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RefSeq (mRNA)



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Forkhead box protein C2 (FOXC2) also known as forkhead-related protein FKHL14 (FKHL14), transcription factor FKH-14, or mesenchyme fork head protein 1 (MFH1) is a protein that in humans is encoded by the FOXC2 gene.[1][2] FOXC2 is a member of the fork head box (FOX) family of transcription factors.

Structure and function

The protein is 501 amino acids in length. The gene has no introns; the single exon is approximately 1.5kb in size.[2][3]

FOX transcription factors are expressed during development and are associated with a number of cellular and developmental differentiation processes. FOXC2 is required during early development of the kidneys, including differentiation of podocytes and maturation of the glomerular basement membrane. It is also involved in the early development of the heart.[4]

An increased expression of FOXC2 in adipocytes can increase the amount of brown adipose tissue leading to lower weight and an increased sensitivity to insulin.[5][6]

Role in disease

Absence of FOXC2 has been shown to lead to the failure of lymphatic valves to form and problems with lymphatic remodelling. A number of mutations in the FOXC2 gene have been associated with Lymphedema–distichiasis syndrome,[7][8] It has also been suggested that there may be a link between polymorphisms in FOXC2 and varicose veins.[8] [9]

FOXC2 is also involved in cancer metastases. In particular, expression of FOXC2 is induced when epithelial cells undergo an epithelial-mesenchymal transition (EMT) and become mesenchymal looking cells. EMT can be induced by a number of genes including Snail, Twist, Goosecoid, and TGF-beta 1.[10] Overexpression of FOXC2 has been noted in subtypes of breast cancer which are highly metastatic.[4] Suppression of FOXC2 expression using shRNA in a highly metastatic breast cancer model blocks their metastatic ability.[11]


  1. Kaestner KH, Bleckmann SC, Monaghan AP, Schlöndorff J, Mincheva A, Lichter P, Schütz G (June 1996). "Clustered arrangement of winged helix genes fkh-6 and MFH-1: possible implications for mesoderm development". Development. 122 (6): 1751–8. PMID 8674414.
  2. 2.0 2.1 Miura N, Iida K, Kakinuma H, Yang XL, Sugiyama T (May 1997). "Isolation of the mouse (MFH-1) and human (FKHL 14) mesenchyme fork head-1 genes reveals conservation of their gene and protein structures". Genomics. 41 (3): 489–92. doi:10.1006/geno.1997.4695. PMID 9169153.
  3. Fang J, Dagenais SL, Erickson RP, Arlt MF, Glynn MW, Gorski JL, Seaver LH, Glover TW (Dec 2000). "Mutations in FOXC2 (MFH-1), a forkhead family transcription factor, are responsible for the hereditary lymphedema-distichiasis syndrome". Am J Hum Genet. 67 (6): 1382–8. doi:10.1086/316915. PMC 1287915. PMID 11078474.
  4. 4.0 4.1 Hader C, Marlier A, Cantley L (2010). "Mesenchymal-epithelial transition in epithelial response to injury: the role of Foxc2". Oncogene. 29 (7): 1031–40. doi:10.1038/onc.2009.397. PMC 2824778. PMID 19935708.
  5. Lidell ME, Seifert EL, Westergren R, Heglind M, Gowing A, Sukonina V, Arani Z, Itkonen P, Wallin S, Westberg F, Fernandez-Rodriguez J, Laakso M, Nilsson T, Peng XR, Harper ME, Enerbäck S (Feb 2011). "The adipocyte-expressed forkhead transcription factor Foxc2 regulates metabolism through altered mitochondrial function". Diabetes. 60 (2): 427–35. doi:10.2337/db10-0409. PMC 3028341. PMID 21270254.
  6. Cederberg A, Gronning LM, Ahren B, Tasken K, Carlsson P, Enerback S (2001). "FOXC2 is a winged helix gene that counteracts obesity, hypertriglyceridemia, and diet-induced insulin resistance". Cell. 106 (5): 563–73. doi:10.1016/s0092-8674(01)00474-3. PMID 11551504.
  7. Connell F, Brice G, Mortimer P (2008). "Phenotypic characterization of primary lymphedema". Ann. N. Y. Acad. Sci. 1131: 140–6. doi:10.1196/annals.1413.013. PMID 18519967.
  8. 8.0 8.1 Norrmén C, Ivanov KI, Cheng J, Zangger N, Delorenzi M, Jaquet M, Miura N, Puolakkainen P, Horsley V, Hu J, Augustin HG, Ylä-Herttuala S, Alitalo K, Petrova TV (May 2009). "FOXC2 controls formation and maturation of lymphatic collecting vessels through cooperation with NFATc1". J. Cell Biol. 185 (3): 439–57. doi:10.1083/jcb.200901104. PMC 2700385. PMID 19398761.
  9. Ng MY, Andrew T, Spector TD, Jeffery S (March 2005). "Linkage to the FOXC2 region of chromosome 16 for varicose veins in otherwise healthy, unselected sibling pairs". J. Med. Genet. 42 (3): 235–9. doi:10.1136/jmg.2004.024075. PMC 1736007. PMID 15744037.
  10. Battula VL, Evans KW, Hollier BG, Shi Y, Marini FC, Ayyanan A, Wang RY, Brisken C, Guerra R, Andreeff M, Mani SA (June 2010). "Epithelial-Mesenchymal Transition-Derived Cells Exhibit Multi-Lineage Differentiation Potential Similar to Mesenchymal Stem Cells". Stem Cells. 28 (8): 1435–45. doi:10.1002/stem.467. PMC 3523728. PMID 20572012.
  11. Mani SA, Yang J, Brooks M, Schwaninger G, Zhou A, Miura N, Kutok JL, Hartwell K, Richardson AL, Weinberg RA (June 2007). "Mesenchyme Forkhead 1 (FOXC2) plays a key role in metastasis and is associated with aggressive basal-like breast cancers". Proc. Natl. Acad. Sci. U.S.A. 104 (24): 10069–74. doi:10.1073/pnas.0703900104. PMC 1891217. PMID 17537911.

Further reading

External links