Hypoxia Flashcards

1
Q

What is hypoxia?

A

State of deficiency of available oxygen in the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is tissue oxygen tension?

A

Determines when a tissue becomes hypoxic - depends on oxygen demand, supply, and tissue aerobic capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is typical oxygen levels in the brain?

A

Low and non-uniform ~1-5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the typical oxygen level in the atmosphere?

A

21%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the typical oxygen level in alveolar air?

A

14%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the typical oxygen level in arterial blood?

A

12%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the typical oxygen level in venous blood?

A

5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the typical oxygen level in tissues?

A

3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is hypoxic hypoxia?

A

Decrease in amount of oxygen taken in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What causes hypoxic hypoxia?

A

Hypoventilation from respiratory distress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of hypoxia is caused by a decrease in inspired oxygen from respiratory distress?

A

Hypoxic hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is anemic hypoxia?

A

Decrease in amount of hemoglobin and therefore, reduced oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What causes anemic hypoxia?

A

Significant blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What type of hypoxia is caused by significant loss of hemoglobin and blood?

A

Anemic hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is stagnant hypoxia?

A

Low blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What causes stagnant hypoxia?

A

Local vasoconstriction or reduced cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What type of hypoxia is caused by reduced cardiac output or local vasoconstriction?

A

Stagnant hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is histotoxic hypoxia?

A

Reduced oxygen due poisoning of oxidative enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can cause histotoxic hypoxia?

A

Cyanide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the physiological response to hypoxia?

A

Vasodilation of brain arteries and veins - to increase cerebral blood flow and oxygen delivery

21
Q

What is an anoxic brain injury?

A

Immediate neuronal death due to complete lack of oxygen delivery

22
Q

What is a hypoxic brain injury?

A

Gradual neuronal death due to restriction of oxygen delivery to the brain

23
Q

What are the clinical symptoms of an anoxic or hypoxic brain injury?

A

Loss of consciousness (short or long term), difficulties with speech, confusion, disorientation, facial drooping (Bell’s palsy)

24
Q

What is HIF1?

A

Hypoxia-inducible factor 1 is a transcription factor that response to decreases in oxygen

25
Q

What is the composition and structure of HIF1?

A

Heterodimer composed of two subunits: alpha and beta. Alpha is larger (120kDa) than beta (91-94kDa). Structure is helix-loop-helix.

26
Q

Which HIF1 subunit is present in all cells?

A

HIF1b

27
Q

Which HIF1 subunit does not respond to changes in oxygen tension?

A

HIF1b

28
Q

What is HIF1b essential for?

A

Hypoxia-induced transcriptional changes mediated by HIF1 heterodimer

29
Q

Under what conditions do HIF1a levels rise exponentially?

A

Hypoxic

30
Q

How is HIF1a usually produced/degradaded and how does this change under hypoxic conditions?

A

Made continuously and rapidly degraded during normoxia. Accumulates in hypoxic cells.

31
Q

What genes are targeted by HIF1 and what do they do?

A

Facilitate acclimatization to low oxygen:
- vasomotor control
- angiogenesis
- iron metabolism
- cell proliferation
- cell death
- energy metabolism

32
Q

How is HIF1a inactivated at normal oxygen levels?

A

Oxygen and 2-oxoglutarate activate prolyl-hydroxylases. CO2 and succinate are formed and prolines in HIF1a are hydroxylated

ARD1 activates lysine in HIF1a and von Hippel Lindau protein binds to the hydroxylated HIF1a with elongin C, elongin B, RBX1, and Cullin 2. This forms an E3 ubiquitin ligase that poly-ubiquitylates HIF1a and marks it for degradation in the proteasome

33
Q

How does hypoxia activate HIF1a?

A

HIF1a is phosphorylated and binds to ARNT to form a dimer which binds to p300/CBP which then binds hypoxia response elements in HIF target genes, activating transcription

34
Q

What other factors can regulate HIF1 activity?

A

Inhibition of oxphos

Accumulation of Krebs cycle metabolites

PI3K/Akt/mTOR axis

35
Q

What effect does inactivation of HIF1a have on the brain?

A

Impaired learning, decreased neurogenesis, and neurodegeneration during normoxia

Increased brain damage and decreased survival following hypoxia

36
Q

What cell types can HIF1a expression be induced in?

A

Neurons
Astrocytes
Ependymal cells
Endothelial cells
Microglia

37
Q

What roles does HIF1a have in embryonic development?

A

Necessary for normal brain development.

Deficient mice have hydrocephalus, reduced neural cells, and impaired spatial memory. Effects rescued by in vivo delivery of HIF1a gene to embryos

38
Q

What effect does HIF1a accumulation have immediately after hypoxic injury? (Within 24h)

A

Promotes cell death

39
Q

What effect does HIF1a have in the later stages of hypoxic injury? (Up to a few days)

A

Pro-survival effect by limiting the infarct size

40
Q

Which HIF1 target genes induce vasodilation?

A

NOS2 and adrenomedullin

41
Q

What do NOS2 and adrenomedullin (HIF1 target genes) do?

A

Induce vasodilation

42
Q

Which HIF1 target genes mediate angiogenesis?

A

VEGF, FLT1, and PAI1

43
Q

What do HIF1 target genes, VEGF, FLT1, and PAI1, do?

A

Mediate angiogenesis

44
Q

Which HIF1 target genes increase glucose transport and glucose/lactate metabolism?

A

GLUT1 and glycolytic enzymes

45
Q

Which HIF1 target gene protects against cerebral ischemia?

A

Erythropoietin

46
Q

How did the pharmacological block of HIF1 suppressors show the neuroprotective effects of HIF1a mediated signaling?

A

Inhibition or deletion of the suppressor PHD2 showed increased HIF1a levels and:

  • Increased cellular expression of erythropoietin and VEGF (angiogenesis and protection against ischemia)
  • Increased neurogenesis in hippocampus
  • Improved cognitive function in mice suffering from chronic hypoperfusion
47
Q

What is hypoxia-induced tolerance?

A

Brief period of hypoxia that protects against otherwise lethal insult

48
Q

How was hypoxia-induced tolerance shown to be neuroprotective in animal models?

A

Animals exposed to sublethal hypoxia (8% oxygen) for 3 hours were resistant to cerebral hypoxic-ischemic insult 24h later

49
Q

What is the molecular basis of hypoxia-induced tolerance to brain ischemia?

A

Hypoxic induction of HIF1 and its target genes that induce neuroprotective effects