Health in the Himalayas and the Himalayan homelands

In September 2012, the eminent Estonian population geneticist Toomas Kivisild convened and hosted a gathering at the University of Cambridge entitled High Altitude and Cold: Adaptation to Extremes. This joyous event was billed as 'a conference to discuss the latest scientific results on human physiological and genetic adaptation to high altitudes and cold environments'. Memorable speakers included Hugh Montgomery, Andrew J. Murray, Miroslava Derenko, Cynthia Beal, Maanasa Raghavan, Dennis O'Rourke, Gianpiero Cavalleri, Anna di Rienzo and Bill Amos. In addition to population geneticists and physiologists, Toomas Kivisild invited to Cambridge a single linguist, who happened to find genetics symposia more enlightening and often more full of ebullience than linguistic gatherings. Just how damaging life at high altitudes can be for people who are genetically ill-equipped to cope with cold high-altitude environments was demonstrated by Andrew J. Murray of Cambridge, who reported on an expedition called Extreme Everest. This scientific expedition aimed to study the metabolic response of heart and muscle tissue to high-altitude hypoxia. It appears that a failing heart is somehow unable to oxidise fatty acids whilst in a state of dilated cardiomyopathy. This inability has to do with hypoxia inducible factors (HIF) and metabolic regulation, with hypoxia inducible factor one-alpha (HIF-1α) accumulating in hypoxic tissues. Fortunately, in healthy individuals, heart impairment caused by high altitude can repair itself after, say, about six months. Most interesting is how this impairment plays out at the biochemical level within the cell.