You Jiuhong, Chen Xinxin, Zhou Mei, Ma Hui, Liu Qiaoling, Huang Cheng
Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China.
Front Physiol. 2023 Jan 25;14:1019103. doi: 10.3389/fphys.2023.1019103. eCollection 2023.
Acute high-altitude diseases, including acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE), have been recognized as potentially lethal diseases for altitude climbers. Various preconditioning stimuli, including hyperbaric oxygen (HBO), have been proposed to prevent acute high-altitude diseases. Herein, we reviewed whether and how HBO preconditioning could affect high-altitude diseases and summarized the results of current trials. Evidence suggests that HBO preconditioning may be a safe and effective preventive method for acute high-altitude diseases. The proposed mechanisms of HBO preconditioning in preventing high-altitude diseases may involve: 1) protection of the blood-brain barrier and prevention of brain edema, 2) inhibition of the inflammatory responses, 3) induction of the hypoxia-inducible factor and its target genes, and 4) increase in antioxidant activity. However, the optimal protocol of HBO preconditioning needs further exploration. Translating the beneficial effects of HBO preconditioning into current practice requires the "conditioning strategies" approach. More large-scale and high-quality randomized controlled studies are needed in the future.
急性高原病，包括急性高原反应（AMS）、高原脑水肿（HACE）和高原肺水肿（HAPE），已被公认为对高原登山者具有潜在致命性的疾病。包括高压氧（HBO）在内的各种预处理刺激措施已被提出用于预防急性高原病。在此，我们回顾了HBO预处理是否以及如何影响高原病，并总结了当前试验的结果。有证据表明，HBO预处理可能是预防急性高原病的一种安全有效的方法。HBO预处理预防高原病的推测机制可能包括：1）保护血脑屏障并预防脑水肿，2）抑制炎症反应，3）诱导缺氧诱导因子及其靶基因，4）提高抗氧化活性。然而，HBO预处理的最佳方案需要进一步探索。将HBO预处理的有益效果转化为当前实践需要采用“预处理策略”方法。未来需要更多大规模、高质量的随机对照研究。
