{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:16:13Z","timestamp":1787314573012,"version":"build-2736575974"},"reference-count":75,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T00:00:00Z","timestamp":1762560000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CIMB"],"abstract":"<jats:p>Exposure to hypoxia may cause lung injury characterized by hydrostatic pulmonary edema (PE), inflammation and oxidative stress. Norepinephrine (NE) infusion can also induce lung injury with similar pathogenetic characteristics. The main questions of this study were (i) whether NE infusion aggravates hypoxia-induced pulmonary injury; (ii) whether inflammation and oxidative stress deteriorate the hypoxic PE; and (iii) whether PE and inflammation recede after three days of normoxic recovery. Ninety-eight female rats were exposed for 72 h to normoxia or normobaric hypoxia and received infusions with NaCl or NE. Some of these animals were transferred to a three-day normoxic recovery period thereafter. We performed histological and immunohistochemical analyses of the lung, determined protein concentrations in pleural fluid (PF) and bronchoalveolar lavage fluid (BALF), and evaluated hemodynamic parameters. While inflammation and oxidative stress receded after 3 days of normoxic recovery, PE did not resolve. Increased protein concentrations in PF and BALF indicated that capillary stress failure increased even further during the normoxic recovery phase, particularly in animals that had previously received an NE infusion. These results highlight the fact that inflammation does not play a causal role in the development of hypoxic PE.<\/jats:p>","DOI":"10.3390\/cimb47110931","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T17:45:34Z","timestamp":1762796734000},"page":"931","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Can Damage to the Rat Lung Induced by Prolonged Normobaric Hypoxia and Norepinephrine Be Reversed by Normoxic Recovery?"],"prefix":"10.3390","volume":"47","author":[{"given":"Sarah","family":"Daunheimer","sequence":"first","affiliation":[{"name":"Carl-Ludwig-Institute of Physiology, Medical Faculty, Leipzig University, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charly","family":"Bambor","sequence":"additional","affiliation":[{"name":"Carl-Ludwig-Institute of Physiology, Medical Faculty, Leipzig University, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5915-6623","authenticated-orcid":false,"given":"Coralie","family":"Raffort","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Heart Centre, Leipzig University, 04289 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Koedel","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Medical Faculty, Leipzig University, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida","family":"Salameh","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Heart Centre, Leipzig University, 04289 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3526-2388","authenticated-orcid":false,"given":"Beate","family":"Rassler","sequence":"additional","affiliation":[{"name":"Carl-Ludwig-Institute of Physiology, Medical Faculty, Leipzig University, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/S0034-5687(98)00006-1","article-title":"Inflammatory cytokines in BAL fluid and pulmonary hemodynamics in high-altitude pulmonary edema","volume":"111","author":"Kubo","year":"1998","journal-title":"Respir. Physiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"L360","DOI":"10.1152\/ajplung.00158.2002","article-title":"Decreased alveolar oxygen induces lung inflammation","volume":"284","author":"Madjdpour","year":"2003","journal-title":"Am. J. Physiol. Lung Cell. Mol. Physiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1007\/s00424-022-02720-9","article-title":"Relaxin does not prevent development of hypoxia-induced pulmonary edema in rats","volume":"474","author":"Kowalleck","year":"2022","journal-title":"Pflugers Arch."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Riha, I., Salameh, A., Hoschke, A., Raffort, C., Koedel, J., and Rassler, B. (2024). Hypoxia-Induced Pulmonary Injury-Adrenergic Blockade Attenuates Nitrosative Stress, and Proinflammatory Cytokines but Not Pulmonary Edema. J. Cardiovasc. Dev. Dis., 11.","DOI":"10.20944\/preprints202401.1506.v1"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2228","DOI":"10.1001\/jama.287.17.2228","article-title":"Pathogenesis of high-altitude pulmonary edema: Inflammation is not an etiologic factor","volume":"287","author":"Swenson","year":"2002","journal-title":"JAMA"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1164\/rccm.200504-654OC","article-title":"Hypoxia impairs systemic endothelial function in individuals prone to high-altitude pulmonary edema","volume":"172","author":"Berger","year":"2005","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.1161\/CIRCULATIONAHA.106.650796","article-title":"Effect of altitude on the heart and the lungs","volume":"116","author":"Gibbs","year":"2007","journal-title":"Circulation"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.pcad.2010.02.004","article-title":"New insights in the pathogenesis of high-altitude pulmonary edema","volume":"52","author":"Scherrer","year":"2010","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1152\/japplphysiol.01167.2004","article-title":"Physiological aspects of high-altitude pulmonary edema","volume":"98","author":"Maggiorini","year":"2005","journal-title":"J. Appl. Physiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1152\/jappl.1988.64.1.384","article-title":"Removal of pleural liquid and protein by lymphatics in awake sheep","volume":"64","author":"Broaddus","year":"1988","journal-title":"J. Appl. Physiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2623","DOI":"10.1152\/jappl.1990.68.6.2623","article-title":"Clearance of lung edema into the pleural space of volume-loaded anesthetized sheep","volume":"68","author":"Broaddus","year":"1990","journal-title":"J. Appl. Physiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1183\/09059180.00002709","article-title":"Mechanisms controlling the volume of pleural fluid and extravascular lung water","volume":"18","author":"Miserocchi","year":"2009","journal-title":"Eur. Respir. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Beretta, E., Roman\u00f2, F., Sancini, G., Grotberg, J.B., Nieman, G.F., and Miserocchi, G. (2021). Pulmonary Interstitial Matrix and Lung Fluid Balance From Normal to the Acutely Injured Lung. Front. Physiol., 12.","DOI":"10.3389\/fphys.2021.781874"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/j.pcad.2010.03.001","article-title":"Prevention and treatment of high-altitude pulmonary edema","volume":"52","author":"Maggiorini","year":"2010","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1159\/000452800","article-title":"Alveolar Hypoxia-Induced Pulmonary Inflammation: From Local Initiation to Secondary Promotion by Activated Systemic Inflammation","volume":"53","author":"Chen","year":"2016","journal-title":"J. Vasc. Res."},{"key":"ref_16","first-page":"1","article-title":"Inflammatory mechanisms in the lung","volume":"2","author":"Moldoveanu","year":"2009","journal-title":"J. Inflamm. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1152\/japplphysiol.00824.2019","article-title":"Early hours in the development of high-altitude pulmonary edema: Time course and mechanisms","volume":"128","author":"Swenson","year":"2020","journal-title":"J. Appl. Physiol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Mendoza, E.N., Ciriolo, M.R., and Ciccarone, F. (2025). Hypoxia-Induced Reactive Oxygen Species: Their Role in Cancer Resistance and Emerging Therapies to Overcome It. Antioxidants, 14.","DOI":"10.3390\/antiox14010094"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"C12","DOI":"10.1152\/ajpcell.00131.2021","article-title":"Mitochondrial redox regulation and myocardial ischemia-reperfusion injury","volume":"322","author":"Chen","year":"2022","journal-title":"Am. J. Physiol. Cell Physiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2925","DOI":"10.1002\/jcp.22640","article-title":"Hypoxia-inducible Factor 1 Mediates Increased Expression of NADPH Oxidase-2 in Response to Intermittent Hypoxia","volume":"226","author":"Yuan","year":"2011","journal-title":"J. Cell. Physiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1091\/mbc.e09-12-1003","article-title":"The NADPH oxidase subunit NOX4 is a new target gene of the hypoxia-inducible factor-1","volume":"21","author":"Diebold","year":"2010","journal-title":"Mol. Biol. Cell"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/j.redox.2015.08.020","article-title":"Reperfusion injury and reactive oxygen species: The evolution of a concept","volume":"6","author":"Granger","year":"2015","journal-title":"Redox Biol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"C1064","DOI":"10.1152\/ajpcell.2001.281.3.C1064","article-title":"Peroxynitrite causes endothelial cell monolayer barrier dysfunction","volume":"281","author":"Knepler","year":"2001","journal-title":"Am. J. Physiol. Cell Physiol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Salameh, A., Z\u00f6bisch, H., Schr\u00f6der, B., Vigelahn, J., Jahn, M., Abraham, G., Seeger, J., D\u00e4hnert, I., and Dhein, S. (2020). Effects of Hypoxia and Acidosis on Cardiac Electrophysiology and Hemodynamics. Is NHE-Inhibition by Cariporide Still Advantageous?. Front. Physiol., 11.","DOI":"10.3389\/fphys.2020.00224"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"199","DOI":"10.3103\/S009639251804003X","article-title":"Role of Reactive Oxygen Species in Inflammation: A Minireview","volume":"73","author":"Chelombitko","year":"2018","journal-title":"Moscow Univ. Biol. Sci. Bull."},{"key":"ref_26","first-page":"72","article-title":"Hemodynamic and nonhemodynamic mechanisms of experimental pulmonary edema in rats and the effect of anisodamine and tetramethylpyrazine. Part 1: Survival rate, pulmonary index, pathological change and pulmonary vascular permeability","volume":"8","author":"Dai","year":"1993","journal-title":"Chin. Med. Sci. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1007\/s003950170029","article-title":"Transient pleural effusion in norepinephrine-stimulated rats","volume":"96","author":"Rassler","year":"2001","journal-title":"Basic Res. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1023\/A:1024942132705","article-title":"Pulmonary edema and pleural effusion in norepinephrine-stimulated rats--hemodynamic or inflammatory effect?","volume":"250","author":"Rassler","year":"2003","journal-title":"Mol. Cell. Biochem."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/00000658-196907000-00005","article-title":"Respiratory insufficiency in combat casualties. II. Pulmonary edema following head injury","volume":"170","author":"Simmons","year":"1969","journal-title":"Ann. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1152\/japplphysiol.00574.2011","article-title":"The role of sympathetic nervous system in the development of neurogenic pulmonary edema in spinal cord-injured rats","volume":"112","author":"Zicha","year":"2012","journal-title":"J. Appl. Physiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1631\/jzus.B1600411","article-title":"Recurrence of non-cardiogenic pulmonary edema and sustained hypotension shock in cystic pheochromocytoma","volume":"18","author":"Dai","year":"2017","journal-title":"J. Zhejiang Univ. Sci. B."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Y-Hassan, S., and Falhammar, H. (2020). Cardiovascular Manifestations and Complications of Pheochromocytomas and Paragangliomas. J. Clin. Med., 9.","DOI":"10.3390\/jcm9082435"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1097\/00003246-199809000-00027","article-title":"Effects of catecholamines on the pulmonary venous bed in sheep","volume":"26","author":"Teboul","year":"1998","journal-title":"Crit. Care Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1007\/s00424-021-02618-y","article-title":"Left ventricular depression and pulmonary edema in rats after short-term normobaric hypoxia: Effects of adrenergic blockade and reduced fluid load","volume":"473","author":"Appelt","year":"2021","journal-title":"Pflugers Arch."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Bambor, C., Daunheimer, S., Raffort, C., Koedel, J., Salameh, A., and Ra\u00dfler, B. (2025). Effects of a Three-Day vs. Six-Day Exposure to Normobaric Hypoxia on the Cardiopulmonary Function of Rats. Curr. Issues Mol. Biol., 47.","DOI":"10.20944\/preprints202501.1374.v1"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Neubert, E., Rassler, B., Hoschke, A., Raffort, C., and Salameh, A. (2023). Effects of Normobaric Hypoxia and Adrenergic Blockade over 72 h on Cardiac Function in Rats. Int. J. Mol. Sci., 24, Erratum in Int. J. Mol. Sci. 2024, 25, 8408. https:\/\/doi.org\/10.3390\/ijms25158408.","DOI":"10.3390\/ijms25158408"},{"key":"ref_37","first-page":"36","article-title":"Image processing with ImageJ","volume":"11","author":"Abramoff","year":"2004","journal-title":"Biophotonics Int."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1002\/ame2.12402","article-title":"Hypoxia in the pulmonary vein increases pulmonary vascular resistance independently of oxygen in the pulmonary artery","volume":"7","author":"Magnusdottir","year":"2024","journal-title":"Animal Model Exp. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1164\/rccm.200406-707OC","article-title":"Pulmonary blood flow heterogeneity during hypoxia and high-altitude pulmonary edema","volume":"171","author":"Hopkins","year":"2005","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1152\/jappl.1991.70.4.1731","article-title":"Stress failure in pulmonary capillaries","volume":"70","author":"West","year":"1991","journal-title":"J. Appl. Physiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2483","DOI":"10.1152\/jappl.2000.89.6.2483","article-title":"Invited review: Pulmonary capillary stress failure","volume":"89","author":"West","year":"2000","journal-title":"J. Appl. Physiol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"B\u00f6lter, C., Gabriel, P., Appelt, P., Salameh, A., Schierle, K., and Rassler, B. (2019). Effects of Adrenergic Agonists and Antagonists on Cardiopulmonary Function During Normobaric Hypoxia in Rat. Front. Physiol., 10.","DOI":"10.3389\/fphys.2019.00860"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/00005382-198807000-00006","article-title":"New concepts about the pathophysiology of pulmonary edema","volume":"3","author":"Staub","year":"1988","journal-title":"J. Thorac. Imaging"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1172\/JCI113747","article-title":"Relationship of pleural effusions to increased permeability pulmonary edema in anesthetized sheep","volume":"82","author":"Broaddus","year":"1988","journal-title":"J. Clin. Investig."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/S1569-9048(03)00062-4","article-title":"Catecholamine-induced pulmonary edema and pleural effusion in rats\u2014Alpha- and beta-adrenergic effects","volume":"135","author":"Rassler","year":"2003","journal-title":"Respir. Physiol. Neurobiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1089\/neu.2014.3609","article-title":"Pathogenetic Mechanisms of Neurogenic Pulmonary Edema","volume":"32","author":"Zicha","year":"2015","journal-title":"J. Neurotrauma"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Rachfalska, N., Putowski, Z., and Krzych, J. (2020). Distant Organ Damage in Acute Brain Injury. Brain Sci., 10.","DOI":"10.3390\/brainsci10121019"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/1043-4666(91)90015-6","article-title":"Hypoxia increases production of interleukin-1 and tumor necrosis factor by human mononuclear cells","volume":"3","author":"Ghezzi","year":"1991","journal-title":"Cytokine"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1006\/cyto.1999.0533","article-title":"High altitude increases circulating interleukin-6, interleukin-1 receptor antagonist and C-reactive protein","volume":"12","author":"Hartmann","year":"2000","journal-title":"Cytokine"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.3181\/0712-RM-337","article-title":"Role of oxidative stress and NF\u03baB in hypoxia-induced pulmonary edema","volume":"233","author":"Sarada","year":"2008","journal-title":"Exp. Biol. Med. (Maywood)"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"856918","DOI":"10.1155\/2012\/856918","article-title":"Lung oxidative damage by hypoxia","volume":"2012","author":"Araneda","year":"2012","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1089\/ars.2012.5149","article-title":"Reactive oxygen species in inflammation and tissue injury","volume":"20","author":"Mittal","year":"2014","journal-title":"Antioxid. Redox Signal."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"8871476","DOI":"10.1155\/2020\/8871476","article-title":"Hypoxia-Inducible Factor-1: A Potential Target to Treat Acute Lung Injury","volume":"2020","author":"Liu","year":"2020","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"El Alam, S., Pena, E., Aguilera, D., Siques, P., and Brito, J. (2022). Inflammation in Pulmonary Hypertension and Edema Induced by Hypobaric Hypoxia Exposure. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms232012656"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1080\/019021400408308","article-title":"Effects of peroxynitrite on pulmonary edema and the oxidative state","volume":"26","author":"Beckman","year":"2000","journal-title":"Exp. Lung Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"L674","DOI":"10.1152\/ajplung.00391.2005","article-title":"Peroxynitrite mediates TNF-alpha-induced endothelial barrier dysfunction and nitration of actin","volume":"290","author":"Neumann","year":"2006","journal-title":"Am. J. Physiol. Lung Cell. Mol. Physiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1165\/rcmb.2022-0431TR","article-title":"Vascular Contribution to Lung Repair and Fibrosis","volume":"69","author":"Caporarello","year":"2023","journal-title":"Am. J. Respir. Cell Mol. Biol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1152\/jappl.1992.73.3.1150","article-title":"Short-term reversibility of ultrastructural changes in pulmonary capillaries caused by stress failure","volume":"73","author":"Elliott","year":"1992","journal-title":"J. Appl. Physiol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1161\/01.RES.0000243584.45145.3f","article-title":"Hypoxia-induced pulmonary vascular remodeling: Cellular and molecular mechanisms","volume":"99","author":"Stenmark","year":"2006","journal-title":"Circ. Res."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.pccm.2024.04.002","article-title":"Mechanisms of pulmonary endothelial barrier dysfunction in acute lung injury and acute respiratory distress syndrome","volume":"2","author":"Su","year":"2024","journal-title":"Chin. Med. J. Pulm. Crit. Care Med."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1080\/00325481.1986.11699566","article-title":"Pleural effusions. 1. Preliminary evaluation--recognition of the transudate","volume":"80","author":"Jay","year":"1986","journal-title":"Postgrad. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"507","DOI":"10.7326\/0003-4819-77-4-507","article-title":"Pleural effusions: The diagnostic separation of transudates and exudates","volume":"77","author":"Light","year":"1972","journal-title":"Ann. Intern. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1001\/jama.1986.03380010067027","article-title":"High-altitude pulmonary edema. Characteristics of lung lavage fluid","volume":"256","author":"Schoene","year":"1986","journal-title":"JAMA"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1146\/annurev.physiol.61.1.543","article-title":"Structure, strength, failure, and remodeling of the pulmonary blood-gas barrier","volume":"61","author":"West","year":"1999","journal-title":"Annu. Rev. Physiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1164\/ajrccm.155.3.9116992","article-title":"Intense exercise impairs the integrity of the pulmonary blood-gas barrier in elite athletes","volume":"155","author":"Hopkins","year":"1997","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1152\/japplphysiol.01048.2005","article-title":"Effects of altitude and exercise on pulmonary capillary integrity: Evidence for subclinical high-altitude pulmonary edema","volume":"100","author":"Eldridge","year":"2006","journal-title":"J. Appl. Physiol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1161\/01.CIR.99.13.1713","article-title":"Augmented sympathetic activation during short-term hypoxia and high-altitude exposure in subjects susceptible to high-altitude pulmonary edema","volume":"99","author":"Duplain","year":"1999","journal-title":"Circulation"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2174\/1567270052774395","article-title":"Involvement of cytokines and inflammation in catecholamine-induced pulmonary injury in rats","volume":"2","author":"Rassler","year":"2005","journal-title":"Vasc. Dis. Prev."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Haditsch, B., Roessler, A., Krisper, P., Frisch, H., Hinghofer-Szalkay, H.G., and Goswami, N. (2015). Volume regulation and renal function at high altitude across gender. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0118730"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1152\/jappl.2000.88.2.599","article-title":"Diuretic effect of hypoxia, hypocapnia, and hyperpnea in humans: Relation to hormones and O(2) chemosensitivity","volume":"88","author":"Hildebrandt","year":"2000","journal-title":"J. Appl. Physiol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1089\/15270290260512846","article-title":"Hypoxic ventilatory response, ventilation, gas exchange, and fluid balance in acute mountain sickness","volume":"3","author":"Swenson","year":"2002","journal-title":"High Alt. Med. Biol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/0034-5687(96)00064-3","article-title":"Ventilatory response to hypoxia in rats: Gender differences","volume":"106","author":"Mortola","year":"1996","journal-title":"Respir. Physiol."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Dzhalilova, D., and Makarova, O. (2020). Differences in Tolerance to Hypoxia: Physiological, Biochemical, and Molecular-Biological Characteristics. Biomedicines, 8.","DOI":"10.3390\/biomedicines8100428"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1089\/ham.2023.0054","article-title":"High-Altitude Pulmonary Edema in Women: A Scoping Review-UIAA Medical Commission Recommendations","volume":"24","author":"Jean","year":"2023","journal-title":"High Alt. Med. Biol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"789","DOI":"10.7326\/0003-4819-141-10-200411160-00010","article-title":"The physiologic basis of high-altitude diseases","volume":"141","author":"West","year":"2004","journal-title":"Ann. Intern. Med."}],"container-title":["Current Issues in Molecular Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1467-3045\/47\/11\/931\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T17:59:59Z","timestamp":1762797599000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1467-3045\/47\/11\/931"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,8]]},"references-count":75,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["cimb47110931"],"URL":"https:\/\/doi.org\/10.3390\/cimb47110931","relation":{},"ISSN":["1467-3045"],"issn-type":[{"value":"1467-3045","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,8]]}}}