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Hypoxia and Selective Autophagy in Cancer Development and Therapy
Open accessAbstract
Low oxygen availability, a condition known as hypoxia, is a common feature of various pathologies including stroke, ischemic heart disease, and cancer. Hypoxia adaptation requires coordination of intricate pathways and mechanisms such as hypoxia-inducible factors (HIFs), the unfolded protein response (UPR), mTOR, and autophagy. Recently, great effort has been invested toward elucidating the interplay between hypoxia-induced autophagy and cancer cell metabolism. Although novel types of selective autophagy have been identified, including mitophagy, pexophagy, lipophagy, ERphagy and nucleophagy among others, their potential interface with hypoxia response mechanisms remains poorly understood. Autophagy activation facilitates the removal of damaged cellular compartments and recycles components, thus promoting cell survival. Importantly, tumor cells rely on autophagy to support self-proliferation and metastasis; characteristics related to poor disease prognosis. Therefore, a deeper understanding of the molecular crosstalk between hypoxia response mechanisms and autophagy could provide important insights with relevance to cancer and hypoxia-related pathologies. Here, we survey recent findings implicating selective autophagy in hypoxic responses, and discuss emerging links between these pathways and cancer pathophysiology.
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“Autophagy can be induced by certain treatments or microevironmental effects in relation to metabolic adaptation and resistance [45].”
From Hypoxia Signaling in Cancer: From Basics to Clinical Practice (2021) · cites this paper as [45]
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“Tumor cells use autophagy to support self-proliferation and metastasis; leading to poor disease prognosis (52), which indicates that hypoxia aids to these tumor features.”
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“Autophagy is a highly conserved cellular process, which is activated by various factors, such as hypoxia (38).”
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“However, under hypoxic conditions, these proteins are stabilized and translocated to the nucleus to initiate the transcription of genes involved in cellular adaptation and survival, including a set of genes essential for autophagy (e.g., ATG5, ATG7, ATG9A, BECN1, BNIP3, and BNI3L) (Daskalaki et al., 2018).”
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“Among the five previously identified ARGs associated with MM, HIF1A is the most widely studied (59,60).”
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Pelle, G. D., & Kostevšek, N. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22105264 · Cited by 31
Autophagic-Related Proteins in Brain Gliomas: Role, Mechanisms, and Targeting Agents
Pizzimenti, C., Fiorentino, V., Franchina, M., Martini, M., Giuffrè, G., Lentini, M., Silvestris, N., Pietro, M. D., Fadda, G., Tuccari, G., et al. (2023) · Cancers · doi:10.3390/cancers15092622 · Cited by 35
The Autophagy Machinery Contributes to E-cadherin Turnover in Breast Cancer
Damiano, V., Spessotto, P., Vanin, G., Perin, T., Maestro, R., & Santarosa, M. (2020) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2020.00545 · Cited by 28
“Mounting evidence suggests that autophagy endows tumor cells with the capability to survive anoikis, hypoxia and chemotherapy treatments (Levine and Kroemer, 2008; Levy et al., 2014; Daskalaki et al., 2018).”
BackgroundGuo, Y., Zhai, Y., Wu, L., Wang, Y., Wu, P., & Xiong, L. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23062927 · Cited by 28
Autophagy and oxidative stress in solid tumors: Mechanisms and therapeutic opportunities
Carretero-Fernández, M., Cabrera-Serrano, A. J., Sánchez‐Maldonado, J. M., Ruiz-Durán, L., Jiménez-Romera, F., García‐Verdejo, F. J., González‐Olmedo, C., Cardús, A., Díaz-Beltrán, L., Gutiérrez‐Bautista, J. F., et al. (2025) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2025.104820 · Cited by 37
“On the other hand, HIF-1 α , which is stabilized under oxidative stress, has been shown to activate autophagy pathways, including the AMPK/mTOR signaling axis, highlighting the crucial role of ROS in modulating autophagic activity (Daskalaki et al., 2018; J. Li et al., 2022; Zhou et al., 2018).”
Roperto, S., Falco, F. D., Perillo, A., Cătoi, C., & Roperto, F. P. (2019) · Veterinary Microbiology · doi:10.1016/j.vetmic.2019.108396 · Cited by 27
Zhang, S., Gong, F., Liu, J., Liu, T., Yang, J., & Hu, J. (2022) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2022.113004 · Cited by 27
Host cell egress of Brucella abortus requires BNIP3L‐mediated mitophagy
Verbeke, J., Fayt, Y., Martin, L. S., Yilmaz, O., Sędzicki, J., Reboul, A., Jadot, M., Renard, P., Dehio, C., Renard, H., et al. (2023) · The EMBO Journal · doi:10.15252/embj.2022112817 · Cited by 32
Zhu, X., Yang, C., Yu, Q., & Han, L. (2024) · Meat Science · doi:10.1016/j.meatsci.2024.109692 · Cited by 27
Beyond Self-Recycling: Cell-Specific Role of Autophagy in Atherosclerosis
Henderson, J. M., Weber, C., & Santovito, D. (2021) · Cells · doi:10.3390/cells10030625 · Cited by 27
HIF1α is required for NK cell metabolic adaptation during virus infection
Victorino, F., Bigley, T. M., Park, E., Yao, C.-H., Benoit, J. B., Yang, L., Piersma, S. J., Lauron, E. J., Davidson, R. M., Patti, G. J., et al. (2021) · eLife · doi:10.7554/elife.68484 · Cited by 24
“The 1 α KO NK cells had an increase in apoptosis as a result of decreased expression of glycolytic genes and abnormal glucose metabolism that have been previously associated with apoptosis ( Dengler et al., 2014 ; El Mjiyad et al., 2011 ; Greer et al., 2012 ; MacFarlane et al., 2012 ).”
InfluentialAutophagy and its role in regeneration and remodeling within invertebrate
Song, Q., Liu, H., Zhen, H., & Zhao, B. (2020) · Cell & Bioscience · doi:10.1186/s13578-020-00467-3 · Cited by 25
Chen, J., Wen, B., Wang, Y., Wu, S., Zhang, X., Gu, Y., Wang, Z., Wang, J., Zhang, W., & Yong, J. (2020) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2020.110898 · Cited by 24
Jiao, B., Liu, S., Zhao, H., Zhuang, Y., Ma, S., Lin, C., Hu, J., & Liu, X. (2022) · Cell Death and Disease · doi:10.1038/s41419-022-05114-y · Cited by 25
“Additionally, HIF-1α and HIF-2α can transcribe independent but overlapping sets of target genes when hypoxia develops [3, 4] (Fig.”
BackgroundMechanistic Insights into Autophagy-Dependent Cell Death (ADCD): A Novel Avenue for Cancer Therapy
Rahman, M. A., Jalouli, M., Al-Zharani, M. M., Apu, E. H., & Harrath, A. H. (2025) · Cells · doi:10.3390/cells14141072 · Cited by 29
“In hypoxic situations, hypoxia-inducible factor 1-alpha (HIF-1 α ) stimulates autophagy to supply an alternate energy source [88].”
Friend or Foe: Paradoxical Roles of Autophagy in Gliomagenesis
Batara, D. C., Choi, M., Shin, H.-U., Kim, H., & Kim, S.-H. (2021) · Cells · doi:10.3390/cells10061411 · Cited by 24
“Phosphoglycerate kinase 1 (PGK1), glucose transporters 1/3 (GLUT1/3), lactate dehydrogenase (LDHA), enolase 1 (ENO1), hexokinases (HK1/2), pyruvate dehydrogenase kinase 1 (PDK1), and 6-Phosphofructokinase-2 (PFK-2) or fructose bisphosphatase-2 (FBPase-2) are all influenced by HIF-1 [86].”
BackgroundTargeting Autophagy in Thyroid Cancer: EMT, Apoptosis, and Cancer Stem Cells
Holm, T. M., Yeo, S. K., Turner, K. M., & Guan, J. (2022) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2022.821855 · Cited by 23
“…to men, the underlying molecular biology driving this mutation has not yet been elucidated and recent epidemiologic studies suggest that the observed disparity between men and women is due to overdiagnosis (Song et al., 2013; Meng et al., 2014; Daskalaki et al., 2018; Gugnoni et al., 2021).”
BackgroundThe Multifaceted Effects of Autophagy on the Tumor Microenvironment
Kang, R., Zeh, H. J., Lotze, M. T., & Tang, D. (2020) · Advances in experimental medicine and biology · doi:10.1007/978-3-030-35727-6_7 · Cited by 22
Focus on the Multimodal Role of Autophagy in Rheumatoid Arthritis
Chadha, S., Behl, T., BUNGAU, S. G., Kumar, A., Kaur, R., Venkatachalam, T., Gupta, A. B., Kandhwal, M., & Chandel, D. (2020) · Inflammation · doi:10.1007/s10753-020-01324-8 · Cited by 21
“From various studies, the role of autophagy is observed in rheumatoid arthritis as well as systemic lupus erythematosus [33, 34].”
BackgroundLiu, R., Tang, J., Ding, C., Liang, W., Zhang, L., Chen, T., Xiong, Y., Dai, X., Li, W., Xu, Y., et al. (2017) · Cancer Letters · doi:10.1016/j.canlet.2016.12.040 · Cited by 22
Pizzimenti, C., Fiorentino, V., Ruggeri, C., Franchina, M., Ercoli, A., Tuccari, G., & Ieni, A. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms252212118 · Cited by 25
Increased ATG5 Expression Predicts Poor Prognosis and Promotes EMT in Cervical Carcinoma
Zhou, S., Wang, X., Ding, J., Yang, H., & Xie, Y. (2021) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2021.757184 · Cited by 21
“Novel increasing evidence showed that the process of EMT could be promoted or inhibited by autophagy (Catalano et al., 2015; Dash et al., 2018; Daskalaki et al., 2018; Wang et al., 2019; Wu et al., 2019; Liu et al., 2020).”
BackgroundWang, N., Muhetaer, G., Zhang, X., Yang, B., Wang, C., Zhang, Y., Wang, X., Zhang, J., Wang, S., Zheng, Y., et al. (2020) · Frontiers in Pharmacology · doi:10.3389/fphar.2020.591400 · Cited by 20
“With regard to hypoxic stress, Hif-1α has been extensively explored in several studies regarding hypoxia-induced autophagy during cancer metastasis (Daskalaki et al., 2018).”
BackgroundJena, B. C., Rout, L., Dey, A., & Mandal, M. (2021) · Journal of Cellular Physiology · doi:10.1002/jcp.30419 · Cited by 20
“Moreover, TGF‐β and hypoxia reprogram the tumor cells towards self‐renewal of CSC and angiogenesis, resulting in EMT and tumor metastasis (Daskalaki et al., 2018; Hardy et al., 2017; Jiang et al., 2016).”
BackgroundFasting promotes acute hypoxic adaptation by suppressing mTOR-mediated pathways
Zhao, R., Zhao, X., Wang, X., Liu, Y., Yang, J., Jiang, S., Zhou, X., Jiao, B., Zhang, L., Liu, Y., et al. (2021) · Cell Death and Disease · doi:10.1038/s41419-021-04351-x · Cited by 21
“BNIP3 is a transmembrane protein in the outer mitochondrial membrane that contains an LIR motif region on the cytoplasmic side, which can be recognized by LC3 to form autophagosomes, engulfing mitochondria [27].”
BackgroundLee, J., Lee, S.-A., Son, S., Choi, J., Nguyen, T. D., Kim, J., Son, D., & Song, C. (2023) · Cell & Bioscience · doi:10.1186/s13578-023-01107-2 · Cited by 20
“In hypoxia, BNIP3 is the target gene of hypoxia-inducible factor-1-alpha (HIF1α) [28, 29]; however, it is not clear whether BNIP3 is regulated by HIF1α during Mtb infection in the absence of hypoxia.”
BackgroundResultInfluentialAutophagy Modulation by Viral Infections Influences Tumor Development
Leonardi, L., Sibéril, S., Alifano, M., Cremer, I., & Joubert, P.-E. (2021) · Frontiers in Oncology · doi:10.3389/fonc.2021.743780 · Cited by 16
Mechanisms of HIF-driven immunosuppression in tumour microenvironment
Bandopadhyay, S., & Patranabis, S. (2023) · Journal of the Egyptian National Cancer Institute · doi:10.1186/s43046-023-00186-z · Cited by 20
“This autophagic degradation of cellular components is attributed to hypoxic stress response [82].”
BackgroundInfluentialSATB2 knockdown decreases hypoxia‑induced autophagy and stemness in oral squamous cell carcinoma
Dong, W., Chen, Y., Qian, N., Sima, G., Zhang, J., Guo, Z., & Wang, C. (2020) · Oncology Letters · doi:10.3892/ol.2020.11589 · Cited by 16
“malignancy of cancer cells during hypoxic stress that ultimately leads to poor clinical outcomes (10,11).”
BackgroundFUNDC1-mediated mitophagy in bovine papillomavirus-infected urothelial cells
Roperto, S., Russo, V., Falco, F. D., Rosati, A., Cătoi, C., & Roperto, F. P. (2019) · Veterinary Microbiology · doi:10.1016/j.vetmic.2019.05.017 · Cited by 15
Metadata
- Authors
- Daskalaki, I., Gkikas, I., & Tavernarakis, N.
- Affiliations
- University of Crete (GR)
- Corresponding author
- Tavernarakis, Nektarios
- Venue
- Frontiers in Cell and Developmental Biology
- Publisher
- Frontiers Media SA
- Published
- 2018-09-10
- Volume
- 6
- Pages
- 104-104
- ISSN
- 2296-634X (ISSN-L)
- PMC
- PMC6139351
- OpenAlex
- W2890767393
- Cited by
- 188
- References
- 216
- Citations by year
- 2026: 17 · 2025: 20 · 2024: 21 · 2023: 19 · 2022: 31 · 2021: 39 · 2020: 22 · 2019: 15 · 2018: 3
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Frontiers in Cell and Developmental Biology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- European Commission
- H2020 European Research Council (695190, 737599)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Autophagy in Disease and Therapy
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Hypoxia, and Metabolism
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Ubiquitin and proteasome pathways
- Keywords
- hypoxia, selective autophagy, cancer, hypoxia-inducible factor, unfolded protein response, mTOR, cancer metabolism, mitophagy, pexophagy, lipophagy, nucleophagy, metastasis, tumor cell survival
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