Adaptation to low oxygen tension (hypoxia) in cells and tissues leads to the transcriptional induction of a series of genes that participate in angiogenesis, iron metabolism, glucose metabolism, and cell proliferation/survival. The primary factor mediating this response is the hypoxia-inducible factor-1 (HIF-1), an oxygen-sensitive transcriptional activator. HIF-1 consists of a constitutively expressed subunit HIF-1 and an oxygen-regulated subunit HIF-1␣ (or its paralogs HIF-2␣ and HIF-3␣). The stability and activity of the ␣ subunit of HIF are regulated by its post-translational modifications such as hydroxylation, ubiquitination, acetylation, and phosphorylation. In normoxia, hydroxylation of two proline residues and acetylation of a lysine residue at the oxygen-dependent degradation domain (ODDD) of HIF-1␣ trigger its association with pVHL E3 ligase complex, leading to HIF-1␣ degradation via ubiquitin-proteasome pathway. In hypoxia, the HIF-1␣ subunit becomes stable and interacts with coactivators such as cAMP response element-binding protein binding protein/p300 and regulates the expression of target genes. Overexpression of HIF-1 has been found in various cancers, and targeting HIF-1 could represent a novel approach to cancer therapy.The transcription factor hypoxia-inducible factor-1 (HIF-1) is a key regulator responsible for the induction of genes that facilitate adaptation and survival of cells and the whole organism from normoxia (ϳ21% O 2 ) to hypoxia (ϳ1% O 2 ) (Wang et al., 1995;Semenza, 1998). Since the identification of HIF, 2 decades ago, our knowledge of it has grown exponentially. Because of the realization that hypoxia has a strong impact, via gene expression, on cell biology and mammalian physiology, there has been enormous growing interest in the biology of the HIF-1 pathway and its role in human diseases such as cancer. Therefore, this review considers what has been learned about HIF-1: its discovery, its regulation, its target gene, its role in development and disease, and its implication for therapy.
The Discovery of HIF-1HIF-1␣. HIF-1 was discovered by the identification of a hypoxia response element (HRE; 5Ј-RCGTG-3Ј) in the 3Ј enhancer of the gene for erythropoietin (EPO), a hormone that stimulates erythrocyte proliferation and undergoes hypoxiainduced transcription (Goldberg et al., 1988;Semenza et al., 1991). Subsequent studies have revealed the protein that binds to the HRE under hypoxic conditions as HIF-1, a heterodimeric complex consisting of a hypoxically inducible subunit HIF-1␣ and a constitutively expressed subunit HIF-1 (Wang et al., 1995). HIF-1 is also known as the aryl hydrocarbon nuclear translocator (ARNT), which was originally identified as a binding partner of the aryl hydrocarbon receptor (Reyes et al., 1992), whereas HIF-1␣ was newly discovered. These proteins belong to the basic helix-loop-helixPer-ARNT-Sim (bHLH-PAS) protein family ( Fig. 1) (Wang et al., 1995). The bHLH and PAS motifs are required for heterodimer formation between the HIF-1␣ and HIF-1 ...