title: [The role of hypoxia inducible factor-1α and vascular endothelial growth factor in hypoxic pulmonary hypertension in patients with acute high altitude reaction of rescue workers in Yushu earthquake].
abstract: OBJECTIVE
  To assess the effects of hypoxia inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) on hypoxic pulmonary hypertension(HPH) in patients with acute high altitude reaction(AHAR) and its change after return to lower altitude.
  
  
  METHODS
  Ninety-six officers and soldier participating in rescue of Yushu megaseism on April 14th in 2010, leaving low altitude area (1 500 m) rapidly to high altitude area(3 700 m) to undertake strenuous physical work were enrolled for study. All of them were male, aged 18-35 years, and they were divided into three groups according to the symptomatic scores of AHAR: without AHAR(group B, n=25), mild to moderate AHAR (group C, n=47 ) and severe AHAR (group D, n=24). Mean pulmonary artery pressure (mPAP), levels in serum HIF-1α and VEGF were measured at high altitude area after a stay of 50 days, and also after their return to lower altitude area (1 500 m) for 12 hours and 15 days. Fifty healthy volunteers at low altitude area served as control (group A).
  
  
  RESULTS
  Level of mPAP (mm Hg, 1 mm Hg=0.133 kPa), serum HIF-1α (pg/L) and VEGF (ng/L) in group B (24.23±1.56, 68.80±7.52 and 82.56±6.32) were significantly higher than those in group A (18.50±1.30, 50.95±3.33 and 65.78±4.03), respectively (all P<0.01). Moreover, the value of all the parameters increased with increase in severity of AHAR, the respective value in group C were 28.42±1.32, 88.10±9.20 and 104.82±10.36, and in group D were 34.70±2.94, 117.93±13.46 and 136.77±12.03, and there were significant differences in comparing two groups (all P<0.01). At high altitude area, AHAR total score was positively correlated with mPAP, serum HIF-1α and VEGF (r=0.672, 0.737 and 0.634, respectively, all P<0.01), mPAP was positively correlated with serum HIF-1α and VEGF (r=0.706, 0.638, both P<0.01). Compared with group A, level of mPAP (29.08±4.22), serum HIF-1α (91.16±20.58) and VEGF (107.11±10.32) were significantly increased in 96 officers and soldiers who stayed for 50 days at an altitude of 3 700 m (all P<0.01), and the values were significantly decreased after returning to lower altitude area for 12 hours(23.05±3.18, 70.99±8.22 and 78.65±6.47) and 15 days(18.96±1.75, 52.31±4.92 and 63.08±4.55). The values showed significant difference between 12 hours and 15 days stay at 1 500 m (all P<0.01). The values of the determined parameters 15 days after return to lower altitude area showed no difference compared with those of group A (all P>0.05).
  
  
  CONCLUSIONS
  Strenuous physical work at high altitude area, AHAR becomes more serious, and it is accompanied by higher values of HIF-1α, VEGF and mPAP, indicating that HPH is closely associated with elevation of HIF-1α and VEGF. These changes are improved after returning to lower altitude area for 12 hours, and they recover to normal lever after 15 days.
authors.affiliation: Center of Respiratory Medicine, the 4th Hospital, Lanzhou Command, PLA, Xining, Qinghai, China. ysyday@163.com
authors.forename: Sheng-yue
authors.initials: SY
authors.lastname: Yang
authors.forename: En-zhi
authors.initials: EZ
authors.lastname: Feng
authors.forename: Zi-qiang
authors.initials: ZQ
authors.lastname: Yan
authors.forename: Wei
authors.initials: W
authors.lastname: He
authors.forename: Zhong-xin
authors.initials: ZX
authors.lastname: Tian
authors.forename: He
authors.initials: H
authors.lastname: Yin
authors.forename: Li-fu
authors.initials: LF
authors.lastname: Ma
authors.forename: Qi-quan
authors.initials: QQ
authors.lastname: Zhou
authors.forename: Zi-fu
authors.initials: ZF
authors.lastname: Shi
mesh_terms: D000293:Adolescent; D000328:Adult; D000531:Altitude; D000532:Altitude Sickness / Q000378:metabolism*; D016022:Case-Control Studies; D004190:Disasters; D055866:Earthquakes; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000378:metabolism*; D000860:Hypoxia / Q000150:complications / Q000378:metabolism; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000378:metabolism*; D008297:Male; D011446:Prospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*; D055815:Young Adult
chemical_list: D051795:Hypoxia-Inducible Factor 1, alpha Subunit; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A