Altitude Sickness: Genetics May Explain Why Only Some Fall Ill

More than 7,000 kilometers (4,400 miles) long and more than 500 kilometers (300 miles) wide in places, the Andes Mountains encompass a wide range of climates and habitats, from snow-capped mountain peaks to rainforests to high deserts. This picture, acqui
More than 7,000 kilometers (4,400 miles) long and more than 500 kilometers (300 miles) wide in places, the Andes Mountains encompass a wide range of climates and habitats, from snow-capped mountain peaks to rainforests to high deserts. This picture, acquired by NASA’s Landsat 7 satellite, shows a dramatic change in landscape about 250 kilometers southeast of la Paz, the capital of Bolivia. (Image credit: NASA)

Some people who live at high altitudes suffer breathlessness, palpitations and dizziness, while others have no health problems, and now a new study reveals which genes may explain the difference.

The genetic changes, described today (Aug. 15) in the American Journal of Human Genetics, allow people to take in enough oxygen from the thin mountain air without developing the heart attacks and strokes of chronic mountain sickness.

"We have ascertained there is a major genetic component that allows populations at high altitude to live better," said study co-author Dr. Gabriel Haddad, a pediatric pulmonologist at the University of California at San Diego.

Mountain sickness

When people who live at low-altitude lowlands go to the highlands, the short-term lack of oxygen can cause acute mountain sickness, which brings headaches, nausea and brain swelling.

Some people, however, live all their lives at higher altitudes, yet still face chronic mountain sickness. To adapt to the lower oxygen content of the air, their bodies have increased the fraction of red blood cells, making their blood more viscous, which in turn makes it more likely that the cells will block blood vessels.

As a result, these people are more prone to heart attacks and strokes, Haddad said. They also suffer from fatigue, depression and headaches.

However, in populations where people's ancestors have lived for thousands of years at altitude, some people are able to get enough oxygen from the air without developing the increased risk of heart attacks and strokes.

Genetic adaptation

Haddad and his colleagues analyzed the genes of 20 people who lived at least 14,000 feet (4,300 meters) above sea level in the Andes Mountains, and whose ancestors had done so for generations. Half the people had signs of chronic mountain sickness. [High and Dry: Images of the Himalayas and the Tibetan Plateau]

Those people who had chronic problems tended to have differences in 11 gene regions, compared with those who did not have health problems.

The researchers inserted the genes from the well-adapted people into fruit flies, and placed the flies in low-oxygen chambers.

Fruit flies that had two of these mutations survived longer in the low-oxygen condition, suggesting those genes were responsible for the human adaptation to altitude. Still, the researchers said it remains unclear exactly how those genes work.

And while these two genes may have evolved to help people live at altitude, there are probably other mutations that also help them, and different populations around the world — for example people in the highlands of Ethiopia, or in the Himalayas — may have different mutations still, Haddad told LiveScience.

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Tia Ghose
Managing Editor

Tia is the managing editor and was previously a senior writer for Live Science. Her work has appeared in Scientific American, Wired.com and other outlets. She holds a master's degree in bioengineering from the University of Washington, a graduate certificate in science writing from UC Santa Cruz and a bachelor's degree in mechanical engineering from the University of Texas at Austin. Tia was part of a team at the Milwaukee Journal Sentinel that published the Empty Cradles series on preterm births, which won multiple awards, including the 2012 Casey Medal for Meritorious Journalism.