Mouse Genetic Models Used to Investigate the Roles of Nrf2 in the Kidney Systemic Nrf2 knockout (Nrf2-KO) mice exhibit no abnormalities at birth, during growth, with fertility or throughout their lifespan under normal conditions [32], whereas analyses of Nrf2-KO mice with various disease models have demonstrated that Nrf2 plays protective roles against respiratory disease [33,34,35,36], cardiac disease [37], neurological disease [38,39], diabetes mellitus [40,41,42,43], obesity [44], sickle-cell disease [45], inflammation [46,47], infection [48], liver disease [49,50,51,52] and sensory organ diseases [53,54,55]

1 Introduction The tumor microenvironment (TME) is a complex and dynamic ecosystem composed of cancer cells, stromal elements, immune infiltrates, blood vessels, and extracellular matrix components ( This oxygen deficiency activates a range of cellular adaptive mechanisms, orchestrated primarily through hypoxia-inducible factors (HIFs), particularly HIF-1 and HIF-2 ( Figure 1 ) ( Figure 2 ) ( Figure 1 Figure 2 Importantly, hypoxia-induced metabolic reprogramming not only promotes cancer cell survival but also actively contributes to immune evasion, therapeutic resistance, and a more aggressive phenotype ( Recent advances in multi-omics, single-cell analysis, and imaging technologies have deepened our understanding of the hypoxic tumor landscape and revealed novel metabolic vulnerabilities ( This review provides a comprehensive overview of the hypoxic microenvironment in cancer, with a particular focus on its role in metabolic reprogramming

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