Hypoxia-driven hif-1α activation reprograms pre-activated nk cells towards highly potent effector phenotypes via erk/stat3 pathways

Seon Ah Lim, Yunwon Moon, Min Hwa Shin, Tae Jin Kim, Sehyun Chae, Cassian Yee, Daehee Hwang, Hyunsung Park, Kyung Mi Lee

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)


NK cells are the predominant innate lymphocyte subsets specialized to kill malignant tumor cells. In patients with advanced cancer, hypoxic stress shapes NK cells toward tumor-resistant and im-munosuppressive phenotypes, hence a strategy to restore NK function is critical for successful tumor immunotherapy. Here, we present evidence that pre-activation and subsequent HIF-1α-dependent metabolic shift of NK cells from oxidative phosphorylation into glycolysis are keys to overcome hypoxia-mediated impairment in NK cell survival, proliferation, and tumor cytotoxicity. Specifically, exposing NK cells to 7–9 days of normoxic culture followed by a pO2 of 1.5% hypoxia led to a highly potent effector phenotype via HIF-1α stabilization and upregulation of its target genes, BNIP3, PDK1, VEGF, PKM2, and LDHA. RNA sequencing and network analyses revealed that concomitant reduc-tion of p21/p53 apoptotic pathways along with upregulation of cell cycle-promoting genes, CCNE1, CDC6, CDC20, and downregulation of cell cycle-arrest genes, CDKN1A, GADD45A, and MDM2 were accountable for superior expansion of NK cells via ERK/STAT3 activation. Furthermore, HIF-1α-dependent upregulation of the NKp44 receptor in hypoxia-exposed NK cells resulted in increased killing against K562, CEM, and A375 tumor targets both in-vitro and in-vivo tumor clearance assays. Therefore, hypoxic exposure on pre-activated proliferating NK cells triggered HIF-1α-dependent pathways to initiate coordinated regulation of cell cycle, apoptosis, and cytotoxicity at the global.

Original languageEnglish
Article number1904
Issue number8
Publication statusPublished - 2021 Apr 2

Bibliographical note

Publisher Copyright:
Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.


  • Hypoxia
  • NK cells
  • Tumor microenvironment

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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