Abstract

Previous investigations have indicated that environmental and genetic factors collectively contribute to the development of acute mountain sickness (AMS), but whether the EDN1 gene is involved in AMS remains to be elucidated. A total of 356 healthy male soldiers who had not traveled to high altitudes in the previous 12 months were enrolled in our study. All participants were taken by plane from 500 m (Chengdu in Sichuan Province) to a 3700 m highland (Lhasa) within 2 hours. Clinical data were collected within 24 hours, and pulmonary function parameters were completed simultaneously. Genotypes were obtained by using iMLDR genotyping assays. A total of 237 soldiers (66.57%) presented AMS symptoms, including headache, dizziness, gastrointestinal upset and fatigue. Soldiers with AMS showed an increase in heart rate (HR), plasma tryptophan and serotonin, and a decrease in SaO2, FEV1, PEF, FVC, V75, V50, V25 and MMF (all P < 0.01). Notably, allele T in single nucleotide polymorphism (SNP) rs2070699 showed a positive correlation with the occurrence of AMS. A general linear regression analysis showed that rs2060799, Mean Arterial Pressure (MAP), SaO2, FVC, tryptophan and serotonin were independent predictors for the occurrence of AMS. Importantly, the area under the curve (AUC) values for tryptophan (0.998), serotonin (0.912) and FVC (0.86) had diagnostic specificity and sensitivity. Our results demonstrated that AMS is accompanied by changes in lung function parameters, increased plasma tryptophan and serotonin levels, and that the EDN1 polymorphism is a potential risk factor for AMS.

Highlights

  • Previous investigations have indicated that environmental and genetic factors collectively contribute to the development of acute mountain sickness (AMS), but whether the EDN1 gene is involved in AMS remains to be elucidated

  • Genome-wide association studies and other genetic investigations have found that some genes (PPAR-alpha, EPAS1 and EGLN1) regulated through the hypoxia-inducible factor (HIF) pathway are closely related to hypoxia adaptation in native Tibetan and Andean populations at high altitudes[9,10,11,12]

  • Soldiers with AMS showed an increase in heart rate (HR), tryptophan, and serotonin and a decrease in SaO2, forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), forced vital capacity (FVC), V75, V50, V25 and maximum mid-expiratory flow (MMF)

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Summary

Introduction

Previous investigations have indicated that environmental and genetic factors collectively contribute to the development of acute mountain sickness (AMS), but whether the EDN1 gene is involved in AMS remains to be elucidated. Previous work demonstrated that polymorphisms of the EPAS1 and EGLN1 genes are associated with susceptibility to acute mountain sickness (AMS) in a Han Chinese population[15,16,17]. Research has indicated that the EPAS1 and EGLN1 proteins interact with endothelin-1 (ET-1, encoded by the gene EDN1), and ET-1 variants have independent and interactive roles in the susceptibility to high altitude pulmonary edema[18]. Current research aims to investigate the polymorphisms of the EDN1 gene associated with AMS in a large Han Chinese soldier population, which may contribute to the prediction of the development of AMS

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