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Burtscher J, Strasser B, Millet GP, Burtscher M. Can melatonin be used as a potential antioxidant and sleep aid supplement for high-altitude travelers? J Travel Med 2022; 29:6495956. [PMID: 34983055 DOI: 10.1093/jtm/taab198] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/10/2021] [Accepted: 12/27/2021] [Indexed: 11/14/2022]
Abstract
Traveling to high-altitude destinations is associated with risks such as high-altitude sicknesses and impaired sleep and performance. Although antioxidant supplementation may be beneficial, conflicting study results impede clear clinical guidelines. Herein, we highlight the potential of the antioxidant compound melatonin that is surprisingly poorly investigated in high-altitude settings.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, CH-1015 Lausanne, Switzerland.,Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland
| | - Barbara Strasser
- Medical Faculty, Sigmund Freud Private University, A-1020 Vienna, Austria
| | - Gregoire P Millet
- Institute of Sport Sciences, University of Lausanne, CH-1015 Lausanne, Switzerland.,Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, A-6020 Innsbruck, Austria.,Austrian Society for Alpine- and High-Altitude Medicine, A-6020 Innsbruck, Austria
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2
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Staab JE, Muza SR, Fulco CS, Andrew SP, Beidleman BA. Impact of 2 days of staging at 2500-4300 m on sleep quality and quantity following subsequent exposure to 4300 m. Physiol Rep 2021; 9:e15063. [PMID: 34713967 PMCID: PMC8554773 DOI: 10.14814/phy2.15063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/10/2021] [Revised: 09/10/2021] [Accepted: 09/12/2021] [Indexed: 12/21/2022] Open
Abstract
The impact of 2 days of staging at 2500-4300 m on sleep quality and quantity following subsequent exposure to 4300 m was determined. Forty-eight unacclimatized men and women were randomly assigned to stage for 2 days at one of four altitudes (2500, 3000, 3500, or 4300 m) prior to assessment on the summit of Pikes Peak (4300 m) for 2 days. Volunteers slept for one night at sea level (SL), two nights at respective staging altitudes, and two nights at Pikes Peak. Each wore a pulse oximeter to measure sleep arterial oxygen saturation (sSpO2 , %) and number of desaturations (DeSHr, events/hr) and a wrist motion detector to estimate sleep awakenings (Awak, awakes/hr) and sleep efficiency (Eff, %). Acute mountain sickness (AMS) was assessed using the Environmental Symptoms Questionnaire and daytime SpO2 was assessed after AMS measurements. The mean of all variables for both staging days (STG) and Pikes Peak days (PP) was calculated. The sSpO2 and daytime SpO2 decreased (p < 0.05) from SL during STG in all groups in a dose-dependent manner. During STG, DeSHr were higher (p < 0.05), Eff was lower (p < 0.05), and AMS symptoms were higher (p < 0.05) in the 3500 and 4300 m groups compared to the 2500 and 3000 m groups while Awak did not differ (p > 0.05) between groups. At PP, the sSpO2 , DeSHr, Awak, and Eff were similar among all groups but the 2500 m group had greater AMS symptoms (p < 0.05) than the other groups. Two days of staging at 2500-4300 m induced a similar degree of sleep acclimatization during subsequent ascent to 4300 m but the 2500 m group was not protected against AMS at 4300 m.
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Affiliation(s)
- Janet E. Staab
- Military Performance DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Stephen R. Muza
- Strategic Scientific Management OfficeU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Charles S. Fulco
- Thermal and Mountain Medicine DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Sean P. Andrew
- Thermal and Mountain Medicine DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Beth A. Beidleman
- Biophysics and Biomedical Modeling DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
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3
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Fehrenbacher K, Apel C, Bertsch D, van der Giet MS, van der Giet S, Grass M, Gschwandtl C, Heussen N, Hundt N, Kühn C, Morrison A, Müller-Ost M, Müller-Tarpet M, Porath S, Risse J, Schmitz S, Schöffl V, Timmermann L, Wernitz K, Küpper T. Temporary threshold shift after noise exposure in hypobaric hypoxia at high altitude: results of the ADEMED expedition 2011. Int Arch Occup Environ Health 2021; 94:1191-1199. [PMID: 34023963 PMCID: PMC8292300 DOI: 10.1007/s00420-021-01715-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 08/29/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate whether there is an increased risk for noise-induced hearing loss at high altitude rsp. in hypobaric hypoxia. METHODS Thirteen volunteers got standard audiometry at 125, 250, 500, 750, 1000, 1500, 2000, 3000, 4000, 6000, and 8000 Hz before and after 10 min of white noise at 90 dB. The system was calibrated for the respective altitude. Measurements were performed at Kathmandu (1400 m) and at Gorak Shep (5300 m) (Solo Khumbu/Nepal) after 10 days of acclimatization while on trek. Temporary threshold shift (TTS) was analyzed by descriptive statistics and by factor analysis. RESULTS TTS is significantly more pronounced at high altitudes. Acclimatization does not provide any protection of the inner ear, although it increases arterial oxygen saturation. CONCLUSION The thresholds beyond which noise protection is recommended (> 80 dB) or necessary (> 85 dB) are not sufficient at high altitudes. We suggest providing protective devices above an altitude of 1500 m ("ear threshold altitude") when noise level is higher than 75 dB and using them definitively above 80 dB. This takes the individual reaction on hypobaric hypoxia at high altitude into account.
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Affiliation(s)
- K Fehrenbacher
- Institute of Occupational and Social Medicine, RWTH Aachen Technical University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - C Apel
- Department of Dental Preservation, Parodontology and Preventive Dentistry, RWTH Aachen Technical University, Aachen, Germany
| | - D Bertsch
- Department of Cardiology, Catholic Hospital Marienhof, Koblenz, Germany
| | - M S van der Giet
- Institute of Occupational and Social Medicine, RWTH Aachen Technical University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - S van der Giet
- Institute of Occupational and Social Medicine, RWTH Aachen Technical University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - M Grass
- Institute of Occupational and Social Medicine, RWTH Aachen Technical University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - C Gschwandtl
- Institute of Occupational and Social Medicine, RWTH Aachen Technical University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - N Heussen
- Department of Medical Statistics, RWTH Aachen Technical University, Aachen, Germany
- Medical School, Sigmund Freud Private University, Vienna, Austria
| | - N Hundt
- Institute of Occupational and Social Medicine, RWTH Aachen Technical University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - C Kühn
- Institute of Occupational and Social Medicine, RWTH Aachen Technical University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - A Morrison
- Royal Free London NHS Foundation Trust, London, UK
| | - M Müller-Ost
- Institute of Occupational and Social Medicine, RWTH Aachen Technical University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - M Müller-Tarpet
- Department of Technical Acoustics, RWTH Aachen University, Aachen, Germany
| | - S Porath
- Institute of Occupational and Social Medicine, RWTH Aachen Technical University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - J Risse
- Institute of Occupational and Social Medicine, RWTH Aachen Technical University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - S Schmitz
- Institute of Occupational and Social Medicine, RWTH Aachen Technical University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - V Schöffl
- Medical Commission of the Union Internationale des Associations d'Alpinisme (UIAA MedCom), Bern, Switzerland
- Department of Sports Medicine-Sports Orthopaedics, Klinikum Bamberg, Bamberg, Germany
- Department of Trauma Surgery, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - L Timmermann
- Institute of Occupational and Social Medicine, RWTH Aachen Technical University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - K Wernitz
- Department of Dental Preservation, Parodontology and Preventive Dentistry, RWTH Aachen Technical University, Aachen, Germany
| | - T Küpper
- Institute of Occupational and Social Medicine, RWTH Aachen Technical University, Pauwelsstr. 30, 52074, Aachen, Germany.
- Medical Commission of the Union Internationale des Associations d'Alpinisme (UIAA MedCom), Bern, Switzerland.
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4
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Ju JD, Zhang C, Sgambati FP, Lopez LM, Pham LV, Schwartz AR, Accinelli RA. Acute Altitude Acclimatization in Young Healthy Volunteers: Nocturnal Oxygenation Increases Over Time, Whereas Periodic Breathing Persists. High Alt Med Biol 2020; 22:14-23. [PMID: 33185483 DOI: 10.1089/ham.2020.0009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Ju, Jia-Der, Cristian Zhang, Francis P. Sgambati, Lidia M. Lopez, Luu V. Pham, Alan R. Schwartz, and Roberto A. Accinelli. Acute altitude acclimatization in young healthy volunteers: nocturnal oxygenation increases over time whereas periodic breathing persists. High Alt Med Biol. 22:14-23, 2021. Study Objectives: This study aimed to examine the acute effects of high altitude (HA) on sleep disordered breathing (sleep apnea and nocturnal hypoxemia) and acute mountain sickness and to characterize acclimatization over time. Methods: Ten native lowlanders residing at sea level (SL) completed the Lake Louise Score (LLS) and underwent nocturnal polygraphy (ApneaLink Plus) for nine consecutive nights (N1-N9) at HA (2,761 m) and two nights before and after HA. Nocturnal oxygen profiles were assessed by measuring the mean nocturnal oxyhemoglobin saturation (SpO2) during sleep, and sleep apnea severity as assessed by measuring the Apnea-Hypopnea Index (AHI). Mixed-effects linear regression was used to model responses in outcomes (mean nocturnal SpO2, logAHI, and LLS) between HA and SL. Changes in SpO2 and AHI were examined in subgroups with mild versus marked nocturnal SpO2 and low versus high AHI during exposure to HA and compared between subgroups. Results: Compared with SL, the mean nocturnal SpO2 was lower (p < 0.0001) and AHI was higher (p < 0.0001) at HA. The mean nocturnal SpO2 increased progressively (p < 0.001), whereas AHI remained high (p < 0.978) and relatively unchanged over nine successive nights at HA. Those with markedly reduced SpO2 upon arrival at HA exhibited progressive increases in the mean nocturnal SpO2 over time at HA compared with those with mild nocturnal desaturation. LLS rose at HA, but no differences were observed between subgroups. Conclusions: In healthy HA sojourners, the mean nocturnal SpO2 increased progressively over time, whereas AHI remained elevated, suggesting distinctive phenotypes and acclimatization responses to HA.
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Affiliation(s)
- Jia-Der Ju
- Instituto de Investigaciones de la Altura, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Cristian Zhang
- Instituto de Investigaciones de la Altura, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Francis P Sgambati
- Johns Hopkins Sleep Center and Center for Interdisciplinary Sleep Research Education, Baltimore, Maryland, USA
| | - Lidia M Lopez
- Instituto de Investigaciones de la Altura, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru.,Hospital Cayetano Heredia, Lima, Perú
| | - Luu V Pham
- Johns Hopkins Sleep Center and Center for Interdisciplinary Sleep Research Education, Baltimore, Maryland, USA.,Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Alan R Schwartz
- Adjunct Professor, Perelman School of Medicine, University of Pennsylvania, Lima, Perú.,Distinguished Visiting Professor, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Roberto A Accinelli
- Instituto de Investigaciones de la Altura, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru.,Hospital Cayetano Heredia, Lima, Perú
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5
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Holmström PK, Bird JD, Thrall SF, Kalker A, Herrington BA, Soriano JE, Mann LM, Rampuri ZH, Brutsaert TD, Karlsson Ø, Sherpa MT, Schagatay EKA, Day TA. The effects of high altitude ascent on splenic contraction and the diving response during voluntary apnoea. Exp Physiol 2020; 106:160-174. [DOI: 10.1113/ep088571] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 09/03/2020] [Indexed: 12/30/2022]
Affiliation(s)
| | - Jordan D. Bird
- Department of Biology Faculty of Science and Technology Mount Royal University Calgary Alberta Canada
| | - Scott F. Thrall
- Department of Biology Faculty of Science and Technology Mount Royal University Calgary Alberta Canada
| | - Ann Kalker
- Department of Biology Faculty of Science and Technology Mount Royal University Calgary Alberta Canada
- Radboud University Nijmegen Netherlands
| | - Brittney A. Herrington
- Department of Biology Faculty of Science and Technology Mount Royal University Calgary Alberta Canada
| | - Jan E. Soriano
- Department of Biology Faculty of Science and Technology Mount Royal University Calgary Alberta Canada
| | - Leah M. Mann
- Department of Biology Faculty of Science and Technology Mount Royal University Calgary Alberta Canada
| | - Zahrah H. Rampuri
- Department of Biology Faculty of Science and Technology Mount Royal University Calgary Alberta Canada
| | - Tom D. Brutsaert
- Department of Exercise Science Syracuse University Syracuse NY USA
| | - Øyvind Karlsson
- Swedish Winter Sports Research Centre Mid Sweden University Östersund Sweden
| | | | - Erika K. A. Schagatay
- Department of Health Sciences Mid Sweden University Östersund Sweden
- Swedish Winter Sports Research Centre Mid Sweden University Östersund Sweden
| | - Trevor A. Day
- Department of Biology Faculty of Science and Technology Mount Royal University Calgary Alberta Canada
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6
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Tannheimer M, Lechner R. Rapid ascents of Mt Everest: normobaric hypoxic preacclimatization. J Travel Med 2020; 27:5861564. [PMID: 32577764 DOI: 10.1093/jtm/taaa099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/22/2020] [Accepted: 06/11/2020] [Indexed: 11/12/2022]
Abstract
BACKGROUND Acclimatization to high altitude is time consuming. An expedition to Mt Everest (8848 m) requires roughly 8 weeks. Therefore it seems very attractive to reach the summit within 3 weeks from home, which is currently promised by some expedition tour operators. These rapid ascent expeditions are based on two main components, normobaric hypoxic training (NHT) prior to the expedition and the use of high flow supplemental oxygen (HFSO2). We attempted to assess the relative importance of these two elements. METHODS We evaluated the effect of NHT on the basis of the available information of these rapid ascent expeditions and our experiences made during an expedition to Manaslu (8163 m) where we used NHT for preacclimatization. To evaluate the effect of an increased O2 flow rate we calculated its effect at various activity levels at altitudes of 8000 m and above. RESULTS So far rapid ascents to Mt Everest have been successful. The participants carried out 8 weeks of NHT, reaching sleeping altitudes = 7100 m and spent at least 300 h in NH. At rest a flow rate of 2 l O2/min is sufficient to keep the partial pressure of inspired oxygen (PIO2) close to 50 mm Hg even at the summit. For ativities of ~80% of the maximum rate of oxygen consumption (VO2max) at the summit 6 l O2/min are required to maintain a PIO2 above 50 mm Hg. DISCUSSION NHT for preacclimatization seems to be the decisive element of the offered rapid ascent expeditions. An increased O2 flow rate of 8 l/min is not mandatory for climbing Mt Everest. CONCLUSIONS Preacclimatization using normobaric hypoxica (NH) is far more important than the use of HFSO2. We think that NHT will be widely used in the future. The most effective regimen of preacclimatization in NH, the duration of each session and the optimal FIO2 are still unclear and require further study.
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Affiliation(s)
- Markus Tannheimer
- University of Ulm, Department of Sport and Rehabilitation Medicine, Leimgrubenweg 14, 89089075 Ulm/75 Ulm, Germany
| | - Raimund Lechner
- Department of Anaesthesiology and Intensive Care, Bundeswehr Hospital Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
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7
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Limper U, Fiala V, Elmenhorst EM, Tank J, Schaelte G, Jordan J. Re: “Positional Changes in Arterial Oxygen Saturation and End-Tidal Carbon Dioxide at High Altitude: Medex 2015” by Kuenzel et al. High Alt Med Biol 2020; 21:305-306. [DOI: 10.1089/ham.2020.0027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ulrich Limper
- Department of Anaesthesiology and Intensive Care Medicine, Merheim Medical Center, Hospitals of Cologne, University of Witten/Herdecke, Cologne, Germany
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany
| | - Vera Fiala
- Department of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
| | - Eva M. Elmenhorst
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany
- Institute for Occupational, Social and Environmental Medicine, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
| | - Jens Tank
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany
| | - Gereon Schaelte
- Department of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
| | - Jens Jordan
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany
- Chair of Aerospace Medicine, Medical Faculty, University of Cologne, Cologne, Germany
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8
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Bondi D, Bhandari S, Verratti V. Case studies in physiology: Nocturnal cardiorespiratory adaptive differences between an Italian trekker and a Nepali guide. Physiol Rep 2020; 8:e14537. [PMID: 32812385 PMCID: PMC7435026 DOI: 10.14814/phy2.14537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/12/2020] [Accepted: 07/18/2020] [Indexed: 01/07/2023] Open
Abstract
The cardiopulmonary system is a physiological cornerstone in the adaptive response to hypobaric hypoxia. Portable devices make it feasible nowadays to precisely assess the response to high altitude (HA) expeditions. In this study, we investigated breathing and arterial blood pressure responses during a Himalayan trek from 665 m to 4,780 m altitude in a white European (Italian) sojourner and a native Nepali (Tamang) guide, both healthy males. Resting diurnal and nocturnal data were acquired by means of ambulatory blood pressure monitoring (ABPM) and sleep apnea monitoring. We found an increase in the mean diurnal arterial blood pressure. Nocturnal blood pressure dipping was confirmed at all altitudes. Oxygen saturation decreased at altitude, with its additional nocturnal fall. Sleep apneic episodes, present in the Italian only, increased with altitude. We conclude that the nocturnal, more than diurnal, cardiorespiratory function is affected by HA hypoxia. Further studies should address the role of ethnicity, medications, and sociodemographic factors in the cardiorespiratory responses to hypobaric hypoxia.
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Affiliation(s)
- Danilo Bondi
- Department of Neuroscience, Imaging and Clinical SciencesUniversity “G. d’Annunzio” of Chieti – PescaraChietiItaly
| | | | - Vittore Verratti
- Department of Psychological, Health and Territorial SciencesUniversity “G. d’Annunzio” of Chieti – PescaraChietiItaly
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9
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Abstract
The first ascent of Mount Everest by Tenzing Norgay and Sir Edmund Hillary in 1953 brought global attention to the Sherpa people and human performance at altitude. The Sherpa inhabit the Khumbu Valley of Nepal, and are descendants of a population that has resided continuously on the Tibetan plateau for the past ∼25,000 to 40,000 years. The long exposure of the Sherpa to an inhospitable environment has driven genetic selection and produced distinct adaptive phenotypes. This review summarizes the population history of the Sherpa and their physiological and genetic adaptation to hypoxia. Genomic studies have identified robust signals of positive selection across EPAS1, EGLN1, and PPARA, that are associated with hemoglobin levels, which likely protect the Sherpa from altitude sickness. However, the biological underpinnings of other adaptive phenotypes such as birth weight and the increased reproductive success of Sherpa women are unknown. Further studies are required to identify additional signatures of selection and refine existing Sherpa-specific adaptive phenotypes to understand how genetic factors have underpinned adaptation in this population. By correlating known and emerging signals of genetic selection with adaptive phenotypes, we can further reveal hypoxia-related biological mechanisms of adaptation. Ultimately this work could provide valuable information regarding treatments of hypoxia-related illnesses including stroke, heart failure, lung disease and cancer.
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Affiliation(s)
- Sushil Bhandari
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Gianpiero L Cavalleri
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
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10
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Burtscher M, Philadelphy M, Gatterer H, Burtscher J, Faulhaber M, Nachbauer W, Likar R. Physiological Responses in Humans Acutely Exposed to High Altitude (3480 m): Minute Ventilation and Oxygenation Are Predictive for the Development of Acute Mountain Sickness. High Alt Med Biol 2019; 20:192-197. [PMID: 30896981 DOI: 10.1089/ham.2018.0143] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The importance of arterial oxygen saturation for the prediction of acute mountain sickness (AMS) is still a matter of debate. Reasons for discrepancies may result from varying laboratory or field conditions and their interactions. Thus, we analyzed data from our prior high-altitude studies, including participants of a broad range of age of both sexes (20 males and 20 females, aged between 20 and 67 years) under strictly standardized conditions of pre-exposure and acute exposure to real high altitude (3480 m). A set of resting cardiovascular, respiratory, hematological, and metabolic variables were recorded at high altitude (Testa Grigia, Plateau Rosa, 3480 m; Swiss-Italian boarder) after performing pretests at low altitude (Innsbruck, 600 m, Austria). Our analyses indicate that (1) smaller changes in resting minute ventilation (VE) and a larger decrease of peripheral oxygen saturation (SpO2) during the first 3 hours of acute exposure to high altitude were independent predictors for subsequent development of AMS (90% correct prediction), (2) there are no differences of responses between sexes, and (3) there is no association of responses with age. Considering the independent effects of both responses (VE and SpO2) may be of clinical/practical relevance. Moreover, the presented data derived from a broad age range of both sexes might be of interest for comparative purposes.
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Affiliation(s)
- Martin Burtscher
- 1 Department of Sport Science, University of Innsbruck, Innsbruck, Austria.,2 Austrian Society for Alpine and Mountain Medicine, Innsbruck, Austria
| | | | - Hannes Gatterer
- 1 Department of Sport Science, University of Innsbruck, Innsbruck, Austria.,3 Institute of Mountain Emergency Medicine, EURAC Research, Bolzano, Italy
| | - Johannes Burtscher
- 4 Laboratory of Molecular and Chemical Biology of Neurodegeneration, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Martin Faulhaber
- 1 Department of Sport Science, University of Innsbruck, Innsbruck, Austria.,2 Austrian Society for Alpine and Mountain Medicine, Innsbruck, Austria
| | - Werner Nachbauer
- 1 Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Rudolf Likar
- 5 Department of Anesthesiology and Intensive Care Medicine, Klinikum Klagenfurt, Klagenfurt, Austria
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11
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Tannheimer M, Lechner R. The correct measurement of oxygen saturation at high altitude. Sleep Breath 2019; 23:1101-6. [DOI: 10.1007/s11325-019-01784-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 01/09/2019] [Accepted: 01/17/2019] [Indexed: 10/27/2022]
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12
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Tang XG, Wen J, Zhang XS, Jiang DC. Association between decreased osteopontin and acute mountain sickness upon rapid ascent to 3500 m among young Chinese men. J Travel Med 2018; 25:5079665. [PMID: 30165389 DOI: 10.1093/jtm/tay075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 08/23/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Hypoxia causes oxidative stress and a decrease in osteopontin (OPN) in rats; however, little is known about the change in OPN in lowlander humans during hypobaric hypoxia. We explore the role of the predicted decrease in plasma OPN levels in humans upon high-altitude exposure and its relationship with acute mountain sickness (AMS), as well as superoxide dismutase (SOD) and malondialdehyde (MDA). METHODS Before and during acute altitude exposure, 261 men's plasma OPN, SOD, MDA, heart rate and pulse oximeter saturation (SpO2) were measured. AMS as assessed using the Lake Louise score (LLS) was defined as headache with a total LLS ≥3. Subjects were divided into AMS-0 (non-AMS subjects), mild AMS (headache with total LLS = 3 or 4) and severe AMS groups (headache with total LLS ≥5). RESULTS At 600 m, no difference in plasma OPN, SOD and MDA was observed between groups. At 3500 m, plasma OPN in severe AMS group was significantly decreased as compared with 600 m. Plasma SOD showed a tendency to decrease during altitude exposure. The opposite trend was observed for plasma MDA. Correlation analysis showed that total LLS was significantly correlated with OPN (ρ = -0.247, P < 0.001) and SOD (ρ = -0.224, P < 0.001). OPN showed significant correlation with SOD (r = 0.235, P < 0.001). Multivariate logistic regression analysis showed that higher plasma OPN was a protective factor for AMS [adjusted odds ratio (OR) 0.924, 95% confidence interval (CI) 0.884-0.966, P < 0.01]. CONCLUSION Our results suggest that decreased plasma OPN is correlated with AMS, and oxidative stress may be implicated in this phenomenon. Decreased plasma SOD is also correlated with AMS.
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Affiliation(s)
- Xu-Gang Tang
- Department of Cardiology, No. 37 Hospital of People's Liberation Army, Ya'an, Sichuan Province, People's Republic of China
| | - Jing Wen
- Department of Pediatrics, People's Hospital of Hechuan district, Chongqing, People's Republic of China
| | - Xue-Sen Zhang
- Department of Cardiology, No. 37 Hospital of People's Liberation Army, Ya'an, Sichuan Province, People's Republic of China
| | - Da-Chun Jiang
- Department of Cardiology, No. 37 Hospital of People's Liberation Army, Ya'an, Sichuan Province, People's Republic of China
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Affiliation(s)
- B Basnyat
- Oxford University Clinical Research Unit-Patan Academy of Health Sciences, Lalitpur, Nepal. Center for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
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Tannheimer M, van der Spek R, Lechner R, Steinacker J, Treff G. Reply to Comment 'Nocturnal decrease of arterial oxygen content-hidden stimulus for erythropoietin secretion at altitude by Böning et al. on Oxygen saturation increases over the course of the night in mountaineers at high altitude (3050m-6354 m) by Tannheimer et al.'. J Travel Med 2018; 25:4780175. [PMID: 29394390 DOI: 10.1093/jtm/tax093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 11/27/2017] [Indexed: 11/14/2022]
Affiliation(s)
- Markus Tannheimer
- Division of Sports and Rehabilitation Medicine, University Hospital Ulm, Leimgrubenweg 14, 89075 Ulm, Germany
| | - Rianne van der Spek
- Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, F5-166, Postbus 22660, 1100 DD Amsterdam, The Netherlands
| | - Raimund Lechner
- Department of Anesthesiology, German Armed Forces Hospital Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - Jürgen Steinacker
- Division of Sports and Rehabilitation Medicine, University Hospital Ulm, Leimgrubenweg 14, 89075 Ulm, Germany
| | - Gunnar Treff
- Division of Sports and Rehabilitation Medicine, University Hospital Ulm, Leimgrubenweg 14, 89075 Ulm, Germany
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