Activation of the receptor for advanced glycation endproducts (RAGE) by its multiple ligands can trigger diverse signaling pathways with injurious or pro-survival consequences. In this study, we show that Rage mRNA and protein levels were stimulated in the mouse brain after experimental stroke and systemic hypoxia. In both cases, RAGE expression was primarily associated with neurons. Activation of RAGE-dependent pathway(s) post-ischemia appears to have a neuroprotective role because mice genetically deficient for RAGE exhibited increased infarct size 24 h after injury. Up-regulation of RAGE expression was also observed in primary neurons subjected to hypoxia or oxygen-glucose deprivation, an in vitro model of ischemia. Treatment of neurons with low concentrations of S100B decreased neuronal death after oxygen-glucose deprivation, and this effect was abolished by a neutralizing antibody against RAGE. Conversely, high concentrations of exogenous S100B had a cytotoxic effect that seems to be RAGE-independent. As an important novel finding, we demonstrate that hypoxic stimulation of RAGE expression is mediated by the transcription factor hypoxia-inducible factor-1. This conclusion is supported by the finding that HIF-1␣ down-regulation by Cre-mediated excision drastically decreased RAGE induction by hypoxia or desferrioxamine. In addition, we showed that the mouse RAGE promoter region contains at least one functional HIF-1 binding site, located upstream of the proposed transcription start site. A luciferase reporter construct containing this RAGE promoter fragment was activated by hypoxia, and mutation at the potential HIF-1 binding site decreased hypoxia-dependent promoter activation. Specific binding of HIF-1 to this putative HRE in hypoxic cells was detected by chromatin immunoprecipitation assay.The receptor for advanced glycation end products (RAGE) 4 is a member of the immunoglobin superfamily of cell surface molecules. It was originally identified by its capacity to bind advanced glycation end products, adducts that accumulate during natural aging and are produced at an augmented rate during diabetes (1). Subsequently, several other ligands for this receptor have been reported including amyloid- peptide, high-mobility group box 1, some members of the S100/calgranulin family, and Mac-1 (2-5). Multiple studies indicate that RAGE signaling has profound stimulatory effects on gene expression of inflammatory mediators, a mechanism that has been implicated in the pathogenesis of diabetic complications in the periphery (for review, see Ref. 6). In the central nervous system, the expression of RAGE has been described in several cell types. During the embryonic and early postnatal period, RAGE is highly expressed by hippocampal, cortical, and cerebellar neurons (4). Expression of this receptor is limited in the normal adult brain, but enhanced in pathological conditions like Alzheimer disease (5, 7). In this pathology, RAGE expression was observed not only in neurons but also in endothelial cells, and microglia (5, 8...