HIF PHD inhibitors are a distinct class of chemical compounds designed to selectively inhibit the activity of the HIF prolyl hydroxylase domain (PHD) enzymes. These enzymes are dioxygenases that play a crucial role in the cellular response to oxygen levels. Under normoxic conditions, HIF PHD enzymes hydroxylate specific proline residues on the hypoxia-inducible factor (HIF), which is a transcription factor involved in the cellular adaptation to low oxygen conditions. The hydroxylation of HIF by PHD enzymes marks it for recognition and subsequent ubiquitination by the von Hippel-Lindau (VHL) E3 ubiquitin ligase complex, leading to its proteasomal degradation. HIF PHD inhibitors interfere with this process by binding to the catalytic domain of the PHD enzymes, thus preventing the post-translational modification of HIF and affecting its stability.The structural composition of HIF PHD inhibitors is tailored to the unique enzymatic pocket of the PHD enzymes, which requires a high degree of specificity to ensure the selective inhibition of the HIF hydroxylation process over other prolyl hydroxylases in the cell. These inhibitors typically mimic the transition state of the enzymatic reaction or compete with the natural substrates, such as 2-oxoglutarate, ferrous iron, and oxygen. The complexity of HIF PHD inhibitors' molecular design is underscored by the need to balance several physicochemical properties to achieve sufficient potency, selectivity, and suitable pharmacokinetic profiles.