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On-demand treatment of metabolic diseases by a synthetic drug-inducible exocytosis system

Yaqing Si, Minghui He, Yilin Li, Jian Jiang, Yuxuan Fan, Shuai Xue, Xinyuan Qiu and Mingqi Xie ()
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Yaqing Si: Fudan University
Minghui He: Fudan University
Yilin Li: Westlake Laboratory of Life Sciences and Biomedicine
Jian Jiang: Westlake Laboratory of Life Sciences and Biomedicine
Yuxuan Fan: Westlake Laboratory of Life Sciences and Biomedicine
Shuai Xue: Westlake Laboratory of Life Sciences and Biomedicine
Xinyuan Qiu: National University of Defense Technology
Mingqi Xie: Westlake Laboratory of Life Sciences and Biomedicine

Nature Communications, 2025, vol. 16, issue 1, 1-14

Abstract: Abstract Here, we present StimExo as a rational design strategy allowing various user-defined control signals to trigger calcium-dependent exocytosis and mediate on-demand protein secretion in cell-therapy settings. Using a modular framework incorporating inducible protein-protein interactions into an engineered bipartite activator of calcium release–activated calcium (CRAC) channels, Ca2+ influx mediated by the STIM/Orai1 machinery was flexibly adjusted to depend on different user-defined input signals. Application of StimExo to various endocrine cells enables instant secretion of therapeutic hormones upon administration of safe and patient-compliant trigger compounds. StimExo also mediated insulin exocytosis using a cell-based gene delivery strategy in vivo, accounting for real-time control of blood glucose homeostasis in male diabetic mice in response to the FDA-approved drug grazoprevir. This study achieves true “sense-and-respond” cell-based therapies and provides a platform for remote control of in vivo transgene activities using various trigger signals of interest.

Date: 2025
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DOI: 10.1038/s41467-025-58184-9

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