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Accelerating Leigh syndrome drug discovery through deep learning screening in brain organoids

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Item Type:Article
Title:Accelerating Leigh syndrome drug discovery through deep learning screening in brain organoids
Creators Name:Menacho, Carmen, Okawa, Satoshi, Álvarez-Merz, Iris, Wittich, Annika, Muñoz-Oreja, Mikel, Lisowski, Pawel, Martín, Mario López, Pentimalli, Tancredi Massimo, Zakin, Shiri, Thevandavakkam, Mathuravani, Jerred, Caleb, Lickfett, Selene, Petersilie, Laura, Rybak-Wolf, Agnieszka, Seibt, Annette, Herebian, Diran, Inak, Gizem, Brodesser, Susanne, Zaliani, Andrea, Mlody, Barbara, Donnelly, Justin, Woleben, Kasey, Soriano, Francesc Xavier, Fernandez-Checa, Jose C., Ventura, Natascia, Cambridge, Sidney, Mayatepek, Ertan, Spinazzola, Antonella, Schuelke, Markus, Rajewsky, Nikolaus, Rossi, Andrea, Peralvarez-Marin, Alex, Distelmaier, Felix, Perlstein, Ethan, Holt, Ian J., Puighermanal, Emma, Pless, Ole, Rose, Christine R., Del Sol, Antonio and Prigione, Alessandro
Abstract:Leigh syndrome (Leigh) is an untreatable mitochondrial disorder characterized by lactic acidosis and basal ganglia and midbrain pathology, leading to psychomotor regression and early death. We previously uncovered impaired neuronal morphogenesis in Leigh cerebral organoids carrying SURF1 gene variants. Leveraging this phenotype, we here develop a deep learning algorithm tailored for cell type-specific drug repurposing screening. In parallel, we perform a survival drug screen in a yeast model of Leigh. The two approaches independently converge on azole compounds, two of which - talarozole and sertaconazole - rescue neuronal morphogenesis in Leigh neurons and lower lactate release and improve growth rate in Leigh midbrain organoids. Mechanistically, these compounds modulate the retinoic acid pathway and membrane-associate lipid metabolism. The findings highlight azoles as promising candidates for Leigh and demonstrate the potential of combining in silico screens with human brain organoids as new approach methodologies (NAMs) to advance the discovery of therapeutics addressing rare neurodevelopmental disorders.
Keywords:Brain, Deep Learning, Drug Discovery, Drug Repositioning, Leigh Disease, Membrane Proteins, Neurons, Organoids, Preclinical Drug Evaluation
Source:Nature Communications
ISSN:2041-1723
Publisher:Nature Publishing Group
Volume:17
Number:1
Page Range:3570
Date:20 April 2026
Official Publication:https://doi.org/10.1038/s41467-026-71391-2
PubMed:View item in PubMed
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