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FIGURE 7 5.3.3 ROS-mediated activation of FoxO and initiation of protein degradation programs The forkhead box O (FoxO) transcription factors, particularly FoxO1 and FoxO3 in skeletal muscle, play a central role in regulating proteolysis by activating both the ubiquitin-proteasome system (UPS) and autophagy-lysosome system (ALS) (Oyabu et al., 2022)

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Conclusions We propose a predisposition to tissue fragility, particularly of the gastrointestinal tract in patients with clEDS