The Mechanism Of Expression Of HIF-1α And Downstream Factors GLUT-1, VEGF And EPO In Lung Hypoxia Metabolism

Objective To analyze the expression of hypoxia inducible factor-la (HIF-la) and glucose transporters1(GLUT-1) in patients undergoing thoracotomy surgery by one-lung ventilation, to explore the roles of HIF-1a and GLUT-1in hypoxia metabolism of alveolar cells.Methods32patients were randomly divided into two groups:two-lung Ventilation group(A,n=8); one-lung ventilation group(B,n=24). And one-lung ventilation group also divided into three Subgroups:group Bl(n=8):one-lung ventilation30min;group B2(n=8):one-lung ventilation60min and group B3(n=8):one-lung ventilation120min. Blood samples were taken immediately before OLV (T1); after OLV30min(T2); after OLV60min(T3); after OLV90min(T4); after OLV120min(T5) and the end of the surgery(T6). Arterial blood was collected by T1, T3, and T6. HIF-1αand GLUT-1were analysed by enzyme-linked immunosorbent assay (ELISA) in serum. PaO2, PaCO2, SPO2and HGB were analysed in arterial blood. The small paraneoplastic lung tissues were taken by the operating surgeons in Tl, T2, T3, T4, T5and T6. The expressi-ons of HIF-la and GLUT-1were tested with Quantitative real-time polymerase chain reaction with reverse transcription (RT-PCR) and Western blot in the lung tissue at different time points.Results PaO2, and PaCoO2, SPO2remained within the normal range during surgery. PaO2decreased with the prolongation of one-lung ventilation time(P< 0.05). The expression of HIF-1α mRNA is extremely low or no expression in group A. The expression HIF-1α mRNA of subgroups B was a significant increased than group A (P<0.05). The expressions of HIF-1a protein was significant increased in group B2and B3(P<0.05) than group A and subgroup Bl. The expressions of GLUT-1protein was significant increased in subgroup B3than group A (P<0.05)ConclusionHIF-1αand Glut-1expression up-regulation are closely related with the hypoxic metabolism pulmonary during OLV period. Objective To explore the expression and significance of the serum vascular endothelial growth factor (VEGF) and erythropoietin (EPO) during one-lung ventilation (OLV).Methods37patients undergoing intrathoracic radical resection of esophageal carcinoma randomly divided into two groups:20patients were undergoing two-lung ventilation(TLV) intraoperatively in group C, while17patients with one-lung ventilation(OLV) in group E.Blood samples were taken immediately before opened chest or OLV (T1), after opened chest or OLV30min (T2), after opened chest or OLV60min (T3), after opened chest or OLV90min (T4), after opened chest or OLV120min (T5),the end of the surgery (T6). VEGF and EPO were analysed by enzyme-linked immunosorbent assay (ELISA),meanwhile assess HGB respectively of subgroup T1,T3and T6.Results Values of VEGF at T4and T5were higher than those at T1in group C (P<0.05),which at T3,T4,T5and T6were significantly higher than those at T1in group E (P<0.05),and those at T3,T4,T5and T6in group E were significantly higher than that in group C (P<0.05).Values of EPO at T1and other subgroups had no statistical changes in group C (P>0.05), nevertheless which in group E shows T6>T5>T4significantly (P<0.05).Values of EPO at T4and T5in group E were significantly higher than that in group C (P<0.05).There were no statistical differences in values of HGB in two groups. Conclusion The expression of VEGF and EPO were obviously increased in hypoxic metabolism pulmonary during OLV period,and two of them may participate in the injuring and healing process of pulmonary tissue.