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Autophagy and Neurodegeneration: Pathogenic Mechanisms and Therapeutic Opportunities
Open accessAbstract
Autophagy is a conserved pathway that delivers cytoplasmic contents to the lysosome for degradation. Here we consider its roles in neuronal health and disease. We review evidence from mouse knockout studies demonstrating the normal functions of autophagy as a protective factor against neurodegeneration associated with intracytoplasmic aggregate-prone protein accumulation as well as other roles, including in neuronal stem cell differentiation. We then describe how autophagy may be affected in a range of neurodegenerative diseases. Finally, we describe how autophagy upregulation may be a therapeutic strategy in a wide range of neurodegenerative conditions and consider possible pathways and druggable targets that may be suitable for this objective.
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“and permanent or transient endogenous defects in autophagy have been associated with embryonic lethality, developmental defects, and multiple pathological disorders, including (but not limited to) neurodegeneration, cancer, and cardiovascular disorders [812–817].”
From Molecular mechanisms of cell death: recommendations of the nomenclature committee on cell death 2018. (2018) · cites this paper as [813]
In the citing paper
“Molecular and histopathologic analyses of patient tissues demonstrate mislocalized or accumulated autophagy machinery, pathogenic mutations underlying familial neurodegenerative diseases disable known autophagy-related factors, and genetically ablating autophagy effectors produce neurodegeneration in cell and animal model systems [74–81], supporting a role for autophagy dysfunction in the devel”
From Autophagy and ALS: mechanistic insights and therapeutic implications (2022) · cites this paper as [80]
In the citing paper
“The autophagic process is essential in preserving the homeostatic requirements of post‐mitotic neurons, both at the central and at the peripheral nervous system levels (Menzies et al, 2017; Scrivo et al, 2018; Mallucci et al, 2020)”
From Autophagy in major human diseases (2021) · cites this paper as Menzies et al, 2017
In the citing paper
“By analogy, a comparable phenotype has been described in Atg16l1 hypomorphic mice (Lv et al, 2014; Wu et al, 2016; Menzies et al, 2017).”
From Autophagy in major human diseases (2021) · cites this paper as Menzies et al, 2017
In the citing paper
“Aβ is targeted for autophagy‐dependent degradation within the lysosome, explaining why activation of autophagy reduces the burden of Aβ plaques in rodents (Boland et al, 2008; Menzies et al, 2017; Meng et al, 2019).”
From Autophagy in major human diseases (2021) · cites this paper as Menzies et al, 2017
In the citing paper
“However, autophagy appears to be causally implicated in the PSEN1 (presenilin 1)‐mediated conversion of APP (amyloid beta precursor protein) into Aβ (Yu et al, 2005), as well as in the non‐canonical secretion of Aβ into the extracellular space (Nilsson et al, 2013; Menzies et al, 2017).”
From Autophagy in major human diseases (2021) · cites this paper as Menzies et al, 2017
In the citing paper
“While autophagy proteins have been shown to impact the clearance of protein aggregates in neurons, most likely by the canonical autophagic process of aggrephagy (Frake et al., 2015; Menzies et al., 2017; Qaisiya et al., 2017; Sarkar et al., 2007; Sarkar et al., 2009; Webb et al., 2003; Yamamoto and Simonsen, 2011), effects in microglia of the CNS are more likely due to LANDO.”
From LC3-Associated Endocytosis Facilitates β-Amyloid Clearance and Mitigates Neurodegeneration in Murine Alzheimer’s Disease (2019) · cites this paper as Menzies et al., 2017
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Enriched oxygen improves age-related cognitive impairment through enhancing autophagy
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BackgroundLoss of KEAP1 Causes an Accumulation of Nondegradative Organelles
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Self-citationAI-based AlphaFold2 significantly expands the structural space of the autophagy pathway
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Introduction to Neurodegenerative Diseases
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“Many studies have shown that mutations in the core ATG gene will trigger neurodegenerative diseases [66, 68, 69].”
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“…including mHTT, as well as other proteins linked to neurodegenerative disorders of the brain 4–7 and autophagy-upregulating drugs have been shown to enhance the clearance of these proteins, thereby attenuating their toxicities in Drosophila, zebrafish and mice (reviewed in Menzies et al 3 ).”
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“Autophagy maintains cellular homeostasis by eliminating cytotoxic protein aggregates and damaged organelles, a function particularly crucial for post-mitotic neurons (Menzies et al., 2017; Morishita and Mizushima, 2019).”
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“Emerging evidence suggests that autophagy is a cellular defense mechanism against NDDs, preventing detrimental oligomer formation, or even clearing aggregates [142, 143].”
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Self-citationA homozygous variant in CHMP3 is associated with complex hereditary spastic paraplegia
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“The importance of autophagosomes in neuronal homeostasis has been demonstrated, partly because loss of autophagosome biogenesis results in protein aggregation (Menzies et al., 2017; Stavoe and Holzbaur, 2019).”
BackgroundSIRT1: A Novel Way to Target Tau?
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Effects and Mechanisms of Rapamycin Action on Experimental Neurodegeneration
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“On the other hand, it is well accepted that the main pathway for removing the aggregated and misfolded proteins is the autophagy pathway (10, 32).”
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“They induce neurodegeneration, particularly affecting dopaminergic neurons. α Syn aggregates are mostly cleared through the autophagy–lysosomal pathway [5,6].”
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“A man-made pharmaceutical, metformin, used in the treatment of diabetes, also has this broad set of attributes, and has protective properties in animal models of neurodegeneration [84,85].”
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“Since the neurotoxic protein aggregates are mainly degraded through autophagy, the activation of autophagy is currently being considered as a potential approach that could ameliorate various diseases including neurodegenerative diseases [15, 70, 71].”
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Cardiac electrical remodeling and neurodegenerative diseases association
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The complexity of biological control systems: An autophagy case study
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“BioEssays published byWiley Periodicals LLC A series of autophagy-related (ATG) proteins participate in the main steps of the autophagy pathway: formation of autophagosomal membranes, maturation and final fusion with lysosomes.[4,5,9]”
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“LC3 precursor is hydrolyzed by a cysteine protease called ATG4B and then converted to a proteolytic form termed LC3-I, which lacks C-terminal amino acids and is processed as a membrane-associated form termed LC3-II [48].”
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“Increased autophagy to remove damaged cellular components has been implicated as a protective mechanism in neurodegeneration (Menzies et al., 2017).”
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Reduced Autophagy in Aged Trigeminal Neurons Causes Amyloid β Diffusion
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“Keywords: aging, trigeminal nuclei, autophagosome, beta amyloid, homeostasis, Alzheimer’s disease released outside the cell (Menzies et al. 2017; Reddy and Oliver 2019).”
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“Indeed, impaired autophagy is directly involved in all major age-related human diseases including cancer [2], cardiovascular disease [26], neurodegeneration [27].”
BackgroundStaufen blocks autophagy in neurodegenerationPreprint
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Autophagy regulates neuronal excitability by controlling cAMP/Protein Kinase A signalingPreprint
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Reduced S-acylation of SQSTM1/p62 in Huntington disease is associated with impaired autophagyPreprint
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“It provides essential building blocks and energy under nutrient deprivation or stress conditions [40,41].”
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“During autophagic flux, dysfunctional organelles and cytotoxic macromolecular aggregates are degraded through the formation of autophagosomes and the consequent fusion with lysosomes (autolysosomes) (Menzies et al. 2017).”
InfluentialLinking endo-lysosomal pH, sterol, and trafficking to neurodegenerative disease
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Dystonin loss-of-function leads to impaired autophagosome–endolysosome pathway dynamics
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Future horizons: Innovation, aging, and equity
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Autophagic mechanisms in longevity intervention: role of natural active compounds
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Álvarez‐Mora, M. I., Garrabou, G., Molina‐Porcel, L., Grillo-Risco, R., Garcia‐García, F., Barcos, T., Cantó, J., & Rodríguez‐Revenga, L. (2023) · Cells · doi:10.3390/cells12192364 · Cited by 3
The Roles of Caloric Restriction Mimetics in Central Nervous System Demyelination and Remyelination
Kaffe, D., Kaplanis, S. I., & Karagogeos, D. (2023) · Current Issues in Molecular Biology · doi:10.3390/cimb45120596 · Cited by 4
“Over the course of decades of research, several hypotheses have arisen, among which the predominant one suggests that CR primarily acts to preserve cellular homeostasis and overall health [28].”
Repurposing dapagliflozin for Alzheimer's disease: a mechanistic exploration
Saeed, M. M. (2024) · Future Journal of Pharmaceutical Sciences · doi:10.1186/s43094-024-00751-w · Cited by 4
“Autophagy, a process vital for maintaining neuronal homeostasis, involves the degradation of defective organelles through autophagosomes [73].”
New Atg9 Phosphorylation Sites Regulate Autophagic Trafficking in Glia
Wang, L., Yi, S., Zhang, S., Tsai, Y.-T., Cheng, Y.-H., Lin, Y.-T., Lin, C.-C., Lee, Y., Wang, H., & Ho, M. S. (2025) · ASN NEURO · doi:10.1080/17590914.2024.2443442 · Cited by 3
“…PD. Autophagy is a highly conserved catabolic process to engulf and degrade cytoplasmic materials, and its dysregulation has been linked to many disorders including neurodegenerative diseases (Dikic & Elazar, 2018; Frake et al., 2015; Kim et al., 2017; Levine & Kroemer, 2019; Menzies et al., 2017).”
The role and therapeutic potential of mitophagy in major depressive disorder
Shi, X.-N., Liu, C., Lin, L., Yao, M.-L., Zhong, Z., & Jiang, Y.-M. (2025) · Frontiers in Pharmacology · doi:10.3389/fphar.2025.1564276 · Cited by 3
“…and Tumor Necrosis Factor-alpha (TNF-α ), Interferon-gamma (IFN-γ ), mitochondrial DNA mutations, nutrient de fi ciency (Dowlati et al., 2010), hunger, hypoxia, traumatic brain injury, viral infections, and metabolic disorders,etc (Menzies et al., 2017; Zilocchi et al., 2020; Wang et al., 2021).”
Wang, H.-X., Deng, Z.-A., Li, Y.-Y., Li, J., Chen, Y., Zhao, Y.-J., Huang, K., Tian, W.-N., Tong, A., & Zhou, L. (2025) · Fluids and Barriers of the CNS · doi:10.1186/s12987-025-00658-5 · Cited by 3
“Moreover, numerous neurodegenerative disorders have been linked to impaired autophagy in neurons or microglia [22, 23].”
Sharbafshaaer, M., Pepe, R., Notariale, R., Canale, F., Tessitore, A., Tedeschi, G., & Trojsi, F. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26157644 · Cited by 4
“Strategies include disaggregase tactics based on heat shock protein (HSP) chaperone modulation and autophagy enhancers (such as rapamycin and trehalose) that enhance the removal of misfolded proteins [194].”
Natural compounds in neuroprotection and nervous system regeneration: A narrative review
Freire, M. A. M. (2025) · Regenerative medicine reports . · doi:10.4103/regenmed.regenmed-d-25-00038 · Cited by 3
Li, Z., Xu, B., Sun, Y., Zhou, L., Tao, Y., Hou, W., Bao, J., Liu, J., & Fan, W. (2022) · Bioengineered · doi:10.1080/21655979.2021.2005223 · Cited by 3
“Autophagy is implicated in many physiological and pathological conditions, including protection against diseases, such as cancer [34,35].”
BackgroundRetractedPotentials of autophagy enhancing natural products in the treatment of Parkinson disease
Olubodun-Obadun, T. G., Ishola, I. O., & Adeyemi, O. O. (2021) · Drug Metabolism and Personalized Therapy · doi:10.1515/dmpt-2021-0128 · Cited by 3
Bjorkli, C., Hemler, M. E., Julian, J. B., Sandvig, A., & Sandvig, I. (2022) · Frontiers in Pharmacology · doi:10.3389/fphar.2022.913971 · Cited by 4
“diminished levels of regulatory proteins in the autophagic system in older ages (Nixon and Yang, 2011; Menzies et al., 2017), which may lead to increased sequestration of nearby Aβ peptides by amyloid plaques.”
BackgroundThe Role of Autophagy in Childhood Central Nervous System Tumors
Wang, Y., Xu, Y., & Zhu, C. (2022) · Current Treatment Options in Oncology · doi:10.1007/s11864-022-01015-6 · Cited by 3
Datta, D. (2023) · The Journals of Gerontology Series A · doi:10.1093/gerona/glad134 · Cited by 3
Regulation and function of neutral sphingomyelinase 2
Mohammed, S., Ren, J., Ghandour, B., Clarke, C. J., & Hannun, Y. A. (2023) · Elsevier eBooks · doi:10.1016/b978-0-443-15313-6.00015-6 · Cited by 3
Polyglutamine disease in peripheral tissues
Barwell, T., & Seroude, L. (2023) · Human Molecular Genetics · doi:10.1093/hmg/ddad138 · Cited by 4
Variants in the WDR45 Gene Within the OPA-2 Locus Associate With Isolated X-Linked Optic Atrophy
Gazit, I., Hecht, I., Weiner, C., Kotlyar, A., Almer, Z. E., Bakshi, E., Or, L., Volkov, H., Feldman, B., Maharshak, I., et al. (2023) · Investigative Ophthalmology & Visual Science · doi:10.1167/iovs.64.13.17 · Cited by 3
“32 Mouse knockout studies have shown that impaired autophagy results in intracytoplasmic aggregation and protein accumulation, leading to axonal damage in multiple neurodegenerative diseases such as Alzheimer, Parkinson, and Huntington diseases; amyotrophic lateral sclerosis; and lysosomal diseases…”
Liu, Y., Qin, K., Dou, K., Ren, J., Hou, B., & Xie, A. (2024) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/j.bbadis.2024.167553 · Cited by 3
Profiling Cysteine Proteases Activities in Neuroinflammatory Cells
Agost-Beltrán, L., Canseco-Rodríguez, A., Schirmeister, T., Rodríguez, S., Sánchez‐Pérez, A. M., & González, F. V. (2024) · ChemMedChem · doi:10.1002/cmdc.202400520 · Cited by 3
Wang, Y., Li, S.-Y., Liang, X., Fan, J.-N., Li, S.-J., Zhou, F., Li, X., Lai, M., Feng, D., & Li, Y. (2025) · Alzheimer's Research & Therapy · doi:10.1186/s13195-025-01771-1 · Cited by 5
“6), which strengthens the classical theory that improving autophagy can reduce Aβ levels to suppress AD pathologic progression [64–66], the temporal-causal relationship between these events remains unresolved.”
Ligon, C., Cai, Y. C., Buch, S. J., & Arikkath, J. (2020) · Neuroscience Letters · doi:10.1016/j.neulet.2020.135048 · Cited by 3
Sun, C., Rosenstock, T. R., Cohen, M. A., & Sarkar, S. (2021) · Methods in molecular biology · doi:10.1007/7651_2021_420 · Cited by 3
Fang, Y., Chen, D., Xie, J., Zeng, W., & Li, Q. (2020) · PubMed Central · doi:10.12122/j.issn.1673-4254.2020.11.15 · Cited by 3
Nandi, N., Zaidi, Z., Tracy, C., & Krämer, H. (2022) · eLife · doi:10.7554/elife.72169 · Cited by 3
“This is consistent with the data above that show elevated autophagy in nil 1 eye discs in combination with the known role of autophagy in the clearance of protein aggregates ( Menzies et al., 2017 ).”
Pragati, Chanu, S., & Sarkar, S. (2019) · Neuroscience Letters · doi:10.1016/j.neulet.2019.134622 · Cited by 3
Antoniou, N., Prodromidou, K., Kouroupi, G., Samiotaki, M. K., Panayotou, G., Xilouri, M., Stefanis, L., Grailhe, R., Taoufik, E., & Matsas, R. (2020) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2020.06.12.148031 · Cited by 3
Pircs, K., Drouin‐Ouellet, J., Gil, J., Rezeli, M., Grassi, D. A., Garza, R., Sharma, Y., St‐Amour, I., Jönsson, M. E., Johansson, P. A., et al. (2021) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2021.03.01.433433 · Cited by 3
Biology of Human Liver Stem Cells
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Dutta, S., Linneweber, G., Andriatsilavo, M., Hiesinger, P., & Hassan, B. A. (2022) · bioRxiv · doi:10.1101/2022.04.06.486606 · Cited by 3
Chakraborty, R., & Zurzolo, C. (2022) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2022.12.13.519450 · Cited by 3
Autophagy in ischemic stroke: role of circular RNAs
Hong, Y., Gu, L., Han, B., & Yao, H. (2023) · Exploration of Medicine · doi:10.37349/emed.2023.00157 · Cited by 3
Sakai, M., Ohnishi, K., Masuda, M., Harumoto, E., Fukuda, T., Ohnishi, A., Ishii, S., Ohminami, H., Yamanaka‐Okumura, H., Ohashi, K., et al. (2024) · Journal of Clinical Biochemistry and Nutrition · doi:10.3164/jcbn.24-22 · Cited by 2
Deng, S., Liu, T.-A., Ilnytska, O., Allada, T., Fomina, A., Lin, N., Petukhova, V. Z., Pathmasiri, K. C., Chinthapally, K., Blagg, B. S. J., et al. (2024) · Journal of Biological Chemistry · doi:10.1016/j.jbc.2024.107889 · Cited by 3
Unlocking the Impact of Phyto-bioactive Compounds against Neurodegenerative Disorders
Rahaman, S. M., Ashique, S., Bhowmick, M., Mollick, M., Bhowmick, P., & Kumar, P. (2024) · Nanoscience & Nanotechnology-Asia · doi:10.2174/0122106812320650241015153325 · Cited by 3
Autophagy Impairment in Parkinson’s Disease: Approaches to Therapy
Usenko, T. S. (2025) · Molecular Biology · doi:10.1134/s0026893324700717 · Cited by 3
Hemorrhagic shock and reperfusion induced cognitive impairment through HIF3α/SIRT1
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Shafik, A. M., & Jin, P. (2025) · Neurochemistry International · doi:10.1016/j.neuint.2025.106037 · Cited by 2
Metadata
- Authors
- Menzies, F. M., Fleming, A., Caricasole, A., Bento, C. F., Andrews, S. P., Ashkenazi, A., Füllgrabe, J., Jackson, A., Jimenez Sanchez, M., Karabiyik, C., Licitra, F., Lopez Ramirez, A., Pavel, M., Puri, C., Renna, M., Ricketts, T., Schlotawa, L., Vicinanza, M., Won, H., Zhu, Y., Skidmore, J., & Rubinsztein, D. C.
- Affiliations
- University of Cambridge (GB)
- Corresponding author
- Rubinsztein, David C.
- ORCID
- Venue
- Neuron
- Publisher
- Elsevier BV
- Published
- 2017-03
- Volume
- 93
- Issue
- 5
- Pages
- 1015-1034
- ISSN
- 0896-6273 (ISSN-L)
- OpenAlex
- W2592067246
- Cited by
- 1,134
- References
- 288
- Citations by year
- 2026: 68 · 2025: 96 · 2024: 107 · 2023: 119 · 2022: 153 · 2021: 138 · 2020: 145 · 2019: 159 · 2018: 108 · 2017: 39
- FWCI
- 16.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Neuron (publishedVersion)
- PubMed (publishedVersion)
- DIGITAL.CSIC (Spanish National Research Council (CSIC)) (acceptedVersion, other-oa)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Apollo (University of Cambridge) (submittedVersion, cc-by-nc-nd)
- Apollo
- Funders
- Tau Consortium
- Alzheimer’s Research UK
- Wellcome Trust (095317/Z/11/Z)
- Cambridge Institute for Medical Research (100140/Z/12/Z)
- NIHR Biomedical Research Unit in Dementia at Addenbrooke’s Hospital
- The Rosetrees Trust
- FEBS
- Addenbrooke’s Charitable Trust
- Sims Scholarship
- James Baird Fund
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Autophagy in Disease and Therapy
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Keywords
- autophagy, neurodegeneration, lysosomal degradation, protein aggregation, neurodegenerative diseases, therapeutic target, druggable targets, mouse knockout models
- MeSH terms
- Animals, Autophagy, Humans, Lysosomes, Motor Neurons, Proteins, Signal Transduction, Neurodegenerative Diseases
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