Hypoxia/HIF1-α alters OXPHOS and mitochondrial metabolism in tumours by inducing Ku80, which binds and activates the pyruvate dehydrogenase kinase (PDK)1 promoter, thereby acting to inhibit the pyruvate dehydrogenase complex (PDC), in turn inhibiting the PDC conversion of pyruvate to acetyl-CoA, which is crucial to driving OXPHOS, the TCA cycle and the melatonergic pathway [46]. Here, PDC is linked to neoplasm.