Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 May 19;9(5):e98136.
doi: 10.1371/journal.pone.0098136. eCollection 2014.

Hypoxia-mediated Mechanism of MUC5AC Production in Human Nasal Epithelia and Its Implication in Rhinosinusitis

Free PMC article

Hypoxia-mediated Mechanism of MUC5AC Production in Human Nasal Epithelia and Its Implication in Rhinosinusitis

Yoon-Ju Kim et al. PLoS One. .
Free PMC article


Background: Excessive mucus production is typical in various upper airway diseases. In sinusitis, the expression of MUC5AC, a major respiratory mucin gene, increases. However, the mechanisms leading to mucus hypersecretion in sinusitis have not been characterized. Hypoxia due to occlusion of the sinus ostium is one of the major pathologic mechanisms of sinusitis, but there have been no reports regarding the mechanism of hypoxia-induced mucus hypersecretion.

Methods and findings: This study aims to identify whether hypoxia may induce mucus hypersecretion and elucidate its mechanism. Normal human nasal epithelial (NHNE) cells and human lung mucoepidermoid carcinoma cell line (NCI-H292) were used. Sinus mucosa from patients was also tested. Anoxic condition was in an anaerobic chamber with a 95% N2/5% CO2 atmosphere. The regulatory mechanism of MUC5AC by anoxia was investigated using RT-PCR, real-time PCR, western blot, ChIP, electrophoretic mobility shift, and luciferase assay. We show that levels of MUC5AC mRNA and the corresponding secreted protein increase in anoxic cultured NHNE cells. The major transcription factor for hypoxia-related signaling, HIF-1α, is induced during hypoxia, and transfection of a mammalian expression vector encoding HIF-1α results in increased MUC5AC mRNA levels under normoxic conditions. Moreover, hypoxia-induced expression of MUC5AC mRNA is down-regulated by transfected HIF-1α siRNA. We found increased MUC5AC promoter activity under anoxic conditions, as indicated by a luciferase reporter assay, and mutation of the putative hypoxia-response element in MUC5AC promoter attenuated this activity. Binding of over-expressed HIF-1α to the hypoxia-response element in the MUC5AC promoter was confirmed. In human sinusitis mucosa, which is supposed to be hypoxic, expression of MUC5AC and HIF-1α is higher than in control mucosa.

Conclusion: The results indicate that anoxia up-regulates MUC5AC by the HIF-1α signaling pathway in human nasal epithelia and suggest that hypoxia might be a pathogenic mechanism of mucus hypersecretion in sinusitis.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.


Figure 1
Figure 1. Anoxia induces the expression of mRNA and production of MUC5AC in NHNE cells.
(A) MTT assay to determine cytotoxic effects of anoxia. Cell viability was not significantly affected by less than 6 h of anoxia (n = 3, *p<0.05, †p<0.0001). (B) The expression of the MUC5AC gene according to anoxia stimulation (95% N2/5% CO2 atmosphere in the hypoxic chamber) for 0–24 h in NHNE cells. MUC5AC gene expression was increased under anoxic conditions, measured by RT-PCR. (C) The expression of MUC5AC mRNA was maximally induced at 12 h during anoxia (measured by real-time PCR, n = 3, *p<0.05, **p<0.001). d) Mucus secretion was sampled at 2, 6, 12, and 24 h after incubating of NHNE cells under anoxic conditions and measured in dot blots with anti-MUC5AC antibody. Secreted MUC5AC was highest at 12 h under anoxic conditions (n = 3, **P<0.001). Data is shown as mean ± standard deviation.
Figure 2
Figure 2. Anoxia induces HIF-1α protein levels in NHNE cells.
The expression of HIF-1α mRNA and protein in NHNE cells under anoxia stimulation for 0–24 h. (A) The transcription of HIF-1α was not altered by anoxia, measured by RT-PCR. (B) Expression of HIF-1α protein was increased under anoxic conditions compared to the normoxic control (western blot).
Figure 3
Figure 3. HIF-1α is involved in the regulation of MUC5AC expression.
When HIF-1α expression is increased, MUC5AC expression is induced; conversely, when HIF-1α expression is decreased, MUC5AC expression is reduced accordingly. (A) Gain-of-function study with mammalian HIF-1α expression vector in NCI-H292 cells. DNA of the pCMV vector encoding HIF-1α, or empty pCMV vector without HIF-1α, was transiently transfected. The expression of both HIF-1α and MUC5AC gene was increased when transfected with pCMV-HIF-1α vector, compared to transfection of empty control vectors under normoxic conditions (n = 3, *p<0.05). (B) Loss-of-function study with transfected HIF-1α siRNA in NCI-H292 cells. The expression of both HIF-1α and MUC5AC gene was suppressed when transfected with siRNA of HIF-1α, compared to transfection of siRNA negative control under hypoxic conditions for 6 h (n = 3, *p<0.05). Data is shown as mean ± standard deviation. (N; normoxia, C; control).
Figure 4
Figure 4. Luciferase reporter assay dependent on MUC5AC promoter sequences.
(A) NCI-H292 cells were transiently transfected with the various deletion mutants and treated under normoxic or anoxic conditions for 6 h. Hypoxia selectively increased luciferase activity driven by sequences corresponding to the −1400/+4 and −776/+4 regions of the MUC5AC promoter, indicating that the −776/+4 region of MUC5AC promoter has a role in the cellular response to anoxia (n = 3, *P<0.01). (B) NCI-H292 cells were transfected with pGL3-basic vectors, pGL3 vectors containing the putative MUC5AC promoter, or pGL3 vectors containing the HRE-mutated MUC5AC promoter. After cells were incubated in the anoxic chamber for 6 h, luciferase activities were measured. Under anoxia conditions, the luciferase reporter activity of the wild-type MUC5AC promoter was increased by 8.3-fold compared to the HRE-mutated MUC5AC promoter, and by 11.2-fold compared to the pGL3-basic vectors (n = 3, **p<0.001). Data is shown as mean ± standard deviation.
Figure 5
Figure 5. The HRE is required for anoxia-induced MUC5AC transcription.
(A) Chromatin immunoprecipitation (ChIP) assay. NCI-H292 cells were transfected with vectors encoding HIF-1α-binding flanking region of the MUC5AC promoter (HRE site), or a region that does not contain an HRE region (non-HRE site; negative control). The cells were treated under normoxic or anoxic conditions for 6 h and subjected to immunoprecipitation with HIF-1α antibody or control IgG. (B) The MUC5AC mRNA transcript was analyzed by real-time PCR. The binding to HRE under anoxic conditions significantly increased the expression of MUC5AC expression compared to non-HRE region, or HRE region under anoxic conditions (n = 3, *p<0.05). (C) EMSA to determine HIF-1α binding to the HRE region of the MUC5AC promoter in response to anoxia. The activity with HIF-1α-specific HRE-containing oligonucleotides is increased remarkably in response to anoxia. The EMSA band of interest was found to be selectively inhibited by specific HRE-containing competitor oligonucleotide, and it was super-shifted by anti-HIF-1α antibody. Data is shown as mean ± standard deviation. (N; normoxia, A; anoxia).
Figure 6
Figure 6. Sinus mucosa from chronic sinusitis patients shows high levels of HIF-1α and MUC5AC expression.
(A) The expression of HIF-1α in the control and sinus mucosa from four patients with sinusitis (western blot analysis). The increase of HIF-1α expression in sinusitis was 4.4-fold greater than in control tissue (n = 4; *p<0.05). (B) Immunohistochemistry with anti-HIF-1α antibody in normal (left) and sinusitis (right) tissues. High HIF-1α protein expression is indicated by the strong antibody reactivity in the epithelium of sinus mucosa from a sinusitis patient. (C) Immunohistochemistry with anti-MUC5AC antibody in normal (upper) and sinusitis (lower) tissues. Pronounced MUC5AC expression is seen in the epithelium from the sinusitis patient. Data is shown as mean ± standard deviation. (N; normal, S; sinusitis).

Similar articles

See all similar articles

Cited by 10 articles

See all "Cited by" articles


    1. Rose MC, Voynow JA (2006) Respiratory tract mucin genes and mucin glycoproteins in health and disease. Physiol Rev 86: 245–278. - PubMed
    1. Ding GQ, Zheng CQ (2007) The expression of MUC5AC and MUC5B mucin genes in the mucosa of chronic rhinosinusitis and nasal polyposis. Am J Rhinol 21: 359–366. - PubMed
    1. Thai P, Loukoianov A, Wachi S, Wu R (2008) Regulation of airway mucin gene expression. Annu Rev Physiol 70: 405–429. - PMC - PubMed
    1. Alenmyr L, Herrmann A, Hogestatt ED, Greiff L, Zygmunt PM (2011) TRPV1 and TRPA1 stimulation induces MUC5B secretion in the human nasal airway in vivo. Clinical physiology and functional imaging 31: 435–444. - PubMed
    1. Koo JS, Kim YD, Jetten AM, Belloni P, Nettesheim P (2002) Overexpression of mucin genes induced by interleukin-1 beta, tumor necrosis factor-alpha, lipopolysaccharide, and neutrophil elastase is inhibited by a retinoic acid receptor alpha antagonist. Exp Lung Res 28: 315–332. - PubMed

Publication types

MeSH terms

Grant support

This research was supported by grants 2010-0008442 and 2012R1A1A2042476 to C.H. Kim, and 2012-0000803 to J.H. Yoon, from the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education, Science and Technology. This study was also supported by a faculty research grant from the Yonsei University College of Medicine for 2011 (6-2011-0140) to C.H. Kim. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.