Review Article

Targeting neurodegenerative disease-associated protein aggregation with proximity-inducing modalities

Rui-xin Ge1, Miao Chen2, Qing-chao Li1, Min Liu1, Jun Zhou1,3, Song-bo Xie4
1 Center for Cell Structure and Function, Collaborative Innovation Center of Cell Biology in Universities of Shandong, College of Life Sciences, Shandong Normal University, Jinan 250014, China
2 School of Life Sciences and Medicine, Shandong University of Technology, Zibo 255500, China
3 State Key Laboratory of Medicinal Chemical Biology, Tianjin Key Laboratory of Protein Science, Haihe Laboratory of Cell Ecosystem, College of Life Sciences, Nankai University, Tianjin 300071, China
4 The Province and Ministry Co- sponsored Collaborative Innovation Center for Medical Epigenetics, Tianjin Medical University. Department of Ophthalmology, Ministry of Education International Joint Laboratory of Ocular Diseases, Tianjin Key Laboratory of Ocular Trauma, Tianjin Institute of Eye Health and Eye Diseases, China-UK “Belt and Road” Ophthalmology Joint Laboratory, Tianjin Medical University General Hospital, Tianjin 300052, China
Correspondence to: Jun Zhou: junzhou@sdnu.edu.cn, Song-bo Xie: songboxie@tmu.edu.cn,
DOI: 10.1038/s41401-025-01538-2
Received: 19 January 2025
Accepted: 10 March 2025
Advance online: 7 April 2025

Abstract

Neurodegenerative diseases (NDDs) are characterized by progressive neuronal dysfunction and anatomical changes caused by neuron loss and gliosis, ultimately leading to severe declines in brain function. While these disorders arise from a variety of pathological mechanisms, a common molecular feature is the accumulation of misfolded proteins, which occurs both inside and outside neurons. For example, Alzheimer’s disease (AD) is defined by extracellular β-amyloid plaques and intracellular tau neurofibrillary tangles. These pathological protein aggregates are often resistant to traditional small molecule drugs. Recent advances in proximity-inducing chimeras such as proteolysis-targeting chimeras (PROTACs), lysosome-targeting chimeras (LYTACs), autophagy-targeted chimeras (AUTOTACs), dephosphorylation-targeting chimeras (DEPTACs) and ribonuclease-targeting chimeras (RIBOTACs) offer promising strategies to eliminate pathological proteins or mRNAs through intracellular degradation pathways. These innovative approaches open avenues for developing new therapies for NDDs. In this review we summarize the regulatory mechanisms of protein aggregation, highlight the advancements in proximity-inducing modalities for NDDs, and discuss the current challenges and future directions in therapeutic development.
Keywords: neurodegenerative diseases; PROTAC; LYTAC; AUTOTAC; DEPTAC; RIBOTAC

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