Cited by 286Metabolism, Diabetes, and CancerMitochondrial Function and PathologySirtuins and Resveratrol in Medicine

The DOI matches its Crossref record; 275 of the 278 references it cites were found in a registry or an index; none of the 250 sources its claims cite is checked for support yet.

AMPK, Mitochondrial Function, and Cardiovascular Disease

Open access
Wu, Shengnan, Zou, Ming-Hui·2020·International Journal of Molecular Sciences

Abstract

Adenosine monophosphate-activated protein kinase (AMPK) is in charge of numerous catabolic and anabolic signaling pathways to sustain appropriate intracellular adenosine triphosphate levels in response to energetic and/or cellular stress. In addition to its conventional roles as an intracellular energy switch or fuel gauge, emerging research has shown that AMPK is also a redox sensor and modulator, playing pivotal roles in maintaining cardiovascular processes and inhibiting disease progression. Pharmacological reagents, including statins, metformin, berberine, polyphenol, and resveratrol, all of which are widely used therapeutics for cardiovascular disorders, appear to deliver their protective/therapeutic effects partially via AMPK signaling modulation. The functions of AMPK during health and disease are far from clear. Accumulating studies have demonstrated crosstalk between AMPK and mitochondria, such as AMPK regulation of mitochondrial homeostasis and mitochondrial dysfunction causing abnormal AMPK activity. In this review, we begin with the description of AMPK structure and regulation, and then focus on the recent advances toward understanding how mitochondrial dysfunction controls AMPK and how AMPK, as a central mediator of the cellular response to energetic stress, maintains mitochondrial homeostasis. Finally, we systemically review how dysfunctional AMPK contributes to the initiation and progression of cardiovascular diseases via the impact on mitochondrial function.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review argues that AMPK is both a redox sensor/modulator and a central regulator of mitochondrial homeostasis, with bidirectional crosstalk: mitochondrial dysfunction can alter AMPK activity, while AMPK controls mitochondrial biogenesis, dynamics, mitophagy, and Ca²⁺ handling. Dysregulated AMPK–mitochondria signaling contributes to cardiovascular disease, and drugs such as metformin, berberine, statins, polyphenols, and resveratrol may act partly through AMPK.

Key findings

  • AMPK is a heterotrimeric complex of α, β, and γ subunits; all isoform combinations produce 12 different AMPK complexes. It is activated by AMP/ADP and inhibited by ATP, with LKB1 and CAMKK2 as major upstream kinases; Thr172 phosphorylation increases AMPK activity about 100-fold, while allosteric regulation changes activity up to tenfold in mammalian cells and about twofold in recombinant bacterially produced AMPK.
  • AMPK functions as a redox sensor and antioxidant modulator: ROS/RNS can activate AMPK via energy stress and/or LKB1–CaMKK signaling, while activated AMPK suppresses mitochondrial and NOX-derived ROS and upregulates antioxidant genes including CAT, SOD1, SOD2, and UCP2, often through PGC1α.
  • AMPK regulates mitochondrial homeostasis by promoting mitochondrial biogenesis via PGC1α, controlling mitochondrial dynamics through MFF phosphorylation at Ser155/Ser173 and DRP1, regulating mitophagy through ULK1 and PINK1–PARKIN signaling, and modulating mitochondrial Ca²⁺ influx through MCU.
  • In cardiovascular disease, AMPK is generally protective across atherosclerosis, ischemia, ischemia/reperfusion injury, vascular calcification, neointimal hyperplasia, cardiac hypertrophy, diabetes, inflammation, and obesity; the review notes that reperfusion failure occurs in approximately 30% of patients with acute myocardial infarction and that ischemic heart disease accounted for 15.96% of total global deaths in 2017.

Methods

  • Not stated in the paper; the text is a narrative review that synthesizes cited literature rather than presenting original experimental data.
  • The review covers AMPK structure and regulation, redox regulation of AMPK, mitochondrial control of AMPK, AMPK regulation of mitochondrial homeostasis, and AMPK–mitochondria signaling in cardiovascular and cardio-metabolic diseases.
  • Main analysis is qualitative synthesis of mechanistic studies across cell, animal, and some human contexts; no systematic search strategy, inclusion criteria, or meta-analysis is described.

Limitations

  • Stated: the authors note that the functions of AMPK during health and disease are “far from clear” and that the interplay within the AMPK–mitochondrial axis during cardiovascular disease initiation and progression is poorly investigated.
  • Stated: limited evidence has focused on mitochondrial dynamics, mitochondrial biogenesis, and mitophagy, and the structural and functional changes to mitochondria under disease conditions remain “far beyond our current knowledge.”
  • Evident from the text: as a narrative review, it does not provide primary data, systematic evidence grading, or quantitative synthesis; many mechanistic conclusions are drawn from preclinical cell and animal models, with clinical evidence cited more selectively.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3390/ijms21144987

Cites

275 of 275 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 250 cited sources checked · 0 supported · 0 flagged

Show all 108 claims

  • It may state two separate claims as one. 71
  • Probably not a substantial claim. 21
86 of 86
  • The paper relies on this without support.

    Mitochondria are the primary source of ATP production in the cell.

    “Mitochondria are considered the primary source of ATP production in the cell.”
  • The paper relies on this without support.

    Mitochondrial dysfunction occurs in the development of many cardiovascular diseases owing to production of ROS beyond control.

    “Mitochondrial dysfunction occurs in the development of many CVDs such as atherosclerosis, ischemia-reperfusion (I/R) injury, hypertension, diabetes, cardiac hypertrophy, and heart failure (HF), owing to the production of ROS beyond control.”
  • The paper relies on this without support.

    AMPK is widely expressed in the cardiovascular system.

    “AMPK is widely expressed in the cardiovascular system.”
  • The paper relies on this without support.

    The α1 isoform predominates in VSMCs, ECs, adipocytes, and monocytes/macrophages, whereas cardiomyocytes express much higher amounts of the α2 isoform.

    “The α1 isoform predominates in VSMCs, ECs, adipocytes, and monocytes/macrophages, whereas cardiomyocytes express much higher amounts of the α2 isoform.”
  • The paper relies on this without support.

    Aberrant AMPK signaling is involved in the pathogenesis of various cardiovascular diseases, including hypertension, atherosclerosis, and stroke.

    “Moreover, aberrant AMPK signaling is involved in the pathogenesis of various CVDs, including hypertension, atherosclerosis, and stroke.”
  • The paper relies on this without support.

    Oxidative stress caused by risk factors represents a major contributor to endothelial dysfunction as a common predisposing condition to atherosclerosis.

    “Oxidative stress caused by risk factors represents a major contributor to endothelial dysfunction as a common predisposing condition to atherosclerosis.”
  • The paper relies on this without support.

    UCP2 appears to have a main function of controlling ROS generation in diabetes, obesity, and atherosclerosis.

    “It appears that UCP2 has a main function of controlling ROS generation in diabetes, obesity, and atherosclerosis, although it was originally considered as a modulator of nonshivering thermogenesis.”
  • The paper relies on this without support.

    Rapid Ca2+ influx into mitochondrial matrix occurs through the mitochondrial Ca2+ uniporter, a specific channel located at the inner mitochondrial membrane.

    “It is well established that rapid Ca2+ influx into mitochondrial matrix occurs through the mitochondrial Ca2+ uniporter (MCU), a specific channel located at the inner mitochondrial membrane.”
8 of 8

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Empagliflozin is said both to inhibit and to cause mitochondrial fission

    Minor

    The passage attributes empagliflozin's protective effect to inhibition of mitochondrial fission, but then says its associated phosphorylation changes ultimately lead to mitochondrial fission.

  • Melatonin is said both to prevent and to induce endothelial apoptosis

    Minor

    The paragraph first says melatonin protects endothelial cells against inflammation-mediated apoptosis, but its concluding sentence says melatonin induces that apoptosis.

  • MFF phosphorylation site differs between adjacent statements

    Minor

    One statement identifies Ser155 and Ser173 as the two MFF sites phosphorylated by AMPK; the next identifies Ser155 and Ser172. The second site is inconsistent.

3 of 3

Citations

Cites

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Metadata

Authors
Wu, S., & Zou, M.-H.
Affiliations
Georgia State University (US)
Corresponding author
Wu, Shengnan
Venue
International Journal of Molecular Sciences
Publisher
MDPI AG
Published
2020-07-15
Volume
21
Issue
14
Pages
4987
ISSN
1422-0067 (ISSN-L)
OpenAlex
W3043111807
Cited by
286
References
278
Citations by year
2026: 48 · 2025: 71 · 2024: 50 · 2023: 45 · 2022: 43 · 2021: 27 · 2020: 2
FWCI
2.80
Type
journal article
Language
en
Open access
Locations
  • International Journal of Molecular Sciences (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • American Heart Association (16POST29960011, 19CDA34760110)
  • Georgia Research Alliance
  • National Institutes of Health
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Mitochondrial Function and Pathology
  • Health Sciences › Medicine › Geriatrics and Gerontology › Sirtuins and Resveratrol in Medicine
Keywords
AMPK, mitochondrial dysfunction, mitochondrial homeostasis, cardiovascular disease, redox sensing, energy homeostasis, statins, metformin, berberine, polyphenols, resveratrol
MeSH terms
Adenosine Triphosphate, Animals, Cardiovascular Diseases, Energy Metabolism, Humans, Mitochondria, Reactive Oxygen Species, AMP-Activated Protein Kinases, Mitochondrial Turnover

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