ArticleBlood2022
Hypoxia and low temperature upregulate transferrin to induce hypercoagulability at high altitude.
Article in Blood, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers.
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Who cites it
45 citing papers in PubMed, 67 citations in OpenAlex.
- Article
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- Venous Thromboembolism in Severe Community-Acquired Pneumonia at High-Altitude Areas: Prevalence, Risk and Outcome.The clinical respiratory journal · 2026Article
- KDIGO 2026 Clinical Practice Guideline for Anemia in Chronic Kidney Disease (CKD): a commentary from the European Renal Best Practice (ERBP).Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026Article
- Iron Homeostasis at High Altitude in Patients With Pulmonary Hypertension.Pulmonary circulation · 2026Article
- Operative Duration as an Independent Risk Factor for Lower-Extremity Deep Vein Thrombosis Following Shoulder Arthroscopy: A Prospective Cohort Study With Systematic Ultrasonographic Screening.Orthopaedic journal of sports medicine · 2026Article
- Hypoxia or tobacco-smoke exposure induce region-specific microvascular remodeling in the brain.Scientific reports · 2026Article
- A stromal PAI1-tPA axis orchestrates immunosuppression in pancreatic cancer.Science advances · 2026Article
- Low serum transferrin predicts adverse outcome in COVID-19 and is related to coagulation activity.British journal of haematology · 2026Article
- Elevated Hemoglobin Levels and Risk of ST-Segment Elevation Myocardial Infarction in High-Altitude Acute Coronary Syndrome: A Retrospective Analysis.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Article
- Prognostic factors for severe community-acquired pneumonia in high altitude areas.Scientific reports · 2026Article
- Mevalonic acid exerts procoagulant effect by potentiating factor Xa.Natural products and bioprospecting · 2026Article
- A paradigm shift and practical exploration in veterinary pharmacology and toxicology teaching reform in China's frontier regions under AI empowerment.Frontiers in veterinary science · 2026Review
- High-altitude thrombosis: divergent pathophysiological mechanisms and preventive strategies in acutely exposed population and native highlanders.Frontiers in cardiovascular medicine · 2026Review
- Venous thromboembolism at high altitude: mechanisms, risk stratification, and precision prevention.Frontiers in physiology · 2026Review
- Clinical characteristic and prognosis of adult inpatients with high altitude pulmonary edema: a multi-central, retrospective study in plateau of China from 2012 to 2022.BMC pulmonary medicine · 2025Article
- Clinical characteristics and outcomes of patients with traumatic brain injury transferred from ultra-high-altitude areas: patient series.Journal of neurosurgery. Case lessons · 2025Article
- Article
- The Vulpes vulpes montana genome provides insights into high-altitude adaptation mechanisms of the Vulpes species.Communications biology · 2025Article
- Clinical changes of cardiac function from high altitude returning to plain.Scientific reports · 2025Article
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Authors and funding
20 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Studies have shown significantly increased thromboembolic events at high altitude. We recently reported that transferrin could potentiate blood coagulation, but the underlying mechanism for high altitude-related thromboembolism is still poorly understood. Here, we examined the activity and concentration of plasma coagulation factors and transferrin in plasma collected from long-term human residents and short-stay mice exposed to varying altitudes. We found that the activities of thrombin and factor XIIa (FXIIa) along with the concentrations of transferrin were significantly increased in the plasma of humans and mice at high altitudes. Furthermore, both hypoxia (6% O2) and low temperature (0°C), 2 critical high-altitude factors, enhanced hypoxia-inducible factor 1α (HIF-1α) levels to promote the expression of the transferrin gene, whose enhancer region contains HIF-1α binding site, and consequently, to induce hypercoagulability by potentiating thrombin and FXIIa. Importantly, thromboembolic disorders and pathological insults in mouse models induced by both hypoxia and low temperature were ameliorated by transferrin interferences, including transferrin antibody treatment, transferrin downregulation, and the administration of our designed peptides that inhibit the potentiation of transferrin on thrombin and FXIIa. Thus, low temperature and hypoxia upregulated transferrin expression-promoted hypercoagulability. Our data suggest that targeting the transferrin-coagulation pathway is a novel and potentially powerful strategy against thromboembolic events caused by harmful environmental factors under high-altitude conditions.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.