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Military members and people who practice recreational activities from moderate to high altitudes are at risk for hypoxic exposure. Hypoxemia\u2019s signs and symptoms vary from asymptomatic to severe responses, such as excessive hypoxic ventilatory responses and residual neurobehavioral impairment. Therefore, it is essential to identify hypoxia-induced biomarkers to indicate people with exposure to hypoxia. Advances have been made in understanding physiological responses to hypoxia, including elevations in circulating levels of endothelin 1 (ET-1) and microRNA 21 (miR-21) and reduction in circulating levels of hydrogen sulfide (H<jats:sub>2<\/jats:sub>S). Although the levels of these factors change upon exposure to hypoxia, it is unclear if these changes are sustained on return to normoxia. We hypothesize that hypoxia-induced ET-1 and miR-21 remain elevated, whereas hypoxia-reduction in H<jats:sub>2<\/jats:sub>S sustains after returning to normoxic conditions. To test this hypothesis, we exposed male rats to 6 h of 12% O<jats:sub>2<\/jats:sub> and measured circulating levels of ET-1 and miR-21, pre, during, and posthypoxia. We found that ET-1 plasma levels increased in response to hypoxia but returned to normal levels within 30 min after the restoration of normoxia. miR-21 plasma levels and transdermal H<jats:sub>2<\/jats:sub>S emissions decreased in response to hypoxia, remaining decreased on return to normoxia, thus following the biomarker criteria. Therefore, this study supports a unique role for plasma miR21 and transdermal H<jats:sub>2<\/jats:sub>S as hypoxia biomarkers that could be used to identify individuals after exposure to hypoxia. <\/jats:p>","DOI":"10.1152\/ajpregu.00199.2022","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T14:11:49Z","timestamp":1666015909000},"page":"R900-R909","update-policy":"https:\/\/doi.org\/10.1152\/aps-crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Hydrogen sulfide and miR21 are suitable biomarkers of hypoxic exposure"],"prefix":"10.1152","volume":"323","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7792-8371","authenticated-orcid":false,"given":"Selina M.","family":"Garcia","sequence":"first","affiliation":[{"name":"Vascular Physiology Group, Department of Cell Biology and Physiology, University of New Mexico Health Sciences Center, Albuquerque, New 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