Changes of hemodynamic and cerebral oxygenation after exercise in normobaric and hypobaric hypoxia: associations with acute mountain sickness

Kämmerer, T; Faihs, Valentina; Hulde, Nikolai; Bayer, Andreas; Hübner, Max; Brettner, Florian; Karlen, Walter; Kröpfl, Julia M.; Rehm, Markus; Spengler, Christina M.; Schäfer, Simon

doi:10.1186/s40557-018-0276-2

Cited by 13 publications

(19 citation statements)

References 22 publications

(25 reference statements)

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“…Subsequently, healthy volunteers took part in an expedition from Munich to Zermatt and blood was withdrawn and stored at three different time points as depicted in Figure 1. Detailed study protocol and results of hemodynamic changes, cerebral oxygenation, and cognitive function were published previously [24].…”

Section: Methodsmentioning

confidence: 99%

“…After this, all subjects performed endurance exercise by descending and re-ascending a ski slope between 3883 and 3500 m a.s.l. over 120 min [24]. Immediately after physical exercise, measurements were performed in an expedition tent (Keron 4 GT, Hilleberg AB, Frösön, Sweden) on the glacier (Exercise at 3883 m) at minus 11 • C. After spending one night at 3883 m a.s.l.…”

Section: Expedition Trialmentioning

confidence: 99%

“…In this context, we have previously shown that additionally to the extent of hypoxic or inflammatory stimuli or their duration, genetic variants in HIF-1, HIF-2, and HIF-degrading PHD-2 alter human adaptation to hypoxia [15][16][17][18][19]. High altitude residents thus have blunted hypoxic ventilatory response and diminished pulmonary hypertension under hypoxia [20,21], increased heart rate, improved peripheral oxygen saturation, and reduced incidence of mountain sickness, as assessed using the Lake Louise Score (LLS) [15,16,[22][23][24]. LLS, which has recently been revised, is a well-established tool to evaluate the severity of acute mountain sickness (AMS) [25,26].…”

Section: Introductionmentioning

confidence: 99%

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Hypoxic-Inflammatory Responses under Acute Hypoxia: In Vitro Experiments and Prospective Observational Expedition Trial

Kämmerer

Faihs

Hulde

et al. 2020

IJMS

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Induction of hypoxia-inducible-factor-1α (HIF-1α) pathway and HIF-target genes allow adaptation to hypoxia and are associated with reduced incidence of acute mountain sickness (AMS). Little is known about HIF-pathways in conjunction with inflammation or exercise stimuli under acute hypobaric hypoxia in non-acclimatized individuals. We therefore tested the hypotheses that (1) both hypoxic and inflammatory stimuli induce hypoxic-inflammatory signaling pathways in vitro, (2) similar results are seen in vivo under hypobaric hypoxia, and (3) induction of HIF-dependent genes is associated with AMS in 11 volunteers. In vitro, peripheral blood mononuclear cells (PBMCs) were incubated under hypoxic (10%/5% O2) or inflammatory (CD3/CD28) conditions. In vivo, Interleukin 1β (IL-1β), C-X-C Chemokine receptor type 4 (CXCR-4), and C-C Chemokine receptor type 2 (CCR-2) mRNA expression, cytokines and receptors were analyzed under normoxia (520 m above sea level (a.s.l.)), hypobaric hypoxia (3883 m a.s.l.) before/after exercise, and after 24 h under hypobaric hypoxia. In vitro, isolated hypoxic (p = 0.004) or inflammatory (p = 0.006) stimuli induced IL-1β mRNA expression. CCR-2 mRNA expression increased under hypoxia (p = 0.005); CXCR-4 mRNA expression remained unchanged. In vivo, cytokines, receptors, and IL-1β, CCR-2 and CXCR-4 mRNA expression increased under hypobaric hypoxia after 24 h (all p ≤ 0.05). Of note, proinflammatory IL-1β and CXCR-4 mRNA expression changes were associated with symptoms of AMS. Thus, hypoxic-inflammatory pathways are differentially regulated, as combined hypoxic and exercise stimulus was stronger in vivo than isolated hypoxic or inflammatory stimulation in vitro.

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Section: Methodsmentioning

confidence: 99%

Section: Expedition Trialmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hypoxic-Inflammatory Responses under Acute Hypoxia: In Vitro Experiments and Prospective Observational Expedition Trial

Kämmerer

Faihs

Hulde

et al. 2020

IJMS

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“…Kim et al reported that trail making test (TMT) performance was not affected after moderate exercise during prolonged exposure to severe hypoxia. Kammerer et al also reported TMT, target reaction test, and sorting reaction test remained unaffected following alternate cycling and walking in moderate hypoxia. However, the number of participants in these studies was small (seven and eight participants) and the absence of statistical significance could be, at least in part, ascribed to low statistical power.…”

Section: Combined Effects Of Acute Exercise and Hypoxiamentioning

confidence: 92%

The interactive effects of acute exercise and hypoxia on cognitive performance: A narrative review

Andò

Komiyama

Sudo

et al. 2019

Scandinavian Med Sci Sports

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Acute moderate intensity exercise has been shown to improve cognitive performance. In contrast, hypoxia is believed to impair cognitive performance. The detrimental effects of hypoxia on cognitive performance are primarily dependent on the severity and duration of exposure. In this review, we describe how acute exercise under hypoxia alters cognitive performance, and propose that the combined effects of acute exercise and hypoxia on cognitive performance are mainly determined by interaction among exercise intensity and duration, the severity of hypoxia, and duration of exposure to hypoxia. We discuss the physiological mechanism(s) of the interaction and suggest that alterations in neurotransmitter function, cerebral blood flow, and possibly cerebral metabolism are the primary candidates that determine cognitive performance when acute exercise is combined with hypoxia. Furthermore, acclimatization appears to counteract impaired cognitive performance during prolonged exposure to hypoxia although the precise physiological mechanism(s) responsible for this amelioration remain to be elucidated. This review has implications for sporting, occupational, and recreational activities at terrestrial high altitude where cognitive performance is essential. Further studies are required to understand physiological mechanisms that determine cognitive performance when acute exercise is performed in hypoxia.

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“…Eleven healthy subjects (age, 36.4 (7.0) years; BMI, 22.7 (2.0) kg m −2 ) were investigated. This study was part of a larger research expedition conducted in October 2016 (Kammerer et al, 2018). However, the primary research questions addressed in the current paper are novel and are exclusively dealt within this study alone with no overlap between this investigation and others completed on the research expedition.…”

Section: Subject Characteristics and Study Designmentioning

confidence: 99%

Acute Exercise in Hypobaric Hypoxia Attenuates Endothelial Shedding in Subjects Unacclimatized to High Altitudes

et al. 2020

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Travel of unacclimatized subjects to a high altitude has been growing in popularity. Changes in endothelial shedding [circulating endothelial cells (ECs)] and hematopoietic stem and progenitor cells (CPCs) during physical exercise in hypobaric hypoxia, however, are not well understood. We investigated the change in ECs and CPCs when exposed to high altitude, after acute exercise therein, and after an overnight stay in hypobaric hypoxia in 11 healthy unacclimatized subjects. Blood withdrawal was done at baseline (520 m a.s.l.; baseline), after passive ascent to 3,883 m a.s.l. (arrival), after acute physical exercise (±400 m, postexercise) and after an overnight stay at 3,883 m a.s.l. (24 h). Mature blood cells, ECs, and CPCs were assessed by a hematology analyzer and flow cytometry, respectively. The presence of matrix metalloproteinases (MMPs), their activity, and hematopoietic cytokines were assessed in serum and plasma. EC and CPC concentrations significantly decreased after exercise (p = 0.019, p = 0.007, respectively). CPCs remained low until the next morning (24 h, p = 0.002), while EC concentrations returned back to baseline. MMP-9 decreased at arrival (p = 0.021), stayed low postexercise (p = 0.033), and returned to baseline at 24 h (p = 0.035 to postexercise). MMP-activity did not change throughout the study. Circulating MMP-9 concentrations, but not MMP-activity, were associated with EC concentrations (r rm = 0.48, p = 0.010). CPC concentrations were not linked to hematopoietic cytokines. Acute exercise at high altitude attenuated endothelial shedding, but did not enhance regenerative CPCs. Results were not linked to endothelial matrix remodeling or CPC mobilization. These results provide information to better understand the endothelium and immature immune system during an active, short-term sojourn at high altitude.

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Changes of hemodynamic and cerebral oxygenation after exercise in normobaric and hypobaric hypoxia: associations with acute mountain sickness

Cited by 13 publications

References 22 publications

Hypoxic-Inflammatory Responses under Acute Hypoxia: In Vitro Experiments and Prospective Observational Expedition Trial

Hypoxic-Inflammatory Responses under Acute Hypoxia: In Vitro Experiments and Prospective Observational Expedition Trial

The interactive effects of acute exercise and hypoxia on cognitive performance: A narrative review

Acute Exercise in Hypobaric Hypoxia Attenuates Endothelial Shedding in Subjects Unacclimatized to High Altitudes

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