Increased size of solid organs in patients with Chuvash polycythemia and in mice with altered expression of HIF-1α and HIF-2α

Donghoon Yoon, David V. Okhotin, Bumjun Kim, Yulia Okhotina, Daniel J. Okhotin, Galina Y. Miasnikova, Adelina I. Sergueeva, Lydia A. Polyakova, Alexei Maslow, Yonggu Lee, Gregg L. Semenza, Josef T. Prchal, Victor R. Gordeuk

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Chuvash polycythemia, the first hereditary disease associated with dysregulated oxygen-sensing to be recognized, is characterized by a homozygous germ-line loss-of-function mutation of the VHL gene (VHLR200W) resulting in elevated hypoxia inducible factor (HIF)-1α and HIF-2α levels, increased red cell mass and propensity to thrombosis. Organ volume is determined by the size and number of cells, and the underlying molecular control mechanisms are not fully elucidated. Work from several groups has demonstrated that the proliferation of cells is regulated in opposite directions by HIF-1α and HIF-2α. HIF-1α inhibits cell proliferation by displacing MYC from the promoter of the gene encoding the cyclin-dependent kinase inhibitor, p21Cip1, thereby inducing its expression. In contrast, HIF-2α promotes MYC activity and cell proliferation. Here we report that the volumes of liver, spleen, and kidneys relative to body mass were larger in 30 individuals with Chuvash polycythemia than in 30 matched Chuvash controls. In Hif1a+/- mice, which are heterozygous for a null (knockout) allele at the locus encoding HIF-1α, hepatic HIF-2α mRNA was increased (2-fold) and the mass of the liver was increased, compared with wild-type littermates, without significant difference in cell volume. Hepatic p21Cip1 mRNA levels were 9.5-fold lower in Hif1a+/- mice compared with wild-type littermates. These data suggest that, in addition to increased red cell mass, the sizes of liver, spleen, and kidneys are increased in Chuvash polycythemia. At least in the liver, this phenotype may result from increased HIF-2α and decreased p21Cip1 levels leading to increased hepatocyte proliferation.

Original languageEnglish (US)
Pages (from-to)523-530
Number of pages8
JournalJournal of Molecular Medicine
Issue number5
StatePublished - May 2010


  • Gene expression
  • Genetics
  • HIF
  • Hematology
  • Hypoxia
  • Hypoxia inducible factor
  • Mouse models
  • Organ size
  • P21
  • Polycythemia
  • VHL

ASJC Scopus subject areas

  • Molecular Medicine
  • Drug Discovery
  • Genetics(clinical)


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