title: Hypoxia-inducible factor 1-α in chronic gastrointestinal ischemia.
abstract: Chronic gastrointestinal ischemia (CGI) is the result of decreased mucosal perfusion. Typical histological characteristics are lacking which hamper its early diagnosis. Hypoxia-inducible factor-1α (HIF-1α) is expressed under acute hypoxia. We investigated HIF-1α expression in chronic ischemic and inflammatory conditions of the human gastrointestinal (GI) tract. Immunohistochemical expression of HIF-1α was analyzed in 61 patients, including patients with CGI, Helicobacter pylori gastritis, ischemic colitis (IC), infectious colitis, and inflammatory bowel disease (IBD), and 22 controls. HIF-1α expression in >10 % of the cells was regarded as positive staining, and expression <10 % of the cells was considered as negative staining. In the upper GI tract, HIF-1α expression was found in 5/20 CGI patients, but not in controls (p = 0.08). The sensitivity and specificity of HIF-1α expression for diagnosing CGI were 25 and 84%, respectively. In the lower GI tract, HIF-1α was expressed in all patients with IC and infectious colitis and in a majority of IBD patients as well as in 7/12 controls. The sensitivity and specificity of HIF-1α for diagnosing IC were 100 and 51%, respectively. HIF-1α expression was more often (p = 0.02) observed in patients with histological signs of inflammation in the lower GI tract. HIF-1α is expressed in acute and chronic ischemic tissue, but also in normal colon tissue and inflammatory disorders.
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre Rotterdam, P.O. Box 2040, 3015 CE, Rotterdam, The Netherlands, j.harki@erasmusmc.nl.
authors.forename: Jihan
authors.initials: J
authors.lastname: Harki
authors.forename: Aria
authors.initials: A
authors.lastname: Sana
authors.forename: Désirée
authors.initials: D
authors.lastname: van Noord
authors.forename: Paul J
authors.initials: PJ
authors.lastname: van Diest
authors.forename: Petra
authors.initials: P
authors.lastname: van der Groep
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Kuipers
authors.forename: Leon M G
authors.initials: LM
authors.lastname: Moons
authors.forename: Katharina
authors.initials: K
authors.lastname: Biermann
authors.forename: Eric T T L
authors.initials: ET
authors.lastname: Tjwa
mesh_terms: D000368:Aged; D005260:Female; D041981:Gastrointestinal Tract / Q000098:blood supply*; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000096:biosynthesis*; D007150:Immunohistochemistry; D015212:Inflammatory Bowel Diseases / Q000378:metabolism; D007511:Ischemia / Q000175:diagnosis* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity
chemical_list: C497442:HIF1A protein, human; D051795:Hypoxia-Inducible Factor 1, alpha Subunit