Joo et al. [23] found that hypoxia-activated Sirt1 directly binds to HIF-1α and performs its deacetylation in hypoxic cancer cells, which leads to both HIF-1α stabilization/accumulation and the expression of HIF-1α target genes such as VEGF, GLUT1 and MMP2; therefore, tumor cell adaptation to hypoxia and tumor invasion requires the hypoxia-responsive activation of Sirt1. The gene discussed is VEGFA; the disease is cancer.