2019 Nobel Prize in Physiology or Medicine

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Summary:
The Nobel Prize in Physiology or Medicine was awarded to three physician-scientists who discovered the molecular pathways by which cells sense and respond to changes in oxygen levels.
Today, the 2019 Nobel Prize in Physiology or Medicine was awarded to three scientists who study how cells sense and respond to changes in oxygen levels:
The 2019 Nobel Prize in Physiology or Medicine is awarded jointly to William G. Kaelin Jr, Sir Peter J. Ratcliffe and Gregg L. Semenza “for their discoveries of how cells sense and adapt to oxygen availability.” They identified molecular machinery that regulates the activity of genes in response to varying levels of oxygen.
https://www.nobelprize.org/prizes/medicine/
These three scientists were previously awarded the Lasker Prize for Basic Medical Research in 2016 for these discoveries.

In particular, Semenza discovered a transcription factor HIF (hypoxia inducible factor) that is important for activating many genes that help cells adapt to changes in oxygen levels, like EPO. Kaelin and Ratcliffe later discovered some of the molecular pathways that help regulate HIF activation, involving dioxygenase enzymes that react HIF with oxygen (when oxygen levels are high enough) to ultimately result in the destruction of the HIF protein.

HIF and the broader molecular pathways that sense and respond to oxygen levels are important in a number of biological processes. For example, HIF and other factors involved in the response to hypoxia (low oxygen levels) are important for understanding processes that occur during tumor growth and the progression of cancer. As tumors grow, cells at the center become cut off from the blood vessels that deliver oxygen to a tissue and become hypoxic. HIF activation, combined with other molecular and genetic changes in these cells, alters these cells and can contribute to the continued growth of the tumor. For example, scientists have found that an important step in the progression of cancer is having these cells promote the growth of blood vessels into the tumor through a process called angiogenesis.

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