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Effect of serotonin (5-HT) on bone metabolism under pathological conditions, such as carcinoid syndrome: the association between forkhead box protein O1 (FOXO1) and cAMP-responsive element–binding protein 1 (CREB) is disrupted, whereas the formation of activating transcription factor 4 (ATF4)-FOXO1 heterodimers is favored. Subsequently, the transcription mediated by FOXO1 is not inhibited, leading to the expression of FOXO1-dependent genes that mediate cell cycle arrest.
