Hypoxia Boosts Aerobic Glycolysis in Carcinoma: A Complex Process for Tumour Development

Hypoxia, a common feature of malignant tumours, is mainly caused by insufficient oxygen supply. Hypoxia is closely associated with cancer development, affecting cancer invasion, metastasis, energy metabolism, and other pathological processes, and is not conducive to cancer treatment and prognosis. Tumour cells exacerbate metabolic abnormalities to adapt to the hypoxic microenvironment, especially to enhance aerobic glycolysis. Glycolysis leads to an acidic microenvironment in cancer tissues, enhancing cancer metastasis, deterioration, and drug resistance. Therefore, hypoxia is a therapeutic target that cannot be ignored in cancer treatment. The adaptation of tumour cells to hypoxia is mainly regulated by hypoxia-inducible factors (HIFs), and the stability of HIFs is improved under hypoxic conditions. HIFs can promote glycolysis in tumours by regulating glycolytic enzymes, transporters, and the TCA cycle. In addition, HIFs indirectly affect glycolysis by interacting with non- coding RNAs. Therefore, targeting hypoxia and HIFs is important for tumour therapy.