Gilbert-Kawai Edward T, Milledge James S, Grocott Michael P W, Martin Daniel S
University College London Centre for Altitude Space and Extreme Environment Medicine, UCLH NIHR Biomedical Research Centre, Institute of Sport and Exercise Health, London, United Kingdom; University College London Division of Surgery and Interventional Science, Royal Free Hospital, London, United Kingdom; University College Hospital London NIHR Biomedical Research Centre, London, United Kingdom;
University College London Centre for Altitude Space and Extreme Environment Medicine, UCLH NIHR Biomedical Research Centre, Institute of Sport and Exercise Health, London, United Kingdom;
Physiology (Bethesda). 2014 Nov;29(6):388-402. doi: 10.1152/physiol.00018.2014.
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.
自高海拔探索伊始，围绕藏族人和夏尔巴人对低压缺氧的非凡耐受性就有了轶事证据。这些人群在缺氧这一持续的进化压力下，已在高海拔地区成功生活和繁衍了数百代。因此，他们很可能经历了自然选择，朝着一种倾向于为持续缺氧提供有益适应的基因型（和表型）发展。随着转化性人类缺氧研究的出现，其中对高海拔健康个体的基因型/表型研究可能会造福医院环境中的低氧重症患者，高海拔原住民可能会提供一个有价值且引人入胜的模型。本综述的目的是全面总结涵盖藏族和夏尔巴人生理适应高海拔居住情况的科学文献。该综述展示了进化压力对这一高海拔人群生理机能的优化程度。此外，尽管已发现高地人和低地人之间存在许多生理差异，但它也暗示了更多潜在的研究途径。
