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Higher blood flow and circulating NO products offset high-altitude hypoxia among Tibetans

Higher blood flow and circulating NO products offset high-altitude hypoxia among Tibetans
Higher blood flow and circulating NO products offset high-altitude hypoxia among Tibetans
The low barometric pressure at high altitude causes lower arterial oxygen content among Tibetan highlanders, who maintain normal levels of oxygen use as indicated by basal and maximal oxygen consumption levels that are consistent with sea level predictions. This study tested the hypothesis that Tibetans resident at 4,200 m offset physiological hypoxia and achieve normal oxygen delivery by means of higher blood flow enabled by higher levels of bioactive forms of NO, the main endothelial factor regulating blood flow and vascular resistance. The natural experimental study design compared Tibetans at 4,200 m and U.S. residents at 206 m. Eighty-eight Tibetan and 50 U.S. resident volunteers (18-56 years of age, healthy, nonsmoking, nonhypertensive, not pregnant, with normal pulmonary function) participated. Forearm blood flow, an indicator of systemic blood flow, was measured noninvasively by using plethysmography at rest, after breathing supplemental oxygen, and after exercise. The Tibetans had more than double the forearm blood flow of low-altitude residents, resulting in greater than sea level oxygen delivery to tissues. In comparison to sea level controls, Tibetans had >10-fold-higher circulating concentrations of bioactive NO products, including plasma and red blood cell nitrate and nitroso proteins and plasma nitrite, but lower concentrations of iron nitrosyl complexes (HbFeIINO) in red blood cells. This suggests that NO production is increased and that metabolic pathways controlling formation of NO products are regulated differently among Tibetans. These findings shift attention from the traditional focus on pulmonary and hematological systems to vascular factors contributing to adaptation to high-altitude hypoxia.
0027-8424
17593-175988
Erzurum, S. C.
9ca085d8-1f21-4226-9f95-4715747d40c5
Ghosh, S.
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Janocha, A. J.
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Xu, W.
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Bauer, S.
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Bryan, N. S.
13350e17-a3a7-4700-ae78-29fbb737d7af
Tejero, J.
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Hemann, C.
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Hille, R.
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Stuehr, D. J.
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Feelisch, M
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Beall, C. M.
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Erzurum, S. C.
9ca085d8-1f21-4226-9f95-4715747d40c5
Ghosh, S.
9fd40cd1-34b3-4ffe-adf4-44e39c2dd576
Janocha, A. J.
f9539e94-aecd-4240-b746-fe3542d47fbf
Xu, W.
367fce1d-4335-45cc-995c-5aa75de74278
Bauer, S.
c3c4afc3-0988-4f44-b9cc-279a47b8cef3
Bryan, N. S.
13350e17-a3a7-4700-ae78-29fbb737d7af
Tejero, J.
315ca7f8-47ad-4ff5-a6d9-9ea1daa3b94e
Hemann, C.
7c6e74e6-07b1-4223-a69e-43fda53a746b
Hille, R.
53209592-beff-48ae-a387-833626ee7786
Stuehr, D. J.
58c117b5-e96d-4d12-bb1e-0aca4ecafe63
Feelisch, M
8c1b9965-8614-4e85-b2c6-458a2e17eafd
Beall, C. M.
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Erzurum, S. C., Ghosh, S., Janocha, A. J., Xu, W., Bauer, S., Bryan, N. S., Tejero, J., Hemann, C., Hille, R., Stuehr, D. J., Feelisch, M and Beall, C. M. (2007) Higher blood flow and circulating NO products offset high-altitude hypoxia among Tibetans. Proceedings of the National Academy of Sciences of the United States of America, 104 (45), 17593-175988. (doi:10.1073/pnas.0707462104). (PMID:12614846)

Record type: Article

Abstract

The low barometric pressure at high altitude causes lower arterial oxygen content among Tibetan highlanders, who maintain normal levels of oxygen use as indicated by basal and maximal oxygen consumption levels that are consistent with sea level predictions. This study tested the hypothesis that Tibetans resident at 4,200 m offset physiological hypoxia and achieve normal oxygen delivery by means of higher blood flow enabled by higher levels of bioactive forms of NO, the main endothelial factor regulating blood flow and vascular resistance. The natural experimental study design compared Tibetans at 4,200 m and U.S. residents at 206 m. Eighty-eight Tibetan and 50 U.S. resident volunteers (18-56 years of age, healthy, nonsmoking, nonhypertensive, not pregnant, with normal pulmonary function) participated. Forearm blood flow, an indicator of systemic blood flow, was measured noninvasively by using plethysmography at rest, after breathing supplemental oxygen, and after exercise. The Tibetans had more than double the forearm blood flow of low-altitude residents, resulting in greater than sea level oxygen delivery to tissues. In comparison to sea level controls, Tibetans had >10-fold-higher circulating concentrations of bioactive NO products, including plasma and red blood cell nitrate and nitroso proteins and plasma nitrite, but lower concentrations of iron nitrosyl complexes (HbFeIINO) in red blood cells. This suggests that NO production is increased and that metabolic pathways controlling formation of NO products are regulated differently among Tibetans. These findings shift attention from the traditional focus on pulmonary and hematological systems to vascular factors contributing to adaptation to high-altitude hypoxia.

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More information

e-pub ahead of print date: 30 October 2007
Published date: 6 November 2007
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 337825
URI: http://eprints.soton.ac.uk/id/eprint/337825
ISSN: 0027-8424
PURE UUID: d460193a-446f-4afb-939d-fc5d3372c000
ORCID for M Feelisch: ORCID iD orcid.org/0000-0003-2320-1158

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Date deposited: 04 May 2012 11:57
Last modified: 15 Mar 2024 03:41

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Contributors

Author: S. C. Erzurum
Author: S. Ghosh
Author: A. J. Janocha
Author: W. Xu
Author: S. Bauer
Author: N. S. Bryan
Author: J. Tejero
Author: C. Hemann
Author: R. Hille
Author: D. J. Stuehr
Author: M Feelisch ORCID iD
Author: C. M. Beall

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