Hypobaric hypoxia (HH) occurring at high altitude activates the sympathetic nervous system (SNS) and increases circulating erythropoietin (Epo) levels. Epo stimulates red blood cell production (erythropoiesis), enhancing oxygen transport in arterial blood to counteract hypoxemia. Present study tested the hypothesis that SNS contributes to Epo activation by HH through epinephrine (Epi) release from the adrenal medullae. Adult male C57B6 mice were exposed to 18 hours of HH (0.4 atm), and renal Epo mRNA and plasma Epo levels were measured. HH increased Epo mRNA and plasma Epo levels, and SNS activation, as indicated by elevated plasma NE and Epi levels. In adrenalmedullectomized mice, HH-induced Epo response was reduced, correlating with decreased circulating NE and absence of Epi elevation. Epi, but not NE infusion, mimicked the effects of HH in room air breathing mice. Epo responses to HH were reduced with β-adrenergic receptor (AR) blockade using dl-propranolol and in β2 adrenergic receptor knockout mice. Mice with heterozygous Hif-2α deficiency ( Hif-2α+/-), but not Hif-1α+/-, showed attenuated the Epo gene activation and elevated plasma Epo levels in response to HH and Epi infusion. These results demonstrate that adrenal Epi facilitates the Epo gene activation by HH through interaction of β2 AR with HIF-2α.
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