Abstract
High-altitude polycythemia (HAPC) is a common aspect of chronic mountain sickness (CMS) caused by hypoxia and is the main cause of other symptoms associated with CMS. However, its pathogenesis and the mechanisms of high-altitude acclimation have not been fully elucidated. Exposure to high altitude is associated with elevated inflammatory mediators. In this study, the subjects were recruited and placed into a plain control (PC) group, plateau control (PUC) group, early HAPC (eHAPC) group, or a confirmed HAPC (cHAPC) group. Serum samples were collected, and inflammatory factors were measured by a novel antibody array methodology. The serum levels of interleukin-2 (IL-2), interleukin-3 (IL-3), and macrophage chemoattractant protein-1 (MCP-1) in the eHAPC group and the levels of interleukin-1 beta (IL-1 beta), IL-2, IL-3, tumor necrosis factor-alpha (TNF-alpha), MCP-1, and interleukin-16 (IL-16) in the cHAPC group were higher than those in the PUC group. More interestingly, the expression of IL-1 beta, IL-2, IL-3, TNF-alpha, MCP-1, and IL-16 in the PUC group showed a remarkable lower value than that in the PC group. These results suggest that these six factors might be involved in the pathogenesis of HAPC as well as acclimation to high altitudes. Altered inflammatory factors might be new biomarkers for HAPC and for high-altitude acclimation.
Highlights
High-altitude polycythemia (HAPC) occurs in 5% to 18% of the population residing on the Qinghai-Tibetan Plateau
30 early HAPC patients; 24 confirmed HAPC patients; 36 healthy control subjects who had been living on the Qinghai-Tibetan plateau for at least one year, most one to two years, who were born in low-altitude and previously lived in low-altitude areas; and 30 control subjects from low-altitude areas were recruited from the young male Han population between May 2010 and Oct 2011
There was a statistical difference in age between the plateau control (PUC) and confirmed HAPC (cHAPC) groups (p < 0:05)
Summary
HAPC occurs in 5% to 18% of the population residing on the Qinghai-Tibetan Plateau. It is caused by hypobaric hypoxia and is characterized by excessive erythrocytosis [1]. According to the Qinghai diagnostic criteria in 2004, HAPC is defined as hemoglobin concentration higher than 210 g/L in male and 190 g/L in female, accompanied by the symptoms of breathlessness, palpitations, sleep disturbance, and headache. On. Mediators of Inflammation the other hand, some people can show acclimations to hypoxic environments, which indicated as lower hemoglobin levels, higher oxygen saturation of the blood, higher work performance, and few symptoms than HAPC when residing at high altitude. Other mechanisms which contribute to high-altitude acclimation are still largely unknown and need to be clarified
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