The Expression of Hypoxia-Inducible Factor-1 Alpha (HIF-1α) as a Potential Target for Hypoxic Therapy in COVID-19 Cases

Abstract

Background: The cellular response to hypoxia is characterized by the stabilization of the HIF-1α protein, which will form a transcription factor that activates genes for low oxygen adaptation. Positive cases of COVID-19 are often characterized by hypoxia, especially in patients with comorbidities. This hypoxic condition will mediate drug resistance or weaken the patient's condition, resulting in lengthening treatment time and even causing death. This study aims to analyze the cellular expression of the HIF-1α gene in patients confirmed positive for COVID-19 with the alpha, beta, delta, and omicron variants. Methods: The research design used was observational, with parameters measuring HIF-1 mRNA expression (RT-PCR, protein (ELISA), and its correlation. The samples used were nose-throat swabs from COVID-19 patients. Results: The expression of HIF-1α mRNA and protein levels produced in variants of COVID-19 patients was compared with controls (times; ng/mL): alpha (0.53; 18.08), beta (0.92; 19.98), delta (0.65; 25.83), and omicron (0.73; 19.85) (Kruskal-Wallis test, p <0.01). The correlation between mRNA expression of HIF-1α and HIF-1α proteins was found to be significantly negative (Pearson Correlation test R = -0.589). Conclusion: In this study, it was found that a decrease in HIF-1α mRNA expression (the result of transcription) increased the levels of HIF-1α protein (the result of translation) and stable HIF-1α expression. Moreover, cellular hypoxia occurred in patients with confirmed positive for COVID-19, with the alpha, beta, delta, and omicron variants. This study can be used as a basis for therapy to control viruses that cause hypoxia in the future. result: The expression of HIF-1α mRNA and protein levels produced in variants of COVID-19 patients compared with controls (times; ng/mL): alpha (0.53; 18.08), beta (0.92; 19.98), delta (0.65 ; 25.83), omicron (0.73; 19.85) (Kruskal Wallis test, p <0.01); The correlation between mRNA expression of HIF-1α and HIF-1α proteins obtained strong negative results (Pearson Correlation test R = -0.589 ).