HIF activation by LA can promote macrophage M1 polarization to disrupt immune tolerance, leading to miscarriages (details in Fig. 1A); decreased succinate expression promotes the degradation of HIF-1α, which in turn inhibits angiogenesis, trophoblast invasion and migration and glycolysis (details in Fig. 1B); the downregulation of the TGF-β/mTOR pathway reduces HIF-1α expression, which inhibits ATP-adenosine metabolism and increases dNK cell toxicity (details in Fig. 1C). The gene discussed is HIF1A; the disease is spontaneous abortion.