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Elevated cytokine levels in patients with High-altitude pulmonary edema
Binyun Liu1, Quzong Zhaxi2, Zhuoga Danzeng3
1People's Hospital of Xizang Autonomous Region, Lhasa, China; Key Laboratory of Translational Medicine for Human Adaptation to the High-Altitude of Tibet Autonomous Region, People's Hospital of Xizang Autonomous Region, Lhasa, China.
Background:
Immunomodulation is integral to the body's adaptation to varying altitudes. Nevertheless, the effects of immune regulation on the onset of high-altitude pulmonary edema (HAPE) are not well understood. This research aimed to explore the influence of immune regulation on HAPE pathogenesis through the assessment of cytokine levels.
Methods:
We analyzed the cytokine profiles of 28 HAPE patients at high altitudes and compared them to 25 healthy individuals who had successfully acclimatized. The levels of seven cytokines released by T helper cells (Th)1/2/17, alongside monocyte chemoattractant protein-1 (MCP-1), interleukin (IL)-8, and IL-1β in serum, were quantified using cytometric bead array (CBA) technology.
Results:
Our findings revealed significantly higher concentrations of IL-2, IL-10, and tumor necrosis factor (TNF) in the peripheral blood of HAPE patients when contrasted with those of healthy individuals (P < 0.001). A comprehensive analysis of these cytokines indicated a robust diagnostic capability for predicting HAPE, achieving an area under the curve (AUC) of 0.98. Conversely, no significant differences were observed in the levels of IL-6, IL-8, interferon-γ (IFN-γ), IL-4, IL-17 A, MCP-1, and IL-1β between the two cohorts.
Conclusions:
Elevated IL-2, IL-10, and TNF in HAPE patients underscore immune dysregulation as a disease driver. Clinically, these cytokines may guide risk prediction (IL-2-hypoxemia link) and targeted therapies (anti-TNF for vascular leakage). Future work should define hypoxia-specific cytokine networks, validate interventions in altitude cohorts, and integrate multi-omics to map immune-vascular crosstalk.
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