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Updated: Feb 24, 2026

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Published on: August 20, 2019
Atorvastatin prevents endothelial dysfunction in high glucose condition through Skp2-mediated degradation of FOXO1
Jonghanne Park1, Injoo Hwang2, Sung-Jean Kim3
1National Research Laboratory for Stem Cell Niche, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea; Strategic Center of CBT (Cell & Bio Therapy) for Heart, Diabetes, & Cancer, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea; Cardiovascular Center & Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
Objective:
The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor atorvastatin has been reported to exert vasculo-protective action in diabetes. We investigated the vasculo-protective mechanism of atorvastatin by evaluating its effect on two major pathogenic molecules, FOXO1 and ICAM1, mediated by S-phase kinase-associated protein 2 (Skp2) in diabetic endothelial dysfunction. APPROACH AND RESULTS: [1] FOXO1: Hyperglycemic condition increased FOXO1 protein level in endothelial cells, which was reversed by atorvastatin. This atorvastatin effect was obliterated by treatment of protease inhibitor, suggesting that atorvastatin induces degradation of FOXO1. Immunoprecipitation showed that atorvastatin facilitated the binding of Skp2 to FOXO1, leading to ubiquitination and degradation of FOXO1. [2] ICAM-1: Increased ICAM1 in high glucose condition was reduced by atorvastatin. But this effect of atorvastatin was obliterated when Skp2 was inhibited, suggesting that atorvastatin enhances binding of Skp2 to ICAM1 leading to degradation. Actually, ubiquitination and degradation of ICAM-1 were reduced when Skp2 was inhibited. In vitro monocyte adhesion assay revealed that atorvastatin reduced monocyte adhesion on endothelial cells in high glucose condition, which was reversed by Skp2 knock-down.
Conclusion:
Atorvastatin strengthens Skp2 binding to FOXO1 or ICAM1, leading to ubiquitination and degradation. Skp2-dependent ubiquitination of major pathogenic molecules is the key mechanism for statin's protective effect on endothelial function in diabetes.
Insights
Atorvastatin protects blood vessels in diabetes by promoting the degradation of harmful proteins FOXO1 and ICAM1. This action is mediated by S-phase kinase-associated protein 2 (Skp2), enhancing endothelial function.
Area of Science:
- Biochemistry
- Cardiovascular Research
- Molecular Biology
Background:
- Diabetic endothelial dysfunction is a major complication.
- Atorvastatin, a statin, shows potential vasculo-protective effects in diabetes.
- Key pathogenic molecules like FOXO1 and ICAM1 contribute to endothelial dysfunction.
Purpose of the Study:
- To investigate the vasculo-protective mechanism of atorvastatin in diabetic endothelial dysfunction.
- To evaluate the role of S-phase kinase-associated protein 2 (Skp2) in mediating atorvastatin's effects.
- To assess atorvastatin's impact on FOXO1 and ICAM1 levels and function.
Main Methods:
- Utilized endothelial cells under hyperglycemic conditions.
- Administered atorvastatin and protease inhibitors.
- Performed immunoprecipitation to assess protein binding and ubiquitination.
- Conducted in vitro monocyte adhesion assays.
- Investigated the effects of Skp2 inhibition and knockdown.
Main Results:
- Atorvastatin reduced FOXO1 protein levels by promoting its degradation via Skp2.
- Atorvastatin decreased ICAM1 levels by enhancing its Skp2-mediated degradation.
- Skp2 inhibition or knockdown reversed atorvastatin's beneficial effects on FOXO1, ICAM1, and monocyte adhesion.
- Atorvastatin reduced high glucose-induced monocyte adhesion to endothelial cells.
Conclusions:
- Atorvastatin enhances the binding of Skp2 to FOXO1 and ICAM1, leading to their ubiquitination and degradation.
- Skp2-dependent ubiquitination of pathogenic molecules is a critical mechanism for atorvastatin's protective effects on endothelial function in diabetes.
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