Activation of the AMPK-FOXO3 pathway reduces fatty acid-induced increase in intracellular reactive oxygen species by upregulating thioredoxin

Diabetes. 2009 Oct;58(10):2246-57. doi: 10.2337/db08-1512. Epub 2009 Jul 10.


Objective: Oxidative stress induced by free fatty acids contributes to the development of cardiovascular diseases in patients with metabolic syndrome. Reducing oxidative stress may attenuate these pathogenic processes. Activation of AMP-activated protein kinase (AMPK) has been reported to reduce intracellular reactive oxygen species (ROS) levels. The thioredoxin (Trx) system is a major antioxidant system. In this study, we investigated the mechanisms involved in the AMPK-mediated regulation of Trx expression and the reduction of intracellular ROS levels.

Research design and methods: We observed that activation of AMPK by 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR) significantly reduced ROS levels induced by palmitic acid in human aortic endothelial cells. Activation of AMPK increased expression of the antioxidant Trx, which mediated the ROS reduction. RT-PCR showed that AMPK regulated Trx at the transcriptional level.

Results: Forkhead transcription factor 3 (FOXO3) was identified as the target transcription factor involved in the upregulation of Trx expression. FOXO3 bound to the Trx promoter, recruited the histone acetylase p300 to the Trx promoter, and formed a transcription activator complex, which was enhanced by AICAR treatment. AMPK activated FOXO3 by promoting its nuclear translocation. We further showed that AICAR injection increased the expression of Trx and decreased ROS production in the aortic wall of ApoE-/- mice fed a high-fat diet.

Conclusions: These results suggest that activation of the AMPK-FOXO3 pathway reduces ROS levels by inducing Trx expression. Thus, the AMPK-FOXO3-Trx axis may be an important defense mechanism against excessive ROS production induced by metabolic stress and could be a therapeutic target in treating cardiovascular diseases in metabolic syndrome.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AMP-Activated Protein Kinases / metabolism*
  • Aminoimidazole Carboxamide / analogs & derivatives
  • Aminoimidazole Carboxamide / pharmacology
  • Animals
  • Aorta
  • Apolipoproteins E / deficiency
  • Apolipoproteins E / genetics
  • DNA Primers
  • Endothelium, Vascular / drug effects
  • Endothelium, Vascular / metabolism*
  • Fatty Acids / pharmacology*
  • Forkhead Box Protein O3
  • Forkhead Transcription Factors / metabolism*
  • Humans
  • Male
  • Mice
  • Mice, Knockout
  • Palmitic Acid / pharmacology*
  • Plasmids / drug effects
  • RNA, Messenger / genetics
  • RNA, Small Interfering / genetics*
  • Reactive Oxygen Species / metabolism*
  • Reverse Transcriptase Polymerase Chain Reaction
  • Ribonucleotides / pharmacology
  • Thioredoxins / genetics*
  • Up-Regulation


  • Apolipoproteins E
  • DNA Primers
  • FOXO3 protein, human
  • Fatty Acids
  • Forkhead Box Protein O3
  • Forkhead Transcription Factors
  • RNA, Messenger
  • RNA, Small Interfering
  • Reactive Oxygen Species
  • Ribonucleotides
  • Palmitic Acid
  • Aminoimidazole Carboxamide
  • Thioredoxins
  • AMP-Activated Protein Kinases
  • AICA ribonucleotide