Changes in Plasma Bradykinin Concentration and Citric Acid Cough Threshold at High Altitude

Mason, Nicholas; Petersen, Morten Krogh; Mélot, Christian; Kim, Elena V.; Aldashev, Almaz; Sarybaev, A. Sh.; Миррахимов, М М; Naeije, Robert

doi:10.1580/1080-6032-020.004.0353

Cited by 10 publications

(11 citation statements)

References 17 publications

(35 reference statements)

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“…Changes in bradykinin levels and changes to the hypercapnic ventilatory response have both been proposed as possible aetiologies, but neither has shown positive correlations with altitude cough in studies (54,55). Another possibility is that altitude cough may simply be an early sign of subclinical acute mountain sickness (AMS) or even HAPE.…”

Section: Shortness Of Breath 2015; 4 (3): 100-106mentioning

confidence: 99%

High altitude respiratory physiology and pathophysiology

Cumpstey¹

2015

SOB

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SummaryAt high altitude, reduced atmospheric pressure causes the partial pressure of oxygen to decreasecreating an environment of hypobaric hypoxia which presents a unique set of challenges for the respiratory system. Pulmonary physiological responses such as the hypoxic ventilatory drive are essential for successful acclimatisation, whilst others such as hypoxic pulmonary vasoconstriction may be implicated in the development of altitude illnesses. Pulmonary conditions are some of the most common (e.g. high altitude cough) and also the most serious illnesses seen at altitude (e.g high altitude pulmonary oedema, HAPE). Minimising the chance of developing HAPE through planning an appropriate ascent profile should be strongly encouraged as HAPE can rapidly be fatal if left untreated. Whilst pharmacological agents such as nifedipine can help with the management of HAPE, rapid descent remains the single-most important treatment option once symptomatic. Given the increasing popularity of travelling to altitude, an awareness of how hypobaric hypoxia affects chronic respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD) is also becoming increasingly important for respiratory physicians.

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Section: Shortness Of Breath 2015; 4 (3): 100-106mentioning

confidence: 99%

High altitude respiratory physiology and pathophysiology

Cumpstey¹

2015

SOB

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“…2), even though one study found that angiotensin-converting enzyme activity was unchanged in subjects moving from 700 to 3,800 m [11]. Renin is a protease synthesized by the renal-afferent-artery proximal cells that is then stored in the kidney until its release into the blood.…”

Section: Raas Pathway Genementioning

confidence: 99%

Gene Polymorphisms and High-Altitude Pulmonary Edema Susceptibility: A 2011 Update

Luo

Zou

Gao³

2012

Respiration

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High-altitude pulmonary edema (HAPE) is a severe disease caused by high-altitude hypoxia. Since some individuals are more susceptible to high altitude than others, the incidence is variable and cannot be predicted. Furthermore, multiple genes can contribute to the occurrence of HAPE, making it even more difficult to predict. The genes associated with HAPE include those in the renin-angiotensin-aldosterone system pathway, the nitric oxide pathway and the hypoxia-inducible factor pathway. Other genes associated with HAPE include tyrosine hydroxylase (TH), vascular endothelial growth factor (VEGF), pulmonary surfactant proteins and β₂-adrenergic receptor. The association of the polymorphisms of these genes with HAPE susceptibility has previously been investigated. Among the genes evaluated, polymorphisms of NOS3, ACE, CYP11B2, Hsp70 and endothelin-1 and pulmonary surfactant proteins A1 and A2 were shown to be associated with HAPE incidence, while associations between TH, VEGF and HAPE remain to be fully elucidated. Novel technological approaches, including genome-wide association studies and next-generation sequencing, are currently being used to identify new HAPE susceptibility genes. The goal of this review article is to summarize the current literature and to define the outstanding areas of research that need to be explored to advance our ability to predict when HAPE will occur.

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“…Despite both AMS and cough occurring commonly at high altitude, there was no demonstrable relationship between AMS and cough in any of the published papers [6,8,12,13]. In subjects with isolated AMS cough is a rarely reported symptom [9,11].…”

Section: Introductionmentioning

confidence: 99%

“…Mason et al [12] measured nocturnal cough frequency, citric acid cough threshold, serum angiotensin converting enzyme activity and plasma bradykinin concentration in 20 healthy volunteers before and during a stay at 3800 m. Citric acid cough threshold fell on ascent to 3800 m; serum ACE activity was unchanged although plasma bradykinin fell precipitously. It is not possible to measure lung ACE activity in living human subjects although measurement of whole lung and serum ACE activity in dogs during exposure to chronic hypoxia yielded comparable results [48].…”

Section: Introductionmentioning

confidence: 99%

“…Signs and symptoms of respiratory tract infection also occur commonly in visitors to altitude [61,62] in whom there is also evidence of impairment of mucociliary transport - a crucial respiratory defence mechanism [56]. There was no clinical evidence of respiratory infection observed in any of the published studies on altitude-related cough [6,8,12,13]. However in the author’s experience cough associated with the production of purulent sputum is not an uncommon finding at altitude, particularly following prolonged exertion.…”

Section: Introductionmentioning

confidence: 99%

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Altitude-related cough

Mason

2013

Cough

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Altitude-related cough is a troublesome condition of uncertain aetiology that affects many visitors to high altitude. The traditionally held belief that it was due solely to the inspiration of cold, dry air was refuted by observations and experiments in long duration hypobaric chamber studies. It is likely that altitude-related cough is a symptom of a number of possible perturbations in the cough reflex arc that may exist independently or together. These include loss of water from the respiratory tract; respiratory tract infections and sub-clinical high altitude pulmonary oedema. The published work on altitude-related cough is reviewed and possible aetiologies for the condition are discussed.

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Changes in Plasma Bradykinin Concentration and Citric Acid Cough Threshold at High Altitude

Abstract: Increased levels of bradykinin are unlikely to be a significant factor in the increased sensitivity to citric acid seen in hypobaric hypoxia. Further studies are required to elucidate the etiology of altitude-related cough.

Cited by 10 publications

References 17 publications

High altitude respiratory physiology and pathophysiology

High altitude respiratory physiology and pathophysiology

Gene Polymorphisms and High-Altitude Pulmonary Edema Susceptibility: A 2011 Update

Altitude-related cough

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