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Clinical Medicine logoLink to Clinical Medicine
. 2002 Jul 1;2(4):356–362. doi: 10.7861/clinmedicine.2-4-356

Oxygen homeostasis and cancer: insights from a rare disease

Patrick H Maxwell 1
PMCID: PMC4953398  PMID: 12195866

Abstract

Many aspects of physiology and anatomy are precisely adjusted so that the right amount of oxygen reaches cells throughout the body. Hypoxia-inducible factor-1 (HIF-1) is activated by low oxygen tension in all mammalian cells and underpins many aspects of the impressive ability to match oxygen supply and demand. As examples, HIF-1 regulates:

  • local capillary architecture via angiogenic signalling

  • red cell production via erythropoietin

  • cellular metabolism via increased expression of glucose transporters and glycolytic enzymes.

HIF-1 is also important in disease, for example in cancer where it is involved in angiogenesis. This review describes how HIF-1 is regulated by oxygen and the central role played by the von Hippel-Lindau tumour suppressor protein. The underlying oxygen sensor is provided by a family of enzymes which oxidise specific proline residues in HIF subunits. Inhibiting these newly discovered enzymes provides a way of activating HIF-1 in the presence of oxygen - an exciting prospect for therapeutic intervention in ischaemic diseases.

Keywords: hypoxia-inducible factor-1, oxygen, ubiquitin, von Hippel-Lindau

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