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-1ɑ and HIF-2ɑ. Recently, more data have found about selective HIF-2ɑ responsive genes and indicate the importance of this isoform in hypoxic gene regulation. The present study purposed to determine the change in HIF-2ɑ values in adult patients in diagnosing COP. A significant statistical correlation was found between (p=0.05) serum HIF-2ɑ levels and the first COHb level. HIF-2ɑ levels at 4th hour in COP patients were significantly higher like first COHb. HIF-2ɑ levels can be used as a new biomarker in long-term for monitoring COP patients.

Does Hypoxia Inducible Factor 1? Levels Contribute to the Diagnosis and Follow Up of Carbon Monoxide Poisoning?

“…[20] In the study of Altıntop et al, headache(46.4%) was the most prevalent complaint, followed by nausea with vomiting(42.9%), asthenia and weakness(41.1%). [3] In this study, the most prevalent complaintwas nausea, and headache and dizziness were the other common complaints.…”

“…In our country, the usage of stoves, barbecues and water heaters is the most important cause of COP. [3] The literature has shown that poisonings due to stoves are the most common cause of poisoning. [3,4,19] The results of our study supported the literature.…”

“…[3] The literature has shown that poisonings due to stoves are the most common cause of poisoning. [3,4,19] The results of our study supported the literature. It is considered to be due to reverse winds in our region, which are very strong and lead to backlash in winter.…”

“…[1,2] The incidence of COP increases due to the use of carbon-based fuels, and the use of flue-free stoves, barbecues and water heaters in small areas with insufficient ventilation is the most important cause of poisoning in our country. [3,4] CO leads to various tempo-rary and permanent effects on human bodydepending on the time of exposure and the effects of treatment. [5] Heart and brain are the most responsive organs to COP due to their high metabolic rates, and neuropsychiatric.…”

“…[16] The importance of biochemical markers such as ischemiamodified albumin (IMA) and HIF-2α as an alternative to COHb, a traditional marker in the COP due to poor correlation amongCOHb levels and clinical picture in the patients with COP, has become an increasing research topic recently. [2,3] This study intendedto evaluate the levels of HIF-1α, a biochemical marker considered to play a role in acute hypoxia, at admission and after the treatment and to compare the levels of COHb, blood gas and hemogram parameters in patients admitted to the ED due to acute COP.…”