# LKB1–AMPK Signaling Pathway in Cardiovascular and Other Diseases

**Authors:** Zhuo Chen, Qin Yang, Guo‐Wei He

PMC · DOI: 10.1002/mco2.70601 · MedComm · 2026-02-24

## TL;DR

The LKB1–AMPK pathway regulates energy balance and is linked to many diseases, including heart, metabolic, neurological, and cancer conditions.

## Contribution

This review systematically explores the LKB1–AMPK pathway's role in multiple diseases and highlights emerging therapeutic strategies.

## Key findings

- Dysfunction of the LKB1–AMPK pathway contributes to cardiovascular and metabolic diseases.
- LKB1 mutations drive tumorigenesis and affect cancer treatment responses.
- AMPK activators and gene therapies show promise but face challenges like tissue specificity.

## Abstract

The LKB1–AMPK signaling pathway is a master regulator of cellular energy homeostasis and a central hub in stress adaptation. As a conserved metabolic sensor, this pathway coordinates glucose, lipid, and protein metabolism, thereby sustaining physiological function across diverse tissues. Beyond its canonical role in energy balance, growing evidence highlights its dysregulation in multiple pathological conditions. Despite extensive mechanistic studies, the disease‐specific regulation and translational potential of the LKB1–AMPK pathway remain incompletely understood. This review systematically studies the molecular basis and regulatory mechanisms of LKB1–AMPK signaling in cardiovascular diseases—including atrial fibrillation, ventricular fibrillation, myocardial infarction, cardiac hypertrophy, heart failure, and atherosclerosis—where impaired pathway activity underlies energy deficits, fibrosis, oxidative stress, and arrhythmogenesis. We further explore its involvement in metabolic disorders such as diabetes and diabetic nephropathy, in neurodegenerative diseases like Alzheimer's and Parkinson's disease, and in oncology, where LKB1 mutations drive tumorigenesis and alter therapeutic responses. Emerging strategies, including metformin, novel AMPK activators, and LKB1‐based gene therapies, are highlighted as promising yet challenged by tissue specificity, off‐target effects, and genetic variation. By integrating insights from cardiovascular, metabolic, neurological, and oncological research, this review underscores the pathway's potential as both a biomarker source and therapeutic target, providing a foundation for precision medicine in complex diseases.

The LKB1–AMPK pathway has a central regulatory role in various diseases. Dysfunction of this pathway can lead to pathological processes in cardiovascular diseases (atrial fibrillation, myocardial infarction, myocardial hypertrophy, atherosclerosis), metabolic diseases (diabetes and kidney disease), neurodegenerative diseases (Alzheimer's disease, Parkinson's disease), and tumors (LKB1 mutation‐driven metabolic reprogramming).

## Linked entities

- **Genes:** STK11 (serine/threonine kinase 11) [NCBI Gene 6794], PRKAA1 (protein kinase AMP-activated catalytic subunit alpha 1) [NCBI Gene 5562]
- **Chemicals:** metformin (PubChem CID 4091)
- **Diseases:** atrial fibrillation (MONDO:0004981), ventricular fibrillation (MONDO:0000190), myocardial infarction (MONDO:0005068), heart failure (MONDO:0005252), atherosclerosis (MONDO:0005311), diabetes (MONDO:0005015), diabetic nephropathy (MONDO:0005016), Alzheimer's disease (MONDO:0004975), Parkinson's disease (MONDO:0005180)

## Full-text entities

- **Genes:** Psen1 (presenilin 1) [NCBI Gene 19164] {aka Ad3h, PS-1, PS1, S182}, CAMKK2 (calcium/calmodulin dependent protein kinase kinase 2) [NCBI Gene 10645] {aka CAMKK, CAMKKB}, MTOR (mechanistic target of rapamycin kinase) [NCBI Gene 2475] {aka FRAP, FRAP1, FRAP2, RAFT1, RAPT1, SKS}, RYR2 (ryanodine receptor 2) [NCBI Gene 6262] {aka ARVC2, ARVD2, RYR-2, RyR, VACRDS, VTSIP}, IRS2 (insulin receptor substrate 2) [NCBI Gene 8660] {aka IRS-2}, SIRT2 (sirtuin 2) [NCBI Gene 22933] {aka SIR2, SIR2L, SIR2L2}, Btk (Bruton tyrosine kinase) [NCBI Gene 367901], GDF15 (growth differentiation factor 15) [NCBI Gene 9518] {aka GDF-15, HG, MIC-1, MIC1, NAG-1, PDF}, TTK (TTK protein kinase) [NCBI Gene 7272] {aka CT96, ESK, MPH1, MPS1, MPS1L1, PYT}, SLC5A2 (solute carrier family 5 member 2) [NCBI Gene 6524] {aka SGLT2}, PPARA (peroxisome proliferator activated receptor alpha) [NCBI Gene 5465] {aka NR1C1, PPAR, PPAR-alpha, PPARalpha, hPPAR}, PRKN (parkin RBR E3 ubiquitin protein ligase) [NCBI Gene 5071] {aka AR-JP, LPRS2, PARK2, PDJ}, Stk11 (serine/threonine kinase 11) [NCBI Gene 20869] {aka Lkb1, Par-4}, SLC12A3 (solute carrier family 12 member 3) [NCBI Gene 6559] {aka NCC, NCCT, TSC}, IGF1R (insulin like growth factor 1 receptor) [NCBI Gene 3480] {aka CD221, IGFIR, IGFR, JTK13}, SLC2A14 (solute carrier family 2 member 14) [NCBI Gene 144195] {aka GLUT14, SLC2A3P3}, SRC (SRC proto-oncogene, non-receptor tyrosine kinase) [NCBI Gene 6714] {aka ASV, SRC1, THC6, c-SRC, p60-Src}, MELK (maternal embryonic leucine zipper kinase) [NCBI Gene 9833] {aka HPK38}, Gja1 (gap junction protein, alpha 1) [NCBI Gene 14609] {aka Cnx43, Cx43, Cx43alpha1, Cxnk1, Gja-1, Npm1}, STK11 (serine/threonine kinase 11) [NCBI Gene 6794] {aka LKB1, PJS, hLKB1}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, CPT1A (carnitine palmitoyltransferase 1A) [NCBI Gene 1374] {aka CPT I, CPT1, CPT1-L, CPTI-L, L-CPT1}, WDR24 (WD repeat domain 24) [NCBI Gene 84219] {aka C16orf21, JFP7}, NFE2L2 (NFE2 like bZIP transcription factor 2) [NCBI Gene 4780] {aka IMDDHH, NRF2, Nrf-2}, Nlrp3 (NLR family, pyrin domain containing 3) [NCBI Gene 216799] {aka AGTAVPRL, AII/AVP, Cias1, FCAS, FCU, MWS}, KRAS (KRAS proto-oncogene, GTPase) [NCBI Gene 3845] {aka 'C-K-RAS, C-K-RAS, CFC2, K-RAS2A, K-RAS2B, K-RAS4A}, IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, PYCARD (PYD and CARD domain containing) [NCBI Gene 29108] {aka ASC, CARD5, TMS, TMS-1, TMS1}, SLC2A4 (solute carrier family 2 member 4) [NCBI Gene 6517] {aka GLUT4}, TSC2 (TSC complex subunit 2) [NCBI Gene 7249] {aka LAM, PPP1R160, TSC4}, Adipoq (adiponectin, C1Q and collagen domain containing) [NCBI Gene 11450] {aka 30kDa, APN, Acdc, Acrp30, Ad, Adid}, SLC7A1 (solute carrier family 7 member 1) [NCBI Gene 6541] {aka ATRC1, CAT-1, ERR, HCAT1, REC1L}, RPS6KB1 (ribosomal protein S6 kinase B1) [NCBI Gene 6198] {aka PS6K, S6K, S6K-beta-1, S6K1, STK14A, p70 S6KA}, PFKFB3 (6-phosphofructo-2-kinase/fructose-2,6-biphosphatase 3) [NCBI Gene 5209] {aka IPFK2, PFK2, iPFK-2}, PRKAA1 (protein kinase AMP-activated catalytic subunit alpha 1) [NCBI Gene 5562] {aka AMPK, AMPK alpha 1, AMPKa1}, Ulk1 (unc-51 like kinase 1) [NCBI Gene 22241] {aka Unc51.1, mKIAA0722}, INS (insulin) [NCBI Gene 3630] {aka IDDM, IDDM1, IDDM2, ILPR, IRDN, MODY10}, FGF21 (fibroblast growth factor 21) [NCBI Gene 26291], ULK1 (unc-51 like autophagy activating kinase 1) [NCBI Gene 8408] {aka ATG1, ATG1A, UNC51, Unc51.1, hATG1}, Prkaa1 (protein kinase, AMP-activated, alpha 1 catalytic subunit) [NCBI Gene 105787] {aka AMPKalpha1, C130083N04Rik}, SNRK (SNF related kinase) [NCBI Gene 54861] {aka HSNFRK}, KLF4 (KLF transcription factor 4) [NCBI Gene 9314] {aka EZF, GKLF}, TBC1D1 (TBC1 domain family member 1) [NCBI Gene 23216] {aka TBC, TBC1}, SNCA (synuclein alpha) [NCBI Gene 6622] {aka NACP, PARK1, PARK4, PD1}, GPX4 (glutathione peroxidase 4) [NCBI Gene 2879] {aka GPx-4, GSHPx-4, MCSP, PHGPx, SMDS, snGPx}, PRKAA2 (protein kinase AMP-activated catalytic subunit alpha 2) [NCBI Gene 5563] {aka AMPK, AMPK2, AMPKa2, PRKAA}, PRKAB1 (protein kinase AMP-activated non-catalytic subunit beta 1) [NCBI Gene 5564] {aka AMPK, HAMPKb}, Prkaa2 (protein kinase AMP-activated catalytic subunit alpha 2) [NCBI Gene 78975] {aka Ampk, Ampka2}, CD274 (CD274 molecule) [NCBI Gene 29126] {aka ADMIO5, B7-H, B7H1, PD-L1, PDCD1L1, PDCD1LG1}, PPARGC1A (PPARG coactivator 1 alpha) [NCBI Gene 10891] {aka LEM6, PGC-1(alpha), PGC-1alpha, PGC-1v, PGC1, PGC1A}, PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha) [NCBI Gene 5290] {aka CCM4, CLAPO, CLOVE, CWS5, HMH, MCAP}, Glp1r (glucagon-like peptide 1 receptor) [NCBI Gene 14652] {aka GLP-1R, GLP1Rc}, BTK (Bruton tyrosine kinase) [NCBI Gene 695] {aka AGMX1, AT, ATK, BPK, IGHD3, IMD1}, STK39 (serine/threonine kinase 39) [NCBI Gene 27347] {aka DCHT, SPAK}, INSR (insulin receptor) [NCBI Gene 3643] {aka CD220, HHF5}, MAP2K7 (mitogen-activated protein kinase kinase 7) [NCBI Gene 5609] {aka JNKK2, MAPKK7, MEK, MEK 7, MKK7, PRKMK7}, NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, App (amyloid beta precursor protein) [NCBI Gene 11820] {aka Abeta, Abpp, Adap, Ag, Cvap, E030013M08Rik}, LGALS3 (galectin 3) [NCBI Gene 3958] {aka CBP35, GAL3, GALBP, GALIG, L31, LGALS2}, BCL2A1 (BCL2 related protein A1) [NCBI Gene 597] {aka ACC-1, ACC-2, ACC1, ACC2, BCL2L5, BFL1}
- **Diseases:** malnutrition (MESH:D044342), abnormal action potential repolarization (MESH:D009207), Cowden disease (MESH:D006223), EndMT (MESH:D008579), tumorigenic (MESH:D002471), hypertension (MESH:D006973), Atherosclerosis (MESH:D050197), mitochondrial damage (MESH:D028361), pulmonary arterial hypertension (MESH:D000081029), Alzheimer's and Parkinson's disease (MESH:D010300), inflammation (MESH:D007249), steatotic liver disease (MESH:D008107), atrial disease (MESH:D004194), cardiovascular, metabolic, neurodegenerative, and oncological diseases (MESH:D019636), reperfusion injury (MESH:D015427), Metabolic Syndrome (MESH:D024821), cerebral hypoperfusion (MESH:D002547), atrial fibrosis (MESH:D005355), weight loss (MESH:D015431), toxicities (MESH:D064420), Vascular Dysfunction (MESH:D002561), hepatic and pancreatic insulin resistance (MESH:D007333), neuroinflammation (MESH:D000090862), chronic kidney disease (MESH:D051436), congenital heart disease (MESH:D006330), NAFLD (MESH:D065626), Cardiovascular Diseases (MESH:D002318), lung cancer (MESH:D008175), impaired (MESH:D060825), AD (MESH:D000544), MI (MESH:D009203), Tumor (MESH:D009369), calcification (MESH:D002114), lactic acidosis (MESH:D000140), cardiac insufficiency (MESH:D000309), valvular calcification (MESH:D006349), von Hippel-Lindau syndrome (MESH:D006623), AF (MESH:D001281), endothelial dysfunction (MESH:D014652), ischemic (MESH:D002545), diabetes (MESH:D003920), hypertrophy (MESH:D006984), gastrointestinal intolerance (MESH:D005767), Cardiac Hypertrophy (MESH:D006332), cachexia (MESH:D002100), fatigue (MESH:D005221), hypokalemia (MESH:D007008), Peutz-Jeghers syndrome (MESH:D010580), tumorigenesis (MESH:D063646), associated (MESH:D018886), myocardial dysfunction (MESH:D006331), stroke (MESH:D020521), calcium handling disorders (MESH:C562385), energy deficiency (MESH:D011502), amyloid (MESH:C000718787), arrhythmic drugs (MESH:D000081015), Type 2 Diabetes (MESH:D003924), hepatic steatosis (MESH:D005234), arteriovenous malformations (MESH:D001165), impaired kidney function (MESH:D007674)
- **Chemicals:** salt (MESH:D012492), Phenformin (MESH:D010629), Na+ (MESH:D012964), MK-8722 (MESH:C000625840), succinate (MESH:D019802), pyruvate (MESH:D019289), acarbose (MESH:D020909), beta-hydroxybutyrate (MESH:D020155), ADaM (-), NO (MESH:D009614), ADP (MESH:D000244), PF-06409577 (MESH:C000617640), fatty acid (MESH:D005227), salicylate (MESH:D012459), dapagliflozin (MESH:C529054), ginsenoside Rh4 (MESH:C101280), Crocetin (MESH:C487773), AICAR (MESH:C031143), NADPH (MESH:D009249), glycogen (MESH:D006003), lipid (MESH:D008055), malonyl-CoA (MESH:D008316), empagliflozin (MESH:C570240), AGEs (MESH:D017127), canagliflozin (MESH:D000068896), ATP (MESH:D000255), AMP (MESH:D000249), metformin (MESH:D008687), ibrutinib (MESH:C551803), cholesterol (MESH:D002784), nitric oxide (MESH:D009569), ketone bodies (MESH:D007657), glucose (MESH:D005947), PXL770 (MESH:C000719997), ROS (MESH:D017382), berberine (MESH:D001599), calcium (MESH:D002118)
- **Species:** Homo sapiens (human, species) [taxon 9606], Rattus norvegicus (brown rat, species) [taxon 10116], Mus musculus (house mouse, species) [taxon 10090]

## Full text

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## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12932976/full.md

## References

176 references — full list in the complete paper: https://tomesphere.com/paper/PMC12932976/full.md

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Source: https://tomesphere.com/paper/PMC12932976