The overall goal of this proposal is to better understand how the brain is affected in Chronic Mountain Sickness (CMS) or Monge's disease. The brain is one of the major targets of CMS, as manifested by the frequently seen CNS symptoms such as headache, dizziness, sleep disturbance, and mental confusion. MRI studies have revealed cerebral edema and multiple ischemic foci in the brain of CMS patients, suggesting that brain cell damage/death occurs in CMS which may lead to the above neurological symptoms. Therefore, understanding the vulnerability of brain cells to hypoxia in CMS is critical for developing the therapeutic strategy of CMS. Recently, we obtained skin biopsies from CMS patients and non-CMS healthy highlanders and re-programmed the skin cells into induced pluripotent stem cells (iPSCs). The iPSCs were then differentiated into neuroprogenitor cells and further into astrocytes and neurons. We then examined the acid- base regulatory mechanisms and the tolerance/vulnerability to hypoxia/ischemia stress in these astrocytes/neurons. Our preliminary data show that astrocytes derived from CMS exhibited increased acid extrusion rate, and CMS astrocytes/neurons were more vulnerable to hypoxic/ischemic challenges than non- CMS cells. Therefore, we hypothesize that astrocytes/neurons in CMS patients have altered acid-base regulatory mechanisms which render neurons/astrocytes more vulnerable to hypoxia. We will test this hypothesis via two specific aims: 1) examine the expression and activities of NHE1 and NBCe1 in CMS and non-CMS astrocytes/neurons under normoxia and hypoxia conditions; 2) investigate the role of NHE1 and NBCe1 in the cell death of CMS astrocytes/neurons following hypoxia. We will use H+ and Na+ imaging system together with the genetic knockdown and pharmacological inhibition of NHE1 and NBCe1 to determine their role in the tolerance/vulnerability of CMS astrocytes/neurons to hypoxic stress. A novel feature of our study is the establishment of an in vitro CMS model that was directly derived from CMS and non-CMS highlanders. It is highly likely from our studies that we will make a number of discoveries that will help us design better CMS therapeutic strategies.

Public Health Relevance

The overall goal of this proposal is to better understand how the brain is affected in Chronic Mountain Sickness (CMS) or Monge's disease. We recently derived astrocytic/neuronal cells from skin cells obtained from high altitude subjects. We will do experiments to see whether cells obtained from subjects with CMS are more or less vulnerable to low O2 and whether cell death in low O2 depends on the function/presence of certain transporters on the cell membranes of these astrocytes.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21NS097899-02
Application #
9418123
Study Section
Brain Injury and Neurovascular Pathologies Study Section (BINP)
Program Officer
Koenig, James I
Project Start
2017-02-01
Project End
2019-01-31
Budget Start
2018-02-01
Budget End
2019-01-31
Support Year
2
Fiscal Year
2018
Total Cost
Indirect Cost
Name
University of California San Diego
Department
Pediatrics
Type
Schools of Medicine
DUNS #
804355790
City
La Jolla
State
CA
Country
United States
Zip Code
92093