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Hypoxia and decreased pHe. Under hypoxia, HIF maintains the pHi by changes including up-regulation of NHE1, MCT4 (which exports H+ and lactate), CA IX or XII which converts CO2 to carbonic acid. The dissociated weak base HCO3- influxes through AE (anion exchangers) and H+ is left outside. The overall results is the decreased pHe.
