NOTCH1 and brain ischemia: HIF-1α plays a pivotal role in cerebral ischemia, and its activation during ischemic events exerts a protective effect on the affected tissues by participating in metabolic, proliferative, and angiogenic processes.[45] The EA treatment induced activation of the HIF-1α/VEGF/Notch1 signaling pathway via exosomal micro RNA-210, resulting in increased expression of cluster of differentiation 34, HIF-1α, VEGF, and Notch1 at both protein and mRNA levels.