HIF-1α in PAs increases the risk of pituitary apoplexy by stimulating the expression and synthesis of the VEGF (which influences MAPK, FAK, PI3K/Akt, p38 MAP kinase signaling pathways), MMP 2, TGF-β, and the signaling pathway Wnt [107,108]. This evidence concerns the gene VEGFA and pituitary apoplexy.