{"title":"Emerging Roles of Mass Spectrometry-Based Proteomics in Drug Discovery.","authors":"Ka Yang, Weiping Tang, Taosheng Chen, Junmin Peng","doi":"10.1146/annurev-pharmtox-060325-040513","DOIUrl":"https://doi.org/10.1146/annurev-pharmtox-060325-040513","url":null,"abstract":"<p><p>Mass spectrometry (MS)-based proteomics has emerged as a versatile platform in modern drug discovery, enabling system-wide interrogation of protein abundance, posttranslational modifications (PTMs), turnover, structural stability, and interactions with small molecules in native biological contexts. In this review, we introduce recent advances in MS and summarize how scalable, high-throughput technologies support target identification and mechanism-of-action studies. We discuss global profiling of the proteome and PTMs under drug perturbation, as well as proteome-wide stability assays such as thermal proteome profiling and limited proteolysis-MS. We further discuss activity-based protein profiling, fully functionalized and photoaffinity probes, and affinity-matrix approaches that expand covalent and noncovalent ligand discovery. Finally, we highlight multiple proteomics-driven strategies in targeted protein degradation. Together, these integrated MS-based approaches in drug discovery, often termed chemoproteomics, provide a coherent framework for linking chemical perturbations to functional proteome remodeling, expanding the druggable proteome and accelerating therapeutic development.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":""},"PeriodicalIF":19.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Molecular Pharmacology of Dopamine Receptors: Structure, Function, and Therapeutic Implications.","authors":"Youwen Zhuang, H Eric Xu","doi":"10.1146/annurev-pharmtox-060425-070659","DOIUrl":"https://doi.org/10.1146/annurev-pharmtox-060425-070659","url":null,"abstract":"<p><p>Dopamine receptors (DRs) mediate central and peripheral dopaminergic signaling and remain major therapeutic targets in movement disorders, psychiatric disease, and endocrine dysfunction. Despite decades of clinical use, existing DR-directed therapies still suffer from limited subtype selectivity, pathway-nonspecific engagement, and substantial adverse effects, reflecting an incomplete molecular understanding of receptor function. In this review, we examine recent advances in DR molecular pharmacology, focusing on how structural, pharmacological, and computational studies have clarified receptor activation, inverse agonism, transducer coupling, signaling bias, allosteric modulation, and ligand selectivity through analyses of inactive and active receptor states, including family-wide receptor-G protein complexes. We discuss how ligand-specific receptor conformations, transducer interactions, and membrane environment shape signaling output, help explain the diverse actions of dopaminergic ligands, and distinguish the activation trajectories of D1-like and D2-like receptors. We also consider how these advances, including insights into allosteric sites, transducer selectivity, and AI-assisted discovery, inform the development of more selective and precise dopaminergic therapies. Together, these developments are shifting the field from descriptive receptor pharmacology toward a mechanistic and structure-guided framework for therapeutic discovery.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":""},"PeriodicalIF":19.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pablo Reina-Gonzalez, Aiesha Anchan, Jennifer Bekos, Abdulla Abu-Salah, Souvarish Sarkar
{"title":"Novel Targets and Treatments for Neurodegenerative Diseases Revealed by <i>Drosophila</i>.","authors":"Pablo Reina-Gonzalez, Aiesha Anchan, Jennifer Bekos, Abdulla Abu-Salah, Souvarish Sarkar","doi":"10.1146/annurev-pharmtox-060325-064705","DOIUrl":"https://doi.org/10.1146/annurev-pharmtox-060325-064705","url":null,"abstract":"<p><p>Neurodegenerative disorders (NDDs) such as Alzheimer's disease, Parkinson's disease, and others lack any disease-modifying therapy due to the lack of mechanistic understanding of the disease etiology. The genetic tractability, short lifespan, and conserved cellular biology of <i>Drosophila melanogaster</i> have positioned the fly as a powerful model organism for a pathway-driven therapeutic discovery across NDDs. Fly models expressing human pathogenic proteins, including Aβ, tau, α-synuclein, and others, recapitulate core features of these NDDs such as proteostasis defects, RNA dysregulation, mitochondrial dysfunction, lipid signaling abnormalities, and innate immune activation. Unbiased genetic and pharmacologic screens in these systems have identified conserved therapeutic nodes such as PARP signaling and insulin/IGF pathways. In this review, we discuss these advances to define conserved therapeutic axes identified in <i>Drosophila</i> and evaluate their translational potential for neurodegenerative disorders.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":""},"PeriodicalIF":19.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Use of High-Resolution Mass Spectrometry in Therapeutic Drug Monitoring of Psychiatric Drugs.","authors":"Espen Molden, Birgit M Wollmann, Léon Reubsaet","doi":"10.1146/annurev-pharmtox-060425-092716","DOIUrl":"https://doi.org/10.1146/annurev-pharmtox-060425-092716","url":null,"abstract":"<p><p>Psychiatric diseases are among the most challenging health issues in terms of human suffering, complex treatments, frequent treatment failure, high degrees of disability and sick leave usage, and high social expenditure. For many patients, chronic drug treatment is often required. However, many patients experience insufficient clinical effects or side effects. Therapeutic drug monitoring (TDM) of plasma/serum concentration of psychiatric drugs aims to facilitate precision dosing and improve outcomes. High-resolution mass spectrometry (HR-MS) is a powerful technique to refine TDM with excellent specificity and sensitivity by measuring the exact mass of drugs and metabolites. The benefits of such an analytical method include that many compounds can be measured simultaneously and with short run times. Additional applications include retrospective data reprocessing to reveal interacting comedications, active/toxic metabolites, and dosing biomarkers, in which researchers reprocess exact masses of stored HR-MS TDM files. This review illustrates the benefits of HR-MS-based TDM focusing on psychiatry and innovative applications.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":""},"PeriodicalIF":19.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karinder K Brar, Adrian J Butcher, Giovanna R Mallucci
{"title":"Protein Synthesis Dysregulation in Neurodegeneration: Mechanisms, Consequences, and Therapeutic Modulation.","authors":"Karinder K Brar, Adrian J Butcher, Giovanna R Mallucci","doi":"10.1146/annurev-pharmtox-080125-105017","DOIUrl":"https://doi.org/10.1146/annurev-pharmtox-080125-105017","url":null,"abstract":"<p><p>Protein synthesis in neurons is essential for shaping and maintaining the proteome, which underpins synaptic function, learning, memory, and neuronal resilience. Dysregulated mRNA translation control, particularly at the level of initiation, results in reduced global protein synthesis and is a common pathological feature of many neurodegenerative disorders. In mouse models of these diseases, sustained global translational repression drives synaptic dysfunction and loss, ultimately leading to neurodegeneration. Crucially, interventions alleviating this repression restore the proteome, rescue synaptic dysfunction, and promote neuronal survival, leading to their therapeutic potential being assessed in clinical trials. Recently, alternative nodes of regulation have emerged, not only of global mRNA translation-including elongation control-but also of mechanisms fine-tuning subcellular translation in different cellular compartments, notably at synapses and mitochondria. These translation regulatory mechanisms bring a more nuanced understanding of the role of local protein synthesis in neuronal health and disease and the opportunity for novel therapies.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":""},"PeriodicalIF":19.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Precision Drug Discovery in the Era of Artificial Intelligence: A Critical Review.","authors":"Mengya Liu, Jiacheng Xiong, Mingyue Zheng","doi":"10.1146/annurev-pharmtox-060325-010428","DOIUrl":"https://doi.org/10.1146/annurev-pharmtox-060325-010428","url":null,"abstract":"<p><p>Traditional drug development suffers from high costs, low success rates, and patient response variability. Precision drug discovery seeks to overcome these limitations by targeting specific genetic and molecular mechanisms but faces challenges in integrating cross-scale, multimodal biomedical data. Recent advances in artificial intelligence (AI), especially deep learning, provide powerful tools to navigate these complexities. This review surveys representative AI methods across four core stages of precision drug discovery: (<i>a</i>) target identification and validation using omics-, drug-, and structure-based approaches; (<i>b</i>) structure- and sequence-guided virtual screening of active compounds; (<i>c</i>) individualized drug response prediction integrating cell-line, single-cell, and multimodal data; and (<i>d</i>) AI-enabled toxicology and safety modeling to anticipate adverse liabilities and improve translational success. We further highlight a paradigm shift toward autonomous scientific agents capable of causal reasoning and end-to-end experimental guidance. Finally, we discuss persistent challenges, including data bias, limited interpretability, and in silico-to-wet lab translation.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":""},"PeriodicalIF":19.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"New Natural Product Antibiotics: Strategies and Tools That Offer New Approaches to Overcome Traditional Roadblocks.","authors":"Maya S B George, Marie I Balea, Gerard D Wright","doi":"10.1146/annurev-pharmtox-060225-120509","DOIUrl":"https://doi.org/10.1146/annurev-pharmtox-060225-120509","url":null,"abstract":"<p><p>Microbial natural products have been the cornerstone of antibiotics used in medicine since their discovery in the early twentieth century. Shaped by natural selection, natural products are privileged compounds that often target complex biological systems. Despite this success, they have increasingly been abandoned by the drug discovery industry. A principal reason for moving away from natural products is the repeated identification of common antibiotic chemical scaffolds through traditional cell-killing phenotypic assays. However, synthetic compounds have largely failed to fill the antibiotic discovery gap. Advances in genomics, bioinformatics, and analytical chemistry have, in recent years, combined to show that there is still significant chemical diversity to be explored in microbes, providing an opportunity to revisit natural products for antibiotic discovery. Sourcing compounds from rare organisms through genome mining and rapid triage using metabolomics are being used to find new compounds with novel modes of action, opening the door to a new era in antibiotic innovation.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":""},"PeriodicalIF":19.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Making Drug Dosing Decisions Based on Therapeutic Monitoring.","authors":"Leslie Z Benet, Jasleen K Sodhi","doi":"10.1146/annurev-pharmtox-060325-032401","DOIUrl":"10.1146/annurev-pharmtox-060325-032401","url":null,"abstract":"<p><p>We review a new methodology for deriving pharmacokinetic clearance equations independent of differential equations or mechanistic models of drug disposition. Nine examples are presented that illustrate the application of this framework to drug dosing decisions based on therapeutic monitoring. Although mass balance is necessary and sufficient in deriving in vitro measures and rate constants relevant to in vivo pharmacokinetics, clinical drug dosing decisions are based on clearance, not rate constants. Mass balance is necessary in deriving pharmacokinetic clearance equations, but in vivo it is not always sufficient in determining which processes drive overall clearance. A key implication of this framework is that pharmaceutical sponsors may possibly formulate a dosage form for high-clearance drugs, where the manufactured delivery clearance from the dosage form becomes the in vivo clearance of drug in the patient, independent of the elimination clearance observed following an intravenous bolus dose and independent of the patient-specific characteristics.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":""},"PeriodicalIF":19.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sidharth Tyagi, Mohammad-Reza Ghovanloo, Mark Estacion, Sulayman D Dib-Hajj, Stephen G Waxman
{"title":"Nonaddictive Analgesia: New Approaches That Target the Hodgkin-Huxley Na<sub>V</sub>/K<sub>V</sub> Dyad.","authors":"Sidharth Tyagi, Mohammad-Reza Ghovanloo, Mark Estacion, Sulayman D Dib-Hajj, Stephen G Waxman","doi":"10.1146/annurev-pharmtox-060325-034103","DOIUrl":"https://doi.org/10.1146/annurev-pharmtox-060325-034103","url":null,"abstract":"<p><p>Chronic pain represents a massive global health burden that is exacerbated by the limitations and liabilities of opioid therapies. This review examines the biophysical basis of nociceptor excitability, framed by the Hodgkin-Huxley dyad of opposing voltage-gated sodium (Na<sub>V</sub>) and potassium (K<sub>V</sub>) conductances. We analyze the roles of peripheral Na<sub>V</sub> isoforms (Na<sub>V</sub>1.7, Na<sub>V</sub>1.8, Na<sub>V</sub>1.9) as drivers of pathological firing and discuss the translational trajectory of Na<sub>V</sub> inhibitors, ranging from the recent clinical approval of Na<sub>V</sub>1.8-selective small molecules to the ongoing challenges facing Na<sub>V</sub>1.7-targeted programs. Beyond canonical pore blockers, we evaluate emerging modalities, including state-dependent cannabinoid modulation, targeted protein degradation, and genetic interventions. Complementing these excitatory targets, we discuss K<sub>V</sub>7 channel activators as molecular brakes capable of buffering hyperexcitability. Finally, we propose that rational comodulation of this dyad offers a mechanistically grounded pathway toward effective, nonaddictive analgesia.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":""},"PeriodicalIF":19.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paolo Reho, Vidhu V Thaker, Arjun P Athreya, Serge Cremers, Young-Mi Go, George Hripcsak, Xin Hu, Dean P Jones, Soon-Mi Kim, Konstantinos N Lazaridis, Shuzhao Li, Kurt D Pennell, Randolph R Singh, Douglas I Walker, Chirag J Patel, Gary W Miller, IndiPHARM Consortium
{"title":"Pharmacoexposomics: The Environmental Complement to Pharmacogenomics to Advance Precision Medicine.","authors":"Paolo Reho, Vidhu V Thaker, Arjun P Athreya, Serge Cremers, Young-Mi Go, George Hripcsak, Xin Hu, Dean P Jones, Soon-Mi Kim, Konstantinos N Lazaridis, Shuzhao Li, Kurt D Pennell, Randolph R Singh, Douglas I Walker, Chirag J Patel, Gary W Miller, IndiPHARM Consortium","doi":"10.1146/annurev-pharmtox-062624-113658","DOIUrl":"10.1146/annurev-pharmtox-062624-113658","url":null,"abstract":"<p><p>Despite advances in pharmacogenomics that have led to innovative therapeutic strategies, substantial interindividual variability in drug efficacy and toxicity persists. Both endogenous and exogenous factors contribute to this unexplained variation, resulting in suboptimal treatment effectiveness, unnecessary healthcare costs, preventable mortality, and significant human suffering. The emerging field of exposomics is aimed at addressing the complex exposures that impact human health and offers an opportunity to interrogate how these exposures influence drug actions and outcomes. Here, we introduce pharmacoexposomics as a complementary framework that systematically quantifies the body's metabolic response to drug and environmental exposures using high-resolution mass spectrometry. We then present IndiPHARM (Individualized Pharmacology), a multi-institution, Advanced Research Projects Agency for Health-supported platform designed to integrate population-scale pharmacoexposomics with pharmacogenomics and clinical data to elucidate interindividual variability in drug response, identify adverse reactions, and inform tailored, effective treatment strategies that advance precision medicine.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":""},"PeriodicalIF":19.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148756976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}