EMBO Molecular Medicine

Niemann-Pick type C1 (NPC1) disease is a fatal lysosomal disorder caused by impaired intracellular cholesterol trafficking, leading to progressive neurodegeneration and premature death. Despite advances in disease modelling, therapeutic development remains limited, partly due to the lack of human neuronal systems that accurately recapitulate disease-relevant phenotypes. Here, we generated a patient-specific neuronal model by differentiating induced pluripotent stem cells (iPSCs) carrying the most common NPC1 p.I1061T variant into cortical neurons. These cells exhibit hallmarks of neuronal pathology associated with NPC1 disease, providing a platform to investigate pathological mechanisms and to validate therapeutic candidates in a human context. Using this experimental model, we explored the effects of pharmacological inhibition of bromodomain and extraterminal (BET) proteins. Treatment with the BET inhibitor JQ1 attenuated disease-associated phenotypes, improving neuronal viability and modulating intracellular cholesterol accumulation. Overall, our findings identify BET inhibition as a novel strategy to ameliorate NPC1-associated neuronal pathology and uncover a previously underexplored link between epigenetic regulation and cholesterol homeostasis, highlighting iPSC-derived neurons as a powerful platform for therapeutic discovery.

For patients diagnosed with long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency (LCHADD) or very-long-chain acyl-CoA dehydrogenase deficiency (VLCADD), fasting episodes or high-energy demands remain life threatening. Due to the low incidence, clinical trials for novel LCHADD/VLCADD therapies are limited, and the current mouse models only partially reflect human symptoms. Here, we report the use of mitochondrial morphology and 3D bioprinted, vascularized tissue models to establish a robust testing platform for dietary-based and experimental treatment approaches. Through this platform, we were able to demonstrate, that mitochondrial morphology is strictly regulated by NOX2-driven ROS formation. Treatment of LCHADD/VLCADD-derived fibroblasts with the NOX2-inhibitor naloxone led to the reassembly of mitochondrial structures controlled by DNM1L/MFN2. Using RNA transcriptomics, we identified a pro-fibrotic phenotype in LCHADD and VLCADD patients that impaired vessel formation in fully 3D bioprinted human tissue equivalents. Metabolic supplementation with dietary approaches, which are used in standard therapy, partially improved vascularization. Naloxone induced the strongest improvement, restoring vessel length and network complexity to those of healthy controls, suggesting increased oxidative stress as main driver. Interestingly, naloxone had no effect on healthy fibroblasts, underscoring its safety. Taken together, these results suggest the opioid antagonist naloxone as a potential rescue medication during LCHADD/VLCADD-driven metabolic crises.

Inflammatory bowel disease (IBD) is a heterogeneous chronic disease driven by dysregulated mucosal immunity and impaired epithelial barrier function. Although biologics have improved disease management, they are frequently associated with systemic immunosuppression and adverse effects, highlighting the need for localized therapeutic strategies that both control inflammation and promote tissue repair. Here, we developed a protein bispecific termed 7A2-IgG4-IL22, composed of a human IgG4-Fc domain displaying an antagonistic anti-human MAdCAM-1 single chain (sc)-Fv and a human interleukin (IL-)22. The anti-MAdCAM-1 scFv retained the functional activity of the parental monoclonal antibody, inhibiting T cell activation, expansion and differentiation from naive precursors. Blockade of the MAdCAM-1 signaling axis also reduced production of pro-inflammatory cytokines relevant to IBD pathogenesis, including IFN{gamma} and TNF. On the epithelial side, the IL-22 cargo induces robust signaling in epithelial cells, promoting the expression of IL-22 response genes associated with antimicrobial defense, mucosal homeostasis, as well as IL-10 and CXCL1 expression. This effect contributes to immune cell trafficking to the intestinal mucosa. Together, this bispecific provides a localized dual-mechanism strategy for restoring intestinal immune homeostasis.

Glioblastoma (GBM), the most aggressive primary brain tumor, remains refractory to conventional therapies, characterized by high relapse rates and poor clinical prognosis. Oncolytic viruses represent a promising therapeutic frontier; specifically, Zika virus (ZIKV) has shown potent oncolytic activity against GBM in vitro and in vivo. However, its impact on the tumor microenvironment (TME) remains poorly understood. Here, we demonstrate that ZIKV modulates pivotal TME components, triggering paracrine anti-angiogenic signaling that impairs endothelial stabilization and reprogramming microglia toward an anti-tumoral phenotype. These findings were corroborated in vivo in GBM-bearing mice. Using unbiased RNA-Seq, we identified type III interferon (IFN) signaling as the primary mediator of this ZIKV-induced TME remodeling. Crucially, analysis of human glioma datasets revealed that the type III IFN receptor complex is highly expressed in patients, identifying a high-risk population equipped with the molecular machinery to respond to this axis. Exogenous treatment with type III IFN in vitro and in vivo successfully mimicked ZIKV's anti-tumoral effects, reducing angiogenesis and promoting immune activation. Our results demonstrate that ZIKV acts as an immunotherapeutic agent capable of shifting the TME toward an anti-tumoral state, highlighting the type III IFN pathway as an actionable vulnerability and a promising strategy for patients failing conventional therapies.

Mechanical circulatory support essential for managing severe heart failure frequently triggers bleeding complications, driven by shear stress-induced over-proteolysis of von Willebrand factor (VWF) by ADAMTS13. Inhibiting ADAMTS13 presents a rationale to treat this condition, known as acquired von Willebrand syndrome (AVWS). However, conventional therapeutic strategies remain limited due to the risk of triggering thrombotic thrombocytopenic purpura. Here we show that HA10, a humanized anti-ADAMTS13 antibody, preserves a residual level of ADAMTS13 activity above the thrombosis-associated threshold. Multimodal structural and biophysical analyses--including NMR, SAXS, and SANS--revealed that HA10 bound to the disintegrin-like domain of ADAMTS13, dynamically competing with VWF while leaving 10- 20% residual enzymatic activity. The therapeutic efficacy and safety of HA10 were verified in non-human primate models of AVWS. Our findings establish a novel paradigm of enzymatic calibration rather than complete blockade, offering a mechanistically targeted and safe therapeutic approach for cardiovascular bleeding.

Most antimalarials are ineffective against the sexual transmission stages, known as gametocytes, of the malaria parasite Plasmodium falciparum. Their low sensitivity to drugs is attributed to limited compound uptake and a poorly understood form of cellular quiescence. Our current understanding of druggable transmission-blocking processes is therefore limited. Based on genetically engineered parasites that facilitate the mass production of synchronous mature gametocytes, we developed a high throughput drug screening platform that allowed us to test more than 50,000 compounds for gametocytocidal effects in one day. By screening a diversity-oriented library, we identified over 40 molecules that kill mature gametocytes in the low nanomolar range. Using resistance selection coupled to whole genome sequencing and drug-target interaction modelling, we followed up on three chemically tractable compounds that are also highly active against asexual parasites and prevent gametocyte transmission to mosquitoes. We show that the compound ONX-0914, a specific inhibitor of the {beta}5i/LMP7 subunit of human immunoproteasomes, targets the parasite proteasomal {beta}5 subunit. In contrast, the compounds CR-1-31-B and brusatol interfere with translation by targeting eukaryotic initiation factor 4A (eIF4A) and the peptidyl transferase center (PTC) of the 80S ribosome, respectively. Interestingly, parasite resistance to brusatol, a broad-spectrum antitumor drug, is linked to the differential modification of specific rRNA bases near the ribosomal A-site, mediated by altered base specificity of a rRNA methyltransferase. In summary, we successfully combined high-throughput compound screening with drug target deconvolution to reveal the targets and mode-of-action for three potent gametocytocidal molecules and discover the mechanism of resistance to the anti-tumorigenic drug brusatol. In addition to critically advancing our understanding of mature gametocyte biology and druggable processes in P. falciparum transmission stages, our observations made with brusatol-resistant parasites may become relevant for anti-cancer drug research.

NOTCH3 is a transmembrane receptor highly expressed in vascular mural cells where it contributes to blood vessel formation and homeostasis. NOTCH3 expression declines in the vasculature with aging, and dysregulated NOTCH3 signalling is implicated in pulmonary arterial hypertension, cancer progression and CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy). RNA-based approaches targeting NOTCH3 are emerging as potential therapeutic strategies, however, the consequences of NOTCH3 suppression in mature vascular smooth muscle cells (VSMCs) remain incompletely understood. Here, we investigated the molecular and functional effects of siRNA-mediated NOTCH3 knockdown in human aortic smooth muscle cells. Transfection with NOTCH3-targeting siRNA efficiently suppressed NOTCH3 transcript and protein levels. Quantitative proteomics revealed remodelling of extracellular matrix (ECM), cytoskeletal and metabolic pathways, with enrichment of collagen biosynthesis and inhibition of glycolytic signalling. Specifically, NOTCH3 knockdown increased ECM components, including COL3A1, elevated F-actin, and upregulated the actin regulator, CTTN. In parallel, glycolytic capacity was reduced, accompanied by decreased expression of the glycolytic enzyme ENO2. Despite reduced VEGFA and alteration in angiogenic signalling proteins, endothelial network formation in co-cultures, as well as VSMC proliferation and migration remained unaffected. Finally, NOTCH3 interactome analysis revealed key collagen and actin-regulating proteins. These findings identify NOTCH3 as an important regulator of ECM homeostasis, cytoskeletal organisation, and glycolytic metabolism. The preservation of primary cellular functions despite molecular remodelling highlights the adaptive capacity of VSMCs. These findings demonstrate that therapeutic modulation of NOTCH3 may alter vascular cell biology which warrants consideration during development of RNA-based therapeutics for CADASIL and other NOTCH3-associated diseases.

Adult-onset Autosomal Dominant Leukodystrophy (ADLD) is a rare fatal leukodystrophy caused by increased LMNB1 gene dosage, most commonly resulting from duplication of the LMNB1 locus. Because ADLD is a gene dosage disorder, selective reduction of pathological LMNB1 expression represents a rational therapeutic strategy. Although allele-specific RNA interference has previously been shown to lower LMNB1 levels in patient-derived fibroblasts and directly reprogrammed neurons, its therapeutic effects have not been evaluated in disease-relevant human glial cells or using functional efficacy endpoints. Here, we established human induced pluripotent stem cell-derived astrocytes from ADLD patients as a human glial model in which to validate allele-specific LMNB1 silencing across molecular, cellular, and functional readouts. ADLD astrocytes recapitulated increased LMNB1 expression and characteristic nuclear abnormalities and displayed transcriptional alterations affecting extracellular matrix organization, calcium homeostasis, metabolism and RNA processing. Functionally, these cells also exhibited functional phenotypes suitable for therapeutic evaluation: astrocyte-conditioned medium impaired the viability of both murine and human oligodendroglial cultures, while conditioned-medium and direct astrocyte-seeding paradigms revealed impaired post-lesion myelin recovery in lysolecithin-treated cerebellar organotypic slices. Allele-specific LMNB1 silencing restored physiological LMNB1 levels, corrected nuclear abnormalities, attenuated astrocyte-mediated oligodendroglial toxicity, improved post-lesion myelin recovery, and was associated with selective transcriptional programs associated with extracellular support and cholesterol metabolism. Together, these findings provide molecular, cellular, and functional validation of allele-specific LMNB1 dosage correction in patient-derived human astrocytes and offer key support for LMNB1-lowering strategies in disease-relevant human glial cells.

The normal cellular prion protein (PrPC) is an essential substrate in all forms of prion diseases and a receptor for A{beta} oligomers in Alzheimers disease. However, it is not fully understood how cells regulate PrPC levels. Recently, we identified glycogen synthase kinase-3{beta} (GSK-3{beta}) as a potential regulator of PrPC levels in a whole genome knockout screen. Here, we show that both cell surface and total PrPC levels can be reduced either by siRNA-mediated Gsk3b (but not Gsk3a) knockdown or by CRISPR-mediated Gs3b knockout. Whole cell mass spectrometric analysis showed that PrPC was the 60th most significantly reduced protein (out of 7227 total proteins detected) in Gsk3b knockout cells, compared to wild-type cells. Two different GSK-3 inhibitors, laduviglusib (CHIR-99021) and AZD-1080, reduced PrPC levels in mouse CAD5 and human BE(2)-C cells, both in undifferentiated and differentiated states. PrPC levels were similarly reduced by cycloheximide treatment in both Gsk3b knockout and WT cells, indicating that GSK-3{beta} regulates PrPC levels through a post-translational mechanism. Finally, treatment with either laduviglusib or AZD-1080 reduced PrPSc levels in CAD5 cells infected with three different rodent prion strains. Overall, the results reveal that GSK-3{beta} activity controls PrPC levels in living cells, revealing a novel regulatory mechanism and promising therapeutic target.

Ion channels remain notoriously recalcitrant drug targets despite their extensive pathophysiological significance. Acid-sensing ion channels (ASICs) are proton-gated cation channels that cause neuronal death when excessively activated, such as during ischaemic stroke. This acidosis-driven injury pathway remains unchallenged by existing therapeutics. Here we generate two de novo designed hASIC1a-specific miniproteins by developing a platform that integrates computational miniprotein design, high-throughput automated patch clamp screening, biophysical and structural characterisation, and in vivo validation. We identify a subtype-selective hASIC1a inhibitor, Denasin1, which achieves near-complete inhibition with nanomolar potency. Denasin1 is disordered in solution but adopts the computationally predicted helix-turn-helix fold when bound to the extracellular acidic pocket of hASIC1a. Crucially, Denasin1 reduces infarct volume by > 50% in a murine model of ischaemic stroke. We thereby establish our de novo design platform as a route to develop potent and selective ion channel modulators.

The modulation of iron metabolism is increasingly explored as a therapeutic strategy in cancer, particularly through the induction of ferroptosis. Given the central role of ferritin as a major intracellular iron buffer, targeting ferritin represents an attractive strategy to disrupt iron homeostasis; however, the lack of pharmacological approaches capable of selectively targeting ferritin currently limits the therapeutic exploitation of this vulnerability. MMRi62, initially developed to target the MDM2-MDM4 axis, has been proposed to induce ferroptosis via ferritin degradation. Here, we revisited this hypothesis in the context of medulloblastoma (MB). Contrary to this proposed mechanism, we found that MMRi62 does not trigger ferroptosis but instead induces robust apoptotic cell death. This effect is observed in both p53-mutant DAOY and p53 wild-type HD-MB03 cells, as well as in c-Myc/OTX2-driven medulloblastoma-like tumours genetically induced in brain organoids. Although ferritin degradation occurs upon treatment, genetic dissection demonstrates that neither ferritin itself nor ferritinophagy are required for MMRi62-induced cytotoxicity. Together, these findings rule out ferritin-dependent mechanisms as primary drivers of cytotoxicity. Instead, we uncovered that MMi62 induces a profound rewiring of iron metabolism consistent with a canonical iron starvation response, accompanied by a marked reduction in intracellular iron levels. Consistently, the UV-visible spectroscopic data were in agreement with the proposed iron-chelating properties of MMRi62. Taken together, our findings identify iron depletion-driven apoptosis, rather than ferroptosis, independently of ferritin degradation, as the primary mechanism of MMRi62 cytotoxicity in MB, refining its mode of action and highlighting iron homeostasis as a therapeutic vulnerability.

Cytomegalovirus (CMV) has been implicated in glioblastoma (GBM) progression. Ongoing clinical trials are assessing therapeutic approaches targeting CMV in GBM but to date no new therapy has been approved outside the standard of care. Previous preclinical studies have highlighted the potential of the antiviral drug Cidofovir (CDV) in GBM; however, its clinical use is limited by dose-dependent nephrotoxicity and poor cellular uptake, necessitating high intravenous doses to achieve therapeutic activity. Brincidofovir (BCV), a lipid conjugate of CDV has been developed, which does not induce nephrotoxicity and has significantly greater cellular bioavailability. Here we examined the effects of BCV in a newly established CMV-driven GBM model (SB28) and in patient-derived tumor neurospheres. We show that BCV prolongs survival in vivo and exerts both CMV-dependent and independent antitumor effects. Mechanistically, BCV induces DNA damage and cell cycle dysregulation in GBM cells and inhibits proliferation of patient-derived neurospheres in a dose-dependent manner. These data identify BCV as a dual-action therapeutic that suppresses viral oncomodulation while directly targeting tumor cell viability.

The human heart has a continuous and exceptionally high demand for energy, which is met primarily through mitochondrial oxidative phosphorylation. This dependence places the maintenance and integrity of mitochondrial DNA (mtDNA) for proper mitochondrial function at the center of cardiac health, as mtDNA instability has been shown to cause mitochondrial dysfunction, which can ultimately impair cardiac function leading to cardiomyopathy (CM) and heart failure. However, the contribution of mtDNA instability to cardiac disease remains poorly understood. A growing number of nuclear-encoded proteins have emerged as essential regulators of mtDNA maintenance, organization and segregation. DNA Topoisomerase 3 (TOP3A) is expressed as two isoforms: one is a nuclear-related isoform involved in nuclear genome maintenance while the other localizes to the mitochondria to preserve mtDNA integrity. Recently, individuals bearing biallelic loss-of-function variants in TOP3A manifested phenotypic traits, including CM, typical for mitochondrial dysfunction, supporting a potential mechanistic link between mitochondrial genome instability and TOP3A-related cardiac disease. Here, we investigated the effects of TOP3A deficiency on mtDNA maintenance and stability in the context of TOP3A-associated CM. We employed isogenic wild-type, TOP3A-knockout and BLM-knockout induced pluripotent stem cells (iPSCs) to generate cardiomyocytes (iPSC-CMs) and established a high-throughput, ultra-deep mtDNA sequencing strategy achieving approximately 500,000X coverage to characterize low-frequency mtDNA mutational patterns. Loss of TOP3A triggered an early burst of low-frequency de novo mtDNA single-nucleotide variants during cardiac differentiation, with a striking enrichment within the mitochondrial ribosomal RNA genes, accompanied by a progressive increase in the heteroplasmy of low-frequency mtDNA variants inherited from the common isogenic background. These unique mtDNA signatures were associated with defective mtDNA copy-number expansion and impaired mitochondrial respiration in mature iPSC-CMs. Together, our approach uncovered a previously uncharacterized consequence of TOP3A deficiency and established a link between impaired mtDNA maintenance and mitochondrial dysfunction in TOP3A-associated CM.

Huntington's disease is caused by a CAG repeat tract expansion in the huntingtin gene, resulting in production of pathogenic N-terminal huntingtin protein fragments associated with disease pathology. Despite their central role, detection of these fragments has relied on a limited antibody repertoire with reproducibility concerns. Here, we describe the generation and characterization of recombinant rabbit monoclonal antibodies targeting two reciprocal neoepitopes flanking the huntingtin exon 1/exon 2 junction corresponding to amino acids P90 and K91. The P90 antibodies (clones 1B12, 11G2) demonstrate fragment-length-selective recognition of the C-terminal HTTexon1 P90 neoepitope with no detectable binding to full length huntingtin. A side-by-side comparison of the widely used monoclonal antibody MW8 from two different sources revealed measurable lot-to-lot drift in its fragment selectivity, whereas the recombinant P90 antibodies, expressed from a defined, sequenced clone, maintained consistent specificity, addressing this source-dependent variability. Whereas P90-positive fragments can arise through alternative splicing of the HTT1a transcript, generation of the reciprocal K91 N-terminal HTTexon2 neoepitope would require site-specific proteolytic cleavage, a mechanism that has not yet been directly tested for lack of a suitable reagent. The K91 antibody (clone 7G10) binds the N-terminal K91 neoepitope with high affinity and specificity over full length huntingtin and provides, for the first time, a tool capable of directly interrogating whether such cleavage occurs. Neoepitope specificity of these antibodies was orthogonally confirmed by protease digestion (Lys-N and Arg-C) coupled with intact mass spectrometry. As an additional outcome of the immunization and selection strategy, we discovered human-mouse cross-reactive antibodies (clones 27F5, 31C10) targeting the proline-rich domain of huntingtin that will facilitate mouse-human translational studies. All antibodies are recombinant, ensuring long-term reproducibility, and are being made available, along with their sequences, to the research community.

Spinocerebellar ataxia type 3 (SCA3) is most common subtype of autosomal dominant spinocerebellar ataxia worldwide and the most prevalent CAG expansion disorder in the east Asian population, but disease-modifying therapies remain unavailable. SCA3 is caused by the accumulation of polyglutamine- (polyQ-) expanded mutant ataxin-3 (mAtxn3), while the wild-type ataxin-3 (wtAtxn3) plays an important cellular role. Thus, allele-selective clearance of mAtxn3 without affecting wtAtxn3 is highly desired for SCA3 treatment. To achieve this goal, we tested previously reported compounds that have been shown to selectively degrade the Huntingtons disease causing mutant HTT protein by tethering the expanded polyQ to the autophagosome protein LC3. Here, we demonstrated that two of these compounds, AN2 and GW5074, selectively reduced both soluble and aggregated mAtxn3 with expanded polyQ (84Q), but not wtAtxn3, in both cellular and mouse models of SCA3. Mechanistically, both compounds lowered mAtxn3 by enhancing its autophagic degradation without obvious activation of global autophagy. At the molecular level, both compounds increased mAtxn3-LC3 interaction and colocalization to enhance the allele-selectively autophagic degradation of mAtxn3. Phenotypically, both compounds rescued cell viability and ATP content of SCA3 cellular models. In SCA3 patient pluripotent stem cells (iPSCs) derived cortical neurons, both compounds allele-selectively reduced mAtxn3 and partially rescued neurite shortening. Importantly, in a well-established SCA3 transgenic mouse model (MJD84.2), intracerebroventricular, intraperitoneal, and oral administration allele-selectively reduced mAtxn3 in multiple brain regions and rescued motor function deficits. Oral dosing achieved nanomolar cerebellar exposure and showed no overt liver, kidney, or glial toxicity over 28 days. Analyses of 1303 Chinese patients with SCA3 and ATXN3 constructs of different polyglutamine lengths further supported the compounds polyQ length-dependent activity with relative sparing of normal-length ataxin-3. Together, these findings provide preclinical proof of concept that utilizing orally available small molecule compounds to allele-selectively enhance mAtxn3 autophagic degradation for SCA3 treatment. One-sentence summarySmall-molecule autophagosome-tethering compounds selectively lower mutant ataxin-3 through an LC3- and autophagy-dependent mechanism and improve disease-related phenotypes in preclinical models of SCA3.

Inhibitor of DNA binding (ID) proteins are key regulators of tumor cell stemness, therapy resistance and pathological angiogenesis in multiple cancer types and other diseases. Here, we characterize the coumarin-derived compound X6632 as a pan-ID inhibitor with dual activity against tumor cells and the tumor-associated microvasculature in a number of human and murine models. X6632 efficiently suppressed ID protein expression, inhibited the proliferation, migration, invasion of melanoma cells, and impaired multiple endothelial cell functions, including proliferation, migration, invasion, tube formation and sprouting in vitro. In back-to-back comparisons, X6632 exhibited an approximately ten-fold higher efficacy compared to the first-generation ID antagonist AGX51. In vivo, X6632 potently reduced pathological (neo)vascularization in established angiogenesis models, including oxygen-induced retinopathy and in Matrigel plug assays. It also significantly decreased blood vessel density in syngeneic melanoma models, delayed tumor growth and, when combined with immune checkpoint blockade, achieved superior tumor control compared with either monotherapy. Moreover, X6632 inhibited clonogenic growth in several breast cancer models, and robustly suppressed the growth of triple negative breast cancer in vivo, both in the highly aggressive 4T1 syngeneic model and in patient-derived xenografts. Collectively, these data establish X6632 as a second-generation, pan-ID protein inhibitor that can simultaneously target malignant cells and the tumor-supporting vasculature, and support the further pre-clinical development of the compound for the treatment of melanoma, breast cancer and potentially additional ID-dependent malignancies, as well as diseases driven by pathological neoangiogenesis.

Despite the advent of immunotherapy in the treatment of human-papilloma-virus (HPV)-negative head and neck squamous cell carcinoma, the overall prognosis still remains dismal. Novel therapeutic approaches are thus urgently needed. We recently reported that SET and MYND containing 3 (SMYD3), a protein methyltransferase that is known to activate the transcription of its target genes through H3K4me3, is overexpressed in ~60% of HPV-negative HNSCC tumors, it drives proliferation and invasion, and induces resistance to immunotherapy in HPV-negative HNSCC. These phenotypes are mediated partially through transcriptional regulation of cell cycle, EMT and immune-related target genes by SMYD3. Despite its enzymatic inhibitory potency in HPV-negative HNSC cell lines, the commercially available SMYD3 inhibitors EPZ031686 and BAY-6035 demonstrated no in vitro phenotypic efficacy in these cell lines, supporting that SMYD3 exerts its oncogenic functions predominantly through catalytically-independent mechanisms. Thus, to effectively target SMYD3, we designed a series of SMYD3 proteolysis targeting chimeras (PROTACs). Treatment of HPV-negative HNSCC cell lines with SMYD3 PROTACs at nanomolar concentrations degraded SMYD3 effectively and induced a drastic decrease in the proliferative and invasive potential of HPV-negative HNSCC cells. One of the designed compounds, IAP-08, showed a promising DC50 at ~177nM with Dmax of ~90%, and effectively induced the formation of ternary complexes with SMYD3 and the XIAP E3 ligase. Furthermore, IAP-08 showed a favorable pharmacokinetic profile in vivo, underscoring the feasibility for further clinical development of this compound. Mass spectrometry analysis of IAP-08 supported its high specificity towards SMYD3. SMYD3 depletion by IAP-08 in HNSCC cells revealed transcriptional regulation of cell cycle, EMT- and type I IFN response genes, in contrast to SMYD3 inhibition which had only a weak transcriptional effect. In summary, we show that inhibition of the enzymatic activity of SMYD3 is not sufficient to repress its oncogenic activity and provide evidence that depletion through PROTACs effectively targets the oncogenic functions of SMYD3 in HPV-negative HNSCC.

Human induced Pluripotent Stem Cell (hiPSC) models have revolutionised drug discovery, offering high translational relevance for recapitulating disease biology and thereby the potential to help reduce drug attrition. Macrophages are pivotal for maintaining tissue homeostasis and orchestrating immune responses; their dysregulation underpins several diseases, including autoinflammatory disorders, neurodegeneration, and cancer. Therapeutically targeting this cell type presents an attractive strategy to simultaneously influence multiple cellular mediators and functions. We have established a scalable, semi-automated, and physiologically relevant hiPSC-derived macrophage model, rigorously characterised through deep comparative multi-omics. We have also integrated our hiPSC-derived macrophage platform with large-scale CRISPR screening workflows designed for parallel genetic interrogation of thousands of gene targets, in both arrayed and pooled formats. In this manuscript, we apply those genetic screening methods to hiPSC-derived macrophages and showcase how genetic perturbations alter pro- and anti-inflammatory transcriptional signatures and significantly impact functional phenotypes in this cell model. This integrated approach allows for the exploration of novel genetic insights linked to causal disease biology, advancing myeloid cell-associated target discovery across a broad spectrum of therapeutic areas.

Wiskott-Aldrich syndrome (WAS) is an inborn error of immunity with a broad disease spectrum, classified into class I (late onset) or II (early onset) variants. Thrombocytopenia and small platelets are the most consistent findings among patients, difficult to treat and related to development of autoimmunity. To identify new treatment options for thrombocytopenia in WAS, we developed a FACS-based screening for drug repurposing. We identified parthenolide as a lead small molecule that increased WASp abundance in cells with residual WASp expression. Using the megakaryocytic MEG-01 cells, gene edited to express WAS class I and II genetic variants, parthenolide induced megakaryocyte maturation as evident by upregulation of CD61, increased cell size and complexity, increased phosphorylation of ERK1/2, and higher DNA ploidy. We generated a new mouse model harboring a WAS class I missense variant WASp-R88C, corresponding to human WASp-R86C, with reduced expression of WASp. WASp-R88C mice had lower numbers of platelets compared to WT mice. Bone marrow-derived WASp-R88C and WASp-KO megakaryocytes, differentiated in the presence of parthenolide derivative, DMAPT, showed increased ploidy and upregulation of the maturation markers CD61, CD41 and CD42d, resulting in improved platelet production in vitro. Treatment with parthenolide derivative, DMAPT, led to increased platelet numbers in vivo in WASp-R88C mice and dampened the hyperactivation of WAS patient platelets by reducing thrombin-induced CD62P exposure after activation. The identification of parthenolide offers a promising therapeutic approach for WAS patients who are unresponsive or unsuitable for definitive therapies.

Glioblastoma remains highly lethal, with median survival of ~15 months. Resistance to temozolomide is ubiquitous, yet its mechanisms are incompletely understood. Here, we identify the CCL20-CCR6 chemokine axis as a stress-responsive survival pathway limiting therapeutic efficacy. Targeting CCL20-CCR6 in combination with temozolomide and cannabidiol was evaluated using clinical datasets, GBM cell lines, tumor organoids, and a syngeneic CT-2A mouse model integrating proteomic and lipidomic profiling. Low CCL20 expression was associated with improved survival, supporting its prognostic relevance. Across models, TMZ alone or with CBD induced CCL20 expression while exerting limited antitumor activity. Targeted disruption of CCL20-CCR6 signaling using dendrimer-delivered shRNA enhanced therapeutic response in murine models and GBM organoids. Multi-omic analyses revealed that CCL20 inhibition reprograms the tumor microenvironment and induces mitochondrial dysfunction, resulting in elevated reactive oxygen species (ROS) and tumor cell death. This effect was accompanied by accumulation of 17-hydroxydocosahexaenoic acid and activation of oxidative stress-associated cytotoxic pathways. Functional assays confirmed that CCL20 blockade selectively amplifies mitochondrial ROS beyond levels induced by TMZ alone potentiating TMZ efficacy by promoting mitochondrial oxidative stress. Targeting this axis represents a promising strategy to overcome chemoresistance and positions CCL20 as both a prognostic biomarker and a therapeutic vulnerability in GBM.