Description

Tatli M, Altintop I, Karakukcu C, Sarıca ZS, Yay AH, Özkan R. Renal Effects of Acute Carbon Monoxide

Poisoning: The Role of HIF-2α as a Biomarker of Tubular Injury. Undersea Hyperb Med. 2026 Second

Quarter; 53(2):295-304.

Introduction: Carbon monoxide (CO) poisoning is a serious public health concern that induces acute

hypoxia, leading to organ damage. The effects of CO exposure on renal function remain insufficiently

studied. This study aimed to investigate the impact of CO poisoning on kidney function and structure in

an experimental rat model and to evaluate the role of hypoxia-inducible factor-2 alpha (HIF-2α) in this

process.

Methods: A total of 69 female Wistar Albino rats were used in the study. The rats were divided into a

control group (n=9) and experimental groups exposed to CO poisoning and sacrificed at one hour (n=12),

six hours (n=12), 12 hours (n=12), 24 hours (n=12), and 48 hours (n=12) post-exposure. CO exposure

was administered at a concentration of 5000 ppm for 60 minutes. Blood gas analysis was performed,

histopathological changes were evaluated using hematoxylin and eosin (H&E) staining, and HIF-2α

expression was assessed via immunohistochemistry.

Results: Significant histopathological changes were observed in kidney tissue following CO poisoning,

including tubular degeneration, epithelial necrosis, and necrotic debris accumulation (p<0.001). Blood

gas analysis showed a significantly elevated carboxyhemoglobin (COHb) level at one hour post-exposure

(p<0.001), which returned to normal after six hours. Immunohistochemical analysis revealed a significant

increase in HIF-2α expression following CO exposure (p<0.001), with a positive correlation between HIF-

2α expression and tubular damage.

Discussion: CO poisoning induces renal tubular injury and increases HIF-2α expression as a hypoxic

response. These findings suggest that HIF-2α could serve as a potential biomarker for assessing renal

damage due to CO exposure. Further studies are needed to evaluate the diagnostic and therapeutic

implications of these findings in CO poisoning.

Keywords: carbon monoxide poisoning; HIF-2α; hypoxia; immunohistochemistry; renal injury