The enzymes involved are prolyl hydroxylases
and lysyl hydroxylase and the reactions require [O.
Berchner-Pfannschmidt, "Role of reactive oxygen species in the regulation of HIF-1 by prolyl hydroxylase
2 under mild hypoxia," Free Radical Research, vol.
Cellular oxygen sensing: crystal structure of hypoxia-inducible factor prolyl hydroxylase
(PHD2)," Proceedings of the National Academy of Sciences of the United States of America, vol.
A Rieske-type [2Fe-2S] cluster serves as an electron-transferring cofactor, and a mononuclear iron site is the putative site for substrate oxygenation, similar to that predicted in prolyl hydroxylases
domain (PHD) enzymes] (Batie and Ballou 1990).
According to the companies, Roxadustat is a hypoxia-inducible factor prolyl hydroxylase
inhibitor (HIF-PHI) that acts by stimulating the body's natural pathway of red blood cell production, or erythropoiesis.
The product is aimed at stabilising hypoxia inducible factor, a transcription factor that regulates the expression of genes involved with red blood cell production in response to changes in oxygen levels, by inhibiting the HIF prolyl hydroxylase