The diterpenoid ester
ingenol mebutate (IngMeb) is the active ingredient
in the topical drug Picato, a first-in-class treatment for the precancerous
skin condition actinic keratosis. IngMeb is proposed to exert its
therapeutic effects through a dual mode of action involving (i) induction
of cell death that is associated with mitochondrial dysfunction followed
by (ii) stimulation of a local inflammatory response, at least partially
driven by protein kinase C (PKC) activation. Although this therapeutic
model has been well characterized, the complete set of molecular targets
responsible for mediating IngMeb activity remains ill-defined. Here,
we have synthesized a photoreactive, clickable analogue of IngMeb
and used this probe in quantitative proteomic experiments to map several
protein targets of IngMeb in human cancer cell lines and primary human
keratinocytes. Prominent among these targets was the mitochondrial
carnitine-acylcarnitine translocase SLC25A20, which we show is inhibited
in cells by IngMeb and the more stable analogue ingenol disoxate (IngDsx),
but not by the canonical PKC agonist 12-<i>O</i>-tetradecanoylphorbol-13-acetate
(TPA). SLC25A20 blockade by IngMeb and IngDsx leads to a buildup of
cellular acylcarnitines and blockade of fatty acid oxidation (FAO),
pointing to a possible mechanism for IngMeb-mediated perturbations
in mitochondrial function