Research advances and prospects on effects of combined exposure to high-altitude hypoxia and fine particulate matter on pulmonary heart disease
- VernacularTitle:高原低氧与细颗粒物联合暴露对肺源性心脏病影响的研究进展与展望
- Author:
Li HE
1
;
Ce LIU
1
;
Hao ZHAO
1
;
Bin LUO
2
Author Information
- Publication Type:Specialtopic:Extremeenvironmentsandhealth
- Keywords: high altitude; hypoxia; fine particulate matter; pulmonary heart disease; combined exposure; synergistic effect
- From: Journal of Environmental and Occupational Medicine 2026;43(9):1069-1076
- CountryChina
- Language:Chinese
- Abstract: Pulmonary heart disease (PHD) is a significant public health concern affecting cardiopulmonary health in high-altitude regions. This review summarized the potential synergistic mechanisms by which combined exposure to high-altitude hypoxia and fine particulate matter (PM2.5) may contribute to the development and progression of PHD. In high-altitude environments, PM2.5 may exhibit unique exposure and toxicity profiles. Intense ultraviolet radiation and elevated atmospheric oxidative capacity can promote the photochemical aging of PM2.5, thereby enhancing its biological activity and oxidative injury potential. Meanwhile, hypoxia-induced compensatory hyperventilation may increase the respiratory deposition dose of PM2.5 compared with that under low-altitude conditions. In addition to acting synergistically with PM2.5 to promote pulmonary vascular injury, hypoxia may further augment right ventricular afterload through sympathetic activation, endothelial dysfunction, and myocardial metabolic reprogramming. Existing in vitro and animal studies suggest that hypoxia and PM2.5 may jointly promote endothelial injury, pulmonary vascular remodeling, and right ventricular decompensation via superimposed “pseudohypoxia” signaling and a positive feedback loop involving oxidative stress and inflammation. However, current research has predominantly focused on the independent effects of hypoxia or PM2.5, whereas the synergistic effects of combined exposure remain insufficiently elucidated. Future studies should establish combined hypoxia-PM2.5 exposure models, clarify dose-response relationships and pathogenic mechanisms, and explore targeted intervention strategies. Such evidence may support the prevention and control of PHD in high-altitude regions and the refinement of environmental health standards.
