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REVIEW

Opportunities and challenges of integrating HIF-1 into clinical practice for cancer treatment

Maria Vasileiou1* ,  Christina Tsianava2 ,  Sotirios Charalampos Diamantoudis3 ,  Teodora Mazneva4 ,  Kleio Giortsiou3
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1 Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
2 Department of Pharmacy, School of Health Sciences, University of Patras, Rion, Greece
3 School of Pharmacy, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
4 Faculty of Pharmacy, Ss Cyril and Methodius University, Skopje, Republic of North Macedonia
GPD 2024, 3(2), 3431 https://doi.org/10.36922/gpd.3431
Submitted: 16 April 2024 | Accepted: 18 June 2024 | Published: 28 June 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

The Warburg effect is one of the most studied mechanisms involved in cancer progression. It refers to the increased glucose uptake by cancer cells through aerobic glycolysis, instead of the Krebs cycle that takes place under normal conditions, followed by lactic acid fermentation. This mechanism is regulated by hypoxia-inducible factor-1 (HIF-1), a transcription factor that regulates the expression of genes responsible for the synthesis of proteins involved in glucose metabolism. Overexpression of HIF-1 has been linked to the Warburg effect. While several HIF-1-targeted strategies have been investigated, the majority have proven to be unsuccessful, especially in cases of aggressive tumors with hypoxic tumor microenvironments. Current strategies expand beyond conventional chemotherapeutic agents and include chemodynamic therapy, radiation therapy, and immune checkpoint molecules. The aim of this literature review is to highlight the implication of HIF-1 in the Warburg effect and the limitations that render cancer treatment less effective.

Keywords
HIF-1
Warburg effect
Cancer metabolism
Hypoxia
Angiogenesis
Drug resistance
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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