The hypoxia signaling pathway is a fundamental cellular response activated under low oxygen (hypoxic) conditions. It enables cells to adapt to oxygen deprivation by regulating gene expression programs involved in angiogenesis, metabolism, immune modulation, and survival.
Central to the hypoxia pathway are hypoxia-inducible factors (HIFs), transcription factors that stabilize when oxygen levels drop. Once activated, HIFs regulate a broad network of genes that promote cellular adaptation to hypoxic stress.
Dysregulation of this pathway is strongly associated with cancer progression, ischemic diseases, fibrosis, chronic inflammation, and metabolic disorders.
Hypoxia pathway activity can be efficiently assessed by measuring gene expression of oxygen sensors, HIF targets, and hypoxia-responsive biomarker signatures.
Hypoxia-inducible factor (HIF) regulation during normoxia and hypoxia. In oxygenated conditions, HIF is hydroxylated on proline residues by prolyl-4-hydroxylases (PHDs) and polyubiquitinated by the von Hippel–Lindau protein (pVHL). This leads to degradation of HIF by the 26S proteasome system. In hypoxic conditions, HIF is stabilized and translocated into the nucleus, where it binds to its dimerization partner HIF1B and enhances the transcription of HIF target genes
Key takeaways
Master regulator of cellular adaptation to low oxygen
Controls angiogenesis and metabolic reprogramming
Central driver of tumor microenvironment adaptation
Interacts with PI3K-AKT, mTOR, NF-κB, and Wnt pathways
Highly relevant for biomarker discovery and translational research
Biological functions of hypoxia signaling
The hypoxia signaling pathway regulates:
Oxygen homeostasis
Angiogenesis and vascular remodeling
Cellular survival under stress
Stem cell maintenance
Tumor progression and metastasis
Ischemic tissue repair
Core mechanisms of the hypoxia signaling pathway
HIF stabilization and activation
Under normoxia (normal oxygen conditions), HIF-α subunits are hydroxylated and rapidly degraded via the VHL complex.
Under hypoxia, hydroxylation is inhibited, allowing HIF-α to stabilize, dimerize withHIF-β, and translocate to the nucleus. The HIF complex then activates transcription of hypoxia-responsive genes.
Angiogenesis regulation
Hypoxia induces expression of angiogenic factors such as VEGF, promoting the formation of new blood vessels to restore oxygen supply.
Metabolic reprogramming
Low oxygen triggers a shift toward glycolysis by upregulating genes such as GLUT1 and LDHA, allowing ATP production independent of oxidative phosphorylation.
The hypoxia signaling pathway is a cellular oxygen-sensing mechanism activated under low oxygen conditions. It regulates gene expression programs that promote angiogenesis, metabolic adaptation, immune modulation, and cell survival through hypoxia-inducible factors (HIFs).
Under low oxygen levels, HIF-α subunits stabilize and dimerize with HIF-β. The complex translocates to the nucleus and activates hypoxia-responsive genes such as VEGF and glycolytic enzymes, enabling cells to adapt to oxygen deprivation.
Tumor hypoxia activates the hypoxia signaling pathway, promoting angiogenesis, metabolic reprogramming, immune evasion, metastasis, and resistance to therapy. Hypoxia biomarkers are therefore critical in oncology research and drug development.
Key genes include HIF1A, EPAS1 (HIF2A), VEGFA, VHL, EGLN1 (PHD2), LDHA, GLUT1 (SLC2A1), and other hypoxia-responsive targets involved in angiogenesis and metabolism.
Hypoxia signaling activity can be assessed by measuring gene expression of HIF regulators, angiogenic factors, metabolic enzymes, and downstream transcriptional targets using targeted gene expression approaches such as qPCR pathway arrays.
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Serebrovska ZO et al. Hypoxia, HIF-1α, and COVID-19: from pathogenic factors to potential therapeutic targets. Acta Pharmacol Sin. (2020);41(12):1539-1546.
Hypoxia signaling pathway biomarker list
You can check the biomarker list included in this pathway, see below: