Elevated pentose phosphate pathway is involved in the recovery of hypoxia‑induced erythrocytosis

Liu,Chang; Liu,Bao; Zhang,Er‑Long; Liao,Wen‑Ting; Liu,Jie; Sun,Bing‑Da; Xu,Gang; Chen,Jian; Gao,Yu‑Qi

doi:10.3892/mmr.2017.7801

Elevated pentose phosphate pathway is involved in the recovery of hypoxia‑induced erythrocytosis

Authors:
- Chang Liu
- Bao Liu
- Er‑Long Zhang
- Wen‑Ting Liao
- Jie Liu
- Bing‑Da Sun
- Gang Xu
- Jian Chen
- Yu‑Qi Gao
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Affiliations: Institute of Medicine and Hygienic Equipment for High Altitude Region, College of High Altitude Military Medicine, Third Military Medical University, Chongqing 400038, P.R. China
Published online on: October 17, 2017 https://doi.org/10.3892/mmr.2017.7801
Pages: 9441-9448
Copyright: © Liu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

As a typical model of hypoxia‑induced excessive erythrocytosis, high altitude polycythemia (HAPC) results in microcirculation disturbance, aggravates tissue hypoxia and results in a severe clinical outcome, without any effective intervention methods except for returning to an oxygen‑rich environment. The present study aimed to explore potential therapeutic targets which may participate in the recovery of HAPC by studying the mechanisms of reducing the hemoglobin (HB) concentration during re‑oxygenation. A total of 14 and 13 subjects were recruited over a 5,300 m distance and 5,170 m area. The patients were classified into HAPC or control groups based on their HB value. Plasma samples were collected on the day when they finished their stay in plateau for a year, and on the 180th day following their reaching in plain. Metabolic profiling was conducted by UPLC‑QTOF/MS. MetaboAnalyst platform was performed to explore the most perturbed metabolic pathways. A panel of differential metabolites were obtained in the recovery phase of HAPC and control groups. The present study identified the uniquely upregulated pentose phosphate pathway in HAPC subjects, along with a significantly decreased HB level. The findings were verified via a direct comparison between HAPC and control subjects at a high altitude. An increased pentose phosphate pathway was identified in control groups compared with HAPC subjects. An elevated pentose phosphate pathway may therefore participate in the recovery of HAPC, whereas a downregulated pentose phosphate pathway may contribute to hypoxia‑induced erythrocytosis. The results of the present study provide potential therapeutic strategies and novel insights into the pathogenesis of hypoxia‑induced polycythemia.

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