Research Article Open Access Paul et al., J Proteomics Bioinform 2015, 8:6 http://dx.doi.org/10.4172/jpb.1000359 Research Article Open Access Proteomics & Bioinformatics Volume 8(6) 116-125 (2015) - 116 J Proteomics Bioinform ISSN: 0974-276X JPB, an open access journal High Altitude Pulmonary Edema: An Update on Omics Data and Redefining Susceptibility Subhojit Paul # , Anamika Gangwar # , Aditya Arya, Kalpana Bhargava and Yasmin Ahmad* Peptide and Proteomics Division, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi -110054, India *Corresponding author: Yasmin Ahmad, Peptide and Proteomics, Defence Institute of Physiology & Allied Science (DIPAS), Defence Research & Development Organization (DRDO), Ministry of Defence, Delhi, India, Tel: 011-23883002; E-mail: yasminchem@gmail.com Received April 21, 2015; Accepted May 28, 2015; Published June 03, 2015 Citation: Paul S, Gangwar A, Arya A, Bhargava K, Ahmad Y (2015) High Altitude Pulmonary Edema: An Update on Omics Data and Redeining Susceptibility. J Proteomics Bioinform 8: 116-125. doi:10.4172/jpb.1000359 Copyright: © 2015 Paul S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Keywords: High altitude pulmonary edema; Biomarker; Proteomics; Susceptibility Introduction High altitude is home for nearly 140 million people across the globe, and a signiicant number of people travel to high altitudes for recreational purposes like skiing, mountaineering; amplifying sporting prowess through high altitude training; pilgrimages and on duty. Mountains have always been admired as one of the most beautiful creations of nature. he environmental condition at high altitude i.e hypobaric hypoxia results in arterial hypoxemia due to reduced barometric pressure and unchanged fractions of inspired oxygen (FiO 2 20%) resulting in, challenges to the human physique and psyche, especially when, people from low altitudes ascent to an altitude beyond 2500 m at a rapid rate, culminating in several ailments and in worst scenario, death. Although, no distinct geological boundary exists between high and low altitude from the medical perspective, but evidences on altitude related sickness, high altitude is generally considered as an elevation of 1500 m or above mean sea level is generally considered as high altitude. Further, it has been classiied in three strata: high altitude, 1500-3500 m, very high altitude 3500-5500 m and extreme altitude >5500 m [1]. Rapid ascent to the altitudes above 2500 m is associated with several diseases like acute mountain sickness (AMS), high altitude cerebral edema (HACE), Monge disease (Chronic mountain sickness) and high altitude pulmonary edema (HAPE) [2]. Although initial phases of many of these diseases are reversible and have successfully been cured, prolonged persistence can prove lethal. HAPE is one of the most common diseases both in terms of prevalence and also in terms of scientiic studies [3]. Evidences suggest that high altitude pulmonary edema (HAPE) is the leakage of protein-rich exudates from pulmonary vasculature into the alveolar airspace due to the combination of increased cardiac output and exaggerated pulmonary artery pressure (causing non-uniform vasoconstriction in pulmonary bed with subsequent over perfusion) as a result of hypobaric hypoxia and hypoxemia, serving as the two pronged weapon of high altitude so as to cause severe acute respiratory distress in the afected individuals [3-6]. HAPE develops upon rapid ascent to altitudes of above 2500, within 2-4 days of arrival, its hallmark victims being non-acclimatized but otherwise healthy individuals [3,4]. Its incidences are estimated in the range of 0.1-4.0% [5]. HAPE is a potentially fatal malady at high altitude and requires immediate medical attention accompanied ideally by a descent to lower altitude. HAPE was irst introduced to medical literature in the 1930s by Alberto Hurtado in Peruvian Andes. By 1960s, Herb Hultgren and then Houston showed what was considered till then, pneumonia or congestive heart failure due to cold and exertion to be a non- cardiogenic form of pulmonary edema [3,6]. It had also been reported in high altitude dwellers who return from a low altitude sojourn to their native lands [4]. Over the past ive decades, HAPE has been unraveled to a large extent in terms of pathophysiology, prevention and treatment. First by clinical observations then physiological observations leading to cellular, biochemical, molecular genetics and proteomics based investigations and insights. A few unanswered but very interesting questions however, remain. his review is aimed at inding common ground among all the seemingly divergent and vast amount of research information that one inds regarding HAPE and presenting it in a cohesive, continuous, simplistic and compact manner. Although several classical and excellent reviews on HAPE have been published, the focus of this review is mainly on the information obtained from omics studies (Genomics, Proteomics and Metabolomics), and current scientiic view on diagnosis, prophylaxis and susceptibility of HAPE in light of this data. We have, however included some of the basic information Abstract High altitude pulmonary edema (HAPE) is a serious pathological condition associated with rapid ascent to high altitude occurring in non-acclimatized but otherwise healthy individuals. Decades of scientiic studies on HAPE have unraveled the disease pathology, diagnosis and therapeutic interventions yet, the etiology is still unknown. A vast scientiic literature is available on HAPE for a quick reference of clinicians, researchers and academicians. Perhaps, the view of mountain travelers is different and their anticipation of HAPE susceptibility comprises of personal experience. Ever-increasing number of visitors to high altitude demands the possibility of HAPE susceptibility screening, however, scientiic community is yet to ind a staunch solution. This review is an update of recent information on HAPE susceptibility indicators from genomics, proteomics and metabolomics as well as information pertaining to treatment/prognosis of HAPE.