Myeloid hypoxia-inducible factor HIF1A provides cardio-protection during ischemia and reperfusion via induction of netrin-1

The transcription factor hypoxia-inducible factor HIF1A elicitics cardioprotection from ischemia and reperfusion injury. Here, we investigated tissue-specific pathways that are critical for HIF1A-elicited tissue protection. Initial studies showed that mice with induced global deletion of Hif1a (Hif1aloxP/loxP UbiquitinCre+) have exaggerated myocardial injury during in situ ischemia and reperfusion. Surprisingly, this phenotype was mirrored only in mice with myeloid-specific Hif1a deletion (Hif1aloxP/loxP LysM Cre+). In contrast, mice with myocardial specific (Hif1aloxP/loxP Myosin Cre+), or vascular Hif1a deletion (Hif1aloxP/loxP VEcadherin Cre+) experienced similar injury levels as controls. Subsequent studies using adoptive transfer of Hif1a-deficient polymorphonuclear neutrophils (PMNs) prior to myocardial injury demonstrated increased reperfusion injury. In contrast, adoptive transfer of PMNS treated ex-vivo with the HIF stabilizer dimethyloxalylglycine (DMOG) was associated with attenuated myocardial injury. Moreover, cardioprotection mediated by DMOG was abolished in Hif1aloxP/loxP LysM Cre+ mice, but not in Hif2aloxP/loxP LysM Cre+ mice. Finally, studies of PMN-dependent HIF1A target genes implicated the neuronal guidance molecule netrin-1 in mediating the cardioprotective effects of myeloid HIF1A. Taken together, the present studies identified a functional role for myeloid-expressed HIF1A in providing cardio-protection during ischemia and reperfusion injury, which - at least in part - is mediated by the induction of neuronal guidance molecule netrin-1 in neutrophils.