Hematopoietic stem cell (HSC) transplantation is a lifesaving therapy for a number of immunologic disorders. For effective transplant, HSCs must traffic from the peripheral blood to supportive bone marrow niches. We previously showed that HSC trafficking can be enhanced by ex vivo treatment of hematopoietic grafts with 16-16 dimethyl prostaglandin E 2 (dmPGE 2 ). While exploring regulatory molecules involved in dmPGE 2 enhancement, we found that transiently increasing the transcription factor hypoxiainducible factor 1-a (HIF1a) is required for dmPGE 2 -enhanced CXCR4 upregulation and enhanced migration and homing of stem and progenitor cells and that pharmacologic manipulation of HIF1a is also capable of enhancing homing and engraftment. We also now identify the specific hypoxia response element required for CXCR4 upregulation. These data define a precise mechanism through which ex vivo pulse treatment with dmPGE 2 enhances the function of hematopoietic stem and progenitor cells; these data also define a role for hypoxia and HIF1a in enhancement of hematopoietic transplantation. (Blood. 2014;123(2):203-207) Introduction Hematopoietic stem cell (HSC) transplantation is a curative treatment of immunologic malignancies, inherited metabolic diseases, and congenital immunodeficiencies, and is an attractive method for gene therapy. Transplantation success is partly dictated by the quality and number of donor cells transplanted, and is dependent on their ability to home to bone marrow (BM) niches, self-renew and differentiate. Some sources of HSCs display reduced engraftment efficiency because of inadequate number, and/or poor homing. Identifying strategies to enhance homing and expansion of HSCs can improve transplant efficiency, particularly when HSC number is limited. It is known that prostaglandin E 2 (PGE 2 ) can stimulate hematopoietic stem and progenitor cell (HSPC) proliferation.1,2 Recently, the long-acting PGE 2 analog 16-16 dimethyl PGE 2 (dmPGE 2 ) was identified in a zebrafish chemical screen as a regulator of hematopoiesis, and ex vivo exposure to dmPGE 2 was shown to increase engraftment in murine and nonhuman primate models. 3,4 This strategy has now progressed to a phase 1 clinical trial. 5 We previously demonstrated that part of the mechanisms of action for PGE 2 were the result of increases in homing, survival, and proliferation of murine and human HSCs.6 PGE 2 enhances HSC homing primarily by increasing CXCR4 expression on HSCs; however, the mechanism(s) whereby PGE 2 modulates CXCR4 and HSC homing has not been defined.HSCs have been reported to lie in hypoxic BM niches 7-10 that support stabilization of hypoxia-inducible factor 1 a (HIF1a) within HSCs. HSCs that reside in hypoxic niches have greater hematopoieticrepopulating ability, 11 although recent evidence suggests that HSCs may inherently maintain hypoxic status independently from their specific BM localization. 12 HIF1a dose-dependently regulates HSC activity, 9 and intracellular oxygenation status plays a role in HSC quiescence and expan...