Published ahead of print on January 9, 2003, doi:10.1164/rccm.200208-864OC
Am. J. Respir. Crit. Care Med., Volume 167, Number 6, March 2003, 862-867
A more recent version of this article appeared on March 15, 2003
Submitted on August 14, 2002
Accepted on January 6, 2003
Nasal potential difference at high altitude (4559 m): evidence for secretion
Heimo Mairbaurl1*, Jorn Weymann1, Andreas Mohrlein1, Erik R Swenson2, Marco Maggiorini3, J. Simon R Gibbs4, and Peter Bartsch1
1 Division of Sports Medicine, Department of Medicine, University of Heidelberg, Heidelberg, Germany,
2 Medical and Research Services,VA Affairs Puget Sound Health Care System, University of Washington, Seattle, WA, USA,
3 Department of Internal Medicine, Intensive Care Unit, University Hospital, Zurich, Zurich, Switzerland,
4 National Heart and Lung Institute, Imperial College School of Science, Technology and Medicine, London, United Kingdom
* To whom correspondence should be addressed. E-mail: heimo.mairbaeurl{at}med.uni-heidelberg.de.
Hypoxia inhibits activity and expression of ion transport proteins of cultured lung alveolar epithelial cells. Here we tested, whether in vivo hypoxia at high altitude (4559m) also inhibits lung ion transport. Transepithelial nasal potentials were determined as a surrogate measure of lung ion transport activity before and during the stay at altitude. In normoxia, total nasal potential was about 20% higher in controls than in susceptibles to high altitude pulmonary edema, but there was no difference between groups in amiloride-inhibitable nasal potentials. At high altitude total nasal potentials increased 250% in both groups, whereas amiloride-sensitive nasal potential decreased in controls only (- 80%), the Cl- sensitive portion of nasal potential almost doubled. Since many mountaineers suffer from nasal dryness at high altitude a control study was performed in normobaric hypoxia (12% O2, 6 hours) at a controlled humidity of 50%. In this study no change in total NP or its amiloride- and Cl- sensitive portions was observed. The increased Cl- secretion at high altitude but no such change in normobaric hypoxia suggests that nasal dryness may stimulate local active Cl- and fluid secretion in the upper respiratory tract. It is therefore uncertain whether similar changes also occur at the alveolar epithelium.
Key words: hypoxia, nasal potential, Na transport, Cl secretion, nasal dryness
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