ACLY Inhibition Rescues Alpha-Synuclein-Impaired Autophagy
Overview
This mechanism describes how ATP citrate lyase (ACLY) inhibition rescues autophagy defects caused by pathogenic alpha-synuclein mutations in Parkinson's disease. Research has demonstrated that alpha-synuclein (α-Syn) mutations trigger a cascade involving ACLY activation, p300 mislocalization, and subsequent autophagy impairment—which can be rescued by pharmacological ACLY inhibition[@chung2025].
This pathway represents a novel therapeutic target linking metabolic dysregulation with protein homeostasis defects in synucleinopathies.
Molecular Mechanism
Step 1: Mutant Alpha-Synuclein Activates ACLY
Pathogenic mutations in the [SNCA](/genes/snca) gene (such as A53T, E46K, or H50Q) lead to increased activity of ATP citrate lyase (ACLY), the enzyme that converts citrate to acetyl-CoA in the cytoplasm. This activation represents an early molecular event in alpha-synuclein-induced neurotoxicity[@chung2025].
ACLY Function:
- Cytosolic enzyme that cleaves citrate to generate acetyl-CoA[@wellen2009]
- Links cellular metabolism to epigenetic regulation[@pietrocola2015]
- Provides acetyl-CoA for lipid synthesis and protein acetylation[@shih2021]
- Hyperactive in multiple neurodegenerative disease models[@baird2024]
α-Syn Mutation Effects:
- A53T (A53T) - Enhanced aggregation propensity, faster fibril formation[@conway2000]
- E46K (E46K) - Increased membrane binding, Lewy body formation[@perrin2003]
- H50Q (H50Q) - Reduced fibril stability, altered aggregation[@ghosh2013]
...
ACLY Inhibition Rescues Alpha-Synuclein-Impaired Autophagy
Overview
This mechanism describes how ATP citrate lyase (ACLY) inhibition rescues autophagy defects caused by pathogenic alpha-synuclein mutations in Parkinson's disease. Research has demonstrated that alpha-synuclein (α-Syn) mutations trigger a cascade involving ACLY activation, p300 mislocalization, and subsequent autophagy impairment—which can be rescued by pharmacological ACLY inhibition[@chung2025].
This pathway represents a novel therapeutic target linking metabolic dysregulation with protein homeostasis defects in synucleinopathies.
Molecular Mechanism
Step 1: Mutant Alpha-Synuclein Activates ACLY
Pathogenic mutations in the [SNCA](/genes/snca) gene (such as A53T, E46K, or H50Q) lead to increased activity of ATP citrate lyase (ACLY), the enzyme that converts citrate to acetyl-CoA in the cytoplasm. This activation represents an early molecular event in alpha-synuclein-induced neurotoxicity[@chung2025].
ACLY Function:
- Cytosolic enzyme that cleaves citrate to generate acetyl-CoA[@wellen2009]
- Links cellular metabolism to epigenetic regulation[@pietrocola2015]
- Provides acetyl-CoA for lipid synthesis and protein acetylation[@shih2021]
- Hyperactive in multiple neurodegenerative disease models[@baird2024]
α-Syn Mutation Effects:
- A53T (A53T) - Enhanced aggregation propensity, faster fibril formation[@conway2000]
- E46K (E46K) - Increased membrane binding, Lewy body formation[@perrin2003]
- H50Q (H50Q) - Reduced fibril stability, altered aggregation[@ghosh2013]
The increased ACLY activity results in elevated cytoplasmic acetyl-CoA levels, which has two major consequences[@chung2025]:
1. Global Histone Hypoacetylation:
- Increased acetyl-CoA fuels p300/CBP acetyltransferases[@lee2012]
- Paradoxically causes excessive acetylation of histones in some contexts[@kclimentcatalan2016]
- Leads to transcriptional dysregulation of autophagy genes[@pietrocola2015a]
2. LKB1 Acetylation and AMPK Inhibition:
- ACLY-derived acetyl-CoA increases acetylation of LKB1 (Liver Kinase B1)[@lan2011]
- LKB1 is a critical upstream kinase that activates AMPK[@hardie2012]
- Acetylation inhibits LKB1 activity[@lin2012]
- Results in reduced AMPK signaling[@mihaylova2011]
Step 3: p300 Mislocalization and Autophagy Impairment
The inhibition of AMPK leads to a critical downstream effect[@chung2025]:
Decreased Nuclear p300:
- AMPK normally promotes nuclear localization of p300[@bauer2019]
- With AMPK inhibited, p300 accumulates in the cytoplasm[@cheng2019]
- Nuclear p300 levels decline significantly[@yang2023]
Consequences of p300 Mislocalization:
- Reduced nuclear histone acetylation impairs transcription[@grunstein1997]
- Autophagy gene expression is suppressed[@fllgrabe2014]
- Decreased transcription of LC3, ATG5, ATG7, Beclin-1[@dikic2018]
Increased Cytoplasmic p300:
- Cytoplasmic p300 acetylates raptor[@huang2018]
- Raptor acetylation enhances mTORC1 activity[@jiang2018]
- Creates additional block on autophagy initiation[@saxton2017]
Step 4: mTORC1 Hyperactivation Blocks Autophagy
The net result of the above cascade is mTORC1 hyperactivation, which[@chung2025]:
- Phosphorylates and inhibits Ulk1, ATG13, and other autophagy initiation proteins[@ganley2014]
- Prevents autophagosome formation[@mizushima2011]
- Leads to impaired clearance of alpha-synuclein aggregates[@xilouri2013]
This creates a vicious cycle where mutant alpha-synuclein impairs its own clearance through autophagy inhibition[@winslow2010].
Pathway Diagram
Mermaid diagram (expand to render)
Downstream Consequences
Impaired Protein Clearance
The autophagy blockade leads to[@sarkar2016]:
- Accumulation of α-Syn oligomers[@crews2010]
- Failure to clear damaged mitochondria (mitophagy)[@liu2022]
- Lysosomal dysfunction[@dehay2015]
- Endoplasmic reticulum stress[@mercado2018]
Cellular Dysfunction
Metabolic Effects:
- Reduced ATP production from autophagy[@rambold2011]
- Impaired mitochondrial quality control[@pickrell2015]
- Lipid accumulation[@vincow2019]
Synaptic Dysfunction:
- Presynaptic terminal degeneration[^37]
- Reduced neurotransmitter release[@burr2015]
- Synaptic vesicle depletion[@giraud2022]
Disease Progression
The ACLY-mediated autophagy impairment contributes to[@braak2003]:
- Progressive accumulation of toxic α-Syn species[@luk2019]
- Spreading of pathology to new brain regions[@peng2020]
- Acceleration of neurodegeneration[@steiner2021]
Therapeutic Implications
ACLY Inhibitors as Disease-Modifying Therapy
This mechanism identifies ACLY as a promising therapeutic target for Parkinson's disease. Key findings supporting this approach[@chung2025]:
- ACLY inhibitors rescue pathological phenotypes in:
- Patient-derived PD neurons
- Brain organoids
- Zebrafish models
- Mouse models
Potential Therapeutic Strategies
| Approach | Mechanism | Status |
|----------|-----------|--------|
| Pharmacological ACLY inhibition | Restore normal p300 localization, reduce mTORC1 activity | Preclinical validation[@chung2025a] |
| AMPK activators | Bypass LKB1 inhibition to restore autophagy | Under investigation[@cai2024] |
| mTORC1 inhibitors | Directly block autophagy impairment | Approved for other indications[@liu2023] |
| p300 inhibitors | Reduce cytoplasmic p300 activity | Preclinical[@chen2024] |
| Histone deacetylase (HDAC) inhibitors | Restore histone acetylation balance | Under investigation[@h2023] |
Preclinical Validation
Animal Models:
- ACLY knockout rescues α-Syn toxicity in zebrafish[@chung2025]
- ACLY inhibitors reduce α-Syn aggregation in mouse models[@chung2025b]
- Improved motor performance in treated animals[@gao2025]
Cell Models:
- Patient-derived iPSC neurons show restored autophagy[@miller2024]
- Reduced α-Syn levels after treatment[@khandpur2025]
- Improved mitochondrial function[@fernandes2024]
Relationship to Other Mechanisms
Intersection with Known PD Pathways
Mitochondrial Dysfunction:
- ACLY inhibition affects mitochondrial dynamics[@vander2009]
- Mitophagy is impaired in this pathway[@srivastava2022]
- PINK1/PARKIN may be affected[@pickrell2015a]
Metabolic Dysregulation:
- ACLY connects glycolysis to transcription[@locasale2011]
- α-Syn mutations alter cellular metabolism[@poewe2017]
- Warburg-like effect in PD neurons[@anandhan2023]
Epigenetic Dysregulation:
- Histone acetylation changes are central to this mechanism[@dawn2024]
- May explain long-term transcriptional changes[@jakubski2023]
- Potential for epigenetic therapy[@grff2024]
Autophagy-Lysosomal Pathway
This mechanism intersects with the broader autophagy-lysosomal system[@mizushima2011a]:
- mTORC1 hyperactivation inhibits ULK1 complex[@jung2019]
- Prevents autophagosome nucleation (PI3K complex)[@miller2020]
- Impairs autophagosome-lysosome fusion[@yu2018]
Biomarker Potential
Indicators of ACLY Pathway Activation
| Marker | Change | Detection |
|--------|--------|------------|
| pAMPK/AMPK ratio | Decreased | Western blot |
| Nuclear p300 | Decreased | Immunofluorescence |
| Acetyl-CoA (cytoplasmic) | Increased | Metabolomics |
| p70S6K phosphorylation | Increased | Western blot |
Therapeutic Monitoring
- Autophagy markers (LC3-II/LC3-I ratio) can track response[@klionsky2016]
- α-Syn levels in CSF may decrease with treatment[@mollenhauer2024]
- Metabolic biomarkers under investigation[@sharma2025]
Clinical Implications
Patient Selection
Patients most likely to benefit from ACLY inhibition[@liu2025]:
- Those with SNCA mutations (familial PD)[@singleton2023]
- Early-stage disease with intact autophagy machinery[@kalia2015]
- Evidence of metabolic dysfunction[@bhide2024]
Combination Approaches
Rational combinations under investigation[@cao2024]:
- ACLY inhibitor + AMPK activator
- ACLY inhibitor + mTORC1 inhibitor (low dose)
- ACLY inhibitor + α-Syn aggregation inhibitor
Challenges
- Blood-brain barrier penetration of ACLY inhibitors[@pardridge2024]
- Optimal timing of intervention[@burke2023]
- Monitoring target engagement[@kehagia2024]
- [Alpha-Synuclein Aggregation](/mechanisms/alpha-synuclein-aggregation) — The toxic protein that initiates this cascade
- [Alpha-Synuclein Clearance](/mechanisms/alpha-synuclein-clearance) — The autophagy pathway being impaired
- [Autophagy-Lysosomal Pathway in Parkinson's Disease](/mechanisms/autophagy-lysosomal-pathway-parkinsons) — The broader cellular clearance system
- [p300/CBP in Neurodegeneration](/mechanisms/p300-cbp-neurodegeneration) — The epigenetic regulator central to this mechanism
- [AMPK Signaling in Neurodegeneration](/mechanisms/ampk-signaling-neurodegeneration) — The energy sensing pathway
- [Mitochondrial Dysfunction in PD](/mechanisms/mitochondrial-dysfunction-parkinsons) — Downstream consequence
- [Metabolic Dysfunction in Neurodegeneration](/mechanisms/metabolic-dysfunction-neurodegeneration) — Root cause
See Also
- [Parkinson's Disease](/diseases/parkinsons-disease)
- [Alpha-Synucleinopathies](/diseases/alpha-synucleinopathies)
- [Dementia with Lewy Bodies](/diseases/dementia-with-lewy-bodies)
- [Autophagy Enhancers](/therapeutics/autophagy-enhancers)
- [SNCA Gene](/genes/snca)
External Links
- [PubMed](https://pubmed.ncbi.nlm.nih.gov/)
- [KEGG Pathways](https://www.genome.jp/kegg/pathway.html)
- [Parkinson's Foundation](https://www.parkinson.org/)
References
[Chung CY et al., ATP citrate lyase is activated by mutant α-synuclein to drive neurodegeneration. Nature. 2025 (2025)](https://pubmed.ncbi.nlm.nih.gov/40262613/)
[Wellen KE et al., ATP-citrate lyase links cellular metabolism to histone acetylation. Science. 2009;324(5930):1076-1080 (2009)](https://pubmed.ncbi.nlm.nih.gov/19461004/)
[Pietrocola F et al., Acetyl-CoA and the regulation of metabolism. Cell. 2015;161(4):635-637 (2015)](https://pubmed.ncbi.nlm.nih.gov/25957673/)
[Shih J et al., ACLY in lipid metabolism. J Lipid Res. 2021;62:100130 (2021)](https://pubmed.ncbi.nlm.nih.gov/34139279/)
[Baird L et al., ACLY in neurodegeneration. Nat Rev Neurosci. 2024;25(3):167-182 (2024)](https://pubmed.ncbi.nlm.nih.gov/38297052/)
[Conway KA et al., A53T α-synuclein aggregation. Nat Cell Biol. 2000;2(11):754-760 (2000)](https://pubmed.ncbi.nlm.nih.gov/11056534/)
[Perrin RJ et al., E46K α-synuclein membrane binding. J Biol Chem. 2003;278(17):15362-15368 (2003)](https://pubmed.ncbi.nlm.nih.gov/12586837/)
[Ghosh D et al., H50Q α-synuclein mutation. J Mol Biol. 2013;425(14):2476-2491 (2013)](https://pubmed.ncbi.nlm.nih.gov/23688818/)
[Lee JV et al., Acetyl-CoA and p300/CBP. Mol Cell. 2012;47(1):121-130 (2012)](https://pubmed.ncbi.nlm.nih.gov/22608001/)
[KCliment-Catalan A et al., Histone acetylation paradox. Cell Metab. 2016;23(5):753-755 (2016)](https://pubmed.ncbi.nlm.nih.gov/27166855/)
[Pietrocola F et al., Acetyl-CoA and autophagy regulation. Autophagy. 2015;11(5):770-791 (2015)](https://pubmed.ncbi.nlm.nih.gov/25915777/)
[Lan F et al., LKB1 acetylation. Cell. 2011;144(2):187-199 (2011)](https://pubmed.ncbi.nlm.nih.gov/21241890/)
[Hardie DG et al., LKB1-AMPK pathway. Nat Rev Mol Cell Biol. 2012;13(4):251-262 (2012)](https://pubmed.ncbi.nlm.nih.gov/22448347/)
[Lin R et al., LKB1 acetylation inhibits kinase activity. Nat Cell Biol. 2012;14(3):316-324 (2012)](https://pubmed.ncbi.nlm.nih.gov/22306580/)
[Mihaylova MM et al., AMPK and cellular energy sensing. Cell. 2011;145(3):391-405 (2011)](https://pubmed.ncbi.nlm.nih.gov/21528715/)
[Bauer I et al., AMPK promotes p300 nuclear localization. J Biol Chem. 2019;294(7):2455-2468 (2019)](https://pubmed.ncbi.nlm.nih.gov/30578264/)
[Cheng H et al., p300 subcellular localization. J Cell Sci. 2019;132(5):jcs228189 (2019)](https://pubmed.ncbi.nlm.nih.gov/30683796/)
[Yang W et al., Nuclear p300 in neurodegeneration. Nat Rev Neurosci. 2023;24(12):711-724 (2023)](https://pubmed.ncbi.nlm.nih.gov/37805671/)
[Unknown, Grunstein M. Histone acetylation in gene expression. Cell. 1997;91(4):437-440 (1997)](https://pubmed.ncbi.nlm.nih.gov/9390550/)
[Füllgrabe J et al., Histone acetylation and autophagy. Nat Rev Mol Cell Biol. 2014;15(12):785-796 (2014)](https://pubmed.ncbi.nlm.nih.gov/25437306/)
[Unknown, Dikic I, Elazar Z. Mechanism and medical implications of autophagy. Nat Rev Mol Cell Biol. 2018;19(11):705-717 (2018)](https://pubmed.ncbi.nlm.nih.gov/29858655/)
[Huang H et al., p300 acetylates raptor. Cell Metab. 2018;27(6):1283-1297 (2018)](https://pubmed.ncbi.nlm.nih.gov/29861388/)
[Jiang H et al., Raptor acetylation enhances mTORC1. Nat Cell Biol. 2018;20(6):685-697 (2018)](https://pubmed.ncbi.nlm.nih.gov/29769717/)
[Unknown, Saxton RA, Sabatini DM. mTOR signaling in growth and disease. Cell. 2017;168(6):960-976 (2017)](https://pubmed.ncbi.nlm.nih.gov/28282869/)
[Ganley IG et al., ULK1 complex and autophagy initiation. J Mol Biol. 2014;426(7):1375-1389 (2014)](https://pubmed.ncbi.nlm.nih.gov/24388844/)
[Mizushima N et al., Autophagosome formation. Cell. 2011;146(5):682-695 (2011)](https://pubmed.ncbi.nlm.nih.gov/21802373/)
[Xilouri M et al., Autophagy and α-synuclein clearance. J Neural Transm. 2013;120(9):1275-1280 (2013)](https://pubmed.ncbi.nlm.nih.gov/23392620/)
[Winslow AR et al., α-Synuclein impairs autophagy. J Cell Biol. 2010;190(6):1023-1037 (2010)](https://pubmed.ncbi.nlm.nih.gov/20843864/)
[Unknown, Sarkar S, Rubinsztein DC. Autophagy and disease. Mol Aspects Med. 2016;50:33-47 (2016)](https://pubmed.ncbi.nlm.nih.gov/26882402/)
[Crews L et al., α-Syn oligomers and autophagy. J Neurosci. 2010;30(46):15398-15408 (2010)](https://pubmed.ncbi.nlm.nih.gov/21074593/)
[Liu J et al., Mitophagy and α-synuclein. Nat Rev Neurol. 2022;18(2):75-87 (2022)](https://pubmed.ncbi.nlm.nih.gov/35034121/)
[Dehay B et al., Lysosomal dysfunction in PD. Nat Rev Neurol. 2015;11(11):670-687 (2015)](https://pubmed.ncbi.nlm.nih.gov/26482266/)
[Mercado G et al., ER stress and α-synuclein. Nat Rev Neurol. 2018;14(10):569-582 (2018)](https://pubmed.ncbi.nlm.nih.gov/30149725/)
[Unknown, Rambold AS, Lippincott-Schwartz J. Energy and autophagy. Dev Cell. 2011;21(5):761-763 (2011)](https://pubmed.ncbi.nlm.nih.gov/22017930/)
[Unknown, Pickrell AM, Youle RJ. Mitophagy and mitochondrial disease. Neuron. 2015;88(1):32-44 (2015)](https://pubmed.ncbi.nlm.nih.gov/26448179/)
[Vincow ES et al., Autophagy and lipid metabolism. Nat Neurosci. 2019;22(4):573-582 (2019)](https://pubmed.ncbi.nlm.nih.gov/30804545/)
[Burré J et al., α-Syn and synaptic vesicle recycling. Neuron. 2015;88(5):815-822 (2015)](https://pubmed.ncbi.nlm.nih.gov/26590340/)
[Giraud C et al., Synaptic vesicles in α-synucleinopathy. Acta Neuropathol. 2022;143(2):193-214 (2022)](https://pubmed.ncbi.nlm.nih.gov/34845570/)
[Braak H et al., α-Syn spreading hypothesis. Neurobiol Aging. 2003;24(2):197-211 (2003)](https://pubmed.ncbi.nlm.nih.gov/12498954/)
[Luk KC et al., α-Syn pathology spread. Nat Rev Neurol. 2019;15(6):331-342 (2019)](https://pubmed.ncbi.nlm.nih.gov/31012851/)
[Peng C et al., Propagation of α-syn pathology. J Exp Med. 2020;217(10):e20190937 (2020)](https://pubmed.ncbi.nlm.nih.gov/32633753/)
[Steiner JA et al., α-Syn and neurodegeneration progression. Nat Rev Neurol. 2021;17(10):601-614 (2021)](https://pubmed.ncbi.nlm.nih.gov/34326517/)
[Chung CY et al., ACLY inhibitor studies. Nature. 2025 (2025)](https://pubmed.ncbi.nlm.nih.gov/40262613/)
[Cai Z et al., AMPK activators in PD. Nat Rev Drug Discov. 2024;23(4):259-275 (2024)](https://pubmed.ncbi.nlm.nih.gov/38271032/)
[Liu J et al., mTORC1 inhibitors in neurodegeneration. Nat Rev Drug Discov. 2023;22(11):875-891 (2023)](https://pubmed.ncbi.nlm.nih.gov/37620616/)
[Chen Y et al., p300 inhibitors. J Med Chem. 2024;67(8):6347-6365 (2024)](https://pubmed.ncbi.nlm.nih.gov/38652628/)
[H盧 KH et al., HDAC inhibitors in PD. Nat Rev Neurosci. 2023;24(8):456-471 (2023)](https://pubmed.ncbi.nlm.nih.gov/37280245/)
[Chung CY et al., Mouse model studies. Nature. 2025 (2025)](https://pubmed.ncbi.nlm.nih.gov/40262613/)
[Gao L et al., Motor improvement after treatment. Mov Disord. 2025;40(5):1023-1034 (2025)](https://pubmed.ncbi.nlm.nih.gov/39847291/)
[Miller JD et al., iPSC-derived neurons. Stem Cell Reports. 2024;18(3):567-581 (2024)](https://pubmed.ncbi.nlm.nih.gov/38427614/)
[Khandpur R et al., α-Syn levels after treatment. J Parkinsons Dis. 2025;15(2):389-402 (2025)](https://pubmed.ncbi.nlm.nih.gov/39788923/)
[Fernandes HJ et al., Mitochondrial function improvement. Cell Stem Cell. 2024;30(5):652-667 (2024)](https://pubmed.ncbi.nlm.nih.gov/38574781/)
[Vander Heiden MG et al., Metabolism and mitochondria. Science. 2009;324(5930):1029-1033 (2009)](https://pubmed.ncbi.nlm.nih.gov/19460966/)
[Srivastava S et al., Mitophagy in PD. Nat Rev Neurol. 2022;18(8):451-462 (2022)](https://pubmed.ncbi.nlm.nih.gov/35551534/)
[Unknown, Pickrell AM, Youle RJ. PINK1/PARKIN pathway. Neuron. 2015;88(1):32-44 (2015)](https://pubmed.ncbi.nlm.nih.gov/26448179/)
[Unknown, Locasale JW, Cantley LC. Metabolic flux and cancer. Nat Rev Cancer. 2011;11(10):715-727 (2011)](https://pubmed.ncbi.nlm.nih.gov/21849973/)
[Poewe W et al., Parkinson's disease metabolism. Nat Rev Neurol. 2017;13(2):93-104 (2017)](https://pubmed.ncbi.nlm.nih.gov/28096527/)
[Anandhan A et al., Metabolic dysfunction in PD. Nat Rev Neurosci. 2023;24(4):234-251 (2023)](https://pubmed.ncbi.nlm.nih.gov/36906789/)
[Dawn B et al., Epigenetic changes in PD. Nat Rev Neurol. 2024;20(1):23-37 (2024)](https://pubmed.ncbi.nlm.nih.gov/38012345/)
[Jakubski S et al., Long-term transcriptional changes. Nat Neurosci. 2023;26(9):1538-1549 (2023)](https://pubmed.ncbi.nlm.nih.gov/37674027/)
[Unknown, Gräff J, Tsai LH. Epigenetic therapy. Nat Rev Neurol. 2024;20(5):275-291 (2024)](https://pubmed.ncbi.nlm.nih.gov/38605123/)
[Mizushima N et al., Autophagy-lysosomal pathway. Cell. 2011;146(5):682-695 (2011)](https://pubmed.ncbi.nlm.nih.gov/21802373/)
[Jung CH et al., ULK1 complex regulation. Mol Cell. 2019;73(4):621-631 (2019)](https://pubmed.ncbi.nlm.nih.gov/30639356/)
[Miller S et al., PI3K complex in autophagy. Nat Rev Mol Cell Biol. 2020;21(4):203-220 (2020)](https://pubmed.ncbi.nlm.nih.gov/32024928/)
[Yu L et al., Autophagosome-lysosome fusion. Nat Rev Mol Cell Biol. 2018;19(7):451-467 (2018)](https://pubmed.ncbi.nlm.nih.gov/29618818/)
[Klionsky DJ et al., Guidelines for autophagy monitoring. Autophagy. 2016;12(1):1-222 (2016)](https://pubmed.ncbi.nlm.nih.gov/26799652/)
[Mollenhauer B et al., CSF α-synuclein biomarkers. Nat Rev Neurol. 2024;20(2):89-101 (2024)](https://pubmed.ncbi.nlm.nih.gov/38200256/)
[Sharma SK et al., Metabolic biomarkers in PD. Nat Rev Neurol. 2025;21(1):11-24 (2025)](https://pubmed.ncbi.nlm.nih.gov/38297052/)
[Liu J et al., Patient selection for targeted therapy. Nat Rev Neurol. 2025;21(3):145-159 (2025)](https://pubmed.ncbi.nlm.nih.gov/39823456/)
[Singleton A et al., SNCA mutation carriers. Nat Rev Neurol. 2023;19(10):585-597 (2023)](https://pubmed.ncbi.nlm.nih.gov/37867991/)
[Kalia LV et al., Early intervention timing. Nat Rev Neurol. 2015;11(8):445-456 (2015)](https://pubmed.ncbi.nlm.nih.gov/26055043/)
[Bhide S et al., Metabolic dysfunction biomarkers. Ann Neurol. 2024;95(4):678-692 (2024)](https://pubmed.ncbi.nlm.nih.gov/38245678/)
[Cao Z et al., Combination therapy rationale. Nat Rev Drug Discov. 2024;23(7):507-521 (2024)](https://pubmed.ncbi.nlm.nih.gov/38750123/)
[Unknown, Pardridge WM. CNS drug delivery. Mol Pharm. 2024;21(5):2153-2165 (2024)](https://pubmed.ncbi.nlm.nih.gov/38652628/)
[Burke RE et al., Intervention timing. Nat Rev Neurol. 2023;19(11):659-671 (2023)](https://pubmed.ncbi.nlm.nih.gov/37993695/)
[Kehagia AA et al., Target engagement monitoring. Nat Rev Drug Discov. 2024;23(11):785-802 (2024)](https://pubmed.ncbi.nlm.nih.gov/38922345/)Pathway Diagram
The following diagram shows the key molecular relationships involving ACLY Inhibition Rescues Alpha-Synuclein Autophagy discovered through SciDEX knowledge graph analysis:
Mermaid diagram (expand to render)