Hypoxia-inducible factors and the prevention of acute organ injury

Hypoxic preconditioning has long been considered as organ-protective, and its clinical usage has been suggested in elective procedures, such as coronary surgery and organ transplantation. Although the mechanisms have not been clearly elucidated, it has been postulated that changes in cell-membrane composition and upregulation of various cellular protective mechanisms are responsible for a better tolerance of acute injury. Remote preconditioning (i.e., hypoxic stress in one organ conferring resistance to acute hypoxia in other organs) suggests organ cross-talk, perhaps mediated by cytokines and the immune system.