Hypoxia-inducible factor-1 (HIF) is a transcription factor central to oxygen homeostasis. It is regulated via its ␣ isoforms. In normoxia they are ubiquitinated by the von Hippel-Lindau E3 ligase complex and destroyed by the proteasome, thereby preventing the formation of an active transcriptional complex. Oxygen-dependent enzymatic hydroxylation of either of two critical prolyl residues in each HIF␣ chain has recently been identified as the modification necessary for targeting by the von Hippel-Lindau E3 ligase complex. Here we demonstrate that polypeptides bearing either of these prolyl residues interfere with the degradative pathway, resulting in stabilization of endogenous HIF␣ chains and consequent up-regulation of HIF target genes. Similar peptides in which the prolyl residues are mutated are inactive. Induction of peptide expression in cell cultures affects physiologically important functions such as glucose transport and leads cocultured endothelial cells to form tubules. Coupling of these HIF␣ sequences to the HIV tat translocation domain allows delivery of recombinant peptide to cells with resultant induction of HIF-dependent genes. Injection of tat-HIF polypeptides in a murine sponge angiogenesis assay causes a markedly accelerated local angiogenic response and induction of glucose transporter-1 gene expression. These results demonstrate the feasibility of using these polypeptides to enhance HIF activity, opening additional therapeutic avenues for ischemic diseases.I schemia is a major cause of morbidity and mortality, and effective molecular therapies are being intensively sought (1, 2). The transcription factor hypoxia-inducible factor-1 (HIF) is a master regulator of the hypoxic response, controlling genes involved in diverse processes that balance metabolic supply and demand within tissues (3, 4), making modulation of HIF activity an attractive approach for the treatment of ischemic disease.Regulation of HIF is mediated at multiple levels via its ␣ chains (5-9). Analysis of the HIF␣ oxygen-dependent degradation domains (ODD) by transient transfection studies (7,8,(10)(11)(12)(13)) suggested a possible specific, alternative approach to HIF stabilization. We have used peptides containing the sites of oxygen-regulated prolyl hydroxylation necessary for proteasomal destruction mediated by the von Hippel-Lindau E3 ubiquitin ligase complex (VHL E3) (14-18). Despite the multiple steps involved in HIF activation, we demonstrate that peptides from two regions of the ODD not only stabilize HIF␣ but produce a transcriptional response that modulates angiogenesis and metabolism in vivo, suggesting that the peptides affect mechanisms that are common to all activation steps, or that when HIF␣ chains are present in large excess mechanisms inhibiting transcriptional activation (9, 19) become saturated. These results indicate that these polypeptides, or molecules based on them, are useful tools for studying HIF-mediated responses and ultimately may provide a viable therapeutic approach for ischemic tissues.
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