DBT is a metabolic switch for maintenance of proteostasis under proteasomal impairment

Reviewer #1 (Public Review):

Summary:
Through an unbiased genomewide KO screen, the authors identified loss of DBT to suppress MG132-mediated death of cultured RPE cells. Further analyses suggested that DBT reduces ubiquitinated proteins by promoting autophagy. Mechanistic studies indicated that DBT loss promotes autophagy via AMPK and its downstream ULK and mTOR signaling. Furthermore, loss of DBT suppresses polyglutamine- or TDP-43-mediated cytotoxicity and/or neurodegeneration in fly models. Finally, the authors showed that DBT proteins are increased in ALS patient tissues, compared to non-neurological controls.

Strengths:
The idea is novel, the evidence is mostly convincing, and the data are clean. The findings have implications for human diseases.

Weaknesses:
More experiments are needed to establish the connections between DBT and autophagy. The mechanistic studies are somewhat biased, and it's unclear whether the same mechanism (i.e., AMPK-->mTOR) can be applied to TDP-43-mediated neurodegeneration. Also, some data interpretation has to be more accurate.

Reviewer #2 (Public Review):

Summary:
Hwang, Ran-Der et al utilized a CRISPR-Cas9 knockout in human retinal pigment epithelium (RPE1) cells to evaluate for suppressors of toxicity by the proteasome inhibitor MG132 and identified that knockout of dihydrolipoamide branched chain transacylase E2 (DBT) suppressed cell death. They show that DBT knockout in RPE1 cells does not alter proteasome or autophagy function at baseline. However, with MG132 treatment, they show a reduction in ubiquitinated proteins but with no change in proteasome function. Instead, they show that DBT knockout cells treated with MG132 have improved autophagy flux compared to wildtype cells treated with MG132. They show that MG132 treatment decreases ATP/ADP ratios to a greater extent in DBT knockout cells, and in accordance causes activation of AMPK. They then show downstream altered autophagy signaling in DBT knockout cells treated with MG132 compared to wild-type cells treated with MG132. Then they express the ALS mutant TDP43 M337 or expanded polyglutamine repeats to model Huntington's disease and show that knockdown of DBT improves cell survival in RPE1 cells with improved autophagic flux. They also utilize a Drosophila model and show that utilizing either a RNAi or CRISPR-Cas9 knockout of DBT improves eye pigment in TDP43M337V and polyglutamine repeat-expressing transgenic flies. Finally, they show evidence for increased DBT in postmortem spinal cord tissue from patients with ALS via both immunoblotting and immunofluorescence.

Strengths:
This is a mechanistic and well-designed paper that identifies DBT as a novel regulator of proteotoxicity via activating autophagy in the setting of proteasome inhibition. Major strengths include careful delineation of a mechanistic pathway to define how DBT is protective. These conclusions are largely justified, but additional experiments and information would be useful to clarify and extend these conclusions.

Weaknesses:
The large majority of the experiments are evaluating suppression of drug (MG132) toxicity in an in vitro epithelial cell line, so the generalizability to disease is unclear. Indeed, MG132 itself has been shown to modulate autophagy, and off-target effects of MG132 are not addressed. While this paper is strengthened by the inclusion of mouse-induced motor neurons, Drosophila models, and postmortem tissue, the putative mechanisms are minimally evaluated in these models.

Also, this effect is only seen with MG132 treatment, at a dose that causes markedly impaired cell survival. In this setting, it is certainly plausible that changes in autophagy could be the result of differences in cell survival, as opposed to an underlying mechanism for cell survival. Additional controls would be useful to increase confidence that DBT knockdown is protective via modulation of autophagy.

While the authors report increased DBT in postmortem ALS tissue as suggestive that DBT may modulate proteotoxicity in neurodegeneration, this point would be better supported with the evaluation of overexpression of DBT in their model.