Liraglutide, a TFEB-Mediated Autophagy Agonist, Promotes the Viability of Random-Pattern Skin Flaps

Figure 8

Mechanistic pathways by which liraglutide promotes flap survival through TFEB-mediated autophagy. Liraglutide activates the MCOLN1 channel (also known as TRPML1 channels) on lysosomes by stimulating AMPK, thereby releasing large amounts of Ca²⁺ and activating calcineurin. Calcineurin dephosphorylates TFEB, which then becomes activated and translocates into the nucleus, thereby stimulating autophagy. Upregulated autophagy inhibits oxidative stress and pyroptosis in flap tissues while stimulating angiogenesis.