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Young JM, Williams DR, Thompson AAR. Thin Air, Thick Vessels: Historical and Current Perspectives on Hypoxic Pulmonary Hypertension. Front Med (Lausanne). 2019;6:93doi: 10.3389/fmed.2019.00093.
Young, J. M., Williams, D. R., & Thompson, A. A. R. (2019). Thin Air, Thick Vessels: Historical and Current Perspectives on Hypoxic Pulmonary Hypertension. Frontiers in medicine, 693. https://doi.org/10.3389/fmed.2019.00093
Young, Jason M, et al. "Thin Air, Thick Vessels: Historical and Current Perspectives on Hypoxic Pulmonary Hypertension." Frontiers in medicine vol. 6 (2019): 93. doi: https://doi.org/10.3389/fmed.2019.00093
Young JM, Williams DR, Thompson AAR. Thin Air, Thick Vessels: Historical and Current Perspectives on Hypoxic Pulmonary Hypertension. Front Med (Lausanne). 2019 May 01;6:93. doi: 10.3389/fmed.2019.00093. eCollection 2019. PMID: 31119132; PMCID: PMC6504829.
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Front Med (Lausanne). 2019 May 01;6:93. doi: 10.3389/fmed.2019.00093. eCollection 2019.

Thin Air, Thick Vessels: Historical and Current Perspectives on Hypoxic Pulmonary Hypertension.

Frontiers in medicine

Jason M Young, David R Williams, A A Roger Thompson

Affiliations

  1. Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom.
  2. Apex (Altitude Physiology Expeditions), Edinburgh, United Kingdom.
  3. Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom.

PMID: 31119132 PMCID: PMC6504829 DOI: 10.3389/fmed.2019.00093

Abstract

The association between pulmonary hypertension (PH) and hypoxia is well-established, with two key mechanistic processes, hypoxic pulmonary vasoconstriction and hypoxia-induced vascular remodeling, driving changes in pulmonary arterial pressure. In contrast to other forms of pulmonary hypertension, the vascular changes induced by hypoxia are reversible, both in humans returning to sea-level from high altitude and in animal models. This raises the intriguing possibility that the molecular drivers of these hypoxic processes could be targeted to modify pulmonary vascular remodeling in other contexts. In this review, we outline the history of research into PH and hypoxia, before discussing recent advances in our understanding of this relationship at the molecular level, focussing on the role of the oxygen-sensing transcription factors, hypoxia inducible factors (HIFs). Emerging links between HIF and vascular remodeling highlight the potential utility in inhibiting this pathway in pulmonary hypertension and raise possible risks of activating this pathway using HIF-stabilizing medications.

Keywords: altitude; hypoxia; hypoxic pulmonary vasoconstriction (HPV); pulmonary hypertension; vascular remodeling

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