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Targeting the autophagy-NAD axis protects against cell death in Niemann-Pick type C1 disease models

Lookup NU author(s): Dr Tetsushi Kataura, Lucy Sedlackova, Niall Wilson, Dr Satomi Miwa, Dr Daniel ErskineORCiD, Dr Viktor Korolchuk



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© The Author(s) 2024.Impairment of autophagy leads to an accumulation of misfolded proteins and damaged organelles and has been implicated in plethora of human diseases. Loss of autophagy in actively respiring cells has also been shown to trigger metabolic collapse mediated by the depletion of nicotinamide adenine dinucleotide (NAD) pools, resulting in cell death. Here we found that the deficit in the autophagy-NAD axis underpins the loss of viability in cell models of a neurodegenerative lysosomal storage disorder, Niemann-Pick type C1 (NPC1) disease. Defective autophagic flux in NPC1 cells resulted in mitochondrial dysfunction due to impairment of mitophagy, leading to the depletion of both the reduced and oxidised forms of NAD as identified via metabolic profiling. Consequently, exhaustion of the NAD pools triggered mitochondrial depolarisation and apoptotic cell death. Our chemical screening identified two FDA-approved drugs, celecoxib and memantine, as autophagy activators which effectively restored autophagic flux, NAD levels, and cell viability of NPC1 cells. Of biomedical relevance, either pharmacological rescue of the autophagy deficiency or NAD precursor supplementation restored NAD levels and improved the viability of NPC1 patient fibroblasts and induced pluripotent stem cell (iPSC)-derived cortical neurons. Together, our findings identify the autophagy-NAD axis as a mechanism of cell death and a target for therapeutic interventions in NPC1 disease, with a potential relevance to other neurodegenerative disorders.

Publication metadata

Author(s): Kataura T, Sedlackova L, Sun C, Kocak G, Wilson N, Banks P, Hayat F, Trushin S, Trushina E, Maddocks ODK, Oblong JE, Miwa S, Imoto M, Saiki S, Erskine D, Migaud ME, Sarkar S, Korolchuk VI

Publication type: Article

Publication status: Published

Journal: Cell Death and Disease

Year: 2024

Volume: 15

Issue: 5

Online publication date: 31/05/2024

Acceptance date: 22/05/2024

Date deposited: 15/07/2024

ISSN (electronic): 2041-4889

Publisher: Springer Nature


DOI: 10.1038/s41419-024-06770-y

PubMed id: 38821960


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Funder referenceFunder name
Alzheimer’s Research UK Senior Fellowship (ARUK-SRF2022A-006)
BB/M023389/1Biotechnology and Biological Sciences Research Council (BBSRC)
BBSRC (BB/R008167/2)
BH174490Procter & Gamble (Cincinnati)
Cancer Research UK Fellowship (C53309/A19702)
FAPESP–University of Birmingham collaboration fund
JSPS (18KK0242)
JSPS (19J12969)
LifeArc (Philanthropic Fund P2019-0004, Pathfinder Award 2324602)
Newcastle University
NIH (RF1AG55549)
the International Medical Research Foundation
UKIERI (2016-17-0087)
Wellcome Trust (109626/Z/15/Z, 1516ISSFFEL10)
TUBITAK Fellowship
Uehara Memorial Foundation