Hypertension, Pulmonary Clinical Trial
Official title:
Study of the Effects of Iron Supplementation on High Altitude Pulmonary Hypertension.
Body iron levels may be important in determining how the blood pressure in the lungs changes in response to low oxygen levels. At high altitude, where oxygen levels are low, some patients develop elevated lung blood pressure. The investigators hypothesize that, in high altitude residents with elevated lung blood pressure, iron supplementation will cause a reduction in lung blood pressure.
Pulmonary hypertensive disorders frequently complicate hypoxic lung disease and worsen
patient survival.
Hypoxia-induced pulmonary hypertension is also a major cause of morbidity at high altitude.
Hypoxia causes pulmonary hypertension through hypoxic pulmonary vasoconstriction and
vascular remodelling. These processes are thought to be regulated at least in part by the
hypoxia-inducible factor (HIF) family of transcription factors, which coordinate
intracellular responses to hypoxia throughout the body.
HIF is regulated through a cellular degradation process that requires iron as an obligate
cofactor. In cultured cells HIF degradation is inhibited by reduced iron availability (by
chelation with desferrioxamine) and potentiated by iron supplementation. In humans,
laboratory experiments lasting eight hours have shown that acute iron supplementation blunts
the pulmonary vascular response to hypoxia, while acute iron chelation with desferrioxamine
enhances the response.
These findings suggest that iron may also affect the pulmonary vascular response to hypoxia
over longer time periods. The purpose of this study, which will take place at high altitude
in Kyrgyzstan, is to investigate whether iron supplementation can reduce pulmonary artery
pressure in patients with established high altitude pulmonary hypertension.
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