Plasma cytokine profiling to predict susceptibility to acute mountain sickness

Extensive studies have been performed on acute mountain sickness (AMS), but biomarkers predicting AMS are lacking. Presently, the mainstay methods to identify AMS biomarkers include proteomic and genetic methods at high altitudes or in hypoxic simulated chambers. In the present study, we compared plasma cytokine profiles between AMS-susceptible individuals and AMS-resistant individuals at low altitude by cytokine array analysis. In total, 75 differentially expressed cytokines were identified between AMS-susceptible individuals and AMS-resistant individuals, most involved in inflammation. A quantifiable human custom cytokine antibody array was then used to further test results of cytokine array analysis. Compared to AMS-resistant individuals, the level of insulin-like growth factor binding protein 6 (IGFBP-6) was significantly lower in AMS-susceptible individuals (37,318.99 ± 23,493.11 pg/mL and 25,665.38 ± 25,691.29 pg/mL, respectively; P = 0.04). Conversely, the levels of serum amyloid A1 (SAA1), dickkopf WNT signaling pathway inhibitor 4 (Dkk4), and interleukin 17 receptor A (IL-17RA) were significantly higher in AMS-susceptible individuals than in AMS-resistant individuals (SAA1: 4,069.69 ± 2,502.93 pg/mL vs. 2,994.98 ± 2,295.91 pg/mL, P = 0.05; Dkk4: 2,090.00 ± 2,094.89 pg/mL vs. 1,049.88 ± 1,690.93 pg/mL, P = 0.07; IL-17RA: 11.52 ± 8.33 pg/mL vs. 8.67 ± 6.22 pg/mL, P = 0.08). Although further in-depth research is required to examine the possible role of these cytokines in the development of AMS, these four cytokines may be of use in predicting AMS-susceptibility in a low-altitude environment.