https://doi.org/10.1038/s41392-026-02836-9
As increasing numbers of people live, work, and travel at high altitudes, experts are calling for a major shift in how altitude-related health conditions are understood, diagnosed, and treated. A new perspective published in
Signal Transduction and Targeted Therapy highlights the growing burden of illnesses linked to low-oxygen environments and introduces a comprehensive framework designed to advance the future of
high-altitude medicine.
High-altitude regions, generally defined as areas above 2,500 metres, are home to millions of permanent residents and attract large numbers of visitors each year. Exposure to reduced oxygen levels can affect multiple organs and contribute to a wide range of conditions, including
acute mountain sickness, pulmonary complications, cardiovascular disorders, metabolic disturbances, and long-term organ damage. Despite decades of progress in understanding individual altitude illnesses, many conditions continue to be viewed and managed separately.
The article proposes a new model known as
Hypoxia Stress-induced Multi-organ Injury (HSMI), which views altitude-related illnesses as interconnected manifestations of a common underlying process. Rather than focusing on isolated organs, the framework emphasizes how oxygen deprivation triggers widespread biological responses that can affect the lungs, brain, heart, liver, kidneys, and gastrointestinal system over time.
“
For decades, altitude-related illnesses have been treated as separate problems” said Prof. Fengming Luo, corresponding author of the study at West China Hospital, Sichuan University. “
HSMI shows they are interconnected responses to oxygen deprivation. That changes how we think about early diagnosis and prevention.” This integrated perspective could help overcome longstanding challenges in the field. Current diagnostic approaches often rely heavily on symptoms rather than objective biological indicators, making early detection difficult. The article highlights the need for
real-time diagnostics, advanced biomarkers, portable imaging technologies, and continuous physiological monitoring capable of identifying health risks before severe symptoms develop.
The proposed roadmap also focuses on understanding why individuals respond differently to altitude exposure. Factors such as genetics, age, sex, and population-specific adaptations may influence vulnerability to hypoxia. Incorporating
multi-omics technologies,
artificial intelligence, and predictive modelling could enable more personalized risk assessment and prevention strategies for people ascending to or residing at high altitude.
In addition, the article outlines opportunities for developing
precision therapeutics that target the biological mechanisms driving altitude-related illness. Such approaches could move beyond symptom management and support interventions aimed at preventing or reducing long-term organ damage associated with chronic hypoxia.
As global engagement with high-altitude environments continues to expand, the HSMI framework offers a new vision for
prevention,
diagnosis, and
treatment, providing a foundation for more coordinated and effective healthcare strategies in some of the world’s most challenging environments.
Article Reference
Wenjin Sun, Xuan Zhang, Ling Chen, Lei Chen, Cheng Deng, Shizheng Wu, Fengming Luo, Advancing high-altitude medicine: a model for the future,
Signal Transduction and Targeted Therapy,
https://doi.org/10.1038/s41392-026-02836-9
Keywords
High-Altitude Medicine, Hypoxia Stress-Induced Multi-Organ Injury (HSMI), Hypoxia, Precision Medicine, Altitude-Related Diseases