Article Text

THU0016 A comprehensive contribution of genes of the hypoxia inducible factor-1 alpha signaling pathway to knee osteoarthritis susceptibility
  1. J Fernandez-Torres1,2,
  2. GA Martínez-Nava1,
  3. A Lόpez-Reyes1,
  4. Y Zamudio-Cuevas1,
  5. D Clavijo-Cornejo1,
  6. K Martínez-Flores1,
  7. MC Gutiérrez-Ruíz2,
  8. LE Gόmez-Quiroz2,
  9. C Pineda1
  1. 1Laboratorio de Líquido Sinovial, Instituto Nacional de Rehabilitacion
  2. 2Cellular Physiology Laboratory, Universidad Autόnoma Metropolitana-Iztapalapa, Mexico City, Mexico


Background The hallmark of osteoarthritis (OA) is the breakdown of articular cartilage. Articular cartilage is an avascular tissue, and this generates a hypoxic microenvironment. Hypoxia inducible factor-1α (HIF-1α) is the main transcriptional regulator of cellular and developmental response to hypoxia.

Objectives The present study was designed to investigate whether genetic polymorphisms of the HIF-1α signaling pathway are involved in the development of knee OA.

Methods A total of 243 unrelated Mexican-mestizo individuals comprising 93 knee OA patients and 150 healthy controls were recruited into the study. 42 genetic polymorphisms from 22 genes involved in the HIF-1α signaling pathway (PIK3R1, AKT2, GSK3B, IL6, AGER, HIF1A, EGLN1, VHL, HIF1AN, VEGFA, EPO, NOS2, NOS3, IGF1, EGF, EDN1, MMP1, MMP3, MMP13, CA, COL2A1, COL3A1) were genotyped in cases and controls using TaqMan-based allelic discrimination assays.

Results After adjusting for age, sex and admixture, significant associations with knee OA were found for 7 SNPs in the case-control study. The following genotypes and alleles were associated with protection against OA: the CT genotype of the HIF1AN rs11190613 polymorphism (OR=0.44, 95% CI=0.19–1.0, P=0.05); the AA genotype of the VEGFA rs1570360 polymorphism (OR=0.14, 95% CI=0.02–0.69, P=0.016); the GT genotype and T allele of the VEGFA rs729761 polymorphism (OR=0.47, 95% CI=0.22–1.0, P=0.05; and OR=0.51, 95% CI=0.27–0.97, P=0.041, respectively); the GA genotype of the COL2A1 rs1793953 polymorphism (OR=0.40, 95% CI=0.20–0.79, P=0.008); and the GG genotype and G allele of the CKM rs4884 polymorphism (OR=0.34, 95% CI=0.14–0.84, P=0.019; and OR=0.51, 95% CI=0.32–0.82, respectively). Otherwise, the CT genotype of the COL3A1 rs2138533 polymorphism (OR=2.89, 95% CI=1.28–6.5, P=0.01); and the GA genotype of the IGF1 rs35767 polymorphism (OR=2.22, 95% CI=1.11–4.43, P=0.024) were associated with an increased risk of OA. However, by using of epistatic interactions between HIF-1α pathway polymorphisms, we found that the gene-gene interaction had a synergistic effect over the estimated OR-values (see table).

Conclusions In this study we could observe that the gene-gene interaction of the HIF-1α signaling pathway highly increases the risk of developing OA, with the exception of COL2A1 and HIF1AN interaction which had a protective role against OA. Further studies are needed to validate this results.


  1. Fernández-Torres J, et al. Polymorphic variation of hypoxia inducible factor-1 A (HIF1A) gene might contribute to the development of knee osteoarthritis: a pilot study. BMC Musculoskelet Disord 2015; 16:218.

  2. Rodríguez-Fontanela C, et al. Assessment of osteoarthritis candidate genes in a meta-analysis of nine genome-wide association studies. Arthritis Rheumatol 2014; 66:940–949.


Disclosure of Interest None declared

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