In addition, hypoxia, acidity, and metabolite buildup within the tumor microenvironment may affect the level of succinyl-CoA and regulate the activity of enzymes in the succinylation pathway, including SIRT5, KAT2A, and CPT1A[74,81,202], constructing a dynamic network of enzymatic modification impacting tumor development. This evidence concerns the gene SIRT5 and neoplasm.