Regulation of glucose uptake and inflammation markers by FOXO1 and FOXO3 in skeletal muscle

Leonidas S. Lundell, Julie Massart, Ali Altıntaş, Anna Krook, Juleen R. Zierath

Skeletal muscle is the main insulin-sensitive tissue for postprandial glucose disposal and for the oxidation of glucose- and lipid-based fuels. Forkhead box (FOXO) proteins play a role in the regulation of energy metabolism. However, the role of specific FOXO isoforms in metabolic homeostasis in skeletal muscle remains unclear. Lundell et al. reveal that FOXO1 and FOXO3 transcriptional activity is necessary for the regulation of glucose handling and control of inflammatory signaling in mature skeletal muscle.

Objective: Forkhead box class O (FOXO) transcription factors regulate whole body energy metabolism, skeletal muscle mass, and substrate switching. FOXO1 and FOXO3 are highly abundant transcription factors, but their precise role in skeletal muscle metabolism has not been fully elucidated.

Methods: To elucidate the role of FOXO in skeletal muscle, dominant negative (dn) constructs for FOXO1 (FOXO1dn) or FOXO3 (FOXO3dn) were transfected by electroporation into mouse tibialis anterior muscle and glucose uptake, signal transduction, and gene expression profiles were assessed after an oral glucose tolerance test. Results were compared against contralateral control transfected muscle.

Results: FOXO1dn and FOXO3dn attenuated glucose uptake (35%, p < 0.01 and 20%, p < 0.05), GLUT4 protein (40%, p < 0.05 and 10%, p < 0.05), and subunits of the oxidative phosphorylation cascade. Intramuscular glycogen content was decreased (20%, p < 0.05) by FOXO3dn, but not FOXO1dn. Transcriptomic analysis revealed major pathways affected by FOXO1dn or FOXO3dn revolve around metabolism and inflammation. FOXO1dn increased Akt protein (140%, p < 0.001), p-AktSer473 (720%, p < 0.05) and p-AktThr308 (570%, p < 0.01), whereas FOXO3dn was without effect. FOXO1dn and FOXO3dn increased mTOR protein content (170% and 190%, p < 0.05), and p-p70S6KThr389 (420%, p < 0.01 and 300%, p < 0.01), while p-mTORSer2448 (500%, p < 0.01), was only increased by FOXO1dn. Chemokines and immune cell markers were robustly upregulated in skeletal muscle following the FOXOdn transfections, but not after control transfection.

Conclusions: FOXO1 and FOXO3 regulate glucose metabolism and markers of inflammation in skeletal muscle, implicating transcriptional control governing “immunometabolic” dynamics.