In individuals with idiopathic MMD, growth factors such as vascular endothelial growth factor (VEGF), fibroblast growth factor, platelet-derived growth factor (PDGF) and multiple cytokines such as matrix metalloproteinases, hypoxia inducible factor 1-alpha, and cellular retinoic binding protein-1 have been reported to be elevated, although it remains unclear whether any of these biomarkers play a primary or secondary role in the vascular condition at hand (11, 38–41). Here, HIF1A is linked to multiminicore myopathy.