Available structures
PDBOrtholog search: PDBe RCSB
Aliases FOXO1, FKH1, FKHR, FOXO1A, forkhead box O1
External IDs MGI: 1890077 HomoloGene: 1527 GeneCards: FOXO1
RNA expression pattern

More reference expression data
Species Human Mouse









RefSeq (mRNA)



RefSeq (protein)



Location (UCSC) Chr 13: 40.56 – 40.67 Mb Chr 3: 52.27 – 52.35 Mb
PubMed search [1] [2]
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Forkhead box protein O1 (FOXO1) also known as forkhead in rhabdomyosarcoma is a protein that in humans is encoded by the FOXO1 gene.[3] FOXO1 is a transcription factor that plays important roles in regulation of gluconeogenesis and glycogenolysis by insulin signaling, and is also central to the decision for a preadipocyte to commit to adipogenesis.[4] It is primarily regulated through phosphorylation on multiple residues; its transcriptional activity is dependent on its phosphorylation state.[5]

Mechanism of action

In its un-phosphorylated state, FOXO1 is localized to the nucleus, where it binds to the insulin response sequence located in the promoter for glucose 6-phosphatase and increases its rate of transcription. FOXO1, through increasing transcription of glucose-6-phosphatase, indirectly increases the rate of hepatic glucose production.[6] However, when FOXO1 is phosphorylated by Akt on Thr-24, Ser-256, and Ser-319, it is excluded from the nucleus, where it is then ubiquitinated and degraded. The phosphorylation of FOXO1 by Akt subsequently decreases the hepatic glucose production through a decrease in transcription of glucose 6-phosphatase.



FOXO1-dependent inhibition of adipogenesis

Recent research has demonstrated that FOXO1 also negatively regulates adipogenesis.[7] Presently, the exact mechanism by which this is accomplished is not entirely understood. In the currently accepted model, FOXO1 negatively regulates adipogenesis by binding to the promoter sites of PPARG and preventing its transcription. Rising levels of PPARG are required to initiate adipogenesis; by preventing its transcription, FOXO1 is preventing the onset of adipogenesis. During stimulation by insulin, FOXO1 is excluded from the nucleus and is subsequently unable to prevent transcription of PPARG and inhibit adipogenesis.[8] However, there is substantial evidence to suggest that there are other factors that mediate the interaction between FOXO1 and the PPARG promoter, and that inhibition of adipogenesis is not entirely dependent on FOXO1 preventing transcription of PPARG.[9] Other research demonstrates that the failure to commit to adipogenesis is primarily due to active FOXO1 arresting the cell in G0/G1 through activation of yet unknown downstream targets, with a putative target being SOD2.[10]

FOXO1 belongs to the forkhead family of transcription factors that are characterized by a distinct fork head domain. The specific function of this gene has not yet been determined; however, it may play a role in myogenic growth and differentiation.[11] FOXO1 is essential for the maintenance of human ESC pluripotency. This function is probably mediated through direct control by FOXO1 of OCT4 and SOX2 gene expression through occupation and activation of their respective promoters.[12] In hepatic cells this transcription factor seems to increase the expression of PEPCK and glycogen-6-phosphatase (the same enzymes that are blocked via the metformin/AMPK/SHP pathway). Blocking this transcription factor offers an opportunity for novel therapies for diabetes mellitus.[13] In pancreatic alpha-cells FOXO1 is important in regulating prepro-glucagon expression.[14] In pancreatic beta cells FOXO1 mediates glucagon-like peptide-1 effects on pancreatic beta-cell mass.[15]

Gluconeogenesis and glycogenolysis

Depicts insulin-regulated nuclear exclusion of FOXO1 and its effect on transcription of glucose-6 phosphatase

When the level of blood glucose is high, the pancreas releases insulin into the bloodstream. Insulin then causes the activation of PI3K, which subsequently phosphorylates Akt. Akt then phosphorylates FOXO1, causing nuclear exclusion. This phosphorylated FOXO1 is then ubiquitinated and degraded by the proteosome.[16] The phosphorylation of FOXO1 is irreversible; this prolongs insulin's inhibitory effect on glucose metabolism and hepatic glucose production. Transcription of glucose 6-phosphatase subsequently decreases, which consequently decreases the rates of gluconeogenesis and glycogenolysis.[17] Certain research groups have also recently suggested that FOXO1 also activates transcription of phosphoenolpyruvate carboxykinase, which is required for gluconeogenesis.[6] Recent research has demonstrated that the activity of FOXO1 is also regulated through CBP induced acetylation[18] on Lys-242, Lys-245, and Lys-262. These lysine residues are located within the DNA-binding domain; acetylation inhibits the ability of FOXO1 to interact with the glucose-6 phosphatase promoter by decreasing the stability of the FOXO1-DNA complex. Additionally, this acetylation increases the rate of phosphorylation on Ser-253 by Akt. Interestingly, mutating Ser-253 to Ala-253 makes FOXO1 constitutionally active. Further research has demonstrated that SIRT1 reverses this acetylation process; however, the exact mechanism by which SIRT1 deacetylates FOXO1 is still under investigation; presently, acetylation is thought to mitigate the transcriptional activity of FOXO1 and thereby provide an additional level of metabolic regulation that is independent of the insulin/PI3K pathway.[19]

Clinical significance

Because FOXO1 provides a link between transcription and metabolic control by insulin, it is also a potential target for genetic control of type 2 diabetes. In the insulin-resistant murine model, there is increased hepatic glucose production due to a loss in insulin sensitivity; the rates of hepatic gluconeogenesis and glycogenolysis are increased when compared to normal mice; this is presumably due to un-regulated FOXO1. When the same experiment was repeated with haploinsufficient FOXO1, insulin sensitivity was partially restored, and hepatic glucose production subsequently decreased.[20] Similarly, in mice fed with a high fat diet (HFD), there is increased insulin resistance in skeletal and liver cells. However, when haploinsufficient FOXO1 mice were treated with the same HFD, there was a notable decrease in insulin resistance in both skeletal and liver cells. This effect was significantly augmented by the simultaneous administration of rosiglitazone, which is a commonly prescribed anti-diabetic drug.[21] These results create an opportunity for a novel gene therapy based approach to alleviating insulin desensitization in type 2 diabetes. Current research is investigating the potential of combining FOXO1 and Notch-1 haploinsufficiency in mice; preliminary results suggest that in HFD-fed mice, the combination of FOXO1 and Notch-1 haploinsufficiency was more effective at restoring insulin sensitivity than FOXO1 haploinsufficiency alone.[22] Translocation of this gene with PAX3 has been associated with alveolar rhabdomyosarcoma.[3][23]


FOXO1 has been shown to interact with:


  1. "Human PubMed Reference:".
  2. "Mouse PubMed Reference:".
  3. 1 2 Galili N, Davis RJ, Fredericks WJ, Mukhopadhyay S, Rauscher FJ, Emanuel BS, Rovera G, Barr FG (November 1993). "Fusion of a fork head domain gene to PAX3 in the solid tumour alveolar rhabdomyosarcoma". Nat. Genet. 5 (3): 230–5. doi:10.1038/ng1193-230. PMID 8275086.
  4. Nakae J, Kitamura T, Kitamura Y, Biggs WH, Arden KC, Accili D (January 2003). "The forkhead transcription factor Foxo1 regulates adipocyte differentiation". Dev. Cell. 4 (1): 119–29. doi:10.1016/S1534-5807(02)00401-X. PMID 12530968.
  5. Rena G, Guo S, Cichy SC, Unterman TG, Cohen P (June 1999). "Phosphorylation of the transcription factor forkhead family member FKHR by protein kinase B". J. Biol. Chem. 274 (24): 17179–83. doi:10.1074/jbc.274.24.17179. PMID 10358075.
  6. 1 2 Nakae J, Kitamura T, Silver DL, Accili D (November 2001). "The forkhead transcription factor Foxo1 (Fkhr) confers insulin sensitivity onto glucose-6-phosphatase expression". J. Clin. Invest. 108 (9): 1359–67. doi:10.1172/JCI12876. PMC 209440Freely accessible. PMID 11696581.
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  8. Armoni M, Harel C, Karni S, Chen H, Bar-Yoseph F, Ver MR, Quon MJ, Karnieli E (July 2006). "FOXO1 represses peroxisome proliferator-activated receptor-gamma1 and -gamma2 gene promoters in primary adipocytes. A novel paradigm to increase insulin sensitivity". J. Biol. Chem. 281 (29): 19881–91. doi:10.1074/jbc.M600320200. PMID 16670091.
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  14. McKinnon CM, Ravier MA, Rutter GA (December 2006). "FoxO1 is required for the regulation of preproglucagon gene expression by insulin in pancreatic alphaTC1-9 cells". J. Biol. Chem. 281 (51): 39358–69. doi:10.1074/jbc.M605022200. PMID 17062568.
  15. Buteau J, Spatz ML, Accili D (May 2006). "Transcription factor FoxO1 mediates glucagon-like peptide-1 effects on pancreatic beta-cell mass". Diabetes. 55 (5): 1190–6. doi:10.2337/db05-0825. PMID 16644672.
  16. Matsuzaki H, Daitoku H, Hatta M, Tanaka K, Fukamizu A (September 2003). "Insulin-induced phosphorylation of FKHR (Foxo1) targets to proteasomal degradation". Proc. Natl. Acad. Sci. U.S.A. 100 (20): 11285–90. doi:10.1073/pnas.1934283100. PMC 208749Freely accessible. PMID 13679577.
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  18. Matsuzaki H, Daitoku H, Hatta M, Aoyama H, Yoshimochi K, Fukamizu A (August 2005). "Acetylation of Foxo1 alters its DNA-binding ability and sensitivity to phosphorylation". Proc. Natl. Acad. Sci. U.S.A. 102 (32): 11278–83. doi:10.1073/pnas.0502738102. PMC 1183558Freely accessible. PMID 16076959.
  19. Jing E, Gesta S, Kahn CR (August 2007). "SIRT2 regulates adipocyte differentiation through FoxO1 acetylation/deacetylation". Cell Metab. 6 (2): 105–14. doi:10.1016/j.cmet.2007.07.003. PMC 2083635Freely accessible. PMID 17681146.
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