King of the mountains: Tibetan and Sherpa physiological adaptations for life at high altitude

Gilbert-Kawai, Edward T, Milledge, James S, Grocott, Michael P W and Martin, Daniel S (2014) King of the mountains: Tibetan and Sherpa physiological adaptations for life at high altitude. Physiology, 29 (6), 388-402. (doi:10.1152/physiol.00018.2014). (PMID:25362633)

Abstract

Anecdotal evidence surrounding Tibetans' and Sherpas' exceptional tolerance to hypobaric hypoxia has been recorded since the beginning of high-altitude exploration. These populations have successfully lived and reproduced at high altitude for hundreds of generations with hypoxia as a constant evolutionary pressure. Consequently, they are likely to have undergone natural selection toward a genotype (and phenotype) tending to offer beneficial adaptation to sustained hypoxia. With the advent of translational human hypoxic research, in which genotype/phenotype studies of healthy individuals at high altitude may be of benefit to hypoxemic critically ill patients in a hospital setting, high-altitude natives may provide a valuable and intriguing model. The aim of this review is to provide a comprehensive summary of the scientific literature encompassing Tibetan and Sherpa physiological adaptations to a high-altitude residence. The review demonstrates the extent to which evolutionary pressure has refined the physiology of this high-altitude population. Furthermore, although many physiological differences between highlanders and lowlanders have been found, it also suggests many more potential avenues of investigation.

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Contributors

Author: Michael P W Grocott

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