Aerospace medicine, hypoxia and lung disease
Project Leader: Dr Tom Smith, NIHR Clinical Lecturer
Tom’s research in hypoxia physiology and aerospace medicine has included studies in the laboratory, at high altitude (in the remote Peruvian Andes) and on commercial airline flights. Through experiments in healthy volunteers and patients, this work has provided evidence that the transcription factor HIF (hypoxia-inducible factor), which coordinates cellular responses to hypoxia, also plays a major role in regulating the cardiopulmonary organ systems upon which cellular oxygen delivery ultimately depends. It has further established that iron status modifies hypoxic pulmonary hypertension in a manner that is consistent with the known biochemical interaction between iron and HIF. These findings have clinical implications for the patients studied and, more generally, have introduced the possibility that iron can be important in the aetiology and clinical management of hypoxic lung disease.
Recent in-flight studies have also established that the mild hypoxia experienced during commercial air travel causes pulmonary artery pressure to increase modestly in healthy passengers, and that this can develop into hypoxic pulmonary hypertension in a genetically susceptible patient.
Tom is currently leading several studies in hypoxia physiology and aerospace medicine in collaboration with the University of Limerick, the Royal Air Force and NASA.