Molecular Classification
E3 ubiquitin ligase complex, Protein degradation pathway
Disease Roles
Multiple myelomaMyelodysplastic syndromeAcute myeloid leukemia

Cereblon E3 Ligase Pathway Overview

The Cereblon E3 ligase pathway is a protein degradation pathway centered around the Cereblon (CRBN) protein, a substrate receptor within the CRL4^CRBN E3 ubiquitin ligase complex. This complex mediates the ubiquitination and subsequent proteasomal degradation of target proteins, regulating various cellular processes. The pathway is a key therapeutic target, particularly through the use of immunomodulatory imide drugs (IMiDs) that bind to cereblon and redirect its activity to degrade disease-relevant proteins. The pathway plays roles in multiple myeloma, myelodysplastic syndrome and other immunologic conditions. The pathway is also being leveraged for next-generation therapeutics such as PROTACs that use synthetic ligands targeting CRBN for induced proximity-mediated target degradation.

Mechanism of Action

IMiDs bind to cereblon, altering its substrate specificity and leading to the ubiquitination and degradation of neosubstrates.

Biological Functions

Protein homeostasis
Targeted protein degradation
Immune response regulation
Cell cycle control
Signal transduction

Disease Associations

Multiple myeloma
Myelodysplastic syndrome
Acute myeloid leukemia
Immunologic conditions
Teratogenicity

Safety Considerations

  • Teratogenicity (Thalidomide)
  • Off-target effects of IMiDs
  • Development of resistance

Interacting Drugs

Thalidomide
Lenalidomide
Pomalidomide
Mezigdomide
Iberdomide