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  5. Itraconazole and posaconazole, inhibitors of NPC1 sterol transport, act as pharmacological chaperones after washout

Itraconazole and posaconazole, inhibitors of NPC1 sterol transport, act as pharmacological chaperones after washout

File(s)
40516874.pdf (2.25 MB)
Permanent Link(s)
https://hdl.handle.net/1813/117944
Collections
Department of Biochemistry
Author
Wang, W.A.
Ma, C.-I.J.
Steinfeld, N.
Maxfield, F.R.
Abstract

Niemann-Pick type C (NPC) disease is a rare lysosomal storage disorder primarily caused by mutations in the NPC Cholesterol Transporter 1 (NPC1) gene, resulting in cholesterol and lipid accumulation in late endosomes and lysosomes. While several therapeutic drugs show promise in reducing cholesterol accumulation, none of the current treatments are highly effective. Itraconazole and posaconazole, widely used antifungal drugs, have been shown to stabilize misfolded NPC1 proteins, enabling their escape from endoplasmic reticulum-associated degradation. This chaperone-like property makes them attractive candidates for testing chaperones as possible treatments for NPC disease, but both drugs also inhibit NPC1 function. In this study, we employed a washout approach to reverse the inhibitory effects of these drugs, leveraging the fact that wildtype NPC1 proteins have a half-life of about 42 hours. Treating NPC1I1061T/I1061T human fibroblasts with itraconazole or posaconazole for 72 hours followed by 24-48 hours of washout, we observed a significant reduction in lysosomal cholesterol accumulation. A modest rebound was observed 72 hours after drug removal, likely due to protein turnover. We also tested a repeated pulsed exposure treatment, in which short drug treatments were followed by extended washout periods. This strategy preserved the functional benefit of NPC1 stabilization while minimizing inhibitory effects. These findings indicate that a washout strategy can enhance the functional benefits of pharmacological chaperones, offering a potential future therapeutic approach for NPC disease.

Journal / Series
The Journal of biological chemistry
Volume & Issue
301(7)
Date Issued
2025-06-16
Publisher
Elsevier
Keywords
WCM Library Coordinated Deposit
•
Itraconazole/pharmacology
•
Humans
•
Niemann-Pick C1 Protein
•
Triazoles/pharmacology
•
Cholesterol/metabolism
•
Lysosomes/metabolism/drug effects
•
Intracellular Signaling Peptides and Proteins
•
Membrane Glycoproteins/metabolism/genetics/antagonists & inhibitors
•
Carrier Proteins/metabolism/genetics/antagonists & inhibitors
•
Molecular Chaperones/pharmacology/metabolism
•
Biological Transport/drug effects
•
Fibroblasts/metabolism/drug effects
•
Antifungal Agents/pharmacology
•
Niemann-Pick Disease, Type C/drug therapy/metabolism/genetics
•
Npc1
•
cholesterol
•
lysosomal storage disease
•
pharmacological chaperones
•
end-of-life treatment preference
•
illness acceptance
•
prognostic awareness
•
quality of life
Related DOI
https://doi.org/10.1016/j.jbc.2025.110370
Previously Published as
Wang WA, Ma C-IJ, Steinfeld N, Maxfield FR. Itraconazole and posaconazole, inhibitors of NPC1 sterol transport, act as pharmacological chaperones after washout. The Journal of biological chemistry. 2025;301(7):110370. doi: 10.1016/j.jbc.2025.110370. PMID: 40516874.
Rights
Attribution 4.0 International
Rights URI
https://creativecommons.org/licenses/by/4.0/
Type
article

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