HIF-1α and VEGF as prognostic biomarkers in hepatocellular carcinoma patients treated with transarterial chemoembolization

BACKGROUND

Neoangiogenesis plays a crucial role in the progression of hepatocellular carcinoma (HCC), and concerns have been raised about the role of neoangiogenesis on the effectiveness of transarterial chemoembolization (TACE).

AIM

In this study, we aimed to evaluate Vascular Endothelial Growth Factor (VEGF) and Hypoxia-Inducible Factor-1α (HIF-1α) as circulating prognostic biomarkers in HCC patients treated with TACE.

METHODS

Blood samples were collected from 163 patients before (t0) and four weeks after TACE (t1).

RESULTS

Higher levels of VEGF after TACE were demonstrated (264.0 [78.7-450.8] vs. 278.6 [95.0-576.6] pg/mL; p < 0.0001). Responders to TACE had lower levels of VEGF than non-responders both at t0 (200.0 [58.9-415.8] vs. 406.6 [181.4-558.6] pg/mL; p = 0.006) and at t1 (257.3 [68.5-528.6] vs. 425.9 [245.2-808.3] pg/mL; p = 0.003), and in both groups there was an increase in VEGF compared to measurements before treatment (p = 0.001 and p = 0.005, respectively). VEGF was not associated with overall survival (OS), while patients with HIF-1α ≤ 0.49 ng/mL showed better prognosis (median OS 28.0 months [95% CI 19.7-36.3] vs. 17.0 months [95% CI 11.1-22.9]; p = 0.01). Moreover, HIF-1α was identified as an independent prognostic parameter.

CONCLUSIONS

VEGF and HIF-1α can be considered useful prognostic biomarkers in HCC patients treated with TACE.

Comparison of HIF-1α and survivin levels in patients with diabetes and retinopathy of varying severity

PURPOSE

This study measured serum hypoxia--inducible factor-1 (HIF-1α) and survivin levels in patients with diabetes and investigated their association with the severity of retinopathy.

METHODS

This study included 88 patients with type 2 diabetes mellitus who underwent routine eye examinations. Three groups were created. Group 1 consisted of patients without diabetic retinopathy. Group 2 included patients with non-proliferative diabetic retinopathy. Group 3 included patients with proliferative diabetic retinopathy. To measure serum HIF-1α and survivin levels, venous blood samples were collected from patients.

RESULTS

The mean HIF-1α levels in groups 1, 2, and 3 were 17.30 ± 2.19, 17.79 ± 2.34, and 14.19 ± 2.94 pg/ml, respectively. Significant differences were detected between groups 1 and 3 (p=0.01) and between groups 2 and 3 (p=0.01). The mean survivin levels in groups 1, 2, and 3 were 42.65 ± 5.37, 54.92 ± 5.55, and 37.46 ± 8.09 pg/ml, respectively. A significant difference was only detected between groups 2 and 3 (p=0.002).

CONCLUSION

The present study revealed that serum HIF-1α and survivin levels are increased in patients with non-proliferative diabetic retinopathy compared to those in patients without diabetic retinopathy.

[Expression and significance of hypoxia-inducible factor 1α and Bcl-2/adenovirus E1B19kDa-interacting protein 3 in children with traumatic brain injury]

OBJECTIVES

To dynamically observe the changes in hypoxia-inducible factor 1α (HIF-1α) and Bcl-2/adenovirus E1B19kDa-interacting protein 3 (BNIP3) in children with traumatic brain injury (TBI) and evaluate their clinical value in predicting the severity and prognosis of pediatric TBI.

METHODS

A prospective study included 47 children with moderate to severe TBI from January 2021 to July 2023, categorized into moderate (scores 9-12) and severe (scores 3-8) subgroups based on the Glasgow Coma Scale. A control group consisted of 30 children diagnosed and treated for inguinal hernia during the same period, with no underlying diseases. The levels of HIF-1α, BNIP3, autophagy-related protein Beclin-1, and S100B were compared among groups. The predictive value of HIF-1α, BNIP3, Beclin-1, and S100B for the severity and prognosis of TBI was assessed using receiver operating characteristic (ROC) curves.

RESULTS

Serum levels of HIF-1α, BNIP3, Beclin-1, and S100B in the TBI group were higher than those in the control group (P<0.05). Among the TBI patients, the severe subgroup had higher levels of HIF-1α, BNIP3, Beclin-1, and S100B than the moderate subgroup (P<0.05). Correlation analysis showed that the serum levels of HIF-1α, BNIP3, Beclin-1, and S100B were negatively correlated with the Glasgow Coma Scale scores (P<0.05). After 7 days of treatment, serum levels of HIF-1α, BNIP3, Beclin-1, and S100B in both non-surgical and surgical TBI patients decreased compared to before treatment (P<0.05). ROC curve analysis indicated that the areas under the curve for predicting severe TBI based on serum levels of HIF-1α, BNIP3, Beclin-1, and S100B were 0.782, 0.835, 0.872, and 0.880, respectively (P<0.05), and for predicting poor prognosis of TBI were 0.749, 0.775, 0.814, and 0.751, respectively (P<0.05).

CONCLUSIONS

Serum levels of HIF-1α, BNIP3, and Beclin-1 are significantly elevated in children with TBI, and their measurement can aid in the clinical assessment of the severity and prognosis of pediatric TBI.

Vitamin D and Hypoxia-Inducible Factor (HIF-1α) Serum Levels as Markers for Progression of Nephropathy in Type 2 Diabetic Patients

BACKGROUND

Vitamin D is a locally acting hormone, which plays a major role in skeletal health. Previous studies reported an important role of vitamin D in modulation of inflammatory response. We aimed to investigate the role of vitamin D deficiency and hypoxia-inducible factor (HIF-1α) as markers for the progression of diabetic nephropathy in Saudi patients with type 2 diabetes mellitus (T2DM).

METHODS

We included 174 Saudi patients with T2DM in addition to 60 healthy control subjects. Patients were classified according to urinary Albumin to Creatinine Ratio (ACR) into three groups: Group AI: ACR < 30 µg/mg, Group AII: ACR levels of 30 - 300 µg/mg and Group AIII: ACR > 300 µg/mg. We estimated fasting blood glucose, HbA1c, lipid profile, serum creatinine, hemoglobin concentration (Hb), estimated glomerular filtration rate (eGFR), urine albumin/creatinine ratio, serum 25 hydroxyvitamin D, calcium, parathyroid hormone (PTH), tumor necrosis factor (TNF-α), C- reactive protein (CRP), and hypoxia-inducible factor (HIF-1α).

RESULTS

There was a significant difference among studied groups regarding serum levels of vitamin D, calcium, PTH, TNF-α, CRP, and HIF-1α levels. The level of vitamin D was lower in diabetic patients in comparison to the controls and was significantly related to the severity of renal nephropathy as indicated by the level of albumin in urine. Moreover, vitamin D levels showed significant negative correlation with the inflammatory markers: TNF-α, CRP, and HIF-1α levels.

CONCLUSIONS

Vitamin D deficiency and elevated HIF-1α serum levels showed a significant correlation to progression of nephropathy in Saudi patients with T2DM.

The Effect of Hypoxia Inducible Factor -1 Alpha and Vascular Endothelial Growth Factor Level in Type 2 Diabetes Microvascular Complications and Development

Background:

Angiogenesis in diabetic patients is often caused by hyperglycemia induced by hypoxia

Objective:

The aim of this study was to analyze the serum level of Hypoxia Inducible Factor -1α (HIF-1α) and Vascular Endothelial Growth Factor (VEGF) between March until Desember 2020.

Methods:

This is a cross-sectional analytic methods, 135 patients with Type 2 Diabetes 48 samples with Microvascular complication and 87 samples with non-microvascular complication were recruited from the various primary health care centers in Medan city and surrounding areas in North Sumatera. VEGF levels and HIF-1α tested were done with ELISA methods in the laboratory of Medical Faculty, Universitas Sumatera Utara. Statistical analysis was performed using the IBM SPSS Statistics version 24. The significance level was set up to 0.005.

Results:

The median HIF-1 levels in patients with microvascular complications were lower than those without microvascular complications, with a range of HIF-1α values in non-complicated samples (0.02-13.96) ng/ml and a range of HIF-1α values in vascular complications (0.52- 8.87) mg/dL. There was a significant difference in HIF-1α levels in patients with Type-2 DM with complications compared to those without complications (p<0.05). Median VEGF levels were higher in complicated Type-2 DM. There was no difference in VEGF levels in patients with Type-2 DM with complications compared to those without complications (p > 0.005).

Conclusion:

HIF-1α and VEGF levels showed the development in vascularity. With the higher level of HIF-1α, an increase in VEGF levels were found, indicating the angiogenesis is occurring. Although complications have not yet occurred, it is predicted that high VEGF values will cause vascular complications in the future.

The lower expression of circulating miR-210 and elevated serum levels of HIF-1α in ischemic stroke; Possible markers for diagnosis and disease prediction

BACKGROUND

Stroke, either due to ischemia or hemorrhage, causes acute neurological damages to the brain. There is shortage of reliable biomarkers for ischemic stroke (IS), and we therefore investigated the serum concentrations of microRNA-210 (miR-210) and hypoxia inducible factor-1α (HIF-1α), as possible diagnostic and/or prognostic markers for IS.

METHODS

Serum samples were acquired from 52 IS patients and their healthy counterparts at five time points: upon admission, 24 and 48 h after admission, upon discharge and 3 months later. Serum levels of miR-210 and HIF-1α were respectively analyzed using real time RT-PCR and ELISA. Diagnostic and prognostic accuracy tests were performed to assess the value of suggested biomarkers.

RESULTS

IS patients demonstrated higher levels of serum HIF-1α and lower miR-210 in comparison to the healthy subjects. MiR-210 was suggested to be a weak diagnostic biomarker at the time of admission (AUC = 0.61; p = 0.05), while HIF-1α was an acceptable diagnostic marker for IS (AUC = 0.73; p < 0.0001). The higher expression of miR-210 and lower levels of HIF-1α were associated with better survivals in IS patients.

CONCLUSIONS

Serum miR-210 is a weak diagnostic marker of IS. Serum HIF-1α is a better biomarker in diagnosing IS patients but further work in larger groups, including those with hemorrhagic stroke is necessary to confirm its diagnostic utility. Similarly, the prognostic potentiality of miR-210 and HIF-1α was acceptable but needs bigger sample size and longer follow-up to be statistically confirmed.

Amelioration of diabetic retinopathy in db/db mice by treatment with different proportional three active ingredients from Tibetan medicine Berberis dictyophylla F

ETHNOPHARMACOLOGICAL RELEVANCE

Berberis dictyophylla F., a famous Tibetan medicine, has been used to prevent and treat diabetic retinopathy (DR) for thousands of years in clinic. However, its underlying mechanisms remain unclear.

AIM OF THE STUDY

The present study was designed to probe the synergistic protection and involved mechanisms of berberine, magnoflorine and berbamine from Berberis dictyophylla F. on the spontaneous retinal damage of db/db mice.

MATERIALS AND METHODS

The 14-week spontaneous model of DR in db/db mice were randomly divided into eight groups: model group, calcium dobesilate (CaDob, 0.23 g/kg) group and groups 1-6 (different proportional three active ingredients from Berberis dictyophylla F.). All mice were intragastrically administrated for a continuous 12 weeks. Body weight and fasting blood glucose (FBG) were recorded and measured. Hematoxylin-eosin and periodic acid-Schiff (PAS) stainings were employed to evaluate the pathological changes and abnormal angiogenesis of the retina. ELISA was performed to assess the levels of IL-6, HIF-1α and VEGF in the serum. Immunofluorescent staining was applied to detect the protein levels of CD31, VEGF, p-p38, p-JNK, p-ERK and NF-κB in retina. In addition, mRNA expression levels of VEGF, Bax and Bcl-2 in the retina were monitored by qRT-PCR analysis.

RESULTS

Treatment with different proportional three active ingredients exerted no significant effect on the weight, but decreased the FBG, increased the number of retinal ganglionic cells and restored internal limiting membrane. The results of PAS staining demonstrated that the drug treatment decreased the ratio of endothelial cells to pericytes while thinned the basal membrane of retinal vessels. Moreover, these different proportional active ingredients can markedly downregulate the protein levels of retinal CD31 and VEGF, and serum HIF-1α and VEGF. The gene expression of retinal VEGF was also suppressed. The levels of retinal p-p38, p-JNK and p-ERK proteins were decreased by drug treatment. Finally, drug treatment reversed the proinflammatory factors of retinal NF-κB and serum IL-6, and proapoptotic Bax gene expression, while increased antiapoptotic Bcl-2 gene expression.

CONCLUSIONS

These results indicated that DR in db/db mice can be ameliorated by treatment with different proportional three active ingredients from Berberis dictyophylla F. The potential vascular protection mechanisms may be involved in inhibiting the phosphorylation of the MAPK signaling pathway, thus decreasing inflammatory and apoptotic events.

Effects of Spironolactone on Hypoxia-Inducible Factor-1α in the Patients Receiving Coronary Artery Bypass Grafting

ABSTRACT

We explored the protective effect of spironolactone on cardiac function in the patients undergoing coronary artery bypass grafting (CABG) by determining serum hypoxia-inducible factor-1α (HIF-1α) before and after CABG. We used the propensity score matching method retrospectively to select 174 patients undergoing CABG in our hospital from March 2018 to December 2019. Of the 174 patients, 87 patients taking spironolactone for more than 3 months before CABG were used as a test group and other 87 patients who were not taking spironolactone as a control group. In all patients, serum HIF-1α and troponin I levels were determined before as well as 24 hours and 7 days after CABG, serum N-terminal probrain natriuretic peptide (NT-proBNP) level was determined before as well as 12, 24, and 36 hours after CABG, and electrocardiographic monitoring was performed within 36 hours after CABG. The results indicated that there were no significant differences in the HIF-1α level between the test group and the control group before and 7 days after CABG, but the HIF-1α level was significantly lower in the test group than that in the control group 24 hours after CABG (P < 0.01). The 2 groups were not significantly different in the troponin I level at any time point. There was no significant difference in the serum NT-proBNP level between the test group and the control group before CABG, but NT-proBNP (BNP) levels were all significantly lower in the test group than those in the control group at postoperative 12, 24, and 36 hour time points (all P <0.05). The incidence of postoperative atrial fibrillation was also significantly lower in the test group than that in the control group (P = 0.035). Spironolactone protects cardiac function probably by improving myocardial hypoxia and inhibiting myocardial remodeling.

Prognostic Significance of VEGF and HIF-1 α in Hepatocellular Carcinoma Patients Receiving Sorafenib Versus Metformin Sorafenib Combination

BACKGROUND

Hepatocellular carcinoma (HCC) is a major health problem. HCC burden has been increasing in Egypt in the past 10 years. Most HCC cases are diagnosed at an advanced stage with limited treatment options. Sorafenib is the standard therapy for advanced HCC, but the effectiveness is not satisfied. Metformin may decrease the risk of HCC development in diabetic patients, reduces tumor invasion, and augments sensitivity to sorafenib; however, safety and efficacy of combined treatment are still unclear. As HCC is characterized by high vascularity, and vascular endothelial growth factor (VEGF) plays an important role in vascularization, many studies questioned if VEGF and HIF-1 α could offer information about HCC response to sorafenib. We conducted this study to assess the benefits from adding metformin to HCC treatment, and appraise the role of VEGF and HIF-1 α in HCC prognosis.

METHOD

This was a prospective, randomized study in which 80 advanced measurable patients consecutively treated with sorafenib plus metformin (arm A) or sorafenib alone (arm B), prognostic value of plasma, and tissue levels of VEGF and HIF-1 α were evaluated.

RESULTS

We enrolled 61 men and 19 women with a median age of 60 years (range 49-68 years). Fifty-seven patients had Child-Pugh A while 23 had early B, the most common etiology of liver disease was hepatitis C (86%). Sixty percent of patients were diabetic. No significant difference was detected between arm A and arm B regarding response to treatment (p = 0.5), time to disease progression (p = 0.3), or overall survival (p = 0.6). Low VEGF and HIF-1 α plasma levels were significantly associated with better treatment response (p < 0.001 for both), and higher OS (p < 0.001). Patients with high expressions of VEGF and HIF in HCC tissue had significantly poor treatment outcome (p < 0.001, p = 0.03, respectively), and poor OS (p < 0.001, p < 0.001, respectively).

CONCLUSIONS

No superior efficacy of adding metformin to sorafenib in HCC treatment. VEGF and HIF-1 α had promising prognostic value in HCC.

Experimental Study on the Correlation between miRNA-373 and HIF-1α, MMP-9, and VEGF in the Development of HIE

INTRODUCTION

Microribonucleic acids (miRNAs) have short (approximately 18 to 25) nucleotides and are evolutionarily conserved and endogenously expressed RNAs belonging to a family of noncoding RNA molecules. miRNA-373 regulates cell proliferation, migration, apoptosis, invasion, and repairing damaged DNA after hypoxia stress. Neonatal hypoxic-ischemic encephalopathy (HIE) refers to perinatal asphyxia caused by partial or complete hypoxia, reduced or suspended cerebral blood flow, and fetal or neonatal brain damage. We aim to investigate the relationship between miRNA-373 and HIF-1α, between miRNA-373 MMP-9, and between miRNA-373 VEGF in the occurrence and development of HIE.

METHODS

Human (children) samples were divided into four groups (n = 15 in each group) according to HIE severity. The patient group was divided into middle, moderate, and severe HIE groups. The control group included healthy children or children with nonneurological diseases. The expressions of miRNA-373, HIF-1α, MMP-9, and VEGF were assayed in the serum samples.

RESULTS

Our study showed a strong relationship between miRNA-373 and HIF-1α, between miRNA-373 and MMP-9, and between miRNA-373 and VEGF. The expression levels of miRNA-373, HIF-1α, MMP-9, and VEGF in the HIE groups were much higher than those of the control group.

CONCLUSION

The increased change in miRNA-373 expression has a certain diagnostic significance on neonatal HIE. In the occurrence and development of HIE, miRNA-373 is positively correlated with HIF-1α, MMP-9, and VEGF.

HIF1A: A Putative Modifier of Hemochromatosis

HFE-related hereditary hemochromatosis (HH) is characterized by marked phenotypic heterogeneity. Homozygosity for p.C282Y is a low penetrance genotype suggesting that the HFE-HH is a multifactorial disease resulting from a complex interaction involving a major gene defect, genetic background and environmental factors. We performed a targeted NGS-based gene panel to identify new candidate modifiers by using an extreme phenotype sampling study based on serum ferritin and iron removed/age ratio. We found an increased prevalence of the HIF1A p.Phe582Ser and p.Ala588Thr variants in patients with a severe iron and clinical phenotype. Accordingly, Huh-7 cells transfected with both variants showed significantly lower HAMP promoter activity by luciferase assay. The qRT-PCR assays showed a downregulation of hepcidin and an upregulation of the HIF1A target genes (VEGF, HMOX, FUR, TMPRSS6) in cells transfected with the HIF1A-P582S vector. We identified mutations in other genes (e.g., Serpina1) that might have some relevance in single cases in aggravating or mitigating disease manifestation. In conclusion, the present study identified HIF1A as a possible modifier of the HFE-HH phenotype cooperating with the genetic defect in downregulating hepcidin synthesis. In addition, this study highlights that an NGS-based approach could broaden our knowledge and help in characterizing the genetic complexity of HFE-HH patients with a severe phenotype expression.

Angiogenic and Immune-Related Biomarkers and Outcomes Following Axitinib/Pembrolizumab Treatment in Patients with Advanced Renal Cell Carcinoma

PURPOSE

Combined axitinib/pembrolizumab is approved for advanced renal cell carcinoma (aRCC). This exploratory analysis examined associations between angiogenic and immune-related biomarkers and outcomes following axitinib/pembrolizumab treatment.

PATIENTS AND METHODS

Prospectively defined retrospective correlative exploratory analyses tested biospecimens from 52 treatment-naïve patients receiving axitinib and pembrolizumab (starting doses 5 mg twice daily and 2 mg/kg respectively, every 3 weeks). Tumor tissue, serum, and whole blood samples were collected at baseline, at cycle 2 day 1 (C2D1), and end of treatment (EOT) for blood-based samples. Clinical outcomes were objective response rate (ORR) and progression-free survival (PFS).

RESULTS

Higher baseline tumor levels of CD8 showed a trend toward longer PFS (HR 0.4; P = 0.091). Higher baseline serum levels of CXCL10 (P = 0.0197) and CEACAM1 (P = 0.085) showed a trend toward better ORR and longer PFS, respectively. Patients for whom IL6 was not detected at baseline had longer PFS versus patients for whom it was detected (HR 0.4; P = 0.028). At C2D1 and/or EOT, mainly immune-related biomarkers showed any association with better outcomes. The genes CA9 (P = 0.084), HIF1A (P = 0.064), and IFNG (P = 0.073) showed trending associations with ORR, and AKT3 (P = 0.0145), DDX58 (P = 0.0726), GZMA (P = 0.0666), LCN2 (NGAL; P = 0.0267), and PTPN11 (P = 0.0287) with PFS.

CONCLUSIONS

With combined axitinib/pembrolizumab treatment in patients with aRCC, mostly immune-related biomarkers are associated with better treatment outcomes. This exploratory analysis has identified some candidate biomarkers to consider in future prospective testing.

Gestational diabetes mellitus in women increased the risk of neonatal infection via inflammation and autophagy in the placenta

BACKGROUND

Gestational diabetes mellitus (GDM) produces numerous problems for maternal and fetal outcomes. However, the precise molecular mechanisms of GDM are not clear.

METHODS

In our study, we randomly assigned 22 pregnant women with fasting glucose concentrations, 1 hour oral glucose tolerance test (1H-OGTT) and 2 hour oral glucose tolerance test (2H-OGTT), different than 28 normal pregnant women from a sample of 107 pregnant women at the First Affiliated Hospital of Jinan University in China. Lipopolysaccharide (LPS), interleukin 1 alpha (IL-1α), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor alpha (TNF-α) were measured from blood plasma of pregnant women and umbilical arteries using ultraviolet spectrophotometry. Hematoxylin & Eosin (H&E), Periodic acid-Schiff (PAS) or Masson staining were performed to examine whether diabetes mellitus altered the morphology of placenta. Quantitative PCR (Q-PCR), western blotting and immunofluorescent staining were performed to examine whether diabetes mellitus and autophagy altered the gene expressions of the placental tissue.

RESULTS

We found that women with GDM exhibited increased placental weight and risk of neonatal infection. The concentrations of IL-6 protein and IL-8 protein in GDM were increased in both maternal and umbilical arterial blood. H&E, Masson and PAS staining results showed an increased number of placental villi and glycogen deposition in patients with GDM, but no placental sclerosis was found. Q-PCR results suggested that the expression levels of HIF-1α and the toll like receptor 4 (TLR4)/ myeloid differential protein-88 (MyD88)/ nuclear factor kappa-B (NF-κB) pathway were increased in the GDM placenta. Through Western Blotting, we found that the expression of NF-kappa-B inhibitor alpha (IKBα) and Nuclear factor-κB p65 (NF-κB p65) in GDM placenta was significantly enhanced. We also showed that the key autophagy-related genes, autophagy-related 7 (ATG7) and microtubule-associated protein 1A/1B-light chain 3 (LC3), were increased in GDM compared with normal pregnant women.

CONCLUSIONS

Our results suggest that women with GDM exhibit an increased risk of neonatal infection via inflammation and autophagy in the placenta.

Plasma expression of HIF-1α as novel biomarker for the diagnosis of obstructive sleep apnea-hypopnea syndrome

Background

Obstructive sleep apnea‐hypopnea syndrome (OSAHS) is a common breathing disorder during sleep with potential lethality and multi‐complications. Polysomnography (PSG) is now the golden standard for the diagnosis obstructive sleep apnea‐hypopnea syndrome. However, PSG is expensive and time‐consuming. Therefore, it is important to find inexpensive and convenient biomarkers for the diagnosis of OSAHS.

Objective

The present study aimed to explore the potential diagnostic value of HIF‐1α for OSAHS and its clinical significance.

Methods

This study consisted of 368 patients admitted to the sleep laboratory. The patients were classified according to their apnea‐hypopnea index (AHI) scores as OSA negative (AHI < 5), mild‐moderate (AHI:5‐30), and severe OSA (AHI > 30), and severe OSA treated with continuous positive airway pressure (CPAP). qRT‐PCR was used to detect mRNA levels in the plasma; Pearson's correlation analysis was performed to analyze the correlation of HIF‐1α mRNA level and the clinicopathological factors of OSAHS; ROC curve was constructed to evaluate the diagnostic value of HIF‐1α mRNA.

Results

HIF‐1α mRNA was significantly up‐regulated in the plasma of OSAHS patients, especially patients with severe OSAHS. HIF‐1α mRNA was positively correlated with the AHI and ODI but negatively correlated with the mean oxygen saturation in patients with OSAHS. Results of ROC curve showed that HIF‐1α is a sensitive biomarker for the diagnosis of OSAHS, especially severe OSAHS.

Conclusions

HIF‐1α mRNA might be used as s a convenient and inexpensive method for triaging OSAHS patients PSG assessment in the hospital and evaluate the curative effect.

Association of Nuclear Receptor Coactivators with Hypoxia-Inducible Factor-1α in the Serum of Patients with Chronic Kidney Disease

Nuclear receptor coactivators (NCOAs), consisting of coactivators and corepressors, dramatically enhance the transcriptional activity of nuclear receptors. Hypoxia-inducible factor-1α (HIF-1α) is a transcription factor that plays a major role under hypoxic conditions. This study was performed with the focus on the association of NCOAs with HIF-1α in the serum of chronic kidney disease (CKD) patients. Sixty patients with stage 5 CKD and 30 healthy controls from The Second Affiliated Hospital of Shantou University Medical College, between March 21, 2019, and October 30, 2019, were recruited in this prospective cohort study. We analyzed the serum levels of NCOAs (NCOA1, NCOA2, and NCOA3), HIF-1α, vascular endothelial growth factor (VEGF), etc. and assessed whether there was any relationship between these parameters and CKD disease. We found that circulating NCOA1 was positively associated with circulating NCOA2, NCOA3, and HIF-1α. A positive correlation was also observed between NCOA2 and NCOA1, NCOA3, HIF-1α, and VEGF. Furthermore, statistically significant correlations between NCOA3 and NCOA1, NCOA2, and HIF-1α were observed. The serum levels of VEGF in the CKD group were higher than those of the healthy control group. Circulating NCOA1 and circulating NCOA2 were negatively associated with procalcitonin. In conclusion, there was an association between circulating NCOA1, NCOA2, NCOA3, and circulating HIF-1α, and circulating VEGF was a risk factor for CKD disease. However, more studies should be performed to confirm this hypothesis.

Modulating effects of preconditioning exercise in the expression of ET-1 and BNP via HIF-1α in ischemically injured brain

It is well-known that in ischemia-induced hypoxia, hypoxia-inducible factor -1α (HIF-1α) is critical in triggering expression of its downstream target genes to produce several products, such as erythropoietin (EPO), vascular endothelial growth factor (VEGF), nitric oxide synthesis (NOS), glucose transportor-1 (GLUT-1), insulin-like growth factor (IGF), which further promote erythropoiesis, angiogenesis, vasodilation and capitalization of glucose to overcome hypoxia. Meanwhile, as the factors with opposite effects on blood vessels, endothelin-1 (ET-1) and brain natriuretic peptide (BNP) also stand out strikingly in ischemic pathophysiology. To this day, several preconditioning manners have been used to induce tolerance to ischemia. During our research, exercise preconditioning was applied and it was demonstrated that HIF-1α triggered expression of ET-1 and BNP, which confirmed their downstream target genes for HIF-1α. And ET-1 may influcence expression of BNP to some degree but not the only factor which regulates BNP expression. Therefore, our findings suggest exercise preconditioning may provide protection to the ischemic brain tissue via HIF-1α which in turn increases expression of BNP to cause vasodilation in cooperation with some other factors, such as VEGF and EPO, to increase the blood flow in the ischemic area and then relieve the injuries induced by ischemia.

Role of SIRT-3, p-mTOR and HIF-1α in Hepatocellular Carcinoma Patients Affected by Metabolic Dysfunctions and in Chronic Treatment with Metformin

The incidence of hepatocellular carcinoma deriving from metabolic dysfunctions has increased in the last years. Sirtuin- (SIRT-3), phospho-mammalian target of rapamycin (p-mTOR) and hypoxia-inducible factor- (HIF-1α) are involved in metabolism and cancer. However, their role in hepatocellular carcinoma (HCC) metabolism, drug resistance and progression remains unclear. This study aimed to better clarify the biological and clinical function of these markers in HCC patients, in relation to the presence of metabolic alterations, metformin therapy and clinical outcome. A total of 70 HCC patients were enrolled: 48 and 22 of whom were in early stage and advanced stage, respectively. The expression levels of the three markers were assessed by immunohistochemistry and summarized using descriptive statistics. SIRT-3 expression was higher in diabetic than non-diabetic patients, and in metformin-treated than insulin-treated patients. Interestingly, p-mTOR was higher in patients with metabolic syndrome than those with different etiology, and, similar to SIRT-3, in metformin-treated than insulin-treated patients. Moreover, our results describe a slight, albeit not significant, benefit of high SIRT-3 and a significant benefit of high nuclear HIF-1α expression in early-stage patients, whereas high levels of p-mTOR correlated with worse prognosis in advanced-stage patients. Our study highlighted the involvement of SIRT-3 and p-mTOR in metabolic dysfunctions that occur in HCC patients, and suggested SIRT-3 and HIF-1α as predictors of prognosis in early-stage HCC patients, and p-mTOR as target for the treatment of advanced-stage HCC.

Amelioration of diabetic nephropathy in db/db mice treated with tibetan medicine formula Siwei Jianghuang Decoction Powder extract

Siwei Jianghuang Decoction Powder (SWJH) documented originally in the Four Medical Tantras-Blue Glaze exhibited beneficial effects on diabetic nephropathy (DN) via combined synergistically action of multiple formula components including Curcumae longae Rhizoma, Berberidis dictyophyllae Cortex, Phyllanthi Fructus and Tribuli Fructus. This study investigated the effects of SWJH on DN in db/db mice and possible underlying mechanisms. The ten weeks old db/db mice treated with SWJH by intra-gastric administration once a day for 8 weeks. After 8 weeks, body weight, water and food intake of mice were recorded. The level of fasting blood glucose (FBG) was measured. Serum creatinine (Scr), blood urea nitrogen (BUN), urine microalbumin (UMAlb), serum uric acid (UA) and urinary albumin excretion (UAE) were detected. An enzyme-linked immunosorbent assay was performed to test serum vascular endothelial growth factor (VEGF) and transforming growth factor-β1 (TGF-β1). Real-time PCR and Western blot analysis were used to test mRNA and protein expression of hypoxia inducible factor-1α (HIF-1α), VEGF and TGF-β1 in kidney tissue. SWJH treatment significantly reduced the levels of FBG, Scr, BUN, UMAlb, UA and UAE and retarded renal fibrosis. SWJH treatment further significantly reduced serum TGF-β1 level and downregulated the expression of HIF-1α, VEGF and TGF-β1 at both mRNA and protein levels. Principal component analysis and partial least squares regression and hierarchical cluster analysis demonstrated that SWJH treatment significantly ameliorated renal damage in DN mice. These consequences suggested that SWJH formulations were effective in the treatment of DN through regulating the HIF-1α, VEGF and TGF-β1 overexpression.

Study on sildenafil combined with inhalational nitric oxide therapy on the curative effects and serum levels of HIF-1α, ET-1, and calcium in neonatal pulmonary hypertension

OBJECTIVE

To explore the effect of sildenafil combined with inhalational nitric oxide (NO) therapy on the curative effects and serum levels of hypoxia-inducible factor (HIF)-1α, endothelin-1 (ET-1), and calcium in persistent pulmonary hypertension of the newborn (PPHN).

PATIENTS AND METHODS

Eighty-six patients with neonatal pulmonary hypertension treated in Xuzhou Children's Hospital from March 2015 to February 2016 were randomly divided into the observation group and control group, treated with sildenafil and sildenafil combined with inhalational NO, respectively. The clinical efficacy of newborns in the two groups was compared. Fraction of inspiration O2 (FiO2), Oxygen Index (OI), blood oxygen partial pressure (PaO2), blood oxygen saturation (SpO2), and pulmonary arterial pressure of newborns in the two groups were compared before treatment and 2 h, 12 h, and 24 h after treatment. The serum levels of HIF-1α, ET-1, and calcium of patients in the two groups were compared before treatment and 3, 5, 7 days after treatment.

RESULTS

The total effective rate of the observation group (95.34%) was significantly higher than that of the control group (74.41%) (p<0.05). After treatment, FiO2, OI, and pulmonary arterial pressure of patients in the two groups decreased, and the decrease in the observation group was significantly lower than in the control group (p<0.05). After treatment, PaO2 and SpO2 of patients in the observation group were higher than those of the control group. The levels of HIF-1α and ET-1 of patients in the two groups decreased and were significantly lower in the observation group compared with the control group. The levels of calcium of patients in the two groups increased and were significantly higher in the observation group than the control group (p<0.05).

CONCLUSIONS

Sildenafil combined with inhalational NO therapy for neonatal pulmonary hypertension can quickly improve oxygenation, effectively reduce pulmonary arterial hypertension, and is worthy of clinical application.

Chronically Hypoxic Fetal Lambs Supported by an Extra-Uterine Device Exhibit Mitochondrial Dysfunction and Elevations of Hypoxia Inducible Factor 1-Alpha

INTRODUCTION

We have recently developed an extra-uterine environment for neonatal development (EXTEND) capable of supporting premature fetal lambs and have been able to replicate hypoxic in utero conditions by controlling fetal oxygen delivery. In this study, we investigated the fetal mitochondrial response to hypoxia.

METHODS

Eight premature fetal lambs were delivered via hysterotomy and transitioned to extra-uterine support for 3 weeks. The lambs were divided into 2 groups: normoxic fetuses which maintained physiologic oxygen delivery and hypoxic fetuses in which oxygen delivery was significantly reduced. Control fetuses were delivered via hysterotomy but not cannulated. Measurements of mitochondrial membrane potential (MMP) were performed in peripheral blood mononuclear cells.

RESULTS

There were no significant differences in MMP between normoxic EXTEND fetuses and controls. Hypoxic fetuses had significantly more depolarized mitochondria compared to normoxic fetuses overall, and these changes were specifically appreciated in weeks 1 and 2, but not by week 3. Hypoxic fetuses had significantly elevated levels of HIF-1α compared to normoxic fetuses in the first 2 weeks.

DISCUSSION

Normoxic fetal lambs supported by EXTEND demonstrate normal mitochondrial function as evidenced by equivalent membrane potentials compared to control fetuses. Hypoxic fetuses exhibit mitochondrial dysfunction, though they do show evidence of adaptation after 3 weeks of hypoxic exposure.

Levels of Endocan, Angiopoietin-2, and Hypoxia-Inducible Factor-1a in Patients with Autosomal Dominant Polycystic Kidney Disease and Different Levels of Renal Function

BACKGROUND

Endothelial dysfunction leading to unbalanced vasoconstriction and ischemia of renal parenchyma is increasingly proposed as an alternative pathway of renal damage in autosomal dominant polycystic kidney disease (ADPKD). However, human studies investigating the evolution of such phenomena are limited. This study investigated the levels of emerging biomarkers of endothelial function, angiogenesis and hypoxia, in ADPKD patients with different renal function.

METHODS

The study population consisted of three groups: 26 ADPKD patients with impaired renal function (Group A; estimated glomerular filtration rate [eGFR] 45-70 mL/min/1.73 m2), 26 ADPKD patients with preserved renal function (Group B; eGFR >70 mL/min/1.73 m2), and 26 age- and sex-matched controls with no history of renal disease. Circulating levels of endocan (endothelial cell-specific molecule-1) angiopoietin-2, and hypoxia-inducible factor-1a (HIF-1a) were determined by enzyme-linked immunosorbent assay techniques.

RESULTS

Patients in Group A had significantly higher levels of endocan (7.17 ± 0.43 ng/mL), angiopoietin-2 (5,595.43 ± 3,390), and HIF-1a (163.68 ± 37.84 pg/mL) compared to patients in Group B (6.86 ± 0.59 ng/mL, p = 0.017, 3,854.41 ± 3,014.30, p = 0.018, 136.84 ± 42.10 pg/mL, p = 0.019 respectively) or controls (4.83 ± 0.69 ng/mL, 1,069 ± 427.88 pg/mL, 70.20 ± 17.49 pg/mL, p < 0.001 for all comparisons). Of note, patients in Group B had also higher levels of all markers compared to controls (p < 0.001) despite having similar renal function. In correlation analyses within ADPKD patients, we noted strong correlations of all studied markers with asymmetric dimethylarginine (ADMA; endocan r = 0.908, p < 0.001, angiopoietin-2 r = 0.983, p < 0.001 and HIF-1a r = 0.998, p < 0.001), and only weak or modest correlations with eGFR.

CONCLUSIONS

This study suggests that endothelial dysfunction causing microcirculatory changes, linked to angiogenesis and hypoxia, may come early in the course of ADPKD and could be a key regulator of renal injury progression.

Protective effect of zinc preconditioning against renal ischemia reperfusion injury is dose dependent

Objectives

Ischemia-reperfusion injury (IRI) is a major cause of acute kidney injury and chronic kidney disease. Two promising preconditioning methods for the kidney, intermittent arterial clamping (IC) and treatment with the hypoxia mimetic cobalt chloride, have never been directly compared. Furthermore, the protective efficacy of the chemically related transition metal Zn²⁺ against renal IRI is unclear. Although Co²⁺ ions have been shown to protect the kidney via hypoxia inducible factor (HIF), the effect of Zn²⁺ ions on the induction of HIF1α, HIF2α and HIF3α has not been investigated previously.

Materials and methods

The efficacy of different preconditioning techniques was assessed using a Sprague-Dawley rat model of renal IRI. Induction of HIF proteins following Zn²⁺ treatment of the human kidney cell lines HK-2 (immortalized normal tubular cells) and ACHN (renal cancer) was measured using Western Blot.

Results

Following 40 minutes of renal ischemia in rats, cobalt preconditioning offered greater protection against renal IRI than IC as evidenced by lower peak serum creatinine and urea concentrations. ZnCl₂ (10 mg/kg) significantly lowered the creatinine and urea concentrations compared to saline-treated control rats following a clinically relevant 60 minutes of ischemia. Zn²⁺ induced expression of HIF1α and HIF2α but not HIF3α in HK-2 and ACHN cells.

Conclusion

ZnCl₂ preconditioning protects against renal IRI in a dose-dependent manner. Further studies are warranted to determine the possible mechanisms involved, and to assess the benefit of ZnCl₂ preconditioning for clinical applications.

Can exercise suppress tumour growth in advanced prostate cancer patients with sclerotic bone metastases? A randomised, controlled study protocol examining feasibility, safety and efficacy

INTRODUCTION

Exercise may positively alter tumour biology through numerous modulatory and regulatory mechanisms in response to a variety of modes and dosages, evidenced in preclinical models to date. Specifically, localised and systemic biochemical alterations produced during and following exercise may suppress tumour formation, growth and distribution by virtue of altered epigenetics and endocrine-paracrine activity. Given the impressive ability of targeted mechanical loading to interfere with metastasis-driven tumour formation in human osteolytic tumour cells, it is of equal interest to determine whether a similar effect is observed in sclerotic tumour cells. The study aims to (1) establish the feasibility and safety of a combined modular multimodal exercise programme with spinal isometric training in advanced prostate cancer patients with sclerotic bone metastases and (2) examine whether targeted and supervised exercise can suppress sclerotic tumour growth and activity in spinal metastases in humans.

METHODS AND ANALYSIS

A single-blinded, two-armed, randomised, controlled and explorative phase I clinical trial combining spinal isometric training with a modular multimodal exercise programme in 40 men with advanced prostate cancer and stable sclerotic spinal metastases. Participants will be randomly assigned to (1) the exercise intervention or (2) usual medical care. The intervention arm will receive a 3-month, supervised and individually tailored modular multimodal exercise programme with spinal isometric training. Primary endpoints (feasibility and safety) and secondary endpoints (tumour morphology; biomarker activity; anthropometry; musculoskeletal health; adiposity; physical function; quality of life; anxiety; distress; fatigue; insomnia; physical activity levels) will be measured at baseline and following the intervention. Statistical analyses will include descriptive characteristics, t-tests, effect sizes and two-way (group × time) repeated-measures analysis of variance (or analysis of covariance) to examine differences between groups over time. The data-set will be primarily examined using an intention-to-treat approach with multiple imputations, followed by a secondary sensitivity analysis to ensure data robustness using a complete cases approach.

ETHICS AND DISSEMINATION

Ethics approval was obtained from the Human Research Ethics Committee (HREC) of Edith Cowan University and the Sir Charles Gairdner and Osborne Park Health Care Group. If proven to be feasible and safe, this study will form the basis of future phase II and III trials in human patients with advanced cancer. To reach a maximum number of clinicians, practitioners, patients and scientists, outcomes will be disseminated through national and international clinical, conference and patient presentations, as well as publication in high-impact, peer-reviewed academic journals.

TRIAL REGISTRATION NUMBER

ACTRN 12616000179437.

MiR-15a expression analysis in non-small cell lung cancer A549 cells under local hypoxia microenvironment

OBJECTIVE

Lung cancer is a common tumor in the clinic. Hypoxia is an important biological characteristic in the solid malignant tumor. MiRNA participates in cell proliferation, differentiation, and apoptosis. This study tested hypoxia-inducible factor 1-α (HIF-1α) in lung cancer patients and analyzed the microRNA-15a (miR-15a) expression in A549 cells under different local hypoxia microenvironments.

PATIENTS AND METHODS

A total of 40 non-small cell lung cancer (NSCLC) patients in First Affiliated Hospital of Zhengzhou University between Jan 2015 and Jan 2016 were involved in this study. The serum and tissue samples of lung cancer were collected. Serum HIF-1α level was tested by enzyme-linked immunosorbent assay (ELISA) assay. HIF-1α expression in tissue was evaluated by using the immunohistochemistry. A549 cells were cultured under normoxic, hypoxic, and anaerobic environment, respectively. HIF-1α mRNA and miR-15a levels were determined by RT-PCR.

RESULTS

HIF-1α levels were up-regulated in serum and tissue (p<0.05). HIF-1α mRNA increased, while miR-15a down-regulated in A549 from hypoxia and anaerobic groups compared with control (p<0.05). HIF-1α shRNA transfection significantly reduced HIF-1α and elevated miR-15a level (p<0.05). MiR-15a shRNA transfection exhibited no statistical impact on HIF-1α expression (p>0.05).

CONCLUSIONS

HIF-1α highly expressed in lung cancer patients. MiR-15a levels were down-regulated in A549 cells under hypoxia and anaerobic conditions.

Changes of serum Mir-217 and the correlation with the severity in type 2 diabetes patients with different stages of diabetic kidney disease

The aim of this study is to investigate the correlation between serum microRNA-217 and the severity of diabetic kidney disease determined by albuminuria. Four hundred ninety five type 2 diabetes patients were divided into three groups: normoalbuminuric group, microalbuminuric group, and macroalbuminuric group. Serum microRNA-217 levels were validated by real-time polymerase chain reaction. Serum silent information regulator 1, Hypoxia-inducible factor-1α and vascular endothelial growth factor were determined by enzyme-linked immunosorbent assay. Compared with control, serum microRNA-217 levels were significantly increased in type 2 diabetes patients and gradually increased in patients of normoalbuminuric, microalbuminuric, and macroalbuminuric groups (P < 0.01). Moreover, increased levels of serum microRNA-217, hypoxia-inducible factor-1α, vascular endothelial growth factor, diabetes mellitus duration, fasting blood glucose, fasting insulin, homeostasis model assessment for insulin resistance, glycated hemoglobin, low-density lipoprotein, total cholesterol, triglyceride, uric acid, serum creatinine, blood urea nitrogen, and decreased levels of serum silent information regulator 1 and high-density lipoprotein were significantly correlated with Ln(ACR) (P < 0.05). In addition, serum microRNA-217 was positively correlated with diabetes mellitus duration, homeostasis model assessment for insulin resistance, glycated hemoglobin, Ln(ACR), low-density lipoprotein, total cholesterol, triglyceride, uric acid, serum creatinine, blood urea nitrogen, hypoxia-inducible factor-1α, vascular endothelial growth factor (P < 0.05), and negatively correlated with serum silent information regulator 1 (P = 0.002). Our findings suggest that microRNA-217 may have an association with the development of proteinuria in type 2 diabetes patients. Serum microRNA-217 may be involved in the development of diabetic kidney disease by promoting chronic inflammation, renal fibrosis, and angiogenesis.

Concentration analysis of hypoxi-inducible factor-1α; and vascular endothelial growth factor in patients with aortic aneurysm at different stages and its clinical significance

This study aims to investigate serum concentration of hypoxia inducible factor-1α; (HIF-1α) and vascular endothelial growth factor (VEGF) in patients with aneurysms at different stages, and to determine critical role in early diagnosis and evaluation of severity. A cohort of 102 cases of patients diagnosed as aneurysms during May 2012 to April 2015 in our hospital were retrospectively analyzed. Patients were divided into early stage group (n=32), mid-term group (n=34), and late stage group (n=36) according to severity of aneurysms. The measurement of concentration of HIF-1α and VEGF was detected by Enzyme-linked immunosorbent assays (ELISA). Serum level of HIF-1α; and VEGF was compared among different groups. The results showed that serum concentrations of HIF-1α (t=25.53, P<0.05) and VEGF (t=12.10, P<0.05) in early stage group were significantly higher than those in normal group. Serum concentrations of HIF-1α (t=25.63, P<0.05) and VEGF (t=9.71, P<0.05) in the mid-term group were significantly higher than those in the early stage group. Serum concentrations of HIF-1α (t=14.61, P<0.05) and VEGF (t=21.42, P<0.05) in the late stage group were significantly higher than those in the mid-term group. In conclusion, serum HIF-1α and VEGF has clinical value of early diagnosis and assessment of disease severity.

Levels of Serum 25(OH)VD3, HIF-1α, VEGF, vWf, and IGF-1 and Their Correlation in Type 2 Diabetes Patients with Different Urine Albumin Creatinine Ratio

OBJECTIVE

To investigate changes in serum 25(OH)VD3, HIF-1α, VEGF, vWf, IGF-1, and their correlation in type 2 diabetes patients at different stages of diabetic kidney disease (DKD).

METHODS

502 type 2 diabetes patients were divided into three groups: Normoalbuminuric group (201 patients), Microalbuminuric group (171 patients), and Macroalbuminuric group (130 patients). Serum 25-hydroxyvitamin D3 [25(OH)VD3] was measured by chemiluminescence. Serum hypoxia-inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF), von Willebrand factor (vWf), and insulin-like growth factor-1 (IGF-1) were determined by enzyme-linked immunosorbent assay. We detected the aforementioned serum factors in all cases and 224 control subjects.

RESULTS

Serum HIF-1α, VEGF, vWf, and IGF-1 in type 2 diabetes patients were significantly higher than those in the control group and increased with the increase of Ln(ACR), respectively (P < 0.001). Serum 25(OH)VD3 was significantly lower in type 2 diabetes patients and decreased with the increase of Ln(ACR) (P < 0.001). Ln(ACR) was positively correlated with duration, HbA1c, Scr, BUN, TC, LDL, TG, UA, HIF-1α, VEGF, IGF-1, vWf, and Fg and negatively correlated with 25(OH)VD3 and eGFR.

CONCLUSION

Serum HIF-1α, VEGF, vWf, and IGF-1 may be involved in DKD process through inflammation, angiogenesis, and endothelial injury. Serum 25(OH)VD3 may have protective effects on DKD partly by inhibiting inflammation, abnormal angiogenesis, and vascular endothelial dysfunction.

The changes in miR-130b levels in human serum and the correlation with the severity of diabetic nephropathy

BACKGROUND

Circulating microRNA 130b has been closely associated with multiple diseases in humans such as cancer, obesity and diabetes mellitus. This study evaluates the correlation between serum miR-130b and the severity of diabetic nephropathy evaluated by measurement of albuminuria.

METHODS

Three hundred twenty-seven patients with type 2 diabetes mellitus (T2DM) were divided into three groups: normoalbuminuria group [diabetes mellitus, urinary albumin to creatinine ratio (UACR) < 30 mg/g, n = 137], microalbuminuria group (DN1, UACR 30-300 mg/g, n = 122) and macroalbuminuria group (DN2, UACR > 300 mg/g, n = 68). The levels of serum miR-130b were validated by real-time polymerase chain reaction. Serum transforming growth factor β1 (TGF-β1), hypoxia inducible factor 1α (HIF-1α) and fibronectin were determined by enzyme-linked immunosorbent assay.

RESULTS

Compared with control, serum miR-130b levels were significantly decreased in T2DM patients and further decreased in the patients of diabetes mellitus, DN1 and DN2 groups (p < 0.001). Furthermore, age-adjusted and sex-adjusted regression analyses showed that decreased level of serum miR-130b, increased levels of glycated haemoglobin (HbA1c ), homeostatic model assessment of insulin resistance (HOMA-IR), triglyceride (TG), low-density lipoprotein (LDL), serum creatinine, blood urea nitrogen (BUN), TGF-β1, HIF-1α and fibronectin were significantly correlated with UACR (p < 0.05). In addition, serum miR-130b levels were inversely correlated with HbA1c , HOMA-IR, TG, LDL, BUN, TGF-β1, HIF-1α and FN (p < 0.05).

CONCLUSION

Our findings suggest that serum miR-130b may be a new biomarker for the early diagnosis of DN in T2DM. Circulating miR-130b may possibly be involved in the pathological mechanism of DN, such as lipid metabolic disorders, oxidative stress, extracellular matrix deposition and renal fibrosis.

Erythrocytosis associated with hyperthyroidism: a rare case report and clinical study of possible mechanism

PURPOSE

To report a rare case of erythrocytosis that occurred in close association with Graves' hyperthyroidism. In order to explore the role of altered erythropoiesis in hyperthyroidism, factors related to erythropoiesis were studied in 30 patients with Graves' hyperthyroidism.

METHOD

The relationship between thyroid hormone level and erythrocytosis was studied in a patient with Graves' hyperthyroidism and erythrocytosis. Later, 30 consecutive patients with proven untreated Graves' hyperthyroidism and 30 age- and sex-matched healthy controls were recruited. All patients received methimazole therapy. Erythrocyte indices, thyroid function, serum erythropoietin (EPO), and hypoxia-inducible factor-1α (HIF-1α) concentrations were measured before and after eight weeks of therapy.

RESULTS

In our case study, erythrocytosis relapsed with elevation of thyroid hormones. Methimazole or subsequent radioiodine therapy reduced the conditions of erythrocytosis and thyroid function returned to normal. In the clinical study, erythrocyte counts, serum erythropoietin, and HIF-1α levels in the hyperthyroid group were significantly higher than those in the control subjects. All subjects were grouped together for correlation analyses and HIF-1α was shown to correlate with total triiodothyronine (TT(3)), total thyroxine (TT(4)), and EPO levels. The correlation between EPO and TT(3) or TT(4) approached significance. After eight weeks of anti-thyroid drug therapy, a small but statistically significant increase in hemoglobin and erythrocyte count with a significant decrease in HIF-1α and EPO level was seen in hyperthyroid subjects.

CONCLUSION

Erythrocytosis may appear in patients with hyperthyroidism, and one possible mechanism is thyroid hormone-induced augmentation of HIF-1α, resulting in increased EPO levels.

Comparison of maternal and umbilical cord blood HIF-1α and nitric oxide levels in early and late onset preeclamptic pregnancies

OBJECTIVE

Despite the absence of a complete physiologic-pathologic understanding, common accepted theory for development of preeclampsia is incomplete trophoblastic invasion leading to failed uterine and spiral arteriolar remodeling, causing maternal vascular endothelial dysfunction by secreted molecules in response to decreased placental perfusion, placental hypoxia, and ischemia. Placental angiogenesis is especially ineffective in early onset preeclampsia and fetal morbidity/mortality rates are higher because of further decreased blood flow. In this study, we aim to compare the maternal and umbilical cord blood levels of hypoxia-inducible transcription factor-1α (HIF-1α), which is believed to regulate hypoxia-related transcriptional responses, to play role in activating genes for initial phases of placental development and angiogenesis and a physiologic vasodilator molecule nitric oxide (NO) in normal, early and late onset preeclamptic pregnant women.

METHODS

Pregnant women who were diagnosed with preeclampsia (early onset ≤34 weeks; late onset >34 weeks) and delivered in our clinic were enrolled for this prospective case-controlled study. Pregnant women without preeclampsia were recruited as control group. HIF-1α and NO levels in maternal and umbilical cord blood measured and compared among groups.

FINDINGS

A total of 46 cases were enrolled for this study, including 25 preeclamptic (13 in the early onset group and 12 in the late onset group) and 21 normal pregnant women in the control group. Comparison of preeclampsia group to controls revealed higher maternal blood HIF-1α levels in the control group, however higher umbilical cord NO levels in the preeclampsia group (p < 0.05 and p < 0.001, respectively). In a second analysis, when compared to control group, both early and late onset preeclampsia subgroups were found to have higher umbilical cord blood NO levels (p < 0.001).

RESULTS

In this study, we observed lower maternal blood HIF-1α levels and higher umbilical cord NO levels in preeclampsia group than controls. These findings suggest that umbilical cord blood NO levels in pregnant women with preeclampsia increase in response to hypoxia. However, lower HIF-1α levels in preeclampsia group can be due to our limited number of cases and we think that there is a need for further studies with larger sample size.

[Expression and significance of hypoxia-inducible factor-1α in patients with chronic obstructive pulmonary disease and smokers with normal lung function]

OBJECTIVE

To study the expression of hypoxia-inducible factor (HIF)-1α in lung tissues and sera from chronic obstructive pulmonary disease (COPD) patients and smokers with normal lung function and explore its clinical significance.

METHODS

Lung tissue samples were obtained from 32 patients undergoing surgery for peripheral lung tumors. Lung function test was performed before lung cancer surgery. Based on lung function and smoking status, 32 patients were devided into three groups: smokers with stable COPD (COPD group, n=10), smokers with normal lung function (S group, n=10) and nonsmokers with nomal lung function (NS group, n=10). The preoperative fasting sera and lung tissues as far as possible away from the tumor site from all patients were collected. HIF-1α levels in sera and lung tissue homogenates were evaluated by ELISA. The expression of HIF-1α in airway epithelium, alveolar wall and blood vessel wall were detected by immunohistochemistry. Furthermore, the correlation between HIF-1α expression levels and pulmonary function was analyzed.

RESULTS

Serum HIF-1α levels were significantly elevated in COPD group [(73.25 ± 6.12) pg/mL] and S group [(60.30 ± 8.00) pg/mL] as compared with NS group [(47.03 ± 8.43) pg/mL, P<0.01], and COPD group was significantly higher than S group (P<0.01). The concentrations of HIF-1α in lung tissue homogenates significantly increased in COPD group [(2.04 ± 0.24) pg/μg] and S group [(1.67 ± 0.34) pg/μg] as compared with NS group [(1.12 ± 0.33) pg/μg, P<0.01], and COPD group was also significantly higher than S group (P<0.01). HIF-1α expression was located in inflammatory cells and macrophages of airway epithelium, alveolar wall and small pulmonary artery wall. HIF-1α levels in sera and lung tissue homogenates showed negative correlations with FEV1/FVC and FEV1% predicted.

CONCLUSION

HIF-1α levels are raised in sera and lung tissues of COPD patients and smokers with normal lung function, and they were positively correlated with the severity of airflow limitation.

Expression of VEGF-A, HIF-1 A, CD34 and Ki67 in clear cell renal cell carcinomas and their relationship with conventional prognostic markers

Clear cell renal carcinoma is the most frequent type of renal carcinoma. Recently, attention has been focused in the expression of angiogenic factors by these tumors, which would justify in part their capacity to grow, invade and disseminate, stating a worse evolution of those patients with an unfavorable angiogenic profile. 83 samples of nephrectomy with a diagnosis of clear cell renal cell carcinoma were studied. Clinical and pathological data were collected. Tumors were studied to assess immunohistochemical expression of the following markers: VEGF-A, HIF-1α, CD34 and Ki67. Results indicated a direct linear relationship between expressions of these four markers. Besides, the expression of HIF-1α was directly related to Furhman grade, invasion of the renal vein and tumor stage. Likewise, tumor proliferation index, assessed with Ki67, was directly related to the presence of necrosis, capsular invasion and advanced tumor stage. Regarding the expression of CD34, vascular density was inversely related to tumor necrosis and overall survival. These findings are controversial compared with the available literature. Then, a research scenery would be open, where the importance of generating prospective and more standardized studies are highlighted to determine the role of these angiogenic factors in tumor evolution and prognostic evaluation of these tumors.

[Tissue hypoxia and related metabolic changes of homeostasis during vibration load in athletes]

We explored the efficacy and the mechanisms of influence on physical performance of vibratory loads in the "whole body vibration" (WBV) at a frequency of 50 Hz, amplitude of 30 mm and a running time of 30 minutes, which was performed after each standard training sessions in athletes for 3 weeks. WBV vibration causes an occurrence ofhypoxia, as evidenced by the end of the study the serum growth athletes content HIF- 1 a with 0.89+/-0.03 to 1.3 1+/-0.01 ngxml-1, which is substantially higher than in control (1.04+/-0.02 ngxml-1). Simultaneously, it is activated such a HIF-1 alpha-dependent process as erythropoiesis: the contents of red blood cells increases at the end of the study to 6.04+/-0.11x10(12) 1-1 (control only to 5.23+/-0.12x10(12)xl-1). Intensification of angiogenic stimuli under the influence of hypoxia is manifested by a significant two times increase in the serum levels of the main angiogenesis factor VEGF (to 62.3+6.8 pgxml-1, from the control level of 32.7+/-4.7 pgxml-1 Vibration loads are accompanied by a lack of oxidative stress, an important ergolytic factor. In contrast, they activate nonenzymatic antioxidant system unit, resulting in an increase in the content of reduced glutathione in the cell membranes. We detected a reduction in endogenous toxicity and improvement of humoral immunity and, as a result, an improvement of physical performance in athletes.

[Effect of different altitudes on telomere length of rat peripheral blood leukocyte]

The present study was aimed to investigate the effect of different altitudes on telomere length of rat peripheral blood leukocyte and possible mechanism. Sixty male rats were randomly divided into three groups, lower altitude control group (10 m), moderate altitude group (2 260 m) and very high altitude group (simulated 5 000 m). The moderate altitude group and very high altitude group rats were transported to Xining and hypobaric chamber in Qinghai University, respectively. The peripheral blood specimens were extracted 30 d after the transportation. By means of real-time PCR, automatic blood cell analyzer, ELISA, TBA and WST-1 methods, the telomere lengths of blood leukocyte, the hemoglobin (Hb) contents, the plasma levels of telomerase reverse transcriptase (TERT) and hypoxia-inducible factor 1α (HIF-1α), the plasma content of malondialdehyde (MDA) and superoxide dismutase (SOD) activity were measured, respectively. The results showed that the telomere lengths of peripheral blood leukocyte in moderate altitude group were longer than those in control group and very high altitude group. The changes of TERT were compatible with the telomere length of peripheral blood leukocyte under different altitudes. The levels of HIF-1α in moderate altitude group and very high altitude group were higher than that of control group. The very high altitude group showed decreased SOD activities and increased level of MDA, compared with the other two groups. These results suggest that the telomere lengths of rat peripheral blood leukocyte in moderate altitude are elongated, and that the telomere-elongating effect is lost under very high altitude. The changes of HIF-1α, TERT and oxidative stress damage are the main mechanisms of telomere length changes. Moderate altitude living might be beneficial to increasing the life span in mammals.

[Serum levels and significance of HIF-1α and HIF-2α in healthy Tibetan and Han residents at different altitudes]

OBJECTIVE

To explore the serum levels and significance of hypoxic inducible factor (HIF)-1α and HIF-2α in Tibetan and Han residents living at different altitudes.

METHODS

A total of 100 healthy adults of Han in plain (altitude 5 m, group P) and Tibetan and Han at moderate altitude (2260 m, groups M1 & M2) and high altitude (4380 m, groups H1 & H2) (n = 20 each) were selected from June 2010 to August 2010. Venous blood samples were collected in the morning. The serum concentrations of HIF-1α and HIF-2α were measured with enzyme-linked immunosorbent assay (ELISA) to analyze the correlations of HIF-1α and HIF-2α with arterial partial pressure of oxygen (PaO2) and hemoglobin (Hb).

RESULTS

The level of HIF-1α in group H2 ( (6.06 ± 1.85) µg/L) was higher than that in groups P ( (4.56 ± 0.85) µg/L, P < 0.05) , M1 ((4.41 ± 1.05) µg/L, P < 0.01) and M2 ( (4.59 ± 1.03) µg/L, P < 0.05) . The level of HIF-1α in group H1 ( (5.27 ± 0.98) µg/L) was higher than that in group M1 (P < 0.05) . The level of HIF-2α in group H2 ((0.83 ± 0.48) µg/L) was higher than that in groups P ((0.33 ± 0.11) µg/L, P < 0.01), M1 ((0.14 ± 0.06 )µg/L, P < 0.01) and M2( (0.24 ± 0.11) µg/L, P < 0.01) . The level of HIF-2α in group M1 was lower than that in groups P (P < 0.01) and M2 (P < 0.01). The level of HIF-2α in group H1((0.18 ± 0.16)µg/L) was lower than that in groups P (P < 0.05) and H2 (P < 0.01) . The levels of HIF-1α and HIF-2α were negatively correlated with PaO2 (r = -0.475, -0.551, both P < 0.01) and positively with Hb in Han groups (r = 0.433, 0.463, all P < 0.01). The levels of HIF-1α and HIF-2α had no correlation with PaO2 in Tibetan groups (r = -0.270, -0.198, both P > 0.05). No correlation existed between HIF-1α and Hb in Tibetan. A positive correlation existed between HIF-2α and Hb in Tibetan (r = 0.325, P < 0.01).

CONCLUSIONS

The changes of HIF-1α and HIF-2α vary for Tibetan and Han residents at different altitudes. And the level of HIF-2α is consistent with the change of Hb. As compared with HIF-1α, HIF-2α may play a more important role in regulating Hb.

Identification of multiple, oxygen-stable HIF1 alpha isoforms, and augmented expression of adrenomedullin in rheumatoid arthritis

OBJECTIVES

To identify and quantitate hypoxia inducible factor 1 alpha (HIF1 α) isoforms in circulating peripheral blood mononuclear cells (PBMCs), and to assess their effects on target gene expression in rheumatoid arthritis (RA) patients.

METHODS

PBMCs from healthy controls and from RA patients were analysed ex-vivo for expression of HIF isoforms, and target genes were assessed by RT-PCR.

RESULTS

Transcripts of multiple HIF1α isoforms exist in circulating PBMCs. Expression of all these isoforms is dramatically, and maximally, augmented by foreign surface recognition. However, HIF1α protein stabilisation requires additional cell activation with phorbol ester. No difference in the expression or regulation of the HIF1α isoforms was seen between patients with active RA and healthy controls. However, analysis of a panel of HIF1α target genes revealed increased basal expression of the adrenomedullin gene in RA PBMCs, with resulting loss of further induction upon cell activation.

CONCLUSIONS

Even in normoxia PBMCs express stable HIF1α protein on cell activation. Whilst multiple HIF1α isoforms exist in PBMCs no differences in expression were seen in RA compared with healthy controls. RA causes constitutive adrenomedullin expression in PBMCs that is not explicable by altered HIF expression, or stabilisation. Adrenomedullin has a variety of potential biological roles in RA, including regulation of angiogenesis, and aberrant gene regulation may be relevant in RA pathogenesis.

[Correlations between serum hypoxia inducible factor-1α, vascular endothelial growth factor and computed tomography perfusion imaging at pre-and post-TACE in patients with primary hepatic carcinoma]

OBJECTIVE

To explore the correlations between the serum levels of hypoxia inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF) and computed tomography (CT) perfusion parameters at pre- and post-transcatheter arterial chemoembolization (TACE) in patients with primary hepatic carcinoma (PHC).

METHODS

A total of 22 PHC patients were recruited.Their serum levels of HIF-1α and VEGF were measured and CT perfusion imaging (CTPI) was performed at Day 1 pre- and Days 32-40 post-TACE to compare and analyze the relevance of the changes of serum levels of HIF-1α, VEGF, tumor's hepatic artery perfusion (HAP), portal vein perfusion (PVP) and hepatic artery perfusion index (HPI) at pre- and post-TACE.

RESULTS

They were divided into stable and tumor residual/recurrent groups according to the efficacy of TACE. No significant differences existed between two groups with respects to serum levels of HIF-1α, VEGF, tumor's HAP, PVP and HPI pre-TACE. The serum levels of HIF-1α and VEGF decreased in stable group and there was significant difference in serum level of VEGF at Days 32-40 post-TACE (P < 0.05). There was no perfusion signal of HAP or PVP in tumor tissue.The serum levels of HIF-1α and VEGF were significantly higher while HAP and HPI were significantly lower than that pre-TACE in tumor residual/recurrent group and had statistical significance (P < 0.05), but PVP had no change.Positive correlations existed between serum levels of HIF-1α, VEGF and tumor's HAP, HPI at 32-40 days post-TACE.

CONCLUSION

Serum levels of HIF-1α and VEGF may indirectly reflect the status of neovascularization and CTPI acts as the intuitive and quantitative responses of hemodynamic changes at post-TACE.Positive correlations exist between serum levels of HIF-1α, VEGF, HAP and HPI. In short, a combination of serum levels of HIF-1α, VEGF and CTPI contributes to the efficacy evaluation of TACE and has great reference significance of determining timing of a second therapy.

Influence of thyroid state on cardiac and renal capillary density and glomerular morphology in rats

The purpose was to analyse the cardiac and renal capillary density and glomerular morphology resulting from a chronic excess or deficiency of thyroid hormones (THs) in rats. We performed histopathological, morphometrical and immunohistochemical analyses in hypothyroid and hyperthyroid rats to evaluate the density of mesenteric, renal and cardiac vessels at 4 weeks after induction of thyroid disorders. The main angiogenic factors in plasma, heart and kidney were measured as possible mediators of vascular changes. Mesenteric vessel branching was augmented and decreased in hyper- and hypothyroid rats respectively. The numerical density of CD31-positive capillaries was higher in left and right ventricles and in cortical and medullary kidney from both hyper- and hypothyroid rats vs controls. Numbers of podocytes and glomeruli per square millimetre were similar among groups. Glomerular area and percentage mesangium were greater in the hyperthyroid vs control or hypothyroid groups. No morphological renal lesions were observed in any group. Vascularisation of the mesenteric bed is related to TH levels, but an increased capillarity was observed in heart and kidney in both thyroid disorders. This increase may be produced by higher tissue levels of angiogenic factors in hypothyroid rats, whereas haemodynamic factors would predominate in hyperthyroid rats. Our results also indicate that the renal dysfunctions of thyroid disorders are not related to cortical or medullary microvascular rarefaction and that the proteinuria of hyperthyroidism is not secondary to a podocyte deficit. Finally, TH or its analogues may be useful to increase capillarity in renal diseases associated with microvascular rarefaction.

The role of insulin-like growth factor I and hypoxia inducible factor 1α in vascular endothelial growth factor expression in type 2 diabetes

BACKGROUND

Vascular endothelial growth factor (VEGF) plays an important role in diabetic vascular complications, and its expression is affected directly or indirectly by hypoxia inducible factor-1α (HIF-1α) and insulin-like growth factor-I (IGF-I) in tumors and certain normal cell lines. However, little is known about the role of HIF-1α/ IGF-I in VEGF expression in patients with diabetic vascular complications. The aim of this study was to elucidate the associations between HIF-1α, IGF-I, and VEGF in type 2 diabetes mellitus (T2DM) patients with or without vascular complications.

METHODS

Sixty patients with T2DM, with(A), and without vascular disease (B) and 26 controls were enrolled. Clinical parameters, HIF-1α, IGF-I and VEGF were assessed in the study and associations among them were analyzed by Spearman rank correlation.

RESULTS

Serum levels of VEGF, HIF-1α and IGF-I were significantly higher in the diabetic patients than in the controls. Positive correlations existed between VEGF and HIF-1α and between HIF-1α and IL-6 in both groups A and B and in the control group.

CONCLUSIONS

Our data demonstrate that HIF-1α and IL-6 could regulate VEGF expression, and that higher levels of HIF-1α, IL-6, and VEGF may contribute to the pathogenesis of diabetic micro-angiopathy.

Effects of hypoxia-inducible factor 1α on bone conduction impairment in otitis media with effusion

CONCLUSION

Elevated levels of hypoxia-inducible factor 1α (HIF-1α) in middle ear effusion may play an important role in the pathogenesis of bone conduction impairment associated with otitis media with effusion (OME). The mechanism may be related to the up-regulation of nitric oxide (NO) expression.

OBJECTIVES

This study was undertaken to investigate the role of HIF-1α in the pathogenesis of sensorineural hearing loss associated with OME.

METHODS

One hundred and eight OME patients were divided into two groups: OME without bone conduction impairment (group 1) and OME with bone conduction impairment (group 2). The levels of HIF-1α, NO, and quinolinic acid (QUIN) in the middle ear effusion and serum of these patients were investigated. The relationship between these factors and the bone conduction threshold (BCT) differences were analyzed.

RESULTS

The levels of HIF-1α and NO concentrations in the middle ear effusion were found to be significantly higher in group 2 than in group 1 (both p < 0.05). The OME patients' BCT differences at 4000 Hz were correlated with the levels of HIF-1α and the NO concentrations in the middle ear effusion. Furthermore, the HIF-1α levels were correlated with the levels of NO but not with the levels of QUIN in the effusion.

[Changes and clinical implications of the levels of serum NO and VEGF and HIF-1alpha in patients with obstructive sleep apnea-hypopnea syndrome]

OBJECTIVE

To observe the levels of nitrogen oxide (NO), vascular endothelial growth factor (VEGF) and hypoxia-inducible factor-1alpha (HIF-1alpha) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and to discuss their roles in the pathogenesis of cardiovascular disease in patients with OSAHS.

METHOD

NO, VEGF and HIF-1alpha levels were measured in 60 OSAHS patients and 26 healthy subjects; OSAHS patients were divided into mild, moderate and severe groups according to AHI.

RESULT

NO levels in the moderate and severe OSAHS groups were significantly lower than that in the control group, but the levels of VEGF and HIF-la were increased compared with the control group (P < 0.05). The serum level of NO was negatively correlated with AHI (P < 0.01) and positively correlated with the lowest SaO2 (P < 0.01); the serum level of VEGF was positively correlated with AHI (P < 0.01) and negatively correlated with the lowest SaO2 (P < 0.01); No significant correlations were observed between HIF-1alpha and AHI and the lowest SaO2 (P > 0.05); NO levels showed negative correlations with VEGF levels (P < 0.01).

CONCLUSION

The serum level of NO was reduced in response to the acceleration of hypoxia, while the level of VEGF was increased with the hypoxia. The results indicate that the levels of both NO and VEGF are associated with the severity of the disease. Decreasing NO levels and increasing VEGF are both the factors leading to endothelial dysfunction, which play an important role in the physiopathological process of the cardiovascular diseases in OSAHS patients.

A randomly-controlled study on the cardiac function at the early stage of return to the plains after short-term exposure to high altitude

High altitude acclimatization and adaptation mechanisms have been well clarified, however, high altitude de-adaptation mechanism remains unclear. In this study, we conducted a controlled study on cardiac functions in 96 healthy young male who rapidly entered the high altitude (3700 m) and returned to the plains (1500 m) after 50 days. Ninety eight healthy male who remained at low altitude were recruited as control group. The mean pulmonary arterial pressure (mPAP), left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS), cardiac function index (Tei index) were tested. Levels of serum creatine kinase isoform MB (CK-MB), lactate dehydrogenase isoenzyme-1 (LDH-1), endothelin-1 (ET-1), nitrogen oxide (NO), serum hypoxia-inducible factor-1α (HIF-1α), 8-iso-prostaglandin F_2α (8-iso PGF_2α), superoxide dismutase (SOD) and malonaldehyde (MDA) were measured at an altitude of 3700 m and 1500 m respectively. The results showed that after short-term exposure to high altitude mPAP and Tei index increased significantly, while LVEF and LVFS decreased significantly. These changes were positively correlated with altitude. On the 15^th day after the subjects returned to low altitude, mPAP, LVEF and LVFS levels returned to the same level as those of the control subjects, but the Tei index in the returned subjects was still significantly higher than that in the control subjects (P<0.01). We also found that changes in Tei index was positively correlated with mPAP, ET-1, HIF-1α and 8-iso PGF_2α levels, and negatively correlated with the level of NO, LVEF, LVFS, CK-MB and LDH-1. These findings suggest that cardiac function de-adapts when returning to the plains after short-term exposure to high altitude and the function recovery takes a relatively long time.

[Expression of HIF-1alpha in serum of primary hepatocellular carcinoma and effects on tumor invasion and metastasis]

AIM

To study the expression of HIF-1alpha in serum of primary hepatocellular carcinoma (PHC) and effects on tumor invasion and metastasis.

METHODS

The serum HIF-1alpha level from 60 cases of PHC patients and 60 cases of normal healthy individuals were detected by ELISA.

RESULTS

The serum HIF-1alpha level of the PHC group was (161.14+/-80.79) pg/mL, the control group was (22.67+/-8.47) pg/mL, compared the different was significant (P<0.05). The serum HIF-1alpha level of distant metastasis of tumor group was (225.15+/-108.16) pg/mL, the no distant metastasis of tumor group was (101.26+/-55.18) pg/mL, compared the different was significant (P<0.05). The serum HIF-1alpha level of portal vein tumor thrombus group was (255.45+/-122.23) pg/mL. The no portal vein tumor thrombus group was (139.97+/-71.49) pg/mL, compared the different was significant (P<0.05). The serum HIF-1alpha level of tumor capsule group was (99.97+/-55.75) pg/mL. The no tumor capsule group was (187.36+/-91.52) pg/mL, compared the different was significant (P<0.05). The serum HIF-1alpha level was no significantly different among the different age, gender, TNM stage and tumor diameter.

CONCLUSION

The serum HIF-1alpha has high expression in PHC. The serum HIF-1alpha expression has close relation with the whether distant metastasis of tumor, portal vein tumor thrombus and tumor capsule. The serum HIF-1alpha level can predict the invasion and metastasis of PHC.

[Association of peripheral blood hypoxia-inducible factor-1α with metastasis of colorectal cancer]

OBJECTIVE

To explore the relationship between hypoxia-inducible factor-1α (HIF-1α) mRNA levels in the peripheral blood and the metastasis of colorectal cancer.

METHODS

HIF-1α mRNA in the peripheral blood was detected by RT-PCR in 40 patients with colorectal cancer and 20 healthy subjects.

RESULTS

Seventeen patients with colorectal cancer showed positivity for HIF-1α mRNA, showing a significantly higher positivity rate (42.5%) than the healthy subjects (P<0.05). The expression of HIF-1α mRNA is closely related to the staging of colorectal cancer (CRC).

CONCLUSION

HIF-1α mRNA may serve as a potential marker in the detection of metastasis of colorectal cancer.

[Serum levels of HIF-1α, ET-1 and Ca(2+) in neonates with hypoxic pulmonary hypertension]

OBJECTIVE

To study the changes and significance of serum hypoxia-inducible factor-1α (HIF-1α), endothelin-1 (ET-1) and calcium (Ca(2+)) levels in neonates with hypoxic pulmonary hypertension (HPH).

METHODS

Seventy-five neonates with HPH (29 mild, 25 moderate and 21 severe) and 22 hospitalized neonates with non-HPH (control group) were enrolled. Pulmonary artery systolic blood pressure (PASP) was measured by bedside echocardiography within 24 hrs after birth. Serum levels of HIF-1α and ET-1 were measured using ELASA. Serum Ca2+ concentrations were measured with ion selective electrode.

RESULTS

Serum levels of HIF-1α and ET-1 in the HPH group increased significantly compared with those in the control group (P<0.01), and were positively related with PASP (Rhif-1α=0.75, P<0.01; Ret-1=0.56,P<0.05). Serum Ca2+ levels in neonates with severe HPH were significantly lower than those in the control group (P<0.05). There were no correlation between serum Ca2+ levels and PASP.

CONCLUSIONS

Serum HIF-1α and ET-1 levels are positively related with PASP in neonates with HPH, suggesting that serum HIF-1α and ET-1 may be involved in the occurrence of neonatal HPH. Serum Ca2+ levels are reduced in severe neonates with HPH, suggesting that serum Ca2+ may play a role in the occurrence of severe HPH.

[Role of hypoxia-inducible factor-1α endothelin-1 and inducible nitric oxide synthase in the pathogenesis of hypoxia-induced pulmonary hypertension of the newborn]

OBJECTIVE

To investigate the roles of hypoxia-inducible factor-1α (HIF-1α), endothelin-1 (ET-1) and inducible nitric oxide synthase (iNOS) in the pathogenesis of hypoxia-induced pulmonary hypertension (HPH) of the newborn.

METHODS

Seventy-five term hospitalized neonates with HPH (mild 29 cases, moderate 25 cases, severe 21 cases) and 22 term hospitalized neonates without HPH (control group) were enrolled between June 2006 and November 2009. Serum levels of HIF-1α, iNOS and ET-1 were measured using ELASA 1, 3 and 7 days after birth.

RESULTS

Serum concentrations of HIF-1α and ET-1 in the mild, moderate and severe HPH groups were significantly higher than those in the control group (P<0.01) 1 day after birth, and were related to the severity of HPH. The serum iNOS concentrations in the moderate and severe HPH groups were also significantly higher than those in the control group (P<0.01). By 3 days after birth, serum ET-1 concentration in the moderate HPH group and serum concentrations of HIF-1α, ET-1 and iNOS in the severe HPH group reminded significantly higher than those in the control group (P<0.05). At 7 days after birth, serum ET-1 concentration in the severe HPH group still remained higher than that in the control group (P<0.05).

CONCLUSIONS

Serum levels of HIF-1α, ET-1 and iNOS increase in neonates with HPH, resulting in an imbalance of ET-1 and NO. This may be of importance in the pathogenesis of neonatal HPH.

[Adaptive hypometabolism in man]

Two hypotheses of functional organization of hypoxic hypometabolism in man is discussed. One is a bioenergetic hypothesis stating that progressive oxygen deficiency in the cells leads to suppression of macrophage production. The other regards hypometabolism as a result of decreased energy consumption in response to hypoxia or the lack of energy of any etiology; it results in impaired intensity of energy metabolism. The letter strategy is underlain by central regulatory mechanisms for which proteins of the HIF-factor system are the most probable markers.

[Iron metabolism regulatory mechanisms in initial leukocytosis in patients with acute leukemia]

AIM

To study levels of hepsidine (Hp), hypoxia-inducible factor-1alpha (HIF-1alpha), erythropoietin (EP) and ferritin in patients with acute leukemia (AL), effects of protein fractions of homogenate of blastic cells (BC) on regulatory proteins studied.

MATERIAL AND METHODS

Depending on leukocyte count in the onset of AL, 70 patients with first ever diagnosed AL were divided into two groups: group 1 - 17 patients with leukocyte count > 30 x 10(9)/l, group 2 - 53 patients with leukocyte count < 30 x 10(9)/l. Serum and leukocyte parameters were studied before treatment, during the treatment with cytostatic drugs, in the course of myelotoxic agranulocytosis (MTA), after normalization of hemograms. EP was detected with enzyme immunoassay, serum and leukocyte ferritin - with radioimmunoassay; HIF-1alpha, Hp - sandwich enzyme immunoassay using monospecific antisera and monoclonal antibodies against relevant antigens. Leukocytes were isolated in ficol and verografin solutions density gradient. Chromatographic division of the protein fractions in 3 patients with leukocytosis in AL onset and leukocytes of 3 donors was made by the method of preparative isoelectrofocusing of BC and leukocytes on LKB colon (Sweden). Effects of these fractions were studied on 11 plasma samples from hematological patients and 4 plasma samples from patients with normal hemopoiesis.

RESULTS

Leukocytosis patients with initial AL have serum ferritin, Hp and HIF-1alpha levels about 2-5 times lower than patients without leukocytosis. Cytostatic treatment raises an HIF-1alpha level in BC about 15-fold (85.8 +/- 24.5 pg/ml), in the study group - 3-fold (15.2 +/- 3.3 pg/ml). The highest EP levels were seen in MTA. It is detected that protein fractions isolated from leukocytes of patients with leukocytosis in the disease onset raise HIF-1alpha content irrespective of HIF-1alpha presence in the fraction. Patients free of hematological diseases have no changes of the above proteins.

CONCLUSION

Great difficulties exist in ferritin and Hp levels between AL patients with leukocytosis in the onset of the disease and without of leukocytosis. The study of leukocytes suggests that tumor cells of such patients contain compounds which can regulate production of HIF-1alpha, Hp and ferritin.

Response to chronic intermittent hypoxia in blood system of Mandarin vole (Lasiopodomys mandarinus)

Mandarin voles (Lasiopodomys mandarinus) spend almost all their lives underground and must have evolved remarkable physiological adaptations to subterranean hypoxic stress. To understand the response to hypoxia in blood system of this rodent in a region with lower altitude, we tested and compared the responding characteristics between Mandarin vole and Kunming mouse (Mus musculus) under chronic normobaric hypoxic treatment (10.0% O(2), 4 w). The results showed that: 1) as for responses to chronic hypoxia, HIF-1 alpha, EPO and VEGF exhibited similar patterns in two species. The expression of HIF-1 alpha and VEGF significantly increased while EPO decreased significantly, and HIF-1 alpha showed a greater increase at 10.0% oxygen level in Mandarin voles; 2) both rodents responded to chronic hypoxia mainly by increasing MCH, though KM mouse responded more acutely; 3) the change in MCHC in Mandarin vole was ignorable though it is significantly higher than that in KM mouse whose MCHC changed extensively and 4) both before and after hypoxic treatment, the capillary density in Mandarin vole was significantly higher than that in KM mouse, and it increased sharply in KM mouse after treatment. Our results indicated that, compared to KM mice, Mandarin voles did respond effectively to hypoxia stress after long-term adaptation to subterranean life environment.