PACS1 syndrome variant alters proteomic landscape of developing cortical organoids

PACS1 syndrome is a neurodevelopmental disorder (NDD) resulting from a unique de novo p.R203W variant in Phosphofurin Acidic Cluster Sorting protein 1 (PACS1). PACS1 encodes a multifunctional sorting protein required for localizing furin to the trans-Golgi network. Although few studies have started to investigate the impact of the PACS1 p.R203W variant, the mechanisms by which the variant affects neurodevelopment are still poorly understood. In recent years, autism spectrum disorder (ASD) patient-derived brain organoids have been increasingly used to identify pathogenic mechanisms and possible therapeutic targets. While most of these studies evaluate the mechanisms by which ASD-risk genes affect the transcriptome, studies considering the proteome are limited. Here, we examine the effect of PACS1 p.R203W on the proteomic landscape of brain organoids using tandem mass tag (TMT) mass-spectrometry. Time series analysis between PACS1^(+/+) and PACS1^(+/R203W) organoids uncovered several proteins with dysregulated abundance or phosphorylation status, including known PACS1 interactors. Although we observed low overlap between proteins with altered expression and phosphorylation, the resulting dysregulated processes converged. The presence of the PACS1 p.R203W variant accelerated the emergence of proteins related to synaptogenesis and impaired vesicle loading and recycling. The earlier presence of these proteins and their related processes could lead to defective and/or incomplete synaptic function. Key dysregulated proteins observed in PACS1^(+/R203W) organoids have been associated with several neurological diseases, and many are classified as NDD-causative and ASD-risk genes. Our results highlight that proteomic analyses not only enhance our understanding of general NDD mechanisms by complementing transcriptomic studies, but could also uncover additional targets, and therefore facilitate therapy development.