In this context, it would be pertinent to highlight that elevated levels of endothelin [58] as well as higher expression of endothelin converting enzyme (ECE1) was found in lowland individuals who developed high altitude pulmonary edema (HAPE) compared to acclimatized lowlanders on acute induction to high altitude [59] while no such differential gene expression was noted between the acclimatized lowlanders and the adapted natives (GEO Accession number: GSE52209). Here, ECE1 is linked to pulmonary edema.