Role of the spleen in the exaggerated polycythemic response to hypoxia in chronic mountain sickness in rats

Departments of 1 Physiology, 2 Pharmacology and Toxicology, and 3 Medicine, Dartmouth Medical School, Lebanon, New Hampshire 03756-001 In a rat model of chronic mountain sickness, the excessive polycythemic response to hypoxic exposure is associated with profound splenic erythropoiesis. We studied the uptake and distribution of radioactive iron and red blood cell (RBC) morphology in intact and splenectomized rats over a 30-day hypoxic exposure. Retention of 59 Fe in the plasma was correlated with 59 Fe uptake by both spleen and marrow and the appearance of 59 Fe-labeled RBCs in the blood. 59 Fe uptake in both the spleen and the marrow paralleled the production of nucleated RBCs. Splenic 59 Fe uptake was ~10% of the total marrow uptake under normoxic conditions but increased to 60% of the total marrow uptake during hypoxic exposure. Peak splenic 59 Fe uptake and splenomegaly occurred at the most intense phase of erythropoiesis and coincided with the rapid appearance of 59 Fe-labeled RBCs in the blood. The bone marrow remains the most important erythropoietic organ under both resting and stimulated states, but inordinate splenic erythropoiesis in this rat strain accounts in large measure for the excessive polycythemia during the development of chronic mountain sickness in chronic hypoxia. interaction of splenic and medullary erythropoiesis; high altitude; splenomegaly; splenectomy; leukocytosis; thrombocytosis; thrombocytopenia