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Hubler, Zita; Allimuthu, Dharmaraja; Bederman, Ilya; Elitt, Matthew S.; Madhavan, Mayur; Allan, Kevin C.; Shick, H. Elizabeth; Garrison, Eric; Karl, Molly T.; Factor, Daniel C.; Nevin, Zachary S.; Sax, Joel L.; Thompson, Matthew A.; Fedorov, Yuriy; Jin, Jing; Wilson, William K.; Giera, Martin; Bracher, Franz; Miller, Robert H.; Tesar, Paul J.; Adams, Drew J. (2018): Accumulation of 8,9-unsaturated sterols drives oligodendrocyte formation and remyelination. In: Nature, Vol. 560, No. 7718: pp. 372-376
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Abstract

Regeneration of myelin is mediated by oligodendrocyte progenitor cells-an abundant stem cell population in the central nervous system (CNS) and the principal source of new myelinating oligodendrocytes. Loss of myelin-producing oligodendrocytes in the CNS underlies a number of neurological diseases, including multiple sclerosis and diverse genetic diseases(1-3). High-throughput chemical screening approaches have been used to identify small molecules that stimulate the formation of oligodendrocytes from oligodendrocyte progenitor cells and functionally enhance remyelination in vivo(4-10). Here we show that a wide range of these pro-myelinating small molecules function not through their canonical targets but by directly inhibiting CYP51, TM7SF2, or EBP, a narrow range of enzymes within the cholesterol biosynthesis pathway. Subsequent accumulation of the 8,9-unsaturated sterol substrates of these enzymes is a key mechanistic node that promotes oligodendrocyte formation, as 8,9-unsaturated sterols are effective when supplied to oligodendrocyte progenitor cells in purified form whereas analogous sterols that lack this structural feature have no effect. Collectively, our results define a unifying sterol-based mechanism of action for most known small-molecule enhancers of oligodendrocyte formation and highlight specific targets to propel the development of optimal remyelinating therapeutics.