The 2018 Global Research Expedition on Altitude Related Chronic Health (Global REACH) to Cerro de Pasco, Peru: an Experimental Overview.
Andean highlanders
Global REACH
high altitude
hypobaric hypoxia
Journal
Experimental physiology
ISSN: 1469-445X
Titre abrégé: Exp Physiol
Pays: England
ID NLM: 9002940
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
25
11
2019
accepted:
26
03
2020
pubmed:
3
4
2020
medline:
22
2
2022
entrez:
3
4
2020
Statut:
ppublish
Résumé
What is the central question of this study? Herein, a methodological overview of our research team's (Global REACH) latest high altitude research expedition to Peru is provided. What is the main finding and its importance? The experimental objectives, expedition organization, measurements and key cohort data are discussed. The select data presented in this manuscript demonstrate the haematological differences between lowlanders and Andeans with and without excessive erythrocytosis. The data also demonstrate that exercise capacity was similar between study groups at high altitude. The forthcoming findings from our research expedition will contribute to our understanding of lowlander and indigenous highlander high altitude adaptation. In 2016, the international research team Global Research Expedition on Altitude Related Chronic Health (Global REACH) was established and executed a high altitude research expedition to Nepal. The team consists of ∼45 students, principal investigators and physicians with the common objective of conducting experiments focused on high altitude adaptation in lowlanders and in highlanders with lifelong exposure to high altitude. In 2018, Global REACH travelled to Peru, where we performed a series of experiments in the Andean highlanders. The experimental objectives, organization and characteristics, and key cohort data from Global REACH's latest research expedition are outlined herein. Fifteen major studies are described that aimed to elucidate the physiological differences in high altitude acclimatization between lowlanders (n = 30) and Andean-born highlanders with (n = 22) and without (n = 45) excessive erythrocytosis. After baseline testing in Kelowna, BC, Canada (344 m), Global REACH travelled to Lima, Peru (∼80 m) and then ascended by automobile to Cerro de Pasco, Peru (∼4300 m), where experiments were conducted over 25 days. The core studies focused on elucidating the mechanism(s) governing cerebral and peripheral vascular function, cardiopulmonary regulation, exercise performance and autonomic control. Despite encountering serious logistical challenges, each of the proposed studies was completed at both sea level and high altitude, amounting to ∼780 study sessions and >3000 h of experimental testing. Participant demographics and data relating to acid-base balance and exercise capacity are presented. The collective findings will contribute to our understanding of how lowlanders and Andean highlanders have adapted under high altitude stress.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
86-103Informations de copyright
© 2020 The Authors. Experimental Physiology © 2020 The Physiological Society.
Références
Aessopos, A., Farmakis, D., Taktikou, H., & Loukopoulos, D. (2000). Doppler-determined peak systolic tricuspid pressure gradient in persons with normal pulmonary function and tricuspid regurgitation. Journal of the American Society of Echocardiography, 13, 645-649.
Aldenderfer, M. S. (2003). Moving up in the world: Archaeologists seek to understand how and when people came to occupy the Andean and Tibetan plateaus. American Scientist, 91, 542-549.
Aldenderfer, M. S. (2008). High elevation foraging societies. In H. G. Silverman & W. H. Isbell (Eds.), Handbook of South American Archaeology, (pp. 131-143). New York: Springer.
Alkorta-Aranburu, G., Beall, C. M., Witonsky, D. B., Gebremedhin, A., Pritchard, J. K., & Di Rienzo, A. (2012). The genetic architecture of adaptations to high altitude in Ethiopia. PLoS Genetics, 8, e1003110.
Bailey, D. M., Rasmussen, P., Evans, K. A., Bohm, A. M., Zaar, M., Nielsen, H. B., … Secher, N. H. (2018). Hypoxia compounds exercise-induced free radical formation in humans; partitioning contributions from the cerebral and femoral circulation. Free Radical and Biology Medicine, 124, 104-113.
Bailey, D. M., Rasmussen, P., Overgaard, M., Evans, K. A., Bohm, A. M., Seifert, T., … Secher, N. H. (2017). Nitrite and S-nitrosohemoglobin exchange across the human cerebral and femoral circulation: Relationship to basal and exercise blood flow responses to hypoxia. Circulation, 135, 166-176.
Bailey, D. M., Rimoldi, S. F., Rexhaj, E., Pratali, L., Salinas Salmòn, C., Villena, M., … Sartori, C. (2013). Oxidative-nitrosative stress and systemic vascular function in highlanders with and without exaggerated hypoxemia. Chest, 143, 444-451.
Baskurt, O. K., Boynard, M., Cokelet, G. C., Connes, P., Cooke, B. M., Forconi, S., … Wautier, J. L. (2009). New guidelines for hemorheological laboratory techniques. Clinical Hemorheology and Microcirculation, 42, 75-97.
Beall, C. M. (2006). Andean, Tibetan, and Ethiopian patterns of adaptation to high-altitude hypoxia. Integrative and Comparative Biology, 46, 18-24.
Beall, C. M. (2007a). Detecting natural selection in high-altitude human populations. Respiratory Physiology and Neurobiology, 158, 161-171.
Beall, C. M. (2007b). Two routes to functional adaptation: Tibetan and Andean high-altitude natives. Proceedings of the National Academy of Sciences of the United States of America, 104(Suppl 1), 8655-8660.
Beall, C. M. (2013). Human adaptability studies at high altitude: Research designs and major concepts during fifty years of discovery. American Journal of Human Biology, 25, 141-147.
Beall, C. M., Decker, M. J., Brittenham, G. M., Kushner, I., Gebremedhin, A., & Strohl, K. P. (2002). An Ethiopian pattern of human adaptation to high-altitude hypoxia. Proceedings of the National Academy of Sciences of the United States of America, 99, 17215-17218.
Berlin, N. I., Waldmann, T. A., & Weissman, S. M. (1959). Life span of red blood cell. Physiological Reviews, 39, 577-616.
Bermudez, D., Azad, P., Figueroa-Mujíca, R., Vizcardo-Galindo, G., Corante, N., Guerra-Giraldez, C., … Villafuerte, F. C. (2020). Increased hypoxic proliferative response and gene expression in erythroid progenitor cells of Andean highlanders with chronic mountain sickness. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 318, R49-R56.
Bertini, M., Sengupta, P. P., Nucifora, G., Delgado, V., Ng, A. C., Marsan, N. A., … Bax, J. J. (2009). Role of left ventricular twist mechanics in the assessment of cardiac dyssynchrony in heart failure. JACC. Cardiovascular Imaging, 2, 1425-1435.
Carr, J., Stone, R. M., Tymko, C., Tymko, K., Coombs, G. B., Hoiland, R., … Patrician, A. (2020). Global REACH 2018: The effect of an expiratory resistance mask with deadspace on sleep and acute mountain sickness during acute exposure to hypobaric hypoxia. High Altitude Medicine and Biology, in press.
Cole, A. M., Petousi, N., Cavalleri, G. L., & Robbins, P. A. (2014). Genetic variation in SENP1 and ANP32D as predictors of chronic mountain sickness. High Altitude Medicine and Biology, 15, 497-499.
Cole, W. R., Arrieux, J. P., Schwab, K., Ivins, B. J., Qashu, F. M., & Lewis, S. C. (2013). Test-retest reliability of four computerized neurocognitive assessment tools in an active duty military population. Archives of Clinical Neuropsychology, 28, 732-742.
Cymerman, A., Reeves, J. T., Sutton, J. R., Rock, P. B., Groves, B. M., Malconian, M. K., … Houston, C. S. (1989). Operation Everest II: Maximal oxygen uptake at extreme altitude. Journal of Applied Physiology, 66, 2446-2453.
Delius, W., Hagbarth, K. E., Hongell, A., & Wallin, B. G. (1972). Manoeuvres affecting sympathetic outflow in human muscle nerves. Acta Physiologica Scandinavica, 84, 82-94.
Dempsey, J. A., Forster, H. V., Chosy, L. W., Hanson, P. G., & Reddan, W. G. (1978). Regulation of CSF[HCO3−] during long-term hypoxic hypocapnia in man. Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology, 44, 175-182.
Foster, G. E., Ainslie, P. N., Stembridge, M., Day, T. A., Bakker, A., Lucas, S. J., … Lovering, A. T. (2014). Resting pulmonary haemodynamics and shunting: A comparison of sea-level inhabitants to high altitude Sherpas. The Journal of Physiology, 592, 1397-1409.
Gassmann, M., Mairbaurl, H., Livshits, L., Seide, S., Hackbusch, M., Malczyk, M., … Muckenthaler, M. U. (2019). The increase in hemoglobin concentration with altitude varies among human populations. Annals of the New York Academy of Sciences, 1450, 204-220.
Gilbert-Kawai, E. T., Milledge, J. S., Grocott, M. P., & Martin, D. S. (2014). King of the mountains: Tibetan and Sherpa physiological adaptations for life at high altitude. Physiology (Bethesda), 29, 388-402.
Gnasso, A., Carallo, C., Irace, C., De Franceschi, M. S., Mattioli, P. L., Motti, C., & Cortese, C. (2001). Association between wall shear stress and flow-mediated vasodilation in healthy men. Atherosclerosis, 156, 171-176.
Groepenhoff, H., Overbeek, Mulè, M. J., van der Plas, M., Argiento, M., Villafuerte, P., … Naeije, R. (2012). Exercise pathophysiology in patients with chronic mountain sickness. Chest, 142, 877-884.
Haas, R., Stefanescu, I. C., Garcia-Putnam, A., Aldenderfer, M. S., Clementz, M. T., Murphy, M. S., … Watson, J. T. (2017). Humans permanently occupied the Andean highlands by at least 7 ka. Royal Society Open Science, 4, 170331.
Hoiland, R. L., Howe, C. A., Carter, H. H., Tremblay, J. C., Willie, C. K., Donnelly, J., … Ainslie, P. N. (2019). UBC-Nepal expedition: Phenotypical evidence for evolutionary adaptation in the control of cerebral blood flow and oxygen delivery at high altitude. The Journal of Physiology, 597, 2993-3008.
Horscroft, J. A., Kotwica, A. O., Laner, V., West, J. A., Hennis, P. J., Levett, D. Z. H., … Murray, A. J. (2017). Metabolic basis to Sherpa altitude adaptation. Proceedings of the National Academy of Sciences of the United States of America, 114, 6382-6387.
Hsieh, M. M., Callacondo, D., Rojas-Camayo, J., Quesada-Olarte, J., Wang, X., Uchida, N., … Tisdale, J. F. (2016). SENP1, but not fetal hemoglobin, differentiates Andean highlanders with chronic mountain sickness from healthy individuals among Andean highlanders. Experimental Hematology, 44, 483-490.e482.
Lang, R. M., Badano, L. P., Mor-Avi, V., Afilalo, J., Armstrong, A., Ernande, L., … Voigt, J. U. (2015). Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of American Society of Echocardiography, 28, 1-39.e14.
Lenfant, C., Torrance, J. D., & Reynafarje, C. (1971). Shift of the O2-Hb dissociation curve at altitude: Mechanism and effect. Journal of Applied Physiology, 30, 625-631.
Léon-Velarde, F., Maggiorini, M., Reeves, J. T., Aldashev, A., Asmus, I., Bernardi, L., … Zubieta-Calleja, G. (2005). Consensus statement on chronic and subacute high altitude diseases. High Altitude Medicine and Biology, 6, 147-157.
Léon-Velarde, F., Ramos, M. A., Hernández, J. A., De Idiáquez, D., Muñoz, L. S., Gaffo, A., … Monge, C. (1997). The role of menopause in the development of chronic mountain sickness. The American Journal of Physiology, 272, R90-R94.
Léon-Velarde, F., Rivera-Chira, M., Tapia, R., Huicho, L., & Monge, C. C. (2001). Relationship of ovarian hormones to hypoxemia in women residents of 4,300 m. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 280, R488-R493.
Levett, D. Z., Martin, D. S., Wilson, M. H., Mitchell, K., Dhillon, S., Rigat, F., … Grocott, M. P. (2010). Design and conduct of Caudwell Xtreme Everest: An observational cohort study of variation in human adaptation to progressive environmental hypoxia. BMC Medical Research Methodology, 10, 98.
Lewis, N. C. S., Bailey, D. M., duManoir, G. R., Messinger, L., Lucas, S. J. E., Cotter, J. D., … Ainslie, P. N. (2014). Conduit artery structure and function in lowlanders and native highlanders: Relationships with oxidative stress and role of sympathoexcitation. The Journal of Physiology, 592, 1009-1024.
Lipman, G. S., Kanaan, N. C., Phillips, C., Pomeranz, D., Cain, P., Fontes, K., … Walsh, D. (2015). Study Looking at End Expiratory Pressure for Altitude Illness Decrease (SLEEP-AID). High Altitude Medicine and Biology, 16, 154-161.
Liu, J., Liu, Y., Ren, L. H., Li, L., Wang, Z., Liu, S. S., … Cao, T. S. (2016). Effects of race and sex on cerebral hemodynamics, oxygen delivery and blood flow distribution in response to high altitude. Scientific Reports, 6, 30500.
Mano, T., Iwase, S., & Toma, S. (2006). Microneurography as a tool in clinical neurophysiology to investigate peripheral neural traffic in humans. Clinical Neurophysiology, 117, 2357-2384.
Monge, C., Léon-Velarde, F., & Arregui, A. (1989). Increasing prevalence of excessive erythrocytosis with age among healthy high-altitude miners. New England Journal of Medicine, 321, 1271.
Morgan, T. J. (2009). The Stewart approach - one clinician's perspective. The Clinical Biochemist. Reviews, 30, 41-54.
Orr, J. E., Heinrich, E. C., Djokic, M., Gilbertson, D., Deyoung, P. N., Anza-Ramirez, C., … Simonson, T. (2018). Adaptive servoventilation as treatment for central sleep apnea due to high-altitude periodic breathing in nonacclimatized healthy individuals. High Altitude Medicine and Biology, 19, 178-184.
Pei, T., Li, X., Tao, F., Xu, H., You, H., Zhou, L., … Gao, Y. (2012). Burden of disease resulting from chronic mountain sickness among young Chinese male immigrants in Tibet. BMC Public Health, 12, 401.
Penaloza, D., & Arias-Stella, J. (2007). The heart and pulmonary circulation at high altitudes: Healthy highlanders and chronic mountain sickness. Circulation, 115, 1132-1146.
Pillar, G., Berall, M., Berry, R., Etzioni, T., Shrater, N., Hwang, D., … Penzel, T. (2019). Detecting central sleep apnea in adult patients using WatchPAT-a multicenter validation study. Sleep & Breathing, 24(1), 387-398. 10.1007/s11325-019-01904-5
Pleurdeau, D. (2005). Human technical behavior in the African Middle Stone Age: The lithic assemblage of Porc-Epic Cave (Dire Dawa, Ethiopia). African Archaeological Review, 22, 177-197.
Porcelli, S., Marzorati, M., Healey, B., Terraneo, L., Vezzoli, A., Bella, S. D., … Samaja, M. (2017). Lack of acclimatization to chronic hypoxia in humans in the Antarctica. Scientific Reports, 7, 18090.
Rudski, L. G., Lai, W. W., Afilalo, J., Hua, L., Handschumacher, M. D., Chandrasekaran, K., … Schiller, N. B. (2010). Guidelines for the echocardiographic assessment of the right heart in adults: A report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. Journal of the American Society of Echocardiography, 23, 685-713; quiz 786-688.
Ryan, B. J., Wachsmuth, N. B., Schmidt, W. F., Byrnes, W. C., Julian, C. G., Lovering, A. T., … Roach, R. C. (2014). AltitudeOmics: Rapid hemoglobin mass alterations with early acclimatization to and de-acclimatization from 5260 m in healthy humans. PLoS One, 9, e108788.
Sahota, I. S., & Panwar, N. S. (2013). Prevalence of chronic mountain sickness in high altitude districts of Himachal Pradesh. Indian Journal of Occupational and Environmental Medicine, 17, 94-100.
Samaja, M., Mariani, C., Prestini, A., & Cerretelli, P. (1997). Acid-base balance and O2 transport at high altitude. Acta Physiologica Scandinavica, 159, 249-256.
Schmidt, W., & Prommer, N. (2005). The optimised CO-rebreathing method: A new tool to determine total haemoglobin mass routinely. European Journal of Applied Physiology, 95, 486-495.
Severinghaus, J. W., Mitchell, R. A., Richardson, B. W., & Singer, M. M. (1963). Respiratory control at high altitude suggesting active transport regulation of CSF pH. Journal of Applied Physiology, 18, 1155-1166.
Sherpa, L. Y., Deji Stigum, H., Chongsuvivatwong, V., Thelle, D. S., & Bjertness, E. (2010). Obesity in Tibetans aged 30-70 living at different altitudes under the north and south faces of Mt. Everest. International Journal of Environmental Research and Public Health, 7, 1670-1680.
Siebenmann, C., Keiser, S., Robach, P., & Lundby, C. (2017). CORP: The assessment of total hemoglobin mass by carbon monoxide rebreathing. Journal of Applied Physiology, 123, 645-654.
Simpson, L. L., Busch, S. A., Oliver, S. J., Ainslie, P. N., Stembridge, M., Steinback, C. D., & Moore, J. P. (2019). Baroreflex control of sympathetic vasomotor activity and resting arterial pressure at high altitude: Insight from lowlanders and Sherpa. The Journal of Physiology, 597, 2379-2390.
Smith, K. J., MacLeod, D., Willie, C. K., Lewis, N. C., Hoiland, R. L., Ikeda, K., … Ainslie, P. N. (2014). Influence of high altitude on cerebral blood flow and fuel utilization during exercise and recovery. The Journal of Physiology, 592, 5507-5527.
Stembridge, M., Ainslie, P. N., Boulet, L. M., Anholm, J., Subedi, P., Tymko, M. M., … Shave, R. (2019). The independent effects of hypovolaemia and pulmonary vasoconstriction on ventricular function and exercise capacity during acclimatisation to 3800 m. The Journal of Physiology, 597, 1059-1072.
Swenson, E. R. (2012). Normal exercise capacity in chronic mountain sickness: How high can the hematocrit go without consequence? Chest, 142, 823-825.
Thomas, K. N., Lewis, N. C., Hill, B. G., & Ainslie, P. N. (2015). Technical recommendations for the use of carotid duplex ultrasound for the assessment of extracranial blood flow. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 309, R707-R720.
Tremblay, J. C., Hoiland, R. L., Carter, H. H., Howe, C. A., Stembridge, M., Willie, C. K., … Ainslie, P. N. (2018). UBC-Nepal expedition: Upper and lower limb conduit artery shear stress and flow-mediated dilation on ascent to 5,050 m in lowlanders and Sherpa. American Journal of Physiology-Heart and Circulatory Physiology, 315, H1532-H1543.
Tremblay, J. C., Howe, C. A., Ainslie, P. N., & Pyke, K. E. (2018). UBC-Nepal Expedition: Imposed oscillatory shear stress does not further attenuate flow-mediated dilation during acute and sustained hypoxia. American Journal of Physiology- Heart and Circulatory Physiology, 315, H122-H131.
Tremblay, J. C., Thom, S. R., Yang, M., & Ainslie, P. N. (2017). Oscillatory shear stress, flow-mediated dilatation, and circulating microparticles at sea level and high altitude. Atherosclerosis, 256, 115-122.
Tymko, M. M., Ainslie, P. N., MacLeod, D. B., Willie, C. K., & Foster, G. E. (2015). End tidal-to-arterial CO2 and O2 gas gradients at low- and high-altitude during dynamic end-tidal forcing. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 308, R895-R906.
Tymko, M. M., Hoiland, R. L., Kuca, T., Boulet, L. M., Tremblay, J. C., Pinske, B. K., … Foster, G. E. (2016). Measuring the human ventilatory and cerebral blood flow response to CO2: A technical consideration for the end-tidal-to-arterial gas gradient. Journal of Applied Physiology, 120, 282-296.
Tymko, M. M., Tremblay, J. C., Hansen, A. B., Howe, C. A., Willie, C. K., Stembridge, M., … Ainslie, P. N. (2017). The effect of α1-adrenergic blockade on post-exercise brachial artery flow-mediated dilatation at sea level and high altitude. The Journal of Physiology, 595, 1671-1686.
Villafuerte, F. C., & Corante, N. (2016). Chronic mountain sickness: Clinical aspects, etiology, management, and treatment. High Altitude Medcine and Biology, 17, 61-69.
Wang, X., Wei, W., Yuan, F., Li, S., Lin, J., & Zhang, J. (2018). Regional cerebral blood flow in natives at high altitude: An arterial spin labeled MRI study. Journal of Magnetic Resonance Imaging, 48, 708-717.
Wehrlin, J. P., & Hallen, J. (2006). Linear decrease in V̇O2max and performance with increasing altitude in endurance athletes. European Journal of Applied Physiology, 96, 404-412.
Willie, C. K., Colino, F. L., Bailey, D. M., Tzeng, Y. C., Binsted, G., Jones, L. W., … Ainslie, P. N. (2011). Utility of transcranial Doppler ultrasound for the integrative assessment of cerebrovascular function. Journal of Neuroscience Methods, 196, 221-237.
Willie, C. K., Smith, K. J., Day, T. A., Ray, L. A., Lewis, N. C., Bakker, A., … Ainslie, P. N. (2014). Regional cerebral blood flow in humans at high altitude: Gradual ascent and 2 wk at 5,050 m. Journal of Applied Physiology, 116, 905-910.
Willie, C. K., Stembridge, M., Hoiland, R. L., Tymko, M. M., Tremblay, J. C., Patrician, A., … Ainslie, P. N. (2018). UBC-Nepal Expedition: An experimental overview of the 2016 University of British Columbia Scientific Expedition to Nepal Himalaya. PLoS One, 13, e0204660.
Woolcott, O. O., Gutierrez, C., Castillo, O. A., Elashoff, R. M., Stefanovski, D., & Bergman, R. N. (2016). Inverse association between altitude and obesity: A prevalence study among Andean and low-altitude adult individuals of Peru. Obesity (Silver Spring), 24, 929-937.
Yalamanchali, S., Farajian, V., Hamilton, C., Pott, T. R., Samuelson, C. G., & Friedman, M. (2013). Diagnosis of obstructive sleep apnea by peripheral arterial tonometry: Meta-analysis. JAMA Otolaryngology Head and Neck Surgery, 139, 1343-1350.
Zhang, X. L., Ha, B. B., Wang, S. J., Chen, Z. J., Ge, J. Y., Long, H., … Gao, X. (2018). The earliest human occupation of the high-altitude Tibetan Plateau 40 thousand to 30 thousand years ago. Science, 362, 1049-1051.
Zhou, D., Udpa, N., Ronen, R., Stobdan, T., Liang, J., Appenzeller, O., … Haddad, G. G. (2013). Whole-genome sequencing uncovers the genetic basis of chronic mountain sickness in Andean highlanders. American Journal of Human Genetics, 93, 452-462.