Plant‑derived natural products alleviate dexamethasone‑induced skeletal muscle atrophy by modulating FoxO (Review)

Muscle atrophy (MA) is a major global health issue, and systematic strategies for its prevention and treatment are lacking. Diverse factors contribute to MA, amongst which the exogenous over‑supplementation and endogenous pathological elevation of glucocorticoids (GCs) are key causes. The present study summarizes MA induced by the GC dexamethasone (DEX) and its molecular mechanisms, including protein metabolism imbalance, mitochondrial dysfunction and abnormalities in epigenetic regulatory proteins, to explore potential therapeutic approaches for MA. FoxO transcription factor serves a central regulatory role in DEX‑induced MA by modulating the ubiquitin‑proteasome system, autophagy‑lysosomal system and energy metabolism pathways. Therefore, FoxO may serve as a critical therapeutic target for DEX‑induced MA. Plant‑derived natural products are promising candidates for the development of clinical drugs for tumors, myocardial infarction and diabetic nephropathy. These products protect against MA by regulating FoxO activity through multiple signaling pathways, including Akt, AMPK, and SIRT. Plant monomer compounds, such as flavonoids, polyphenols and terpenes, exert therapeutic effects and may provide new strategies for the precise prevention and treatment of MA induced by elevated GC levels.