Berger Marc M, Köhne Hannah, Hotz Lorenz, Hammer Moritz, Schommer Kai, Bärtsch Peter, Mairbäurl Heimo
Department of Anesthesiology, University of Heidelberg, Heidelberg, Germany Department of Anesthesiology, Perioperative and General Critical Care Medicine, Salzburg General Hospital Paracelsus Medical University, Salzburg, Austria
Department of Anesthesiology, University of Heidelberg, Heidelberg, Germany.
Physiol Rep. 2015 Mar;3(3). doi: 10.14814/phy2.12325.
Acute mountain sickness (AMS) is a neurological disorder occurring when ascending too fast, too high. Remote ischemic preconditioning (RIPC) is a noninvasive intervention protecting remote organs from subsequent hypoxic damage. We hypothesized that RIPC protects against AMS and that this effect is related to reduced oxidative stress. Fourteen subjects were exposed to 18 hours of normoxia (21% oxygen) and 18 h of normobaric hypoxia (12% oxygen, equivalent to 4500 m) on different days in a blinded, randomized order. RIPC consisted of four cycles of lower limb ischemia (5 min) and 5 min of reperfusion, and was performed immediately before the study room was entered. A control group was exposed to hypoxia (12% oxygen, n = 14) without RIPC. AMS was evaluated by the Lake Louise score (LLS) and the AMS-C score of the Environmental Symptom Questionnaire. Plasma concentrations of ascorbate radicals, oxidized sulfhydryl (SH) groups, and electron paramagnetic resonance (EPR) signal intensity were measured as biomarkers of oxidative stress. RIPC reduced AMS scores (LLS: 1.9 ± 0.4 vs. 3.2 ± 0.5; AMS-C score: 0.4 ± 0.1 vs. 0.8 ± 0.2), ascorbate radicals (27 ± 7 vs. 65 ± 18 nmol/L), oxidized SH groups (3.9 ± 1.4 vs. 14.3 ± 4.6 μmol/L), and EPR signal intensity (0.6 ± 0.2 vs. 1.5 ± 0.4 × 10(6)) after 5 h in hypoxia (all P < 0.05). After 18 hours in hypoxia there was no difference in AMS and oxidative stress between RIPC and control. AMS and plasma markers of oxidative stress did not correlate. This study demonstrates that RIPC transiently reduces symptoms of AMS and that this effect is not associated with reduced plasma levels of reactive oxygen species.
急性高原病（AMS）是在快速登高、登得过高时发生的一种神经系统疾病。远程缺血预处理（RIPC）是一种非侵入性干预措施，可保护远端器官免受随后的缺氧损伤。我们假设RIPC可预防AMS，且这种作用与氧化应激减轻有关。14名受试者在不同日期以盲法、随机顺序分别暴露于18小时常氧（21%氧气）和18小时常压缺氧（12%氧气，相当于海拔4500米）环境中。RIPC包括四个下肢缺血（5分钟）和5分钟再灌注周期，在进入研究室前立即进行。一个对照组在无RIPC情况下暴露于缺氧环境（12%氧气，n = 14）。通过路易斯湖评分（LLS）和环境症状问卷的AMS-C评分评估AMS。测量血浆中抗坏血酸自由基、氧化巯基（SH）基团的浓度以及电子顺磁共振（EPR）信号强度作为氧化应激的生物标志物。在缺氧5小时后，RIPC降低了AMS评分（LLS：1.9±0.4对3.2±0.5；AMS-C评分：0.4±0.1对0.8±0.2）、抗坏血酸自由基（27±7对65±18 nmol/L）、氧化SH基团（3.9±1.4对14.3±4.6 μmol/L）以及EPR信号强度（0.6±0.2对1.5±0.4×10(6)）（所有P<0.05）。在缺氧18小时后，RIPC组和对照组之间的AMS及氧化应激无差异。AMS与氧化应激的血浆标志物不相关。本研究表明，RIPC可短暂减轻AMS症状，且这种作用与血浆活性氧水平降低无关。
