The use of serum hypoxia-inducible factor two alpha levels and diagnostic values in adult carbon monoxide poisoning

Abstract

Carbon monoxide poisoning (COP) is a life-threatening intoxication which should be interfered immediately to be prevented from serious damages. The effect of carbon monoxide (CO) in the body at the cell level is mediated by a CO-releasing molecule. This molecule results in heme degradation via heme oxygenase. Because of the high affinity of CO on heme, many enzymes with biological signal transduction cause heme protein increase. Universally, this signal activation with similar enzymes and mechanisms are used in COP. The most widely used test is Carboxyhaemoglobin (COHb) in serum. The COHb is used as a standard parameter in the diagnosis of COP. COHb levels, are high after CO poisoning and decrease rapidly with oxygen therapy in the first four hours. So COHb is insufficient to demonstrate chronic ischemic damage of hypoxia. Hypoxia-inducible factors (HIFs) are the master regulators of oxygen homeostasis. The best known HIF isoforms in the literature are HIF-1α and HIF-2α. Recently, more data have found about selective HIF-2α responsive genes and indicate the importance of this isoform in hypoxic gene regulation. The present study purposed to determine the change in HIF-2α values in adult patients in diagnosing COP. A significant statistical correlation was found between (p=0.05) serum HIF-2α levels and the first COHb level. HIF-2α levels at 4th hour in COP patients were significantly higher like first COHb. HIF-2α levels can be used as a new biomarker in long-term for monitoring COP patients.