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AK2 inhibitors are a class of therapeutic agents designed to target adenylate kinase 2 (AK2), a mitochondrial enzyme responsible for maintaining adenine nucleotide homeostasis by catalyzing the interconversion of ATP, ADP, and AMP. Research presented at ASH 2021 identified AK2 as a selective dependency in multiple myeloma (MM), particularly in cases characterized by the t(4;14) chromosomal translocation and subsequent overexpression of the histone methyltransferase NSD2. Inhibition of AK2 in these cells leads to perturbed purine metabolism, specifically the accumulation of purine metabolites and reduction of pyrimidines, which triggers the apoptotic unfolded protein response (UPR) signaling pathway. Preclinical studies suggest that AK2 inhibition could be a viable strategy for treating high-risk MM, potentially in combination with proteasome inhibitors like bortezomib.
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