Hypoxia-inducible factor 1-α in chronic gastrointestinal ischemia

Jihan Harki, Aria Sana, Désirée van Noord, Paul J. van Diest, Petra van der Groep, Ernst J. Kuipers, Leon M.G. Moons, Katharina Biermann, Eric T.T.L. Tjwa

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)125-132
Number of pages8
JournalVirchows Archiv
Issue number2
StatePublished - Feb 2015


  • Chronic gastrointestinal ischemia
  • Hypoxia
  • Hypoxia-inducible factor-1α
  • Immunohistochemistry
  • Inflammation
  • Ischemic colitis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Molecular Biology
  • Cell Biology


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