Fig. 10: Schematic of the metabolic and signaling pathways affected in senescent or progeria myoblasts and reversed by NANOG or MAT2A inhibition.

Both insulin resistance and Akt2 inactivation prevent GLUT4 translocation and inhibit glucose usage for energy production. In response, bioenergetics is maintained and augmented by MAT2A catalyzing the breakdown of methionine for ATP. Ammonium generation is a side effect of methionine catabolism that may contribute to weakness and atrophy of aged muscle. NANOG expression restores insulin sensitivity, muscle regeneration, and strength via suppression of MAT2A.