Ubiquitin-specific peptidase-19 links TDP-43 aggregation to ER stress

Y Yan Yan X Xinming Wang H Hanna Jeon (Department of Pathology, School of Medicine, Case Western Reserve University) T Teresa R. Kee (Department of Pathology, School of Medicine, Case Western Reserve University) K Khoi D. Tran (Department of Pathology, School of Medicine, Case Western Reserve University) H Hyunkyoung Lee (Department of Pathology, School of Medicine, Case Western Reserve University) X Xingyu Zhao (Department of Pathology, School of Medicine, Case Western Reserve University) T Tian Liu (Key Laboratory of Photochemical Conversion and Optoelectronic Materials) S Simon S. Wing (Department of Medicine, Division of Endocrinology and Metabolism, Research Institute of the McGill University Health Centre, McGill University) J Jung-A A Woo (Department of Pathology, School of Medicine, Case Western Reserve University) D David E. Kang (Department of Pathology, School of Medicine, Case Western Reserve University)

Abstract

Aggregation and deposition of TAR DNA-binding protein 43 (TDP-43) is a salient pathological signature of amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration-TDP (FTLD-TDP). TDP-43 proteostasis and aggregation are controlled by several posttranslational modifications, including ubiquitination. While multiple E3 ubiquitin ligases are known to facilitate TDP-43 clearance, little is known about the role of deubiquitinases (DUBs) in controlling TDP-43 proteostasis. Through an unbiased discovery screen of DUBs, here we identify and demonstrate using in vitro and in vivo models, as well as human brain tissue, that ubiquitin-specific peptidase-19 (USP19) acts as a TDP-43-directed DUB that removes K48- and K63-linked ubiquitin conjugates from TDP-43 and preferentially promotes cytoplasmic aggregation of TDP-43 C-terminal fragments (TDP-CTFs) through its catalytic activity. Specifically, the endoplasmic reticulum (ER)-anchored USP19 isoform (USP19-ER) exhibits superior activity in deubiquitinating TDP-CTFs, enhancing its phase separation and aggregation, compared to its cytosolic isoform (USP19-Cyto). Furthermore, as TDP-CTFs are generated at the ER, USP19 acts to couple the aggregation of TDP-CTFs to ER stress (ATF6, ATF4, IRE1, & CHOP). In humans, USP19 protein levels increase in FTLD-TDP brains, which extensively colocalize with cytoplasmic phospho-TDP-43 (pTDP-43) pathology. Importantly, we demonstrate in vivo that genetic reduction of usp19 mitigates pTDP-43 pathology, astrogliosis, and ER stress while reversing long-term potentiation (LTP) and motor deficits in a mouse model of TDP-43 pathogenesis (TAR4 mice). These findings establish a critical role of USP19 at the nexus of TDP-43 proteostasis and ER stress, implicating its pathogenic role in FTLD-TDP and ALS.

Article Details

Volume / Issue Vol. 123, Issue 11
Published March 17, 2026
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (11)

Y

Yan Yan

X

Xinming Wang

H

Hanna Jeon

Department of Pathology, School of Medicine, Case Western Reserve University

T

Teresa R. Kee

Department of Pathology, School of Medicine, Case Western Reserve University

K

Khoi D. Tran

Department of Pathology, School of Medicine, Case Western Reserve University

H

Hyunkyoung Lee

Department of Pathology, School of Medicine, Case Western Reserve University

X

Xingyu Zhao

Department of Pathology, School of Medicine, Case Western Reserve University

T

Tian Liu

Key Laboratory of Photochemical Conversion and Optoelectronic Materials

S

Simon S. Wing

Department of Medicine, Division of Endocrinology and Metabolism, Research Institute of the McGill University Health Centre, McGill University

J

Jung-A A Woo

Department of Pathology, School of Medicine, Case Western Reserve University

D

David E. Kang

Department of Pathology, School of Medicine, Case Western Reserve University