While it is not clear how HIF-1α may induce hypoxic necrotic granulomas – since it has known properties that mitigates hypoxia and its detrimental sequelae such as induction angiogenesis and switch to glycolytic metabolism – one possible mechanism is that HIF-1α can induce mucin production and transepithelial resorption of sodium ion and water, resulting in increased mucus in the airways and thus indirectly worsening hypoxia to the lungs and the granulomas (219). This evidence concerns the gene HIF1A and Granuloma.