The analytical review examines the key elements of mitochondrial adaptations that occur in eukaryotes forced to live in hypoxic conditions for extended periods. In these organisms, mitochondria retain their activity, including synthetic, signaling, and, albeit to a lesser extent, bioenergetic functions. These adaptations, primarily characterized by the reversal of the succinate dehydrogenase reaction and the presence of low-potential quinone, enable the organisms to sustain energy production via mitochondrial Complex I. A comprehensive analysis of all changes induced by prolonged hypoxia allows for the development of anti-hypoxic strategies aimed at mitigating the effects of undesirable factors associated with hypoxic remodeling. On the other hand, understanding all elements of hypoxia-induced adaptations makes it possible to exploit them in combating solid tumor cells, which inhabit in an oxygen-deprived microenvironment.
D. B. Zorov (Wed,) studied this question.