NFAT5: a stress-related transcription factor with multiple functions in health and disease.

Nuclear factor of activated T cells 5 (NFAT5) is a transcription factor within the Rel family, primarily recognized for its role in cellular adaptation to osmotic stress, particularly in hypertonic and hyperosmotic environments. Beyond osmotic regulation, NFAT5 responds to diverse stimuli, including cytokines, growth factors, oxidative stress, and microbial signals. This versatility enables NFAT5 to regulate essential cellular processes such as proliferation, survival, migration, and vascular remodelling. In the immune system, NFAT5 modulates the function of monocytes, macrophages, astrocytes, microglia, and T cells, contributing to immune homeostasis and inflammatory responses. Dysregulation of NFAT5 activity is implicated in various pathological conditions, including autoimmune diseases, cancer, and cardiovascular disorders, largely due to its ability to control genes involved in inflammatory and immune pathways under both isotonic and hypertonic conditions. Recent studies have unveiled new regulatory mechanisms, including interactions with non-coding RNAs, offering deeper insights into the functional landscape of NFAT5 and its therapeutic potential. This review delves into the multifaceted roles of NFAT5 in health and disease, emphasizing its emerging importance as a promising therapeutic target.