Immunomodulatory agents lenalidomide and pomalidomide co‐stimulate T cells by inducing degradation of T cell repressors I karos and A iolos via modulation of the E 3 ubiquitin ligase complex CRL 4 CRBN
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Summary: Cereblon ( CRBN ), the molecular target of lenalidomide and pomalidomide, is a substrate receptor of the cullin ring E 3 ubiquitin ligase complex, CRL 4 CRBN . T cell co‐stimulation by lenalidomide or pomalidomide is cereblon dependent: however, the CRL 4 CRBN substrates responsible for T cell co‐stimulation have yet to be identified. Here we demonstrate that interaction of the transcription factors Ikaros ( IKZF 1, encoded by the IKZF 1 gene) and A iolos ( IKZF 3, encoded by the IKZF 3 gene) with CRL 4 CRBN is induced by lenalidomide or pomalidomide. Each agent promotes A iolos and I karos binding to CRL 4 CRBN with enhanced ubiquitination leading to cereblon‐dependent proteosomal degradation in T lymphocytes. We confirm that A iolos and I karos are transcriptional repressors of interleukin‐2 expression. The findings link lenalidomide‐ or pomalidomide‐induced degradation of these transcriptional suppressors to well documented T cell activation. Importantly, Aiolos could serve as a proximal pharmacodynamic marker for lenalidomide and pomalidomide, as healthy human subjects administered lenalidomide demonstrated A iolos degradation in their peripheral T cells. In conclusion, we present a molecular model in which drug binding to cereblon results in the interaction of I karos and A iolos to CRL 4 CRBN , leading to their ubiquitination, subsequent proteasomal degradation and T cell activation.
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In 2014, landmark studies revealed that thalidomide and lenalidomide did not behave as inhibitors but functioned as molecular glue degraders analogous to auxin degrader TIR1.
“the second breakthrough came in 2014 when a series of landmark studies revealed that thalidomide, and its more potent derivative lenalidomide, did not behave as inhibitors but in fact functioned as molecular glue degraders analogous to the auxin degrader tiR1 (chamberlain et al. 2014;Fischer et al. 2014;gandhi et al. 2014;Krönke et al. 2014;lu et al. 2014).”
From From serendipity to strategy: molecular glue degraders in cancer therapeutics (2025) · cites this paper as Gandhi et al. 2014
The Discussion (page unavailable) reports that lenalidomide promotes CRL4CRBN-mediated recruitment and degradation of Ikaros and Aiolos, rather than simply inhibiting the ligase. The paper studies lenalidomide and pomalidomide, not thalidomide as a degrader, and the cited passages do not establish an analogy to auxin–TIR1. (LLM, conf=0.86)
Experimental — accuracy not yet measuredFollowing iMiD treatment and selective degradation of IKZF1, T cells increase production of IFN-γ, IL-21, and IL-2, enhancing the anti-tumor capability of the immune system.
“Following iMiD treatment and the selective degradation of iKZF1, t cells increase their production of iFN-γ, il-21, and il-2 enhancing the anti-tumor capability of the immune system to target the cancerous plasma cells (gandhi et al. 2014;D'Souza et al. 2021;Bird and Pawlyn 2023) (Figure 5A, iii).”
From From serendipity to strategy: molecular glue degraders in cancer therapeutics (2025) · cites this paper as gandhi et al. 2014
The Results section on Ikaros knockdown reports increased IL-2 production in T cells, and the Discussion identifies IFN-γ among cytokines negatively regulated by Ikaros. But the paper describes drug-induced degradation of both IKZF1 (Ikaros) and IKZF3 (Aiolos), not IKZF1 alone. Our copy does not report increased IL-21 or show that these cytokine changes enhance targeting of cancerous plasma cells. (LLM, conf=0.88)
Experimental — accuracy not yet measuredLenalidomide promotes the interaction between CRBN and IKZF1 and IKZF3.
“lenalidomide was shown to promote the interaction between cRBN and two members of the ikaros transcription factor family: iKZF1 and iKZF3 (gandhi et al. 2014;Krönke et al. 2014;lu et al. 2014).”
From From serendipity to strategy: molecular glue degraders in cancer therapeutics (2025) · cites this paper as Gandhi et al. 2014
MG degraders can induce the degradation of target proteins otherwise deemed unligandable, such as IKZF1/3 and RBM39.
“(ii) can induce the degradation of target proteins otherwise deemed unligandable (e.g., IKZF1/3, RBM39); [44][45][46][47][48][49][50][51][52][53][54][55]”
From Chasing molecular glue degraders: screening approaches (2022) · cites this paper as [46]
IMiDs trigger CRBN-dependent proteasomal degradation of the transcription factors IKZF1 and IKZF3.
“In brief, IMiDs were first shown to trigger CRBN-dependent proteasomal degradation of the C2H2-type zing-finger transcription factors Ikaros (IKZF1) and Aiolos (IKZF3).[46][47][48]”
From Chasing molecular glue degraders: screening approaches (2022) · cites this paper as [46]
IMiD binding to the E3 CRL4 CRBN leads to induced degradation of several targets.
“Seminal biochemical and structural studies uncovered that IMiD binding to the E3 CRL4 CRBN leads to the induced degradation of several targets.[44][45][46][47][48][49][50]”
From Chasing molecular glue degraders: screening approaches (2022) · cites this paper as [46]
Lenalidomide and pomalidomide induce CRBN-dependent ubiquitination and degradation of Ikaros and Aiolos, transcription factors required for development of lymphoids and survival of multiple myeloma.
“lenalidomide and pomalidomide induce CRBN-dependent ubiquitination and degradation of Ikaros and Aiolos, transcription factors required for the development of lymphoids and survival of multiple myeloma8–10.”
From Genome-wide screening reveals a role for subcellular localization of CRBN in the anti-myeloma activity of pomalidomide (2020) · cites this paper as [10]
Thalidomide analogues co-opt CRBN to target IKAROS family zinc finger 1 (IKZF1) and IKZF3 for degradation, and are now considered as pioneering examples of molecular glues.
“These drugs co-opt CRBN to target IKAROS family zinc finger 1 (IKZF1) and IKZF3 for degradation3,4,24, and are now considered as pioneering examples of molecular glues.”
From PROTAC targeted protein degraders: the past is prologue (2022) · cites this paper as [24]
In 2013, thalidomide analogues were discovered to exert their therapeutic effects by acting as a molecular glue to recruit disease-relevant neosubstrate proteins to an E3 ubiquitin ligase, resulting in neosubstrate ubiquitination and proteasomal degradation.
“In 2013, thalidomide analogues were discovered to exert their therapeutic effects by acting as a molecular glue to recruit disease-relevant neosubstrate proteins to an E3 ubiquitin ligase, resulting in neosubstrate ubiquitination and, ultimately, proteasomal degradation11–13.”
From Cancer therapies based on targeted protein degradation — lessons learned with lenalidomide (2021) · cites this paper as [13]
Thalidomide and its analogues do not inhibit the enzymatic activity of CRL4CRBN, but instead confer neomorphic activity on CRBN to mediate selective ubiquitination and proteasomal degradation of IKZF1 and IKZF3 in MM cells and T cells.
“thalidomide and its analogues do not inhibit the enzymatic activity of CRL4CRBN, but instead confer neomorphic activity on CRBN to mediate the selective ubiquitination and resultant proteasomal degradation of the transcription factors Ikaros family zinc finger protein 1 (IKZF1) and IKZF3 (Aiolos) in MM cells and T cells11–13.”
From Cancer therapies based on targeted protein degradation — lessons learned with lenalidomide (2021) · cites this paper as [13]
In T cells, the ubiquitination and degradation of Ikaros and Aiolos induced by IMiDs leads to enhanced expression of IL-2.
“our group, in collaboration with Celgene, demonstrated that in T cells, the ubiquitination and degradation of Ikaros and Aiolos induced by IMiDs leads to the enhanced expression of IL-2 [27].”
From Cereblon and its downstream substrates as molecular targets of immunomodulatory drugs (2016) · cites this paper as [27]
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Crbn I391V is sufficient to confer in vivo sensitivity to thalidomide and its derivatives in mice
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Targeted protein degradation and the enzymology of degraders
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Acute pharmacological degradation of Helios destabilizes regulatory T cells
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Crystal structure of the SALL4-pomalidomide-cereblon-DDB1 complex
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Cereblon modulators: Low molecular weight inducers of protein degradation
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Mining the CRBN target space redefines rules for molecular glue-induced neosubstrate recognition
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Structural bases of IMiD selectivity that emerges by 5-hydroxythalidomide
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p97/VCP promotes degradation of CRBN substrate glutamine synthetase and neosubstrates
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Cereblon and its downstream substrates as molecular targets of immunomodulatory drugs
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Thalidomide mimics uridine binding to an aromatic cage in cereblon
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UBE2G1 governs the destruction of cereblon neomorphic substrates
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Self-citationPIKES Analysis Reveals Response to Degraders and Key Regulatory Mechanisms of the CRL4 Network
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Self-citationProfiling the Landscape of Drug Resistance Mutations in Neosubstrates to Molecular Glue Degraders
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A critical evaluation of the approaches to targeted protein degradation for drug discovery
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Self-citationA decade of progress in myelodysplastic syndrome with chromosome 5q deletion
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Design of a Cereblon construct for crystallographic and biophysical studies of protein degraders
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Targeting oncoproteins with a positive selection assay for protein degraders
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Self-citationMolecular glue degraders: exciting opportunities for novel drug discovery
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Structural Dynamics of the Cereblon Ligand Binding Domain
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From serendipity to strategy: molecular glue degraders in cancer therapeutics
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Cereblon induces G3BP2 neosubstrate degradation using molecular surface mimicry
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- Authors
- Gandhi, A. K., Kang, J., Havens, C. G., Conklin, T., Ning, Y., Wu, L., Ito, T., Ando, H., Waldman, M. F., Thakurta, A., Klippel, A., Handa, H., Daniel, T. O., Schafer, P. H., & Chopra, R.
- Affiliations
- Celgene (United States) (US)
- Celgene Corporation San Diego CA USA
- Tokyo Medical University (JP)
- Corresponding author
- Gandhi, Anita K.
- ORCID
- Venue
- British Journal of Haematology
- Publisher
- Wiley
- Published
- 2013-12-13
- Volume
- 164
- Issue
- 6
- Pages
- 811-821
- ISSN
- 0007-1048 (ISSN-L)
- 1365-2141
- PMC
- PMC4232904
- OpenAlex
- W1973999018
- Cited by
- 619
- References
- 31
- Citations by year
- 2026: 24 · 2025: 57 · 2024: 52 · 2023: 53 · 2022: 60 · 2021: 76 · 2020: 72 · 2019: 44 · 2018: 42 · 2017: 36 · 2016: 47 · 2015: 30 · 2014: 26
- FWCI
- 15.39
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- British Journal of Haematology (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Celgene corporation
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Protein Degradation and Inhibitors
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Ubiquitin and proteasome pathways
- Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
- Keywords
- lenalidomide, pomalidomide, cereblon, Ikaros, Aiolos, IKZF1, IKZF3, T cell costimulation, ubiquitination, proteasomal degradation, immunomodulators, pharmacodynamic biomarkers, T cells
- MeSH terms
- Lenalidomide, Humans, Immunologic Factors, Peptide Hydrolases, T-Lymphocytes, Thalidomide, Transcription Factors, Transfection, Angiogenesis Inhibitors, Ubiquitin-Protein Ligases, Proteasome Endopeptidase Complex, Adaptor Proteins, Signal Transducing, Ikaros Transcription Factor, Ubiquitination
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