Status of Research on Molecular Mechanisms and Management of Acute Mountain Sickness

CHEN Ling , WU Shizheng, LUO Fengming

Abstract

Acute mountain sickness (AMS), a condition characterized primarily by symptoms such as headache and nausea, has a high incidence and seriously affects the life and health of individuals undertaking rapid ascensions to high altitudes. The main pathophysiological manifestations of AMS include cerebral vasodilation and transient increases in intracranial pressure, with severe cases potentially incurring cerebral edema. The occurrence and development of AMS is associated with factors such as the susceptibility, physiological state, and psychological state of an individual. The molecular mechanisms involved include inflammatory responses, oxidative stress, immune regulation, and energy metabolism at the levels of genes, proteins, and metabolism. The management of AMS includes both prevention and treatment strategies. This article provides a comprehensive discussion of AMS from several aspects, including diagnosis, pathophysiological manifestations, susceptibility factors, molecular mechanisms, and prevention and treatment strategies.

 

Keywords: Acute mountain sickness, Pathophysiology, Susceptibility factors, Mechanism, Prevention and treatment, Review

 

Full Text:

PDF


References


Introduction of the nomenclature, classification and diagnosis criteria of high altitude disease in China (Chinese Medical Association Standard in 1995) and its English translation. J High Alt Med, 2010, 1: 5-9.

LUKS A M, BEIDLEMAN B A, FREER L, et al. Wilderness Medical Society clinical practice guidelines for the prevention, diagnosis, and treatment of acute altitude illness: 2024 update. Wilderness Environ Med, 2024, 35(1_suppl): 2S-19S. doi: 10.1016/j.wem.2023.05.013.

ROACH R C, HACKETT P H, OELZ O, et al. The 2018 Lake Louise acute mountain sickness score. High Alt Med Biol, 2018, 19(1): 4-6. doi: 10. 1089/ham.2017.0164.

HONIGMAN B, THEIS M K, KOZIOL-MCLAIN J, et al. Acute mountain sickness in a general tourist population at moderate altitudes. Ann Intern Med, 1993, 118(8): 587-592. doi: 10.7326/0003-4819-118-8-199304150-00003.

WU T Y, DING S Q, LIU J L, et al. Who are more at risk for acute mountain sickness: a prospective study in Qinghai-Tibet railroad construction workers on Mt.Tanggula. Chin Med J (Engl), 2012, 125(8): 1393-1400.

SIBOMANA I, FOOSE D P, RAYMER M L, et al. Urinary metabolites as predictors of acute mountain sickness severity. Front Physiol, 2021, 12: 709804. doi: 10.3389/fphys.2021.709804.

ARALDI E, SCHIPANI E. Hypoxia, HIFs and bone development. Bone, 2010, 47(2): 190-196. doi: 10.1016/j.bone.2010.04.606.

ANDERSON P J, WOOD-WENTZ C M, BAILEY K R, et al. Objective versus self-reported sleep quality at high altitude. High Alt Med Biol, 2023, 24(2): 144-148. doi: 10.1089/ham.2017.0078.

MEIER D, COLLET T H, LOCATELLI I, et al. Does this patient have acute mountain sickness? The rational clinical examination systematic review. JAMA, 2017, 318(18): 1810-1819. doi: 10.1001/jama.2017.16192.

SAVIOLI G, CERESA I F, GORI G, et al. Pathophysiology and therapy of high-altitude sickness: practical approach in emergency and critical care. J Clin Med, 2022, 11(14): 3937. doi: 10.3390/jcm11143937. BURTSCHER M, WILLE M, MENZ V, et al. Symptom progression in acute mountain sickness during a 12-hour exposure to normobaric hypoxia equivalent to 4500 m. High Alt Med Biol, 2014, 15(4): 446-451. doi: 10.1089/ham.2014.1039.

IMRAY C, CHAN C, STUBBINGS A, et al. Time course variations in the mechanisms by which cerebral oxygen delivery is maintained on exposure to hypoxia/altitude. High Alt Med Biol, 2014, 15(1): 21-27. doi: 10.1089/ham.2013.1079.

LAWLEY J S, LEVINE B D, WILLIAMS M A, et al. Cerebral spinal fluid dynamics: effect of hypoxia and implications for high-altitude illness. J Appl Physiol (1985), 2016, 120(2): 251-262. doi: 10.1152/japplphysiol. 00370.2015.

STOKUM J A, GERZANICH V, SIMARD J M. Molecular pathophysiology of cerebral edema. J Cereb Blood Flow Metab, 2016, 36(3): 513-538. doi: 10.1177/0271678X15617172.

TURNER R E F, GATTERER H, FALLA M, et al. High-altitude cerebral edema: its own entity or end-stage acute mountain sickness? J Appl Physiol (1985), 2021, 131(1): 313-325. doi: 10.1152/japplphysiol.00861. 2019.

MURDOCH D R. Altitude illness among tourists flying to 3740 meters elevation in the Nepal Himalayas. J Travel Med, 1995, 2(4): 255-256. doi: 10.1111/j.1708-8305.1995.tb00671.x.

SHEN Y, YANG Y Q, LIU C, et al. Association between physiological responses after exercise at low altitude and acute mountain sickness upon ascent is sex-dependent. Mil Med Res, 2020, 7(1): 53. doi: 10.1186/s40779-020-00283-3.

WU T Y, DING S Q, LIU J L, et al. Who should not go high: chronic disease and work at altitude during construction of the Qinghai-Tibet railroad. High Alt Med Biol, 2007, 8(2): 88-107. doi: 10.1089/ham.2007. 1015.

SCHNEIDER M, BERNASCH D, WEYMANN J, et al. Acute mountain sickness: influence of susceptibility, preexposure, and ascent rate. Med Sci Sports Exerc, 2002, 34(12): 1886-1891. doi: 10.1097/00005768-200212000-00005.

WANG Y F, CIDANQUNPEI, SUN H J, et al. Correlation analysis of body mass index and incidence of acute mountain sickness. Chin J Emerg Med, 2006, 15(1): 85-86. doi: 10.3760/j.issn:1671-0282.2006.01.027.

YU J, LIU C, ZHANG C, et al. EDN1 gene potentially involved in the development of acute mountain sickness. Sci Rep, 2020, 10(1): 5414. doi: 10.1038/s41598-020-62379-z.


Refbacks

  • There are currently no refbacks.