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MMSDH facilitates ACSL4 propionylation to counteract ferroptosis upon hypoxia and impairs PDAC chemotherapy efficacy

Nature Cancer, Published online: 11 September 2026; doi:10.1038/s43018-026-01236-w

Zheng et al. describe how hypoxia-induced methylmalonate semialdehyde dehydrogenase lactylation promotes acyl-CoA synthetase long-chain family member 4 propionylation and degradation, thereby suppressing ferroptosis induced by chemotherapy, and develop a blocking peptide that increased chemotherapy efficacy in pancreatic ductal adenocarcinoma.
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