Identification and functional validation of FDA-approved positive and negative modulators of the mitochondrial calcium uniporter

The mitochondrial calcium uniporter (MCU), the highly selective channel responsible for mitochondrial Ca²⁺ entry, plays important roles in physiology and pathology. However, only few pharmacological compounds directly and selectively modulate its activity. Here, we perform high-throughput screening on a US Food and Drug Administration (FDA)-approved drug library comprising 1,600 compounds to identify molecules modulating mitochondrial Ca²⁺ uptake. We find amorolfine and benzethonium to be positive and negative MCU modulators, respectively. In agreement with the positive effect of MCU in muscle trophism, amorolfine increases muscle size, and MCU silencing is sufficient to blunt amorolfine-induced hypertrophy. Conversely, in the triple-negative breast cancer cell line MDA-MB-231, benzethonium delays cell growth and migration in an MCU-dependent manner and protects from ceramide-induced apoptosis, in line with the role of mitochondrial Ca²⁺ uptake in cancer progression. Overall, we identify amorolfine and benzethonium as effective MCU-targeting drugs applicable to a wide array of experimental and disease conditions.

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We screen an FDA-approved drug library for mitochondrial Ca²⁺ uptake modulators

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Amorolfine and benzethonium modulate MCU activity

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Amorolfine increases MCU-dependent mitochondrial metabolism and muscle size

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Benzethonium decreases MCU-dependent cancer cell growth and migration

Dimerization of MICU Proteins Controls Ca2+ Influx through the Mitochondrial Ca2+ Uniporter

The mitochondrial Ca²⁺ uniporter complex (MCUC) is responsible for Ca²⁺ influx into the mitochondrial matrix, playing critical roles in various mitochondrial functions. Eukaryotic MCUC consists of multiple subunits, and its Ca²⁺ influx activity is controlled by regulatory subunits, including mitochondrial Ca²⁺ uptake 1 (MICU1) and its paralogs (MICU2 and MICU3). However, the underlying mechanism remains unclear. Here, we determined multiple crystal structures of MICU2 and MICU3 from Homo sapiens. Our data demonstrate that distinct MICU protein N-domains determine the specific type of MICU dimers that perform the opposing roles in mitochondrial Ca²⁺ uptake at low cytosolic Ca²⁺ levels. In contrast, at high cytosolic Ca²⁺ levels, all MICU proteins undergo dimer rearrangement induced by Ca²⁺ binding, which releases the suppression of the MCUC pore-forming subunit and promotes the influx of large amounts of Ca²⁺. Altogether, our results elucidate the delicate mechanism of mitochondrial Ca²⁺ uptake regulation by MICU proteins.