Role of Forkhead Transcription Factors in Myocardial Ischemic Reperfusion Injury in Diabetes

Diabetes, characterized by hyperglycemia resulting from either insulin deficiency or insulin resistance, is a chronic metabolic disorder. Hearts of subjects with diabetes are more sensitive to myocardial ischemia/reperfusion injury but the underlying mechanism is largely unclear. Recent evidence suggests that alteration in cardiac metabolism is a key contributor to the increased vulnerability of diabetic heart to ischemia/reperfusion injury. The FoxO family of forkhead transcription factors including FoxO1, 3 and 4 play important roles in the regulation of many cellular and biological processes and are critical regulators of cardiac metabolism and cellular oxidative stress in the heart. This brief review focuses on the role of FoxO in regulating cardiac metabolism and its association with myocardial ischemia/reperfusion injury, especially in diabetes.