Fig. 7. Mechanisms of IGF-1-induced human myotube hypertrophy. (1) IGF-1 induces an increase in the protein content of myotubes via Akt. Within Akt targets, IGF-1 acts on the mTOR/p70S6K and GSK-3
pathways, both of which are involved in the control of protein translocation. IGF-1 also downregulates the Foxo/atrogin-1 protein degradation pathway. (2) IGF-1 induces an increase in the recruitment of reserve cells for fusion via the secretion of IL-13 by myotubes under the control of NFATc2.