Xu Hemiao, Yang Daiyu, Li Shuai, He Kun, Bian Macuo, Liu Zhijuan, Xu Chengli, Wu Dong
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
State Key Laboratory of Complex Severe and Rare Diseases, Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Public Health. 2024 Dec 24;12:1490647. doi: 10.3389/fpubh.2024.1490647. eCollection 2024.
The transition from low to high altitude environments is associated with a multifaceted series of physiological and psychological alterations that manifest over time. These changes are intricately intertwined, with physiological acclimatization primarily mediated through the regulation of hypoxia-inducible factor (HIF), which orchestrates the expression of critical molecules and hormones. This process extends to encompass the epigenome, metabolism, and other regulatory mechanisms. In the realm of psychological acclimatization, chronic hypoxia and changes in atmospheric pressure at high altitudes may contribute to decreased levels of neurotransmitters, with potential implications for mental health, particularly in relation to sleep quality. Despite significant advancements in our understanding of plateau acclimatization mechanisms in recent years, there remain many uncertain factors that necessitate further research.
This study is a single-center prospective observational study. It aims to utilize a series of physiological and medical instruments in conjunction with internationally recognized physiological and psychological questionnaires to monitor the dynamic shifts in the acclimatization ability of doctors from Peking Union Medical College Hospital. The monitoring will occur at seven distinct time points: pre-departure from Beijing, 1-7 days post-arrival at the Tibetan plateau during the acute phase of plateau hypoxic stress, and during the chronic phase of plateau hypoxic stress at 2 weeks, 3 months, 6 months, 12 months of residency in Tibet, and post-return to Beijing. Concurrently, a spectrum of omics analyses will be conducted, including comprehensive genomic, proteomic, and metabolomic assessments of blood leukocytes, fecal, and oral samples.
从低海拔环境过渡到高海拔环境会伴随着一系列多方面的生理和心理变化,这些变化会随着时间显现出来。这些变化错综复杂地交织在一起,生理适应主要通过缺氧诱导因子(HIF)的调节来介导,HIF协调关键分子和激素的表达。这个过程还延伸到表观基因组、新陈代谢和其他调节机制。在心理适应方面,高海拔地区的慢性缺氧和大气压力变化可能导致神经递质水平降低,对心理健康有潜在影响,尤其是在睡眠质量方面。尽管近年来我们对高原适应机制的理解有了显著进展,但仍有许多不确定因素需要进一步研究。
本研究是一项单中心前瞻性观察性研究。其目的是结合一系列生理和医学仪器以及国际认可的生理和心理问卷,监测北京协和医院医生适应能力的动态变化。监测将在七个不同时间点进行:从北京出发前、到达青藏高原急性期(到达后1 - 7天)以及在西藏居住2周、3个月、6个月、12个月的高原缺氧应激慢性期以及返回北京后。同时,将进行一系列组学分析,包括对血液白细胞、粪便和口腔样本的综合基因组、蛋白质组和代谢组评估。