Ubiquitin-mediated TAK1 and IKK complex activation. Hypoxia/reperfusion activates the ubiquitin E3 ligase TRAF6, and TNF/TNFR activates TRAF2 and 5. TRAF6 increases K63-linked polyubiquitin chains, which associate with the TAB2 subunit of TAK1 kinase and activate TAK1 kinase. The K63-Ub chains also bind NEMO to recruit the IKK complex, thereby accelerating the phosphorylation of IKK Adapted, reprinted, and modified from Abe et al. [185] with permission from Circ Res, Jun 7, 2013, published by Wolters Kluwer Health, Inc.