disease:A chromosomal aberration involving FOXO4 is found in acute leukemias. Translocation t(X;11)(q13;q23) with MLL/HRX. The result is a rogue activator protein.,function:Transcription factor involved in the regulation of the insulin signaling pathway. Binds to insulin-response elements (IREs) and can activate transcription of IGFBP1. Down-regulates expression of HIF1A and suppresses hypoxia-induced transcriptional activation of HIF1A-modulated genes. Also involved in negative regulation of the cell cycle.,pharmaceutical:A constitutively active FOXO4 mutant where phosphorylation sites Thr-32, Ser-187 and Ser-262 have been mutated to alanine may have therapeutic potential in ERBB2/HER2-overexpressing cancers as it inhibits ERBB2-mediated cell survival, transformation and tumorigenicity.,PTM:Acetylation by CBP, which is induced by peroxidase stress, inhibits transcriptional activity. Deacetylation by SIRT1 is NAD-dependent and stimulates transcriptional activity.,PTM:Phosphorylation by PKB/AKT1 inhibits transcriptional activity and is responsible for cytoplasmic localization.,similarity:Contains 1 fork-head DNA-binding domain.,subcellular location:When phosphorylated, translocated from nucleus to cytoplasm. Dephosphorylation triggers nuclear translocation.,subunit:Interacts with CBP, MYOCD, SIRT1, SRF and YWHAZ. Acetylated by CBP and deacetylated by SIRT1. Binding of YWHAZ inhibits DNA-binding.,tissue specificity:Heart, brain, placenta, lung, liver, skeletal muscle, kidney and pancreas. Isoform zeta is most abundant in the liver, kidney, and pancreas.,