Folate metabolism is intricately linked to purine de novo synthesis through the incorporation of folate-derived one-carbon units into the purine scaffold. By investigating chemical and genetic dependencies caused by mutations in methylenetetrahydrofolate dehydrogenase, cyclohydrolase, and formyltetrahydrofolate synthetase 1 (MTHFD1), we discovered a key role for Nudix hydrolase 5 (NUDT5) in regulating purine de novo synthesis. Genetic depletion and selective chemical degradation showed that a scaffolding role, rather than NUDT5 enzymatic activity, was causing this phenotype. NUDT5 interacted with phosphoribosyl pyrophosphate amidotransferase (PPAT), the rate-limiting enzyme of purine de novo synthesis, to repress the pathway in response to increased purine abundance. Through this mechanism, loss of NUDT5 mediates resistance to purine analogs in cancer treatment and prevents adenosine toxicity in MTHFD1 deficiency.

Myeloproliferative neoplasms (MPN) are genetically very complex and heterogeneous diseases in which the acquisition of a somatic driver mutation triggers three main myeloid cytokine receptors, and phenotypically expresses as polycythemia vera (PV), essential thrombocytosis (ET), and primary myelofibrosis (PMF). The course of the diseases may be influenced by germline predispositions, modifying mutations, their order of acquisition and environmental factors such as aging and inflammation. Deciphering these contributory elements, their mutual interrelationships, and their contribution to MPN pathogenesis brings important insights into the diseases. Animal models (mainly mouse and zebrafish) have already significantly contributed to understanding the role of several acquired and germline mutations in MPN oncogenic signaling. Novel technologies such as induced pluripotent stem cells (iPSCs) and precise genome editing (using CRISPR/Cas9) contribute to the emerging understanding of MPN pathogenesis and clonal architecture, and form a convenient platform for evaluating drug efficacy. In this overview, the genetic landscape of MPN is briefly described, with an attempt to cover the main discoveries of the last 15 years. Mouse and zebrafish models of the driver mutations are discussed and followed by a review of recent progress in modeling MPN with patient-derived iPSCs and CRISPR/Cas9 gene editing.

Loss of functional β cells is a hallmark of diabetes, and restoring β cell mass remains a critical goal in the quest for a specific therapy. One potential strategy is to convert non-β cells in the islet, such as α cells, into insulin-producing cells. Although several compounds have been identified to induce β cell-like features in α cells, none have been successfully translated into clinical applications. In this study, we identify PRC2 inhibitors as potent inducers of β cell-enriched gene expression in α cells, acting through modulation of the AR–ETV1 complex. AR inhibition suppresses glycogen synthesis and enhances the pentose phosphate pathway. Direct metabolic reprogramming with methyl esterified 6-phosphogluconate, an intermediate metabolite of the pentose phosphate pathway, induces β cell-like features in α cells, stimulates β cell regeneration and ameliorates diabetes. Our findings demonstrate that metabolic reprogramming drives β cell regeneration and highlight a promising therapeutic strategy for diabetes.

Despite biomedical advances, major knowledge gaps regarding human development remain, and many developmental disorders lack effective treatment, representing a huge clinical burden. This results from fetuses being largely inaccessible for analysis. Here, we employ fetal cells in human amniotic fluid (AF) to establish personalized fetal kidney and lung organoids (AFKO and AFLO, respectively), recapitulating fetal organs at single-cell resolution. AFKO harbor key fetal kidney cell populations, including nephrogenic, urothelial and stromal, endocytose albumin, and model PAX2 -related anomalies. Strikingly, upon injection into the nephrogenic cortex of human fetal kidney explants, AFKO-derived progenitors integrate into the host progenitor niche and contribute to developing nephrons. AFLO comprise alveolar cells and most airway cell types in a typical pseudostratified structure, upregulate surfactant expression upon corticosteroid treatment, and show functional CFTR channels. Overall, this platform represents a new personalized tool that can be applied to virtually any fetus in real-time, affording unprecedented options in studying development, uncovering mechanisms of in utero pathologies (e.g., congenital anomalies, infections or chemical teratogens) deciphering the developmental origins of chronic diseases, and tailoring treatments for these pathologies, as well as for prematurity-related complications. Importantly, since AF contains cells from additional tissues (e.g., skin and gastrointestinal tract), and is derived in a procedure already performed in many patients, this platform may well become a broadly applicable tool in fetal medicine.