Up-regulation of hypoxia-inducible factor 1 alpha and hemodynamic responses following massive small bowel resection

Kathryn J. Rowland, Junjie Yao, Lidai Wang, Christopher R. Erwin, Konstantin I. Maslov, Lihong V. Wang, Brad W. Warner

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Purpose Massive small bowel resection (SBR) results in an adaptive response within the remnant bowel. We have previously shown an immediate reduction in intestinal blood flow and oxygen saturation (sO2) after SBR. We therefore sought to determine the duration of resection-induced intestinal hypoxia and expression of hypoxia-inducible factors (HIFs) following SBR. Methods C57B6 mice were subjected to 50% proximal SBR or a sham procedure. Photoacoustic microscopy (PAM) was used to measure blood flow and sO2 on postoperative days (PODs) 1, 3, and 7. Ileal tissue was harvested 6 h postoperatively and on PODs 1 and 2, and HIF1α, HIF2α, and VEGF mRNA expression were assessed via RT-PCR. A p value of less than 0.05 was considered significant. Results Following SBR, reduction in intestinal blood flow persists for 24 h and is followed with hyperemia by POD 3. The immediate reduction in venous sO2 and increased tissue oxygen utilization continued through POD 7. Enhanced expression of HIF1α was demonstrated 6 h following SBR. Conclusion Massive SBR results in an immediate relative hypoxic state within the remnant bowel with early enhanced expression of HIF1α. On POD 7, increased tissue oxygen extraction and elevated blood flow persist in the adapting intestine.

Original languageEnglish
Pages (from-to)1330-1339
Number of pages10
JournalJournal of Pediatric Surgery
Issue number6
StatePublished - Jun 2013


  • Blood flow
  • HIF1α
  • Hypoxia-inducible factor
  • Intestine
  • Oxygen saturation
  • Photoacoustic microscopy
  • Small bowel resection (SBR)


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