared with the plain group (4.18 ±0.06 vs. 2.13±0.06, t=11.57, P<0.01). CONCLUSION Under the high-altitude hypoxia environment, the absorption of gliquidone in rats was reduced and the metabolism was accelerated in rats, which may be related to the up-regulation of CYP2C9 expression in liver tissues.
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Camacho-Cardenosa A, Camacho-Cardenosa M, Tomas-Carus P, Timón R, Olcina G, Burtscher M. Acute physiological response to a normobaric hypoxic exposure: sex differences. Int J Biometeorol 2022; 66:1495-1504. [PMID: 35585281 DOI: 10.1007/s00484-022-02298-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
Although preliminary studies suggested sex-related differences in physiological responses to altitude/hypoxia, controlled studies from standardised exposures to normobaric hypoxia are largely lacking. Hence, the goals of this study were to provide information on cardiorespiratory responses to a 7-h normobaric hypoxia exposure and to explore potential differences between men and women. In this crossover study, a total of 15 men and 14 women were subjected to a 7-h exposure in normoxia (FiO2: 21%) and normobaric hypoxia (FiO2: 15%). Values of peripheral oxygen saturation, heart rate, systolic and diastolic blood pressure and respiratory gases were recorded every hour (8 time points), and oxygen saturation every 30 min (15 time points). Compared to normoxia, exposure to hypoxia significantly increased minute ventilation from baseline to hour 7 in males (+ 71%) and females (+ 40%), significantly greater in men (p < 0.05). A steeper decrease in peripheral oxygen saturation until 2.5 h in hypoxia was seen in females compared to males (p < 0.05). In conclusion, the ventilatory response to hypoxia was more pronounced in men compared to women. Moreover, during the first hours in hypoxia, peripheral oxygen saturation dropped more markedly in women than in men, likely due an initially lower and/or less efficient ventilatory response to moderate hypoxia. Those findings should be considered when performing interventions for therapy or prevention in normobaric hypoxia. Nevertheless, further large-scaled and well-controlled studies are needed.
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Affiliation(s)
| | - Marta Camacho-Cardenosa
- Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain.
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Av. Menéndez Pidal, Edificio IMIBIC, s/n, 14004, Córdoba, Córdoba, Spain.
| | - Pablo Tomas-Carus
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
| | - Rafael Timón
- Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
| | - Guillermo Olcina
- Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
| | - Martin Burtscher
- Sport Science, Medical Section, University of Innsbruck, Innsbruck, Austria
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Flores K, Siques P, Brito J, Arribas SM. AMPK and the Challenge of Treating Hypoxic Pulmonary Hypertension. Int J Mol Sci 2022; 23:ijms23116205. [PMID: 35682884 PMCID: PMC9181235 DOI: 10.3390/ijms23116205] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/29/2022] [Accepted: 04/30/2022] [Indexed: 02/01/2023] Open
Abstract
Hypoxic pulmonary hypertension (HPH) is characterized by sustained elevation of pulmonary artery pressure produced by vasoconstriction and hyperproliferative remodeling of the pulmonary artery and subsequent right ventricular hypertrophy (RVH). The search for therapeutic targets for cardiovascular pathophysiology has extended in many directions. However, studies focused on mitigating high-altitude pulmonary hypertension (HAPH) have been rare. Because AMP-activated protein kinase (AMPK) is involved in cardiovascular and metabolic pathology, AMPK is often studied as a potential therapeutic target. AMPK is best characterized as a sensor of cellular energy that can also restore cellular metabolic homeostasis. However, AMPK has been implicated in other pathways with vasculoprotective effects. Notably, cellular metabolic stress increases the intracellular ADP/ATP or AMP/ATP ratio, and AMPK activation restores ATP levels by activating energy-producing catabolic pathways and inhibiting energy-consuming anabolic pathways, such as cell growth and proliferation pathways, promoting cardiovascular protection. Thus, AMPK activation plays an important role in antiproliferative, antihypertrophic and antioxidant pathways in the pulmonary artery in HPH. However, AMPK plays contradictory roles in promoting HPH development. This review describes the main findings related to AMPK participation in HPH and its potential as a therapeutic target. It also extrapolates known AMPK functions to discuss the less-studied HAPH context.
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Affiliation(s)
- Karen Flores
- Institute of Health Studies, University Arturo Prat, Av. Arturo Prat 2120, Iquique 1110939, Chile; (P.S.); (J.B.)
- Institute DECIPHER, German-Chilean Institute for Research on Pulmonary Hypoxia and Its Health Sequelae, 20251 Hamburg, Germany and Iquique 1100000, Chile
- Correspondence: ; Tel.: +56-572526392
| | - Patricia Siques
- Institute of Health Studies, University Arturo Prat, Av. Arturo Prat 2120, Iquique 1110939, Chile; (P.S.); (J.B.)
- Institute DECIPHER, German-Chilean Institute for Research on Pulmonary Hypoxia and Its Health Sequelae, 20251 Hamburg, Germany and Iquique 1100000, Chile
| | - Julio Brito
- Institute of Health Studies, University Arturo Prat, Av. Arturo Prat 2120, Iquique 1110939, Chile; (P.S.); (J.B.)
- Institute DECIPHER, German-Chilean Institute for Research on Pulmonary Hypoxia and Its Health Sequelae, 20251 Hamburg, Germany and Iquique 1100000, Chile
| | - Silvia M. Arribas
- Department of Physiology, University Autonoma of Madrid, 28049 Madrid, Spain;
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Gandhi S, Chinnadurai V, Bhadra K, Gupta I, Kanwar RS. Urinary metabolic modulation in human participants residing in Siachen: a 1H NMR metabolomics approach. Sci Rep 2022; 12:9070. [PMID: 35641596 PMCID: PMC9156790 DOI: 10.1038/s41598-022-13031-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/19/2022] [Indexed: 12/15/2022] Open
Abstract
The main physiological challenge in high altitude environment is hypoxia which affects the aerobic metabolism reducing the energy supply. These changes may further progress toward extreme environment-related diseases. These are further reflected in changes in small molecular weight metabolites and metabolic pathways. In the present study, metabolic changes due to chronic environmental hypoxia were assessed using 1H NMR metabolomics by analysing the urinary metabolic profile of 70 people at sea level and 40 people at Siachen camp (3700 m) for 1 year. Multivariate statistical analysis was carried out, and PLSDA detected 15 metabolites based on VIP score > 1. ROC analysis detected cis-aconitate, Nicotinamide Mononucleotide, Tyrosine, Choline and Creatinine metabolites with a high range of sensitivity and specificity. Pathway analysis revealed 16 pathways impact > 0.05, and phenylalanine tyrosine and tryptophan biosynthesis was the most prominent altered pathway indicating metabolic remodelling to meet the energy requirements. TCA cycle, Glycine serine and Threonine metabolism, Glutathione metabolism and Cysteine alterations were other metabolic pathways affected during long-term high-altitude hypoxia exposure. Present findings will help unlock a new dimension for the potential application of NMR metabolomics to address extreme environment-related health problems, early detection and developing strategies to combat high altitude hypoxia.
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Affiliation(s)
- Sonia Gandhi
- Metabolomics Research Facility, Institute of Nuclear Medicine and Allied Sciences (INMAS), Lucknow Road, Timarpur, Delhi, 110054, India.
| | - Vijayakumar Chinnadurai
- Cognitive Control and Machine Learning Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, 110054, India
| | - Kuntal Bhadra
- Department of Endocrinology and Thyroid Research Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, 110054, India
| | - Isha Gupta
- Metabolomics Research Facility, Institute of Nuclear Medicine and Allied Sciences (INMAS), Lucknow Road, Timarpur, Delhi, 110054, India
| | - Ratnesh Singh Kanwar
- Department of Endocrinology and Thyroid Research Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, 110054, India
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Liang H, Yan J, Song K. Comprehensive lipidomic analysis reveals regulation of glyceride metabolism in rat visceral adipose tissue by high-altitude chronic hypoxia. PLoS One 2022; 17:e0267513. [PMID: 35522648 PMCID: PMC9075645 DOI: 10.1371/journal.pone.0267513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/10/2022] [Indexed: 11/18/2022] Open
Abstract
Adipose tissue plays a central role in energy substrate homeostasis and is a key regulator of lipid flow throughout these processes. As hypoxia affects lipid metabolism in adipose tissue, we aimed to investigate the effects of high-altitude chronic hypoxia on lipid metabolism in the adipose tissue of rats using a lipidomic analysis approach. Visceral adipose tissues from rats housed in a high-altitude hypoxia environment representing 4,300 m with 14.07% oxygen (hypoxia group) and from rats housed in a low-altitude normoxia environment representing 41 m with 20.95% oxygen (normoxia group) for 8 weeks were analyzed using an ultra-performance liquid chromatography-Orbitrap mass spectrometry system. After 8 weeks, the body weight and visceral adipose tissue weight of the hypoxia group were significantly decreased compared to those of the normoxia group (p < 0.05). The area and diameter of visceral adipose cells in the hypoxia group were significantly smaller than those of visceral adipose cells in the normoxia group (p < 0.05). The results of lipidomic analysis showed a total of 21 lipid classes and 819 lipid species. The total lipid concentration of the hypoxia group was lower than that in the normoxia group (p < 0.05). Concentrations of diacylglycerols and triacylglycerols in the hypoxia group were significantly lower than those in the normoxia group (p < 0.05). Using univariate and multivariate analyses, we identified 74 lipids that were significantly altered between the normoxia and hypoxia groups. These results demonstrate that high-altitude chronic hypoxia changes the metabolism of visceral adipose glycerides, which may potentially modulate other metabolic processes.
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Affiliation(s)
- Hong Liang
- Department of Basic Medical Sciences, Medical College, Qinghai University, Xining, PR, China
| | - Jun Yan
- Cardiovascular Medicine Department, Xuzhou Medical University affiliated Hospital, Xuzhou, PR China
| | - Kang Song
- Endocrinology Department, Qinghai Provincial People’s Hospital, Xining, PR, China
- Qinghai University affiliated Provincial People’s Hospital, Xining, PR, China
- * E-mail:
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Hansen AB, Amin SB, Hofstätter F, Mugele H, Simpson LL, Gasho C, Dawkins TG, Tymko MM, Ainslie PN, Villafuerte FC, Hearon CM, Lawley JS, Moralez G. Global Reach 2018: sympathetic neural and hemodynamic responses to submaximal exercise in Andeans with and without chronic mountain sickness. Am J Physiol Heart Circ Physiol 2022; 322:H844-H856. [PMID: 35333117 PMCID: PMC9018046 DOI: 10.1152/ajpheart.00555.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/14/2022] [Accepted: 03/14/2022] [Indexed: 11/22/2022]
Abstract
Andeans with chronic mountain sickness (CMS) and polycythemia have similar maximal oxygen uptakes to healthy Andeans. Therefore, this study aimed to explore potential adaptations in convective oxygen transport, with a specific focus on sympathetically mediated vasoconstriction of nonactive skeletal muscle. In Andeans with (CMS+, n = 7) and without (CMS-, n = 9) CMS, we measured components of convective oxygen delivery, hemodynamic (arterial blood pressure via intra-arterial catheter), and autonomic responses [muscle sympathetic nerve activity (MSNA)] at rest and during steady-state submaximal cycling exercise [30% and 60% peak power output (PPO) for 5 min each]. Cycling caused similar increases in heart rate, cardiac output, and oxygen delivery at both workloads between both Andean groups. However, at 60% PPO, CMS+ had a blunted reduction in Δtotal peripheral resistance (CMS-, -10.7 ± 3.8 vs. CMS+, -4.9 ± 4.1 mmHg·L-1·min-1; P = 0.012; d = 1.5) that coincided with a greater Δforearm vasoconstriction (CMS-, -0.2 ± 0.6 vs. CMS+, 1.5 ± 1.3 mmHg·mL-1·min-1; P = 0.008; d = 1.7) and a rise in Δdiastolic blood pressure (CMS-, 14.2 ± 7.2 vs. CMS+, 21.6 ± 4.2 mmHg; P = 0.023; d = 1.2) compared with CMS-. Interestingly, although MSNA burst frequency did not change at 30% or 60% of PPO in either group, at 60% Δburst incidence was attenuated in CMS+ (P = 0.028; d = 1.4). These findings indicate that in Andeans with polycythemia, light intensity exercise elicited similar cardiovascular and autonomic responses compared with CMS-. Furthermore, convective oxygen delivery is maintained during moderate-intensity exercise despite higher peripheral resistance. In addition, the elevated peripheral resistance during exercise was not mediated by greater sympathetic neural outflow, thus other neural and/or nonneural factors are perhaps involved.NEW & NOTEWORTHY During submaximal exercise, convective oxygen transport is maintained in Andeans suffering from polycythemia. Light intensity exercise elicited similar cardiovascular and autonomic responses compared with healthy Andeans. However, during moderate-intensity exercise, we observed a blunted reduction in total peripheral resistance, which cannot be ascribed to an exaggerated increase in muscle sympathetic nerve activity, indicating possible contributions from other neural and/or nonneural mechanisms.
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Affiliation(s)
- Alexander B Hansen
- Division of Performance, Physiology and Prevention, Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Sachin B Amin
- Division of Performance, Physiology and Prevention, Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Florian Hofstätter
- Division of Performance, Physiology and Prevention, Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Hendrik Mugele
- Division of Performance, Physiology and Prevention, Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Lydia L Simpson
- Division of Performance, Physiology and Prevention, Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Christopher Gasho
- Division of Pulmonary and Critical Care, Department of Medicine, University of Loma Linda, Loma Linda, California
| | - Tony G Dawkins
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Michael M Tymko
- Physical Activity and Diabetes Laboratory, Faculty of Kinesiology and Recreation, University of Alberta, Edmonton, Alberta, Canada
- Centre of Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Philip N Ainslie
- Centre of Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Francisco C Villafuerte
- Laboratorio de Fisiología Comparada/Fisiología del Transporte de Oxígeno Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Christopher M Hearon
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
| | - Justin S Lawley
- Division of Performance, Physiology and Prevention, Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Gilbert Moralez
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
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47
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Abstract
Wang, Yuliang, Xuewen Huang, Weibo Yang, and Qingxian Zeng. Platelets and high-altitude exposure: a meta-analysis. High Alt Med Biol. 23:43-56, 2022. Background: How high-altitude hypoxia influences platelets is controversial. We attempted to quantify the impact of high-altitude exposure on platelets through meta-analysis. Methods: We systematically searched electronic databases (PubMed, Embase, Web of Science, VIP, Wanfang, and CNKI) and identified articles reporting an association between platelet count (PC) or platelet indices (platelet distribution width, mean platelet volume [MPV], and plateletcrit) and high-altitude exposure. The mean and standard deviation were extracted, and the standard mean difference (SMD) was estimated using random-effects models. Stata 15.3 was used to analyze statistical data. Results: Thirty-two studies were ultimately included. For acute high-altitude hypoxia (1-14 days), no significant difference was detected, even in patients with acute mountain disease. For the chronic high-altitude hypoxia (≥1 month) group, a significant decrease in PC (SMD [95% confidence interval, CI] = -0.34 [-0.63 to -0.04]) and increase in MPV (SMD [95% CI] = 1.55 [0.60 to 2.49]) were detected compared with those in the control group. Subgroup analysis showed that the tendency was more obvious in the group with longer exposure (≥1 year). Moreover, the PC of the chronic mountain sickness group was less compared with the healthy altitude control group (SMD [95% CI] = -1.82 [-2.74 to -0.91]). Conclusion: A reduced PC and an increased MPV are associated with chronic exposure to high-altitude hypoxia. Moreover, acute high-altitude exposure has no significant influence on platelets.
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Affiliation(s)
- Yuliang Wang
- Department of High Altitude Disease, Xizang Military General Hospital, Xizang Province, Lhasa City, China
| | - Xuewen Huang
- Department of High Altitude Disease, Xizang Military General Hospital, Xizang Province, Lhasa City, China
| | - Weibo Yang
- Department of High Altitude Disease, Xizang Military General Hospital, Xizang Province, Lhasa City, China
| | - Qingxian Zeng
- Department of High Altitude Disease, Xizang Military General Hospital, Xizang Province, Lhasa City, China
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48
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Li X, Wang R, Huo Y, Zhao A, Li W, Feng S. Pharmacodynamic of cilostazol for anti-altitude hypoxia. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2022; 47:202-210. [PMID: 35545410 PMCID: PMC10930518 DOI: 10.11817/j.issn.1672-7347.2022.200972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Indexed: 06/15/2023]
Abstract
OBJECTIVES The plateau environment is characterized by low oxygen partial pressure, leading to the reduction of oxygen carrying capacity in alveoli and the reduction of available oxygen in tissues, and thus causing tissue damage. Cilostazol is a phosphodiesterase III inhibitor that has been reported to increase the oxygen release of hemoglobin (Hb) in tissues. This study aims to explore the anti-hypoxic activity of cilostazol and its anti-hypoxic effect. METHODS A total of 40 male BALB/C mice were randomly divided into a low-dose cilostazol (6.5 mg/kg) group, a medium-dose (13 mg/kg) group, a high-dose (26 mg/kg) group, and a control group. The atmospheric airtight hypoxia experiment was used to investigate the anti-hypoxic activity of cilostazol and to screen the optimal dosage. Twenty-four male Wistar rats were randomly divided into a normoxia control group, a hypoxia model group, an acetazolamide (22.33 mg/kg) group, and a cilostazol (9 mg/kg) group. After 3 days of hypoxia in the 4 010 m high altitude, blood from the abdominal aorta was collected to determine blood gas indicators, the levels of IL-6 and TNF-α in plasma were determined by enzyme-linked immunosorbent assay, and the levels of malondialdehyde (MDA), superoxide dismutase (SOD), and glutataione (GSH) were measured. The degree of pathological damage for rat tissues was observed with HE staining. RESULTS Compared with the control group, the survival time of mice in the low, medium, and high dose group of cilostazol was significantly prolonged, and the survival time of mice in the medium dose group was the longest, with an extension rate at 29.34%, so the medium dose was the best dose. Compared with the hypoxia model group, the P50 (oxygen partial pressure at Hb oxygen saturation of 50%) value of rats in the cilostazol group was significantly increased by 1.03%; Hb and Hct were significantly reduced by 8.46% and 8.43%, and the levels of IL-6 and TNF-α in plasma were reduced by 50.65% and 30.77%. The MDA contents in heart, brain, lung, liver, and kidney tissues were reduced by 37.12%, 29.55%, 25.00%, 39.34%, and 21.47%, respectively. The SOD activities were increased by 94.93%, 9.14%, 9.42%, 13.29%, and 20.80%, respectively. The GSH contents were increased by 95.24%, 28.62%, 28.57%, 20.80%, and 44.00%, respectively. The results of HE staining showed that compared with the hypoxia model group, cilostazol significantly improved the damage of heart, lung, and kidney tissues in rats after hypoxia. CONCLUSIONS Cilostazol can significantly improve the oxidative stress and inflammatory reaction caused by rapid altitude hypoxia, and it has a significant protective effect on tissue damage caused by hypoxia, suggesting that it has obvious anti-hypoxic activity.
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Affiliation(s)
- Xue Li
- School of Pharmacy, Lanzhou University, Lanzhou 730000.
- Pharmacy Department, the 940th Hospital of Joint Logistics Support Force, Lanzhou 730050, China.
| | - Rong Wang
- School of Pharmacy, Lanzhou University, Lanzhou 730000
- Pharmacy Department, the 940th Hospital of Joint Logistics Support Force, Lanzhou 730050, China
| | - Yan Huo
- School of Pharmacy, Lanzhou University, Lanzhou 730000
- Pharmacy Department, the 940th Hospital of Joint Logistics Support Force, Lanzhou 730050, China
| | - Anpeng Zhao
- Pharmacy Department, the 940th Hospital of Joint Logistics Support Force, Lanzhou 730050, China
| | - Wenbin Li
- Pharmacy Department, the 940th Hospital of Joint Logistics Support Force, Lanzhou 730050, China.
| | - Shilan Feng
- School of Pharmacy, Lanzhou University, Lanzhou 730000. fengshl@ lzu.edu.cn
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49
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Brent MB, Emmanuel T, Simonsen U, Brüel A, Thomsen JS. Hypobaric hypoxia deteriorates bone mass and strength in mice. Bone 2022; 154:116203. [PMID: 34536630 DOI: 10.1016/j.bone.2021.116203] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/30/2021] [Accepted: 09/13/2021] [Indexed: 12/20/2022]
Abstract
Mountaineers at high altitude are at increased risk of acute mountain sickness as well as high altitude pulmonary and cerebral edema. A densitometric study in mountaineers has suggested that expeditions at high altitude decrease bone mineral density. Surprisingly, the in vivo skeletal effects of hypobaric hypoxia are largely unknown, and have not been studied using advanced contemporary methods to assess bone microstructure. Eighty-four 22-week-old female mice were divided into seven groups with 12 mice in each group: 1. Baseline; 2. Normobaric, 4 weeks; 3. Hypobaric hypoxia, 4 weeks; 4. Normobaric, 8 weeks; 5. Hypobaric hypoxia, 8 weeks; 6. Normobaric, 12 weeks; and 7. Hypobaric hypoxia, 12 weeks. Hypobaric hypoxia mice were housed in hypobaric chambers at an ambient pressure of 500 mbar (5500 m altitude), while normobaric mice were housed at sea level atmospheric pressure for 4, 8, or 12 weeks, respectively. Hypobaric hypoxia had a profound impact on femoral cortical bone and L4 trabecular bone, while the effect on femoral trabecular bone was less pronounced. Hypobaric hypoxia reduced the bone strength of the femoral mid-diaphysis and L4 at all time-points. At femoral cortical bone, hypobaric hypoxia reduced bone formation through fewer mineralizing surfaces and lower bone formation rate after 2 weeks. In addition, bone strength decreased, and C-terminal telopeptide of type I collagen (CTX-I) increased independently of the duration of exposure to simulated high altitude. At L4, hypobaric hypoxia resulted in a substantial reduction in bone volume fraction, trabecular thickness, and trabecular number after 4 weeks of exposure. Hypobaric hypoxia reduced bone strength and femoral bone mass, while femoral trabecular bone was much less affected, indicating the skeletal response to hypobaric hypoxia differ between cortical and trabecular bone. These findings provide initial preclinical support for future clinical studies in mountaineers to assess bone status and bone strength after exposure to prolonged high altitude exposure.
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Affiliation(s)
- Mikkel Bo Brent
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.
| | - Thomas Emmanuel
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Ulf Simonsen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Annemarie Brüel
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
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50
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Diaz GF, Marquez A, Ruiz-Parra A, Beghetti M, Ivy D. An Acute Hyperoxia Test Predicts Survival in Children with Pulmonary Hypertension Living at High Altitude. High Alt Med Biol 2021; 22:395-405. [PMID: 34905397 PMCID: PMC8742266 DOI: 10.1089/ham.2021.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Diaz, Gabriel F., Alicia Marquez, Ariel Ruiz-Parra, Maurice Beghetti, and Dunbar Ivy. An acute hyperoxia test predicts survival in children with pulmonary hypertension living at high altitude. High Alt Med Biol. 22:395-405, 2021. Background: Pulmonary hypertension (PH) causes significant morbidity and mortality in children at altitude. Materials and Methods: Fifty-two children living at 2,640 m were included. During hyperoxia test (O2Test), patients received high oxygen concentrations (FiO2 >80, through Mask, using Venturi or nonrebreathing mask); echocardiography was used to evaluate pulmonary vasculature reactivity. A decrease >20% from the basal pulmonary artery systolic pressure was considered a positive response. Results: Most of the patients had severe PH. The median age at diagnosis was 4.5 years; 34 were female (65.4%). Idiopathic PH was present in 44 patients (84.6%). Six developed severe PH after ductus closure. They were classified in responders (n = 25), and nonresponders (n = 26). Responders were younger (3 years vs. 7 years, p = 0.02), and 22 (88%), had better functional class (FC) 1-2, than nonresponders: 18 (69.23%) of them had worse FC: 3-4 (p = 0.000). In responders, 10/12 who went to live at low altitude became asymptomatic, compared with 7/13 who remained at high altitude. FC 1-2 was achieved by 70% of the patients with idiopathic PH who went to a low altitude, compared with 30% who continued at high altitude (p = 0.03). In nonresponders, 10/26 patients moved to a low altitude: four improved, one worsened, and five died; of the 16/26 patients living at high altitude, four are stable, eight worsened, and four died. Four patients (30.76%) in responder group and nine (69.24%) in the nonresponder group died (p = 0.03). There were differences between both groups in systolic (88 mm Hg vs. 110 mm Hg; p = 0.037), diastolic (37 mm Hg vs. 56 mm Hg; p = 0.035), and mean pulmonary artery pressures (57 mm Hg vs. 88 mm Hg; p = 0.038). Conclusions: This specific hyperoxia test applied until 24 hours (not published before) helps to predict survival and prognosis of children with PH. Children with PH at a high altitude improve at low altitude.
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Affiliation(s)
- Gabriel F Diaz
- Department of Pediatrics, Universidad Nacional de Colombia, Fundación Santa Fe de Bogotá, Bogotá Colombia
| | - Alicia Marquez
- Clínica De La Mujer, Centro Policlínico del Olaya, Bogotá, Colombia
| | - Ariel Ruiz-Parra
- Instituto de Investigaciones Clínicas and Department of Obstetrics and Gynecology, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Maurice Beghetti
- Head of Pediatric Cardiology Unit (HUG), Director Pulmonary Hypertension Program (HUG) Children's University Hospital, Geneva, Switzerland
| | - Dunbar Ivy
- Chief and Selby's Chair of Pediatric Cardiology, University of Colorado, School of Medicine, Children's Hospital Colorado, Denver, Colorado, USA
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