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Roxadustat as a HIF-1α Stabilizer for Anemia in Myelodysplastic Syndrome

Hypoxia-inducible factor (HIF) stabilization is a molecular mechanism in which oxygen-dependent degradation of HIF-1α is normally active under sufficient oxygen tension, but under hypoxic conditions HIF-1α escapes degradation, dimerizes with HIF-1β, and transcriptionally upregulates erythropoiesis-related genes; pharmacologic HIF stabilizers exploit this pathway to treat anemia by inducing endogenous erythropoietin production and suppressing hepcidin-mediated inflammatory iron restriction, offering a mechanism distinct from exogenous erythropoiesis-stimulating agents. This belongs to the domain of hematology/nephrology pharmacology, situated within the broader physiology of oxygen-sensing and erythropoiesis regulation.