Cited by 461Inflammatory Bowel DiseaseGut microbiota and healthCancer, Hypoxia, and Metabolism

The DOI matches its Crossref record; 62 of the 63 references it cites were found in a registry or an index; none of the 48 sources its claims cite is checked for support yet.

Hypoxia: an alarm signal during intestinal inflammation

Open access
Colgan, Sean P., Taylor, Cormac T.·2010·Nature Reviews Gastroenterology & Hepatology

Abstract

Intestinal epithelial cells that line the mucosal surface of the gastrointestinal tract are positioned between an anaerobic lumen and a highly metabolic lamina propria. As a result of this unique anatomy, intestinal epithelial cells function within a steep physiologic oxygen gradient relative to other cell types. Furthermore, during active inflammatory disease such as IBD, metabolic shifts towards hypoxia are severe. Studies in vitro and in vivo have shown that the activation of hypoxia-inducible factor (HIF) serves as an alarm signal to promote the resolution of inflammation in various mouse models of disease. Amelioration of disease occurs, at least in part, through transcriptional upregulation of nonclassic epithelial barrier genes. There is much interest in harnessing hypoxia-inducible pathways, including stabilizing HIF directly or via inhibition of prolyl hydroxylase enzymes, for therapy of IBD. In this Review, we discuss the signaling pathways involved in the regulation of hypoxia and discuss how hypoxia may serve as an endogenous alarm signal for the presence of mucosal inflammatory disease. We also discuss the pros and cons of targeting these pathways to treat patients with IBD.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review argues that hypoxia in the inflamed intestinal mucosa acts as an endogenous alarm signal, with HIF activation promoting resolution of inflammation and barrier protection in murine colitis models. It discusses PHD inhibitors as potential IBD therapies but cautions about hematocrit elevation and cancer risk.

Key findings

  • The intestinal mucosa normally exists in a steep oxygen gradient; 2-nitroimidazole dye studies in murine IBD models show physiologic hypoxia in normal colon and profoundly hypoxic or anoxic inflammatory lesions. The adult intestinal epithelium covers approximately 300 m² and absorbs at least 9 L of fluid daily; gut blood volume shifts from less than 5% during fasting to approximately 30% after a meal.
  • HIF-1 is induced in inflammatory lesions. Loss of epithelial HIF-1α resulted in a more severe colitic phenotype than wild-type animals, with increased weight loss, decreased colon length and increased epithelial permeability, whereas constitutively active intestinal epithelial HIF was protective; however, another study found epithelial HIF-based signaling can promote inflammation.
  • HIF-dependent barrier protection involves non-classical epithelial barrier genes, including mucins, intestinal trefoil factor, P-glycoprotein, CD73 and the adenosine A2B receptor, rather than tight junction proteins occludin or claudin. PHDs also regulate NF-κB via IKKβ hydroxylation.
  • PHD inhibitors DMOG and FG-4497 reduced symptoms in at least two mouse models of colitis (TNBS or DSS) and were well tolerated; high-dose FG-4497 (>60 mg/kg) with 5 daily intervals caused occasional intestinal vascular occlusion, likely from erythrocyte sludging, rectified by lowering the dose and decreasing the dosing interval. No trials have been initiated for the treatment of IBD.

Methods

  • Design: narrative review of hypoxia signaling in intestinal inflammation, synthesizing in vitro studies, murine disease models and patient-derived materials.
  • Main analysis: descriptive synthesis of HIF, PHD and NF-κB pathways and preclinical therapeutic studies of PHD inhibitors in colitis models; no systematic search or quantitative meta-analysis is reported.

Limitations

  • Stated: increased susceptibility to colitis after genetic deletion of intestinal epithelial HIF may be somewhat model-dependent and requires additional validation with PHD inhibitors before clinical studies can be implemented. The paper also cautions that HIF activators substantially elevate hematocrit; high-dose FG-4497 caused occasional vascular occlusion, and chronic HIF-1 and HIF-2 stabilization has been significantly associated with cancers, so safest use may be acute or short-term adjunct therapy.
  • Evident from the text: this is a narrative review without systematic search or quantitative synthesis, and therapeutic evidence is largely from murine colitis models; no IBD trials have been initiated.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1038/nrgastro.2010.39

Cites

62 of 62 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 48 cited sources checked · 0 supported · 0 flagged

Show all 21 claims

  • Probably not a substantial claim. 5
  • It may state two separate claims as one. 18
21 of 21
  • The paper relies on this without support.

    Loss of epithelial barrier function with unrestricted flux of luminal antigens to the mucosal immune system underlies the pathology of IBD and results in hypoxia within the chronically inflamed mucosa, particularly within the epithelial cell layer.

    “Loss of epithelial barrier function with the resultant unrestricted flux of luminal antigens to the mucosal immune system underlies the pathology of IBD, and results in hypoxia within the chronically inflamed mucosa, particularly within the epithelial cell layer.”
  • The paper relies on this without support.

    When activated, PMN can consume up to 10 times more O2 than any other cell in the body.

    “When activated, it is estimated that PMN can consume up to 10 times more O2 than any other cell in the body.”
  • The paper relies on this without support.

    There is a steep oxygen gradient from the anaerobic lumen of the intestine across the epithelium into the highly vascularized sub-epithelium.

    “Notably, there is a steep oxygen gradient from the anaerobic lumen of the intestine across the epithelium into the highly vascularized sub-epithelium.”
  • The paper relies on this without support.

    Chronic HIF-1 and HIF-2 stabilization are significantly associated with a number of cancers.

    “As a second precautionary note, chronic HIF-1 and HIF-2 stabilization have been significantly associated with a number of cancers.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Prolyl hydroxylase is described as both stabilizing and degrading HIF

    Minor

    The abstract says the prolyl-hydroxylase enzyme stabilizes HIF, but the main text says these enzymes lead to HIF degradation and that inhibiting them stabilizes HIF.

1 of 1

Citations

Cites

Flagged first, then by citations

Show all 63 references

1 of the 63 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Items 101–200 of 457

Metadata

Authors
Colgan, S. P., & Taylor, C. T.
Affiliations
  • University of Colorado Denver (US)
  • University College Dublin (IE)
Corresponding author
Colgan, Sean P.
Venue
Nature Reviews Gastroenterology & Hepatology
Published
2010-04-06
Volume
7
Issue
5
Pages
281-287
ISSN
  • 1759-5045 (ISSN-L)
  • 1759-5053
OpenAlex
W2018782206
Cited by
461
References
63
Citations by year
2026: 22 · 2025: 25 · 2024: 28 · 2023: 26 · 2022: 28 · 2021: 35 · 2020: 20 · 2019: 31 · 2018: 32 · 2017: 33 · 2016: 38 · 2015: 37 · 2014: 31 · 2013: 29 · 2012: 21
FWCI
2.54
Type
journal article
Language
en
Open access
Locations
  • Nature Reviews Gastroenterology & Hepatology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Research Repository UCD (University College Dublin) (submittedVersion, cc-by-nc-nd)
  • Arrow@dit (Dublin Institute of Technology) (submittedVersion, cc-by-nc-nd)
Funders
  • Crohn's and Colitis Foundation of America
  • Crohn's and Colitis Foundation
  • National Institutes of Health (DE016191, DK-50189, HL60569)
  • National Heart, Lung, and Blood Institute (R01HL060569, HL-60569)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK050189, R37DK050189, R29DK050189, DK-50189)
  • National Institute of Dental and Craniofacial Research (P50DE016191, DE 016191)
Topics
  • Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Hypoxia, and Metabolism
Keywords
hypoxia, intestinal inflammation, inflammatory bowel disease, hypoxia-inducible factor, HIF stabilization, prolyl hydroxylase inhibition, intestinal epithelial barrier, oxygen gradients, inflammation resolution, mucosal inflammation
MeSH terms
Animals, Hypoxia, Humans, Intestinal Mucosa, Inflammatory Bowel Diseases, Oxidative Stress, Hypoxia-Inducible Factor 1

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

A language model drew the claims from the paper on 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review