Cited by 119High Altitude and HypoxiaCancer, Hypoxia, and MetabolismErythropoietin and Anemia Treatment

Hypoxia: Adapting to High Altitude by Mutating EPAS-1 , the Gene Encoding HIF-2α

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Tissot van Patot, Martha C., Gassmann, Max·2011·High Altitude Medicine & Biology

Abstract

Living at high altitude is demanding and thus drives adaptational mechanisms. The Tibetan population has had a longer evolutionary period to adapt to high altitude than other mountain populations such as Andeans. As a result, some Tibetans living at high altitudes do not show markedly elevated red blood cell production as compared to South American high altitude natives such as Quechuas or Aymaras, thereby avoiding high blood viscosity creating cardiovascular risk. Unexpectedly, the responsible mutation(s) reducing red blood cell production do not involve either the gene encoding the blood hormone erythropoietin (Epo), or the corresponding regulatory sequences flanking the Epo gene. Similarly, functional mutations in the hypoxia-inducible transcription factor 1α (HIF-1α) gene that represents the oxygen-dependent subunit of the HIF-1 heterodimer, the latter being the main regulator of over 100 hypoxia-inducible genes, have not been described so far. It was not until very recently that three independent groups showed that the gene encoding HIF-2α, EPAS-1 (Wenger et al. 1997), represents a key gene mutated in Tibetan populations adapted to living at high altitudes (Beall et al. 2010 , Yi et al. 2010 , Simonson et al. 2010). Hypoxia-inducible transcription factors were first identified by the description of HIF-1 (Semenza et al. 1991 , 1992), which was subsequently found to enhance transcription of multiple genes that encode proteins necessary for rescuing from hypoxic exposure, including erythropoietic, angiogenic and glycolytic proteins. Then HIF-2 was identified (Ema et al. 1997 ; Flamme et al. 1997 ; Hogenesch et al. 1997 ; and Tian et al. 1997) and although it is highly similar to HIF-1 and has the potential to bind (Camenisch et al. 2001) and mediate (Mole et al. 2009) many of the same genes as HIF-1, its biological actions in response to hypoxia are distinct from those of HIF-1 (reviewed by Loboda et al. 2010). By now, several of these HIF-2 mediated processes have been implicated in the human response to high altitude exposure including erythropoiesis (Kapitsinou et al. 2010), iron homeostasis (Peyssonnaux et al. 2008), metabolism (Shohet et al. 2007; Tormos et al. 2010; Biswas et al. 2010 ; Rankin et al. 2009) and vascular permeability (Chen et al. 2009; Tanaka et al. 2005), among others. Clearly, mutation of EPAS-1 has the potential to bring far more advantage when adapting to high altitude than solely mutating the Epo gene.

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Crossref · 10.1089/ham.2010.1099

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  • Men and women have different hemoglobin reference ranges yet similar EPO levels.

    “This new equilibrium set point for EPO/hemoglobin has precedent in the observation that men and women have different hemoglobin reference ranges yet similar EPO levels (42).”
  • Genetic variations in HIF2A, PHD2 and PPARA associate with lower hemoglobins in native Tibetans compared to Han Chinese and with high altitude adaptation in other populations.

    “Genome-wide searches for single-nucleotide polymorphisms (SNP), candidate gene approaches and exome sequencing have identified genetic variations in the HIF2A, PHD2 and PPARA genes that associate with lower hemoglobins in native Tibetans compared to Han Chinese and with high altitude adaptation in other populations.”

    From Regulation of erythropoiesis by hypoxia-inducible factors (2013) · cites this paper as [180]

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Authors
Tissot van Patot, M. C., & Gassmann, M.
Affiliations
  • Institute of Veterinary Physiology, Vetsuisse Faculty and Zurich Center for Integrative Human Physiology (ZIHP), University of Zürich, Zürich, Switzerland.
  • University of Zurich (CH)
Venue
High Altitude Medicine & Biology
Published
2011-06
Volume
12
Issue
2
Pages
157-167
ISSN
  • 1527-0297 (ISSN-L)
  • 1557-8682
OpenAlex
W2010389102
Cited by
119
References
137
Citations by year
2026: 6 · 2025: 9 · 2024: 6 · 2023: 6 · 2022: 9 · 2021: 6 · 2020: 11 · 2019: 3 · 2018: 3 · 2017: 8 · 2016: 12 · 2015: 7 · 2014: 7 · 2013: 16 · 2012: 8
FWCI
6.57
Type
journal article
Language
en
Open access
Locations
  • High Altitude Medicine & Biology (publishedVersion)
  • PubMed (publishedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › High Altitude and Hypoxia
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Hypoxia, and Metabolism
  • Health Sciences › Medicine › Hematology › Erythropoietin and Anemia Treatment
Keywords
HIF-2α, high-altitude adaptation, Tibetan population, hypoxia, erythropoiesis, HIF-1α, erythropoietin, hypoxia-inducible factor, hypoxia-responsive genes, Andean peoples, blood viscosity, cardiovascular risk, genetic mutations
MeSH terms
Endothelial PAS Domain-Containing Protein 1, Adaptation, Biological, Altitude, Hypoxia, Erythropoiesis, Erythropoietin, Humans, Mutation, Tibet, Asian People, Basic Helix-Loop-Helix Proteins

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