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Activation of AMPK as a therapeutic strategy for FBXL4-related mitochondrial DNA depletion syndrome

Lookup NU author(s): Professor Robert TaylorORCiD

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


Abstract

© The Author(s) 2026.Distinct mitophagy pathways can eliminate not only damaged mitochondria but also healthy ones. In Mitochondrial DNA Depletion Syndrome 13 (MTDPS13), dysregulated BNIP3/NIX-driven mitophagy of functional mitochondria is thought to be the key pathological driver. Patient mutations in the E3 ubiquitin ligase FBXL4 impair the proteasomal degradation of the mitophagy receptors BNIP3 and NIX, causing their accumulation and excessive mitophagy. As a result, mitochondrial content and oxidative phosphorylation decline sharply across multiple tissues, leading to early mortality, with no effective treatments currently existing. Here, we build on our work showing that AMPK can inhibit mitophagy via sequestration of the ULK1 autophagy-initiating kinase ULK1 and demonstrate that it is also critically relevant for mitophagy induced by FBXL4 disruption. Using FBXL4-deficient cells, as well as fibroblasts derived from MTDPS13 patients and a chemically-induced mouse model, we show that small molecule AMPK activation inhibits BNIP3/NIX-mediated mitophagy and recovers functional mitochondrial content. This work therefore validates AMPK as a realistic target in treating MTDPS13.


Publication metadata

Author(s): Bishnu A, Zapata-Munoz J, Taylor RW, Sakamoto K, Ganley IG

Publication type: Article

Publication status: Published

Journal: EMBO Molecular Medicine

Year: 2026

Pages: epub ahead of print

Online publication date: 17/06/2026

Acceptance date: 03/06/2026

Date deposited: 29/06/2026

ISSN (print): 1757-4676

ISSN (electronic): 1757-4684

Publisher: Springer Science and Business Media Deutschland GmbH

URL: https://doi.org/10.1038/s44321-026-00471-z

DOI: 10.1038/s44321-026-00471-z

Data Access Statement: This study includes no data deposited in external repositories. The source data of this paper are collected in the following database record: biostudies:S-SCDT-10_1038-S44321-026-00471-z. Expanded view data, supplementary information, appendices are available for this paper at https://doi.org/10.1038/s44321-026-00471-z


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Funding

Funder referenceFunder name
Medical Research Council (MR/W019027/1)
Medical Research Council, UK (MC_UU_00038/2)
Novo Nordisk Foundation Center for Basic Metabolic Research (NNF CBMR)
Novo Nordisk Foundation (Grant numbers NNF18CC0034900 and NNF23SA0084103).
UK NIHR Biomedical Research Centre for Ageing and Age-related disease award

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