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International Journal of Molecular Medicine
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Print ISSN: 1107-3756 Online ISSN: 1791-244X
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June-2026 Volume 57 Issue 6

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International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

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Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

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Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

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Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

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Review Open Access

High‑altitude polycythemia: Unveiling the molecular landscape beyond erythropoietin (Review)

  • Authors:
    • Haiyan Li
    • Hongjuan Zhang
    • Hujun Zhang
    • Yujie Li
    • Yigang He
    • Jia Luan

  • View Affiliations / Copyright

    Affiliations: Department of Blood Transfusion, The 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou, Gansu 730000, P.R. China, Department of Neurology, General Hospital of Western Theater Command, Chengdu, Sichuan 610083, P.R. China, Minimally Invasive Department, Lanzhou Time Laser Plastic and Aesthetic Hospital, Lanzhou, Gansu 730000, P.R. China, Health Examination Center, The 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou, Gansu 730000, P.R. China
    Copyright: © Li et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 164
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    Published online on: April 17, 2026
       https://doi.org/10.3892/ijmm.2026.5835
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Abstract

High‑altitude polycythemia (HAP) is classically attributed to erythropoietin (EPO)‑driven erythrocytosis, yet epidemiological and mechanistic evidence increasingly challenges this monocular view. Field data have demonstrated that up to 40% of individuals with a hematocrit level >68% circulate EPO within the sea‑level reference range, whereas multi‑omics studies have revealed sustained HIF activity, mitochondrial oxidative stress, iron dysregulation, gut dysbiosis and epigenetic reprogramming as parallel, EPO‑independent drivers. Hypoxia‑inducible microRNAs, hepcidin suppression, TLR4‑IL‑6 signaling and defective mitophagy converge to lock erythroid precursors into a survival‑plus‑proliferation state even after ambient oxygen levels normalize. The purpose of the present review is to integrate these disparate pathways into a unified molecular framework and to outline a phased, biomarker‑guided therapeutic roadmap for the precise prevention of maladaptive polycythemia at high altitudes.

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Copy and paste a formatted citation
Spandidos Publications style
Li H, Zhang H, Zhang H, Li Y, He Y and Luan J: High‑altitude polycythemia: Unveiling the molecular landscape beyond erythropoietin (Review). Int J Mol Med 57: 164, 2026.
APA
Li, H., Zhang, H., Zhang, H., Li, Y., He, Y., & Luan, J. (2026). High‑altitude polycythemia: Unveiling the molecular landscape beyond erythropoietin (Review). International Journal of Molecular Medicine, 57, 164. https://doi.org/10.3892/ijmm.2026.5835
MLA
Li, H., Zhang, H., Zhang, H., Li, Y., He, Y., Luan, J."High‑altitude polycythemia: Unveiling the molecular landscape beyond erythropoietin (Review)". International Journal of Molecular Medicine 57.6 (2026): 164.
Chicago
Li, H., Zhang, H., Zhang, H., Li, Y., He, Y., Luan, J."High‑altitude polycythemia: Unveiling the molecular landscape beyond erythropoietin (Review)". International Journal of Molecular Medicine 57, no. 6 (2026): 164. https://doi.org/10.3892/ijmm.2026.5835
Copy and paste a formatted citation
x
Spandidos Publications style
Li H, Zhang H, Zhang H, Li Y, He Y and Luan J: High‑altitude polycythemia: Unveiling the molecular landscape beyond erythropoietin (Review). Int J Mol Med 57: 164, 2026.
APA
Li, H., Zhang, H., Zhang, H., Li, Y., He, Y., & Luan, J. (2026). High‑altitude polycythemia: Unveiling the molecular landscape beyond erythropoietin (Review). International Journal of Molecular Medicine, 57, 164. https://doi.org/10.3892/ijmm.2026.5835
MLA
Li, H., Zhang, H., Zhang, H., Li, Y., He, Y., Luan, J."High‑altitude polycythemia: Unveiling the molecular landscape beyond erythropoietin (Review)". International Journal of Molecular Medicine 57.6 (2026): 164.
Chicago
Li, H., Zhang, H., Zhang, H., Li, Y., He, Y., Luan, J."High‑altitude polycythemia: Unveiling the molecular landscape beyond erythropoietin (Review)". International Journal of Molecular Medicine 57, no. 6 (2026): 164. https://doi.org/10.3892/ijmm.2026.5835
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