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Lysosomal homeostasis at the crossroads of neurodegeneration
Stefano De Tito, Sharon A. Tooze
Stefano De Tito, Sharon A. Tooze
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Lysosomal homeostasis at the crossroads of neurodegeneration

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Abstract

Lysosomes function as metabolic control centers that integrate degradation, nutrient sensing, and stress signaling. In neurons, which must maintain proteostasis and energetic balance throughout life, lysosomal homeostasis determines cellular resilience. Emerging evidence identifies lysosomal injury and defective repair as common denominators across neurodegenerative diseases. Damage to the lysosomal membrane caused by oxidative stress, lipid imbalance, or genetic mutations triggers a hierarchical quality control cascade. Early lesions recruit the endosomal sorting complex required for transport (ESCRT) machinery for mechanical resealing, while larger ruptures activate lipid-centered recovery modules. When repair fails, lysophagy eliminates irreparable organelles and a TFEB-dependent transcriptional program regenerates the lysosomal pool. These tightly coupled responses safeguard neurons from catastrophic proteostatic collapse. Their impairment, through mutations in lysosomal proteins, or through aging, produces the lysosomal fragility that underlies Alzheimer disease, Parkinson disease, amyotrophic lateral sclerosis/frontotemporal dementia, and Huntington disease. Crosstalk between lysosomes, mitochondria, and ER integrates local damage with systemic metabolic adaptation, while dysregulated lysosomal exocytosis and inflammation propagate pathology. Understanding how ESCRT complexes, lipid transport, and transcriptional renewal cooperate to preserve lysosomal integrity reveals unifying principles of neurodegeneration and defines molecular targets for intervention. Restoring lysosomal repair and renewal offers a rational path toward preventing neuronal loss.

Authors

Stefano De Tito, Sharon A. Tooze

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Figure 3

Lysosomal inter-organelle contact sites.

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Lysosomal inter-organelle contact sites.
Lysosomes establish membrane co...
Lysosomes establish membrane contact sites with multiple organelles to coordinate metabolism and stress responses. At ER-lysosome interfaces, VAPA and VAPB engage ORPs to mediate cholesterol and phosphatidylserine exchange essential for membrane maintenance and repair. Mitochondria-lysosome contacts organized by Rab7 regulate calcium and lipid transfer, linking degradative capacity with mitochondrial energy supply. Peroxisome-lysosome junctions involving synaptotagmin 7 (SYT7) enable bidirectional lipid trafficking critical for plasmalogen and cholesterol homeostasis. Disruption of these connections impairs lipid balance and lysosomal positioning, sensitizing neurons to metabolic and oxidative stress.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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