# Dual targeting of the UPS and autophagy as a novel therapy for neurodegenerative proteinopathies

**Authors:** Georgie Lines, Martin Helley, Sébastien Gillotin, Janet Brownlees, James Duce, Phillip Smethurst

PMC · DOI: 10.3389/fncel.2026.1738415 · Frontiers in Cellular Neuroscience · 2026-02-18

## TL;DR

This review explores combining therapies targeting two protein-clearance systems to treat diseases caused by protein buildup in the brain.

## Contribution

The paper proposes dual targeting of the UPS and autophagy as a novel therapeutic strategy for neurodegenerative diseases.

## Key findings

- The UPS and autophagy pathways interact and share regulatory components.
- Modulating both systems together may improve protein clearance in neurodegenerative diseases.
- Emerging evidence supports the potential of combined therapies for treating proteinopathies.

## Abstract

Neurodegenerative proteinopathies are characterized by impaired protein clearance and the accumulation of misfolded or aggregated proteins, ultimately leading to neuronal death. The two principal pathways responsible for protein degradation in cells are the ubiquitin proteasome system (UPS) and autophagy. Emerging evidence indicates that these pathways share regulatory components and engage in extensive crosstalk. In this review, we summarize the mechanisms of the UPS and autophagy, highlight their points of interaction, and discuss therapeutic opportunities to modulate both systems in parallel to enhance protein clearance in neurodegenerative disease.

## Full-text entities

- **Genes:** TRAF6 (TNF receptor associated factor 6) [NCBI Gene 7189] {aka MGC:3310, RNF85}, Cul3 (cullin 3) [NCBI Gene 26554] {aka KIAA0617}, BECN1 (beclin 1) [NCBI Gene 8678] {aka ATG6, VPS30, beclin1}, MLST8 (MTOR associated protein MLST8) [NCBI Gene 64223] {aka GBL, GbetaL, LST8, POP3, WAT1}, BAG1 (BAG cochaperone 1) [NCBI Gene 573] {aka BAG-1, HAP, RAP46}, UCHL5 (ubiquitin C-terminal hydrolase L5) [NCBI Gene 51377] {aka CGI-70, INO80R, UCH-L5, UCH37}, Gabarapl1 (GABA type A receptor associated protein like 1) [NCBI Gene 57436] {aka 3110025G09Rik, 9130422N19Rik, Apg8l, Atg8l, GECI, MNCb-0091}, PIK3CB (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit beta) [NCBI Gene 5291] {aka P110BETA, PI3K, PI3KBETA, PIK3C1}, EIF2A (eukaryotic translation initiation factor 2A) [NCBI Gene 83939] {aka CDA02, EIF-2A, MST089, MSTP004, MSTP089}, CP (ceruloplasmin) [NCBI Gene 1356] {aka AB073614, CP-2}, GABARAPL2 (GABA type A receptor associated protein like 2) [NCBI Gene 11345] {aka ATG8, ATG8C, GATE-16, GATE16, GEF-2, GEF2}, Psmb5 (proteasome (prosome, macropain) subunit, beta type 5) [NCBI Gene 19173], NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, KIR2DL4 (killer cell immunoglobulin like receptor, two Ig domains and long cytoplasmic tail 4) [NCBI Gene 3805] {aka CD158D, G9P, KIR-103AS, KIR-2DL4, KIR103, KIR103AS}, ATG3 (autophagy related 3) [NCBI Gene 64422] {aka APG3, APG3-LIKE, APG3L, PC3-96, hApg3}, ATG10 (autophagy related 10) [NCBI Gene 83734] {aka APG10, APG10L, ATG10S, pp12616}, Atg12 (autophagy related 12) [NCBI Gene 67526] {aka 4931423H11Rik, A330058M13Rik, Apg12l, Atg12l}, PSMB5 (proteasome 20S subunit beta 5) [NCBI Gene 5693] {aka LMPX, MB1}, TFEB (transcription factor EB) [NCBI Gene 7942] {aka ALPHATFEB, BHLHE35, TCFEB}, VCP (valosin containing protein) [NCBI Gene 7415] {aka CDC48, FTDALS6, TERA, p97}, TRIM11 (tripartite motif containing 11) [NCBI Gene 81559] {aka BIA1, RNF92}, RpL40 (Ribosomal protein L40) [NCBI Gene 33629] {aka BcDNA:RE10554, CEP52, CG2960, DUb52, Dmel\CG2960, Dub52}, ATG101 (autophagy related 101) [NCBI Gene 60673] {aka C12orf44}, ATG5 (autophagy related 5) [NCBI Gene 9474] {aka APG5, APG5-LIKE, APG5L, ASP, SCAR25, hAPG5}, Bag3 (BCL2-associated athanogene 3) [NCBI Gene 29810] {aka Bis, mg638}, PRKAB1 (protein kinase AMP-activated non-catalytic subunit beta 1) [NCBI Gene 5564] {aka AMPK, HAMPKb}, PSME2 (proteasome activator subunit 2) [NCBI Gene 5721] {aka PA28B, PA28beta, REGbeta}, CUL3 (cullin 3) [NCBI Gene 8452] {aka CUL-3, NEDAUS, PHA2E}, SNAP29 (synaptosome associated protein 29) [NCBI Gene 9342] {aka CEDNIK, SNAP-29}, CACNG1 (calcium voltage-gated channel auxiliary subunit gamma 1) [NCBI Gene 786] {aka CACNLG}, MAP2K3 (mitogen-activated protein kinase kinase 3) [NCBI Gene 5606] {aka MAPKK3, MEK3, MKK3, PRKMK3, SAPKK-2, SAPKK2}, ZNF418 (zinc finger protein 418) [NCBI Gene 147686] {aka ZFP418}, Pink1 (PTEN induced putative kinase 1) [NCBI Gene 68943] {aka 1190006F07Rik, BRPK, mFLJ00387}, Map1lc3a (microtubule-associated protein 1 light chain 3 alpha) [NCBI Gene 66734] {aka 1010001H21Rik, 4922501H04Rik, LC3, LC3a}, HSPA5 (heat shock protein family A (Hsp70) member 5) [NCBI Gene 3309] {aka BIP, GRP78, HEL-S-89n}, AT4G30790 (autophagy-like protein) [NCBI Gene 829202] {aka ATG11, AUTOPHAGY-RELATED 11, T10C21.140, T10C21_140}, CRIP1 (cysteine rich protein 1) [NCBI Gene 1396] {aka CRHP, CRIP, CRP-1, CRP1}, Foxo3 (forkhead box O3) [NCBI Gene 56484] {aka 1110048B16Rik, 2010203A17Rik, FKHRL1, Fkhr2, Foxo3a}, NEDD4 (NEDD4 E3 ubiquitin protein ligase) [NCBI Gene 4734] {aka NEDD4-1, RPF1}, RPTOR (regulatory associated protein of MTOR complex 1) [NCBI Gene 57521] {aka KOG1, Mip1}, TP53 (tumor protein p53) [NCBI Gene 7157] {aka BCC7, BMFS5, LFS1, P53, TRP53}, Ulk2 (unc-51 like kinase 2) [NCBI Gene 29869] {aka A830085I22Rik, Unc51.2, mKIAA0623}, MAPT (microtubule associated protein tau) [NCBI Gene 4137] {aka DDPAC, FTD1, FTDP-17, MAPTL, MSTD, MTBT1}, NSF (N-ethylmaleimide sensitive factor, vesicle fusing ATPase) [NCBI Gene 4905] {aka DEE96, SEC18, SKD2}, HSPB8 (heat shock protein family B (small) member 8) [NCBI Gene 26353] {aka CMT2L, DHMN2, E2IG1, H11, HMN2, HMN2A}, UBR1 (ubiquitin protein ligase E3 component n-recognin 1) [NCBI Gene 197131] {aka JBS}, Itgb5 (integrin beta 5) [NCBI Gene 16419] {aka ESTM23, [b]-5, [b]5, [b]5A, [b]5B, beta-5}, Snca (synuclein, alpha) [NCBI Gene 20617] {aka NACP, alpha-Syn, alphaSYN}, Htt (huntingtin) [NCBI Gene 15194] {aka C430023I11Rik, Hd, Hdh, IT15}, RNF216 (ring finger protein 216) [NCBI Gene 54476] {aka CAHH, TRIAD3, U7I1, UBCE7IP1, ZIN}, HDAC6 (histone deacetylase 6) [NCBI Gene 10013] {aka CPBHM, HD6, JM21, KDAC6, PPP1R90}, IFNG (interferon gamma) [NCBI Gene 3458] {aka IFG, IFI, IMD69}, ATG13 (autophagy related 13) [NCBI Gene 9776] {aka KIAA0652, PARATARG8}, Huwe1 (HECT, UBA and WWE domain containing 1) [NCBI Gene 59026] {aka 5430439H10Rik, Arf-bp1, C430014N20Rik, Gm1718, Ib772, LASU1}, FUS (FUS RNA binding protein) [NCBI Gene 2521] {aka ALS6, ETM4, FUS1, HNRNPP2, POMP75, TLS}, HTT (huntingtin) [NCBI Gene 3064] {aka HD, IT15, LOMARS}, Rpn2 (ribophorin II) [NCBI Gene 20014] {aka 1300012C06Rik, Rpn-2}, MAP1LC3A (microtubule associated protein 1 light chain 3 alpha) [NCBI Gene 84557] {aka ATG8E, LC3, LC3A, MAP1ALC3, MAP1BLC3}, DNAJB6 (DnaJ heat shock protein family (Hsp40) member B6) [NCBI Gene 10049] {aka DJ4, DnaJ, HHDJ1, HSJ-2, HSJ2, LGMD1D}, Nrf1 (nuclear respiratory factor 1) [NCBI Gene 18181] {aka D6Ertd415e}
- **Diseases:** neuronal damage (MESH:D009410), dementia (MESH:D003704), dopaminergic toxicity (MESH:D010523), PSP (MESH:D013494), FTD (MESH:D057180), multiple sclerosis (MESH:D009103), Friedreich's ataxia (MESH:D005621), ALS (MESH:D008113), Amyotrophic lateral sclerosis (MESH:D000690), neurodegeneration (MESH:D019636), inflammation (MESH:D007249), PD (MESH:D010300), mitochondrial dysfunction (MESH:D028361), HD (MESH:D006816), AD (MESH:D000544), myeloma (MESH:D009101), multisystem proteinopathy (MESH:C563476), neuroinflammation (MESH:D000090862), cytotoxicity (MESH:D064420)
- **Chemicals:** 6-hydroxydopamine (MESH:D016627), ATP (MESH:D000255), genistein (MESH:D019833), PI3P (MESH:C055525), lipids (MESH:D008055), nucleotide (MESH:D009711), cysteine (MESH:D003545), resveratrol (MESH:D000077185), calcium (MESH:D002118), PE (MESH:C483858), LY2874455 (MESH:C570663), DMF (-), VCPs (MESH:C034588), Omaveloxolone (MESH:C000589490), phosphatidylinositol (MESH:D010716), quercetin (MESH:D011794), Fluspirilene (MESH:D005484), SFN (MESH:C016766), Lecanemab (MESH:C000612089)
- **Species:** C. elegans [taxon 328850], Drosophila melanogaster (fruit fly, species) [taxon 7227], Arabidopsis thaliana (mouse-ear cress, species) [taxon 3702], Mus musculus (house mouse, species) [taxon 10090], Saccharomyces cerevisiae (baker's yeast, species) [taxon 4932], Homo sapiens (human, species) [taxon 9606]
- **Mutations:** R155C, A232E, R155H, R191Q, A 26 S, R42P, T240R, R95G
- **Cell lines:** HeLa — Homo sapiens (Human), Human papillomavirus-related endocervical adenocarcinoma, Cancer cell line (CVCL_0030), HEK293 — Homo sapiens (Human), Transformed cell line (CVCL_0045)

## Full text

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## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12956652/full.md

## References

313 references — full list in the complete paper: https://tomesphere.com/paper/PMC12956652/full.md

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Source: https://tomesphere.com/paper/PMC12956652