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<journal-id journal-id-type="publisher-id">Front. Physiol.</journal-id>
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<journal-title>Frontiers in Physiology</journal-title>
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<issn pub-type="epub">1664-042X</issn>
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<article-id pub-id-type="publisher-id">1764165</article-id>
<article-id pub-id-type="doi">10.3389/fphys.2026.1764165</article-id>
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<subject>Review</subject>
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<title-group>
<article-title>Enzymes that generate and regulate intracellular persulfides and polysulfides: mechanistic insights and inhibitors</article-title>
<alt-title alt-title-type="left-running-head">Hirabayashi et al.</alt-title>
<alt-title alt-title-type="right-running-head">
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fphys.2026.1764165">10.3389/fphys.2026.1764165</ext-link>
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<contrib-group>
<contrib contrib-type="author" equal-contrib="yes">
<name>
<surname>Hirabayashi</surname>
<given-names>Ko</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
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<sup>&#x2020;</sup>
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<contrib contrib-type="author" equal-contrib="yes">
<name>
<surname>Sasaki</surname>
<given-names>Eita</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
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<xref ref-type="author-notes" rid="fn001">
<sup>&#x2020;</sup>
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<contrib contrib-type="author">
<name>
<surname>Ohno</surname>
<given-names>Hisashi</given-names>
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<xref ref-type="aff" rid="aff1">
<sup>1</sup>
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<contrib contrib-type="author">
<name>
<surname>Takayama</surname>
<given-names>Orie</given-names>
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<sup>1</sup>
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<contrib contrib-type="author">
<name>
<surname>Yamada</surname>
<given-names>Sota</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
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<contrib contrib-type="author" corresp="yes">
<name>
<surname>Hanaoka</surname>
<given-names>Kenjiro</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
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<aff id="aff1">
<label>1</label>
<institution>Graduate School of Pharmaceutical Sciences, Keio University</institution>, <city>Tokyo</city>, <country country="JP">Japan</country>
</aff>
<aff id="aff2">
<label>2</label>
<institution>Human Biology-Microbiome-Quantum Research Center (WPI-Bio2Q), Keio University</institution>, <city>Tokyo</city>, <country country="JP">Japan</country>
</aff>
<author-notes>
<corresp id="c001">
<label>&#x2a;</label>Correspondence: Kenjiro Hanaoka, <email xlink:href="mailto:khanaoka@keio.jp">khanaoka@keio.jp</email>
</corresp>
<fn fn-type="equal" id="fn001">
<label>&#x2020;</label>
<p>These authors have contributed equally to this work</p>
</fn>
</author-notes>
<pub-date publication-format="electronic" date-type="pub" iso-8601-date="2026-02-09">
<day>09</day>
<month>02</month>
<year>2026</year>
</pub-date>
<pub-date publication-format="electronic" date-type="collection">
<year>2026</year>
</pub-date>
<volume>17</volume>
<elocation-id>1764165</elocation-id>
<history>
<date date-type="received">
<day>15</day>
<month>01</month>
<year>2026</year>
</date>
<date date-type="rev-recd">
<day>29</day>
<month>12</month>
<year>2025</year>
</date>
<date date-type="accepted">
<day>19</day>
<month>01</month>
<year>2026</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2026 Hirabayashi, Sasaki, Ohno, Takayama, Yamada and Hanaoka.</copyright-statement>
<copyright-year>2026</copyright-year>
<copyright-holder>Hirabayashi, Sasaki, Ohno, Takayama, Yamada and Hanaoka</copyright-holder>
<license>
<ali:license_ref start_date="2026-02-09">https://creativecommons.org/licenses/by/4.0/</ali:license_ref>
<license-p>This is an open-access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License (CC BY)</ext-link>. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</license-p>
</license>
</permissions>
<abstract>
<p>Reactive sulfur species (RSS), which include various persulfides and polysulfides, are generated by multiple enzymes <italic>in vivo</italic> and play critical roles in mammalian physiological processes such as redox signaling, metabolic regulation, radical scavenging and anti-inflammatory responses. Cystathionine <italic>&#x3b2;</italic>-synthase (CBS), cystathionine <italic>&#x3b3;</italic>-lyase (CSE) and 3-mercaptopyruvate sulfurtransferase (3MST) are well known to mediate endogenous production of hydrogen sulfide (H<sub>2</sub>S), and, together with the mitochondrial isoform of cysteinyl-tRNA synthetase (CARS2), are proposed to be major sources of intracellular persulfides and polysulfides. In mitochondria, enzymes involved in the sulfide oxidation pathway, including sulfide:quinone oxidoreductase (SQOR), persulfide dioxygenase (ETHE1) and thiosulfate sulfurtransferase (TST), also contribute to maintaining and regulating intracellular persulfide levels. Selective inhibitors targeting these enzymes are expected to be powerful tools for elucidating the functions of RSS, as well as having therapeutic potential. In this review, we present a comprehensive overview of these enzymes, focusing on their reaction mechanisms and inhibitors.</p>
</abstract>
<kwd-group>
<kwd>mitochondrial respiration</kwd>
<kwd>persulfide</kwd>
<kwd>polysulfide</kwd>
<kwd>protein persulfide</kwd>
<kwd>reactive sulfur species</kwd>
<kwd>selective inhibitor</kwd>
<kwd>sulfide oxidation</kwd>
<kwd>transsulfuration pathway</kwd>
</kwd-group>
<funding-group>
<funding-statement>The author(s) declared that financial support was received for this work and/or its publication. This work was supported in part by JSPS KAKENHI Grant Numbers JP23K27304, JP23K20040, JP23K17389, JP21H05262 and 24K01446 to KeH, 25K08844 and 25H01419 to ES, a grant from the Japan Agency for Medical Research and Development (AMED) (JP24ak0101182s0104 and JP24gm1510012s0202) to KeH, JST CREST to KeH and Program for the Advancement of Next-Generation Research Projects (Keio University), Academic Development Fund (Keio University Academic Development Funds) and Fukuzawa Fund (Keio Gijuku Fukuzawa Memorial Fund for the Advancement of Education and Research) to KeH and KoH was supported by the WPI-Bio2Q STaMP program (WPI-Bio2Q, Keio University).</funding-statement>
</funding-group>
<counts>
<fig-count count="13"/>
<table-count count="2"/>
<equation-count count="0"/>
<ref-count count="103"/>
<page-count count="00"/>
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<custom-meta-group>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Redox Physiology</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="s1">
<title>Introduction</title>
<p>Reactive sulfur species (RSS), including (hydro)persulfides and (hydro)polysulfides, are critical mediators in mammalian physiology (<xref ref-type="bibr" rid="B14">Barayeu et al., 2023</xref>; <xref ref-type="bibr" rid="B4">Akaike et al., 2024</xref>; <xref ref-type="bibr" rid="B75">Pan et al., 2025</xref>), playing essential roles in redox signaling (<xref ref-type="bibr" rid="B47">Kasamatsu et al., 2016</xref>), metabolic regulation (<xref ref-type="bibr" rid="B3">Akaike et al., 2017</xref>; <xref ref-type="bibr" rid="B70">Nishimura et al., 2024</xref>), radical scavenging (<xref ref-type="bibr" rid="B95">Wu et al., 2023</xref>), anti-inflammatory responses (<xref ref-type="bibr" rid="B88">Tsutsuki et al., 2024</xref>), etc. The various biological functions of these molecules arise from their unique chemical properties (<xref ref-type="bibr" rid="B76">Park et al., 2015</xref>; <xref ref-type="bibr" rid="B28">Fukuto et al., 2018</xref>; <xref ref-type="bibr" rid="B36">Iciek et al., 2022</xref>; <xref ref-type="bibr" rid="B87">Switzer, 2023</xref>). In general, hydropersulfides/hydropolysulfides serve as stronger nucleophiles than thiols. These species exist largely in a deprotonated anionic form at physiological pH, while most biothiols exist largely in a neutral protonated form (e.g., the p<italic>K</italic>
<sub>a</sub> values of glutathione persulfide (GSSH) and glutathione (GSH) were reported to be 5.45 and 8.94, respectively) (<xref ref-type="fig" rid="F1">Figure 1A</xref>) (<xref ref-type="bibr" rid="B16">Benchoam et al., 2020</xref>). In contrast, the hydropersulfides/hydropolysulfides and polysulfides (catenated sulfur), whose terminal sulfurs are both alkylated, are electrophilic and readily react with various nucleophiles such as hydroxide, sulfite, cyanide and thiolate (<xref ref-type="fig" rid="F1">Figure 1B</xref>) (<xref ref-type="bibr" rid="B76">Park et al., 2015</xref>). For example, thiolate can nucleophilically attack hydropersulfide to form disulfide and release hydrogen sulfide (H<sub>2</sub>S), which is similar to the reaction of thiolate with sulfenic acid or hydroperoxide (<xref ref-type="bibr" rid="B87">Switzer, 2023</xref>). In addition, the persulfidation of protein cysteine functions as an important protective modification to prevent irreversible overoxidation of cysteine residues to sulfinic and sulfonic acids. The S&#x2212;S bond of the corresponding perthiosulfinic and perthiosulfonic acids can be readily reduced, thereby regenerating the native cysteine (<xref ref-type="fig" rid="F1">Figure 1C</xref>) (<xref ref-type="bibr" rid="B73">Ono et al., 2014</xref>). Hydropersulfides/hydropolysulfides also participate in one-electron reactions through perthiyl radicals, which are considerably more stable than the corresponding thiyl radicals (e.g., the S&#x2212;H bond dissociation energies for persulfide and thiol were reported to be 70 and 92 kcal/mol, respectively) (<xref ref-type="bibr" rid="B17">Bianco et al., 2016</xref>; <xref ref-type="bibr" rid="B71">Noguchi et al., 2023</xref>). Interestingly, perthiyl radicals rapidly self-recombine to form non-radical products, whereas thiyl radicals tend to abstract a hydrogen atom from other molecules and propagate radical reactions (<xref ref-type="fig" rid="F1">Figure 1D</xref>) (<xref ref-type="bibr" rid="B14">Barayeu et al., 2023</xref>; <xref ref-type="bibr" rid="B95">Wu et al., 2023</xref>). These radical-scavenging properties of hydropersulfides/hydropolysulfides were recently highlighted in connection with the suppression of lipid peroxidation (<xref ref-type="bibr" rid="B95">Wu et al., 2023</xref>). Collectively, the versatile chemical features of RSS enable them to reduce oxidative stress and modulate cellular signaling pathways.</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption>
<p>Representative reactions involving hydropersulfides and hydropolysulfides. <bold>(A)</bold> Nucleophilic reactions of hydropersulfides (<italic>n</italic> &#x3d; 1) or hydropolysulfides (<italic>n</italic> &#x2265; 2) toward electrophiles (E<sup>&#x2b;</sup>). <bold>(B)</bold> Electrophilic reactions of hydropersulfides (<italic>n</italic> &#x3d; 1, m &#x3d; 1) or hydropolysulfides (n &#x2b; m &#x2265; 3) with nucleophiles (:Nu). <bold>(C)</bold> Overoxidation and subsequent reduction of protein persulfides. <bold>(D)</bold> Radical-scavenging reactions of hydropersulfides (<italic>n</italic> &#x3d; 1, m &#x3d; 1) or hydropolysulfides (<italic>n</italic> &#x2265; 2, m &#x2265; 2). In all panels, <italic>n</italic> and <italic>m</italic>, which represent the number of sulfur atoms, are natural numbers.</p>
</caption>
<graphic xlink:href="fphys-17-1764165-g001.tif">
<alt-text content-type="machine-generated">Chemical reaction diagrams labeled (A) to (D). (A) shows deprotonation and electrophile addition to form R-S&#x2099;S-E. (B) depicts nucleophilic attack on R-S&#x2099;-S&#x2098;-H, producing R-S&#x2099;-Nu and H-S&#x2098;&#x207B;. (C) features oxidation of R-SSH to perthiosulfonic acid and reduction to R-SH and SO&#x2083;&#xB2;&#x207B;. (D) illustrates radical formation and chain elongation from R&#x2081;-S&#x2099;-S-H to R&#x2081;-S&#x2099;-S-S-S&#x2098;-R&#x2082;.</alt-text>
</graphic>
</fig>
<p>RSS are predominantly produced through reactions catalyzed by a diverse set of sulfur-metabolizing enzymes. Among them, cystathionine <italic>&#x3b2;</italic>-synthase (CBS), cystathionine <italic>&#x3b3;</italic>-lyase (CSE) and 3-mercaptopyruvate sulfurtransferase (3MST) have long been studied based on their roles in H<sub>2</sub>S biogenesis (<xref ref-type="bibr" rid="B48">Kimura, 2011</xref>). Recent studies, however, have broadened our understanding, revealing their potential roles in producing persulfides and polysulfides (<xref ref-type="bibr" rid="B37">Ida et al., 2014</xref>). Furthermore, cysteinyl-tRNA synthetase (CARS) has emerged as a novel contributor to intracellular cysteine persulfide (CysSSH) production (<xref ref-type="bibr" rid="B3">Akaike et al., 2017</xref>). CARS has also been reported to produce protein persulfides in a translation-coupled manner (<xref ref-type="bibr" rid="B3">Akaike et al., 2017</xref>). Mitochondrial enzymes such as sulfide:quinone oxidoreductase (SQOR), persulfide dioxygenase (ETHE1) and thiosulfate sulfurtransferase (TST) further regulate RSS levels in the sulfide oxidation pathway, where H<sub>2</sub>S is converted to thiosulfate and sulfate (<xref ref-type="bibr" rid="B59">Libiad et al., 2014</xref>; <xref ref-type="bibr" rid="B32">Hanna et al., 2023</xref>).</p>
<p>Despite the growing understanding of the physiological roles of RSS, the precise contribution of each enzyme to specific biological events remains elusive. Although genetic methods (i.e., gene knockout and knockdown) are powerful approaches, they often activate compensatory pathways, making it difficult to determine the specific role of each enzyme (<xref ref-type="bibr" rid="B62">Marutani and Ichinose, 2020</xref>; <xref ref-type="bibr" rid="B101">Zainol et al., 2023</xref>). In contrast, selective inhibitors targeting each enzyme can block its activity at defined time points and in a dose-dependent manner, enabling more refined experimental control. Small molecule inhibitors may also have therapeutic potential (<xref ref-type="bibr" rid="B93">Whiteman et al., 2011</xref>). This review aims to provide a comprehensive overview of the enzymatic reaction mechanisms underlying the biogenesis and regulation of persulfides and polysulfides, and also to highlight key inhibitors together with their modes of action.</p>
</sec>
<sec id="s2">
<title>Enzymes and reaction pathways</title>
<p>Biogenesis and regulation of persulfides and polysulfides are orchestrated by several key enzymes (<xref ref-type="fig" rid="F2">Figure 2</xref>). CBS and CSE, both of which are pyridoxal 5&#x2032;-phosphate (PLP)-dependent enzymes, function sequentially in the transsulfuration pathway, converting homocysteine and serine into cystathionine and subsequently cysteine (<xref ref-type="fig" rid="F2">Figures 2 a,b</xref>) (<xref ref-type="bibr" rid="B84">Sbodio et al., 2019</xref>). In addition to these canonical reactions, both enzymes have been proposed to produce H<sub>2</sub>S by utilizing alternative substrates, namely, a combination of cystine and homocysteine for CBS and either cysteine or homocysteine for CSE (<xref ref-type="bibr" rid="B84">Sbodio et al., 2019</xref>). In 2014, Ida et al. reported that CBS and CSE can also use cystine as a preferential substrate and produce cysteine persulfide (CysSSH) <italic>in vitro</italic> (<xref ref-type="fig" rid="F2">Figure 2c</xref>) (<xref ref-type="bibr" rid="B37">Ida et al., 2014</xref>). Furthermore, mass spectrometry (MS)-based metabolomic analysis revealed that the concentrations of low-molecular-weight persulfides/polysulfides, including CysSSH and GSSH, in A549 cells were significantly increased or decreased when the corresponding enzymes were overexpressed or knocked down, respectively (<xref ref-type="bibr" rid="B37">Ida et al., 2014</xref>). However, the same group later revisited these findings and proposed a revised view of the roles of CBS and CSE <italic>in vivo</italic>. Rather than directly producing CysSSH formation from cystine, these enzymes are now thought to contribute primarily to cysteine production via the transsulfuration pathway, and it was suggested that CARS, which can use cysteine as a substrate to produce CysSSH, is a more plausible major contributor to intracellular CysSSH biogenesis (<xref ref-type="bibr" rid="B3">Akaike et al., 2017</xref>). One line of evidence supporting this view is that intracellular cystine concentrations (sub-micromolar to low micromolar) are far below the <italic>K</italic>
<sub>m</sub> value of CSE for cystine (&#x3e;200 &#xb5;M), making efficient CysSSH formation from cystine unlikely under physiological conditions. Nevertheless, CBS and CSE may still produce CysSSH under pathophysiological conditions in which the intracellular cystine concentration is markedly elevated.</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption>
<p>Enzymatic pathways involved in the production and regulation of RSS. <bold>(a)</bold> CBS-catalyzed reaction in the transsulfuration pathway. <bold>(b)</bold> CSE-catalyzed reaction in the transsulfuration pathway. <bold>(c)</bold> Possible CBS/CSE-catalyzed reaction for generation of CysSSH from cystine. <bold>(d)</bold> 3MST-catalyzed reaction. <bold>(e)</bold> CARS-catalyzed reaction for the generation of CysSSH from two molecules of cysteine. <bold>(f)</bold> SQOR-catalyzed reaction in the mitochondrial sulfide oxidation pathway. <bold>(g)</bold> ETHE1-catalyzed reaction in the mitochondrial sulfide oxidation pathway. <bold>(h)</bold> TST-catalyzed reaction in the mitochondrial sulfide oxidation pathway.</p>
</caption>
<graphic xlink:href="fphys-17-1764165-g002.tif">
<alt-text content-type="machine-generated">Biochemical pathway diagram illustrating enzymes and intermediates in cysteine and sulfur metabolism, including CBS, CSE, CARS, 3MST, CAT, Trx, SQOR, ETHE1, SUOX, and TST, with chemical structures and arrows indicating reaction steps.</alt-text>
</graphic>
</fig>
<p>3MST is another enzyme known to be involved in H<sub>2</sub>S biogenesis, and is also reported to generate persulfidated species (<xref ref-type="bibr" rid="B51">Kimura et al., 2017</xref>; <xref ref-type="bibr" rid="B77">Pedre and Dick, 2021</xref>). It is predominantly localized in mitochondria and functions as a sulfurtransferase that converts 3-mercaptopyruvate, which is produced from cysteine by cysteine aminotransferase (CAT), into pyruvate (<xref ref-type="fig" rid="F2">Figure 2d</xref>) (<xref ref-type="bibr" rid="B68">Nag et al., 2006</xref>; <xref ref-type="bibr" rid="B50">Kimura, 2015</xref>). 3MST transfers the sulfur of 3-mercaptopyruvate to its active-site cysteine, affording a 3MST-bound persulfide intermediate. This intermediate subsequently transfers its sulfur to a thiophilic acceptor molecule, such as thioredoxin (Trx) (<xref ref-type="bibr" rid="B66">Mikami et al., 2011</xref>). In 2017, Kimura et al., reported that 3MST in a mouse brain cell suspension could produce various RSS including hydrogen disulfide (H<sub>2</sub>S<sub>2</sub>), hydrogen trisulfide (H<sub>2</sub>S<sub>3</sub>), CysSSH, and GSSH in addition to H<sub>2</sub>S (<xref ref-type="bibr" rid="B51">Kimura et al., 2017</xref>). Therefore, this enzyme may contribute to the <italic>in vivo</italic> generation of protein persulfides, as well as low-molecular-weight persulfides/polysulfides.</p>
<p>In 2017, Akaike et al. reported a study that drew increased attention to RSS. They showed that CARS, an enzyme canonically known for catalyzing the attachment of cysteine to its cognate transfer RNA (tRNA), is the major source of endogenous persulfides/polysulfides (<xref ref-type="bibr" rid="B3">Akaike et al., 2017</xref>). They discovered that CARS catalyzes a novel PLP-dependent reaction to produce CysSSH using two molecules of cysteine as substrates (<xref ref-type="fig" rid="F2">Figure 2e</xref>). They also found that the enzyme may utilize CysSSH as a substrate for aminoacylation, thereby enabling its incorporation into nascent polypeptides during translation (<xref ref-type="bibr" rid="B3">Akaike et al., 2017</xref>). Interestingly, knockout (KO) of the mitochondrial isoform of CARS (CARS2) in HEK293T cells resulted in an approximately two-thirds reduction in intracellular CysSSH levels compared with wild-type (WT) cells. In addition, CBS and CSE knockdown in CARS2 KO cells suppressed the intracellular cysteine levels, but did not lead to a further reduction in the CysSSH levels, suggesting that CARS2 is the major enzyme responsible for CysSSH production (<xref ref-type="bibr" rid="B3">Akaike et al., 2017</xref>). In 2023, Zainol Abidin et al. further supported this conclusion by performing an extensive sulfur metabolome analysis in CBS/CSE/3MST triple-KO mice (<xref ref-type="bibr" rid="B101">Zainol et al., 2023</xref>). Their results showed that CysSSH levels in the triple-KO mice were not significantly changed compared with those of WT mice. In contrast, the CysSSH levels in liver and lung tissues of CARS2-deficient heterozygous mice were reduced by more than 50% compared with those of WT mice, highlighting the principal role of CARS2 in CysSSH biogenesis (<xref ref-type="bibr" rid="B101">Zainol et al., 2023</xref>).</p>
<p>In the mitochondrial sulfide oxidation pathway, SQOR, a flavin adenine dinucleotide (FAD)-dependent enzyme, initiates H<sub>2</sub>S oxidation coupled with the reduction of coenzyme Q (CoQ or ubiquinone) (<xref ref-type="bibr" rid="B57">Landry et al., 2021</xref>). During catalysis, FAD is reduced to its dihydrogenated form (FADH<sub>2</sub>), which subsequently reduces CoQ. Electrons from the reduced CoQ then enter the mitochondrial electron transport chain at complex III. In the SQOR-catalyzed reaction, sulfur of H<sub>2</sub>S is accepted by GSH to generate GSSH under physiological conditions (<xref ref-type="fig" rid="F2">Figure 2f</xref>) (<xref ref-type="bibr" rid="B57">Landry et al., 2021</xref>). The released GSSH is then transferred to the downstream enzyme ETHE1, which contains an iron atom in its active site. It catalyzes the conversion of GSSH to GSH and sulfite (<xref ref-type="fig" rid="F2">Figure 2g</xref>) (<xref ref-type="bibr" rid="B44">Kabil and Banerjee, 2012</xref>). Subsequently, TST, which belongs to the sulfurtransferase family, like 3-MST, converts sulfite to thiosulfate using another molecule of GSSH as a sulfur donor (<xref ref-type="fig" rid="F2">Figure 2h</xref>) (<xref ref-type="bibr" rid="B19">Buonvino et al., 2022</xref>). Alternatively, sulfite is further oxidized to sulfate by sulfite oxidase (SUOX) (<xref ref-type="bibr" rid="B26">Fu et al., 2025</xref>). Although H<sub>2</sub>S is a toxic gas that binds to the heme of cytochrome c oxidase and inhibits mitochondrial respiration, it also serves as an electron donor for the mitochondrial electron transport chain (<xref ref-type="bibr" rid="B18">Bouillaud and Blachier, 2011</xref>). Therefore, SQOR and its downstream enzymes play important roles in energy generation by regulating H<sub>2</sub>S and RSS (primarily GSSH) levels.</p>
</sec>
<sec id="s3">
<title>Reaction mechanisms and inhibitors</title>
<sec id="s3-1">
<title>CBS</title>
<p>CBS is a PLP-dependent <italic>&#x3b2;</italic>-replacement enzyme in the transsulfuration pathway. It utilizes homocysteine and serine to generate cystathionine (<xref ref-type="bibr" rid="B13">Banerjee et al., 2003</xref>). In the canonical CBS-catalyzed reaction, serine first forms an external aldimine with PLP. Subsequently, a <italic>&#x3b2;</italic>-elimination reaction occurs, releasing a water (H<sub>2</sub>O) molecule and yielding an aminoacrylate intermediate. This is the key intermediate in the CBS reaction and was directly observed by time-resolved spectroscopy (<xref ref-type="bibr" rid="B96">Yadav et al., 2012</xref>). Next, the thiolate of homocysteine nucleophilically attacks this aminoacrylate, leading to cystathionine formation (<xref ref-type="fig" rid="F3">Figure 3</xref>) (<xref ref-type="bibr" rid="B96">Yadav et al., 2012</xref>; <xref ref-type="bibr" rid="B12">Banerjee and Zou, 2005</xref>).</p>
<fig id="F3" position="float">
<label>FIGURE 3</label>
<caption>
<p>Proposed catalytic mechanism of CBS.</p>
</caption>
<graphic xlink:href="fphys-17-1764165-g003.tif">
<alt-text content-type="machine-generated">Chemical reaction diagram illustrating the transsulfuration pathway of serine converting to cystathionine. Key intermediates include internal aldimine, aminoacrylate, and the involvement of cystathionine beta-synthase (CBS) at lysine 119.</alt-text>
</graphic>
</fig>
<p>Mammalian CBS is an unusual PLP enzyme that contains a heme cofactor and <italic>S</italic>-adenosyl-L-methionine (SAM). Although the C-terminal SAM-binding site is located away from the catalytic center, it was revealed that SAM binding induces a structural rearrangement of the catalytic core that relieves autoinhibition and stabilizes an activated conformation (<xref ref-type="bibr" rid="B64">McCorvie et al., 2014</xref>; <xref ref-type="bibr" rid="B24">Ere&#xf1;o-Orbea et al., 2014</xref>). Therefore, SAM allosterically enhances the enzyme activity (<xref ref-type="bibr" rid="B41">Janos&#xed;k et al., 2001</xref>; <xref ref-type="bibr" rid="B80">Prudova et al., 2006</xref>). The crystal structure of human CBS had been determined only after deletion of the regulatory loop (aa 515&#x2013;525) (<xref ref-type="bibr" rid="B64">McCorvie et al., 2014</xref>; <xref ref-type="bibr" rid="B24">Ere&#xf1;o-Orbea et al., 2014</xref>), but McCorvie et al. recently visualized the structure of full-length human CBS using cryo-electron microscopy (cryo-EM) (<xref ref-type="bibr" rid="B65">McCorvie et al., 2024</xref>). Interestingly, the full-length enzyme assembles into higher-order oligomers forming helical filaments. The conformation of these filaments was shown to change upon SAM binding, from three CBS dimers per turn to two. This conformational change results in the removal of the steric block imposed by the regulatory domains on the active site of the catalytic core (<xref ref-type="bibr" rid="B65">McCorvie et al., 2024</xref>).</p>
<p>Historically, aminooxyacetic acid (AOAA) has been the most commonly used inhibitor of CBS (<xref ref-type="bibr" rid="B93">Whiteman et al., 2011</xref>; <xref ref-type="bibr" rid="B10">Asimakopoulou et al., 2013</xref>; <xref ref-type="bibr" rid="B103">Zuhra et al., 2020</xref>). Although AOAA has been suggested to act as an irreversible inhibitor that forms a dead-end oxime complex with PLP (<xref ref-type="bibr" rid="B103">Zuhra et al., 2020</xref>), Petrosino et al. recently demonstrated that the catalytic activity of AOAA-modified CBS can be rescued in the presence of high concentrations of serine (<xref ref-type="bibr" rid="B78">Petrosino et al., 2022</xref>). They also reported the crystal structure of human CBS complexed with AOAA, in which the oxime intermediate is stabilized by a newly formed hydrogen-bond network involving Thr146, Thr150, and Gln222 (<xref ref-type="fig" rid="F4">Figure 4A</xref>) (<xref ref-type="bibr" rid="B78">Petrosino et al., 2022</xref>). However, it should be noted that AOAA is a broad-spectrum inhibitor of PLP-dependent enzymes. For example, it shows similar inhibitory activity toward CSE and CBS with half-maximal inhibitory concentration (IC<sub>50</sub>) values of 1.1 &#xb5;M and 8.5 &#xb5;M, respectively (<xref ref-type="bibr" rid="B10">Asimakopoulou et al., 2013</xref>). Therefore, its limited selectivity must be considered when interpreting cellular or <italic>in vivo</italic> experiments.</p>
<fig id="F4" position="float">
<label>FIGURE 4</label>
<caption>
<p>Inhibitor of CBS. <bold>(A)</bold> Chemical structure of AOAA and its interactions with active-site residues of CBS. <bold>(B)</bold> Chemical structure of CH004.</p>
</caption>
<graphic xlink:href="fphys-17-1764165-g004.tif">
<alt-text content-type="machine-generated">Chemical structure illustrations with labels. (A) Shows the internal aldimine resting state of CBS with Lysine-119, transitioning with AOAA involvement, and interactions involving Gln-222, Thr-150, and Thr-146. (B) Displays the chemical structure of compound CH004.</alt-text>
</graphic>
</fig>
<p>To overcome this limitation, numerous high-throughput screening efforts to identify CBS inhibitors have been conducted, but a truly CBS-selective compound has yet to be discovered (<xref ref-type="bibr" rid="B7">Ascen&#xe7;&#xe3;o and Szabo, 2022</xref>; <xref ref-type="bibr" rid="B83">Sasaki et al., 2023</xref>). One inhibitor, CH004, identified by Wang et al. in 2018, exhibits an IC<sub>50</sub> value of 1 &#x3bc;M for CBS and shows approximately 30-fold higher inhibitory activity toward CBS than toward CSE (<xref ref-type="fig" rid="F4">Figure 4B</xref>) (<xref ref-type="bibr" rid="B91">Wang et al., 2018</xref>). They also demonstrated that CH004 binds reversibly to CBS and determined the dissociation constant (<italic>K</italic>
<sub>d</sub>) to be 0.6 &#x3bc;M. Although the structure of the CBS&#x2013;CH004 complex has not yet been reported, Q222A mutation largely abolishes the inhibitory activity of CH004, suggesting that Gln222 is a key residue for its binding. A potential issue with CH004 is that it also possesses direct H<sub>2</sub>S-scavenging activity (<xref ref-type="bibr" rid="B91">Wang et al., 2018</xref>). In addition, several other targets unrelated to CBS have been suggested by later studies (<xref ref-type="bibr" rid="B7">Ascen&#xe7;&#xe3;o and Szabo, 2022</xref>).</p>
</sec>
<sec id="s3-2">
<title>CSE</title>
<p>CSE is another PLP-dependent enzyme in the transsulfuration pathway. It catalyzes the breakdown of cystathionine into cysteine, <italic>&#x3b1;</italic>-ketobutyrate, and ammonia (<xref ref-type="bibr" rid="B84">Sbodio et al., 2019</xref>; <xref ref-type="bibr" rid="B85">Stipanuk and Ueki, 2011</xref>). In the resting state, PLP is covalently bound to an active-site lysine residue (Lys212) as an internal aldimine. Cystathionine first enters the active site to form an external aldimine with PLP. It is then tautomerized to ketimine and subsequently undergoes cleavage of the C&#x3b3;&#x2013;S bond to release cysteine. The remaining vinylglycine ketimine intermediate is tautomerized to the PLP-bound aminocrotonate, which is subsequently hydrolyzed to release <italic>&#x3b1;</italic>-ketobutyrate and ammonia. Finally, Lys212 forms a Schiff base with PLP to restore the resting state (<xref ref-type="fig" rid="F5">Figure 5</xref>) (<xref ref-type="bibr" rid="B20">Chiku et al., 2009</xref>; <xref ref-type="bibr" rid="B86">Sun et al., 2009</xref>; <xref ref-type="bibr" rid="B35">Huang et al., 2010</xref>).</p>
<fig id="F5" position="float">
<label>FIGURE 5</label>
<caption>
<p>Proposed catalytic mechanism of CSE.</p>
</caption>
<graphic xlink:href="fphys-17-1764165-g005.tif">
<alt-text content-type="machine-generated">Chemical reaction pathway illustrating the conversion of cystathionine to internal aldimine (resting state). Key intermediates include external aldimine, ketimine, vinylglycine ketimine, and PLP-bound aminocrotonate. The reaction involves bases, proton transfers, and the formation of products like cysteine, alpha-ketobutyrate, and ammonia. CSE enzyme and Lysine two hundred twelve are mentioned.</alt-text>
</graphic>
</fig>
<p>In addition to the canonical <italic>&#x3b3;</italic>-lyase reaction, CSE also catalyzes <italic>&#x3b2;</italic>-elimination reactions with various substrates including cysteine and cystine (<xref ref-type="bibr" rid="B20">Chiku et al., 2009</xref>). Namely, it has potential for <italic>in vivo</italic> generation of H<sub>2</sub>S and CysSSH from cysteine and cystine, respectively. The former reaction has been reported to be important particularly in the cardiovascular system (<xref ref-type="bibr" rid="B102">Zhao et al., 2014</xref>; <xref ref-type="bibr" rid="B49">Kimura, 2014</xref>). The latter reaction has been analyzed in detail using rat liver CSE (<xref ref-type="bibr" rid="B100">Yamanishi and Tuboi, 1981</xref>), and Ida et al. reported that human CSE can also catalyze this reaction at least <italic>in vitro</italic> (<xref ref-type="bibr" rid="B37">Ida et al., 2014</xref>). In contrast, more recent studies using CBS/CSE/3MST triple-KO mice suggest that mitochondrial CARS2 is the major contributor to both H<sub>2</sub>S and CysSSH production <italic>in vivo</italic> (<xref ref-type="bibr" rid="B101">Zainol et al., 2023</xref>). In 2023, Araki et al. reported that persulfidation of Cys136 in rat CSE suppresses its <italic>&#x3b2;</italic>-lyase activity to generate CysSSH from cystine (<xref ref-type="bibr" rid="B6">Araki et al., 2023</xref>). Similarly, in 2024, Jia et al. showed that persulfidation of Cys137 in human CSE (equivalent to Cys136 in rat CSE) decreases the <italic>&#x3b2;</italic>-lyase activity to generate H<sub>2</sub>S from cysteine (<xref ref-type="bibr" rid="B42">Jia et al., 2024</xref>). Both studies suggest that persulfidation of this redox-sensitive cysteine residue functions as a negative feedback mechanism regulating the production of H<sub>2</sub>S or CysSSH. The relative contributions of CSE and CARS to H<sub>2</sub>S and CysSSH biogenesis <italic>in vivo</italic> remain to be fully clarified.</p>
<p>Propargylglycine (PAG) is an irreversible inhibitor of CSE (<xref ref-type="bibr" rid="B93">Whiteman et al., 2011</xref>; <xref ref-type="bibr" rid="B10">Asimakopoulou et al., 2013</xref>; <xref ref-type="bibr" rid="B2">Abeles and Walsh, 1973</xref>). It first forms an external aldimine with PLP, like other CSE substrates. Lys212 has been proposed to deprotonate the <italic>&#x3b2;</italic>-position of PAG, yielding a reactive allene intermediate. This intermediate is nucleophilically attacked by the active site tyrosine residue (Tyr114) to form a covalent vinylether adduct, leading to inhibition of the enzyme (<xref ref-type="fig" rid="F6">Figure 6A</xref>) (<xref ref-type="bibr" rid="B86">Sun et al., 2009</xref>; <xref ref-type="bibr" rid="B98">Yadav et al., 2019</xref>). Sun et al. reported the crystal structure of the CSE complex with PAG, confirming a covalent bond between Tyr114 and C&#x3b3; of PAG (<xref ref-type="bibr" rid="B86">Sun et al., 2009</xref>). Although high selectivity of PAG for CSE over CBS has been reported (i.e., an IC<sub>50</sub> of 40 &#x3bc;M for the CSE-catalyzed reaction using 1 mM of cysteine as the substrate, with no detectable inhibition of CBS even at 10 mM PAG), it also inhibits several other PLP enzymes, such as aspartate aminotransferase, alanine aminotransferase, and methionine <italic>&#x3b3;</italic>-lyase (<xref ref-type="bibr" rid="B10">Asimakopoulou et al., 2013</xref>; <xref ref-type="bibr" rid="B86">Sun et al., 2009</xref>). In 2019, Yadav et al. showed that the extent of PAG&#x2019;s inhibitory activity toward CSE, with cysteine as the substrate, depends on the preincubation time of the inhibitor with the enzyme as well as on the concentration of cysteine (<xref ref-type="bibr" rid="B98">Yadav et al., 2019</xref>). They proposed that cysteine competitively interferes with PAG binding to the enzyme, thereby preventing PAG from completing the formation of the dead-end complex with Tyr114. Therefore, the effective concentration of PAG required for CSE inhibition may vary substantially across tissues with different intracellular cysteine levels (<xref ref-type="bibr" rid="B98">Yadav et al., 2019</xref>).</p>
<fig id="F6" position="float">
<label>FIGURE 6</label>
<caption>
<p>Inhibitors of CSE. Chemical structures and inhibitory mechanisms of <bold>(A)</bold> PAG, <bold>(B)</bold> CPC and <bold>(C)</bold> oxamic hydrazide.</p>
</caption>
<graphic xlink:href="fphys-17-1764165-g006.tif">
<alt-text content-type="machine-generated">Chemical reaction diagrams showcase mechanisms of enzyme inhibition involving CSE. Part (A) illustrates reaction with PAG progressing from internal to external aldimine, forming an irreversible covalent adduct. Part (B) displays CPC interaction leading to external aldimine and amino acrylate formation. Part (C) shows oxamic hydrazide converting internal to external aldimine, involving multiple amino acids. Each part highlights steps in red, detailing specific bonds and molecular structures.</alt-text>
</graphic>
</fig>
<p>As an alternative CSE inhibitor, Yadav et al. identified a cystathionine analog, <italic>S</italic>-3-carboxypropyl-L-cysteine (CPC), with a reversible inhibitory mechanism (<xref ref-type="bibr" rid="B98">Yadav et al., 2019</xref>). It suppresses both cystathionine cleavage and H<sub>2</sub>S production by human CSE with inhibition constant (<italic>K</italic>&#x1d62;) values of 50 &#xb5;M and 180 &#x3bc;M, respectively. They also demonstrated that it does not exhibit inhibitory activity toward other PLP-dependent enzymes, CBS and CAT, or the H<sub>2</sub>S-producing enzyme 3MST at concentrations up to 5&#x2013;10 mM. In addition, the crystal structure of the human CSE complex with CPC has been reported, confirming the presence of the PLP-bound amino acrylate intermediate (<xref ref-type="fig" rid="F6">Figure 6B</xref>) (<xref ref-type="bibr" rid="B98">Yadav et al., 2019</xref>).</p>
<p>Our group recently identified oxamic hydrazide as a potent CSE inhibitor by screening a large chemical library of 161,600 compounds (<xref ref-type="bibr" rid="B23">Echizen et al., 2023</xref>). It forms a Schiff base with the active-site PLP of CSE and exhibits an IC<sub>50</sub> value of 13 &#xb5;M with high selectivity over other PLP-dependent enzymes including CBS, alanine aminotransferase and methionine <italic>&#x3b3;</italic>-lyase. The high selectivity of oxamic hydrazide toward CSE was rationalized based on the crystal structure of the rat CSE complex with this inhibitor. In this structure, the PLP-bound oxamic hydrazide is stabilized through hydrogen bonds formed with the active-site residues Glu339, Ser340, Arg375, and Asn161 (<xref ref-type="fig" rid="F6">Figure 6C</xref>). Importantly, these amino acids are conserved in human CSE, and inhibitory activity of oxamic hydrazide toward human CSE has been confirmed in cellular assays using HEK293 cells overexpressing this enzyme (<xref ref-type="bibr" rid="B23">Echizen et al., 2023</xref>).</p>
</sec>
<sec id="s3-3">
<title>3MST</title>
<p>Catalysis by 3MST involves a two-step ping&#x2013;pong mechanism. The active-site cysteine first attacks 3-mercaptopyruvate to form an enzyme-bound cysteine persulfide intermediate while releasing pyruvate. Subsequently, the outer sulfur atom of this persulfide is transferred to thiophilic acceptors (<xref ref-type="bibr" rid="B77">Pedre and Dick, 2021</xref>). The crystal structure of human 3MST reveals that 3-mercaptopyruvate is positioned adjacent to Arg188 and Arg197, to which it is linked through hydrogen bonds. A Ser&#x2013;His&#x2013;Asp triad has been proposed to facilitate thiolate formation at Cys248, enabling nucleophilic attack on the sulfur atom of 3-mercaptopyruvate (<xref ref-type="fig" rid="F7">Figure 7</xref>) (<xref ref-type="bibr" rid="B97">Yadav et al., 2013</xref>).</p>
<fig id="F7" position="float">
<label>FIGURE 7</label>
<caption>
<p>Proposed catalytic mechanism of 3MST.</p>
</caption>
<graphic xlink:href="fphys-17-1764165-g007.tif">
<alt-text content-type="machine-generated">Diagram depicting the enzymatic mechanism of 3-Mercaptopyruvate sulfurtransferase (3MST). The top section shows the catalytic triad involving Aspartate 63, Histidine 74, and Serine 250. Sulfur from Cysteine 248 is transferred to 3-Mercaptopyruvate (3MP) to form Pyruvate. This process creates a persulfide intermediate and involves transitions between reduced and oxidized states of Thioredoxin (Trx). The bottom section shows the 3MST resting state and oxidized form of Trx. Arrows indicate reaction progress and molecular transformations.</alt-text>
</graphic>
</fig>
<p>So far, various thiol-containing biomolecules such as Trx, dihydrolipoic acid, cysteine and molybdenum cofactor synthesis protein 3 (MOCS3) have been proposed and investigated as sulfur acceptors (<xref ref-type="bibr" rid="B51">Kimura et al., 2017</xref>; <xref ref-type="bibr" rid="B66">Mikami et al., 2011</xref>; <xref ref-type="bibr" rid="B97">Yadav et al., 2013</xref>; <xref ref-type="bibr" rid="B25">Fr&#xe4;sdorf et al., 2014</xref>; <xref ref-type="bibr" rid="B99">Yadav et al., 2020</xref>). Yadav et al. demonstrated that Trx is the physiologically preferred sulfur acceptor based on detailed kinetic analyses (<xref ref-type="bibr" rid="B97">Yadav et al., 2013</xref>; <xref ref-type="bibr" rid="B99">Yadav et al., 2020</xref>). They determined that the Michaelis constant (<italic>K</italic>
<sub>m</sub>) for Trx (2.5 &#x3bc;M) is reasonably low compared with physiological Trx concentrations (1&#x2013;20 &#x3bc;M). Further, the catalytic efficiency (<italic>k</italic>
<sub>cat</sub>/<italic>K</italic>
<sub>m</sub>) of human 3MST toward Trx is at least 1,000-fold higher than that toward dihydrolipoic acid or cysteine. Upon accepting sulfur from 3MST, Trx undergoes intramolecular attack by its vicinal thiol, forming an internal disulfide bond and thereby yielding oxidized Trx and releasing H<sub>2</sub>S (<xref ref-type="bibr" rid="B77">Pedre and Dick, 2021</xref>; <xref ref-type="bibr" rid="B97">Yadav et al., 2013</xref>). In contrast, reduced Trx interacts with 3MST and causes substrate inhibition, resulting in an increased <italic>K</italic>
<sub>m</sub> for 3-mercaptopyruvate (<xref ref-type="bibr" rid="B99">Yadav et al., 2020</xref>). Therefore, under oxidative conditions, where the level of reduced Trx is low, the sulfur-transfer activity of 3MST may be enhanced, leading to the increased production of low-molecular-weight RSS, such as CysSSH (<xref ref-type="bibr" rid="B99">Yadav et al., 2020</xref>).</p>
<p>In 2017, our group identified a potent and selective inhibitor of 3MST (<xref ref-type="bibr" rid="B31">Hanaoka et al., 2017</xref>). This compound, later referred to as I3MT-3 or HMPSNE (2-[(4-hydroxy-6-methylpyrimidin-2-yl)sulfanyl]-1-(naphthalen-1-yl)ethan-1-one), exhibits an IC<sub>50</sub> value of 2.7 &#x3bc;M toward mouse 3MST and shows high selectivity over rat CBS, rat CSE, and bovine rhodanese (<xref ref-type="bibr" rid="B31">Hanaoka et al., 2017</xref>). Augsburger et al. determined that the IC<sub>50</sub> value of I3MT-3 toward human 3MST is 13.6 &#x3bc;M (<xref ref-type="bibr" rid="B11">Augsburger et al., 2020</xref>). The crystal structure of the rat 3MST complex with I3MT-3 revealed a unique binding mode, in which the persulfidated anion at the active site cysteine (Cys248) has a long-distance electrostatic interaction (&#x3e;3.45 &#xc5;) with the positively charged carbonyl carbon of the pyrimidone ring. Direct hydrogen bonds with Arg188 and Ser250, as well as water-mediated hydrogen bonds with Tyr108, Glu195, Arg197 and Thr253 were also observed (<xref ref-type="fig" rid="F8">Figure 8</xref>) (<xref ref-type="bibr" rid="B31">Hanaoka et al., 2017</xref>). In addition, isothermal titration calorimetry demonstrated that I3MT-3 binds tightly and selectively to the persulfidated form of 3MST with a <italic>K</italic>
<sub>d</sub> value of 0.5 &#x3bc;M, whereas no binding was detected with the reduced form (<xref ref-type="bibr" rid="B31">Hanaoka et al., 2017</xref>). I3MT-3 has become a standard pharmacological probe for suppressing 3MST-dependent bioenergetics and tumor cell proliferation (<xref ref-type="bibr" rid="B81">Rao et al., 2023</xref>). For example, it has been used in a murine colon cancer cell line (CT26) (<xref ref-type="bibr" rid="B11">Augsburger et al., 2020</xref>), a human endothelial cell line (EA.hy926) (<xref ref-type="bibr" rid="B1">Abdollahi Govar et al., 2020</xref>), a human colon cancer cell line (HCT116) (<xref ref-type="bibr" rid="B8">Ascen&#xe7;&#xe3;o et al., 2022a</xref>), human colonic epithelial cell organoids (<xref ref-type="bibr" rid="B9">Ascen&#xe7;&#xe3;o et al., 2022b</xref>) and porcine coronary artery segments (<xref ref-type="bibr" rid="B5">Almaheize et al., 2025</xref>). In addition to the inhibitory activity toward 3MST, a recent study by Otani et al. demonstrated that I3MT-3 directly inhibits caspase-1, suppressing IL-1&#x3b2; release and pyroptosis induced by multiple effectors (<xref ref-type="bibr" rid="B74">Otani et al., 2025</xref>).</p>
<fig id="F8" position="float">
<label>FIGURE 8</label>
<caption>
<p>Inhibitor of 3MST. <bold>(A)</bold> Chemical structure of I3MT-3. <bold>(B)</bold> Interactions of I3MT-3 with the active-site residues of 3MST.</p>
</caption>
<graphic xlink:href="fphys-17-1764165-g008.tif">
<alt-text content-type="machine-generated">Diagram showing two panels. (A) Chemical structure of I3MT-3, featuring aromatic rings and a thioamide linkage. (B) Interaction diagram of the persulfide intermediate in a 3MST enzyme. Key interactions include cysteine-linked persulfide, and residues such as serine, threonine, arginine, and tyrosine. Blue spheres represent water molecules.</alt-text>
</graphic>
</fig>
</sec>
<sec id="s3-4">
<title>CARS</title>
<p>CARS catalyzes the formation of cysteinyl aminoacyl-tRNA<sup>Cys</sup> (Cys-tRNA<sup>Cys</sup>) through ATP-dependent activation of L-cysteine, yielding cysteinyl adenylate (Cys-AMP), followed by transfer of cysteine to the 3&#x2032;-terminus of tRNA<sup>Cys</sup> (<xref ref-type="bibr" rid="B69">Newberry et al., 2002</xref>; <xref ref-type="bibr" rid="B33">Hauenstein et al., 2004</xref>). In addition to this canonical role, Akaike et al. reported in 2017 that CARS also has cysteine persulfide synthase (CPERS) activity, producing CysSSH in a PLP-dependent manner (<xref ref-type="bibr" rid="B3">Akaike et al., 2017</xref>). They determined the <italic>K</italic>
<sub>m</sub> of <italic>E. coli</italic> CARS for this reaction to be 7.4 &#x3bc;M, which is sufficiently low relative to intracellular cysteine concentrations (100&#x2013;1000 &#x3bc;M) (<xref ref-type="bibr" rid="B3">Akaike et al., 2017</xref>; <xref ref-type="bibr" rid="B27">Fujii et al., 2019</xref>). LC-MS/MS analysis of the CARS-catalyzed CysSSH formation using stable-isotope-labeled cysteine further indicated that sulfur is transferred from one cysteine molecule to another. Moreover, extensive mutational analyses using <italic>E. coli</italic> CARS showed that the lysine residues within the <sup>73</sup>KIIK<sup>76</sup> and <sup>266</sup>KMSK<sup>269</sup> motifs are important for CPERS activity (but not for aminoacylation activity) and likely serve as PLP binding sites (<xref ref-type="bibr" rid="B3">Akaike et al., 2017</xref>). Interestingly, these KIIK and KMSK motifs are highly conserved across diverse species, including mammals, supporting their functional relevance in CPERS activity (<xref ref-type="bibr" rid="B3">Akaike et al., 2017</xref>).</p>
<p>In mammals, there are two isoforms of CARS: CARS1, which is localized in the cytosol, and CARS2, which is localized in the mitochondria (<xref ref-type="bibr" rid="B30">Hallmann et al., 2014</xref>). Both isoforms possess CPERS activity (<xref ref-type="bibr" rid="B3">Akaike et al., 2017</xref>; <xref ref-type="bibr" rid="B27">Fujii et al., 2019</xref>). The study by Akaike et al., together with subsequent <italic>in vivo</italic> and metabolomic analyses, has strengthened the view that CARS2 is the principal source of intracellular persulfides (<xref ref-type="bibr" rid="B3">Akaike et al., 2017</xref>; <xref ref-type="bibr" rid="B70">Nishimura et al., 2024</xref>; <xref ref-type="bibr" rid="B101">Zainol et al., 2023</xref>). CARS2-derived CysSSH has also been proposed to receive electrons from components of the mitochondrial electron transport chain and thereby produce H<sub>2</sub>S (<xref ref-type="bibr" rid="B3">Akaike et al., 2017</xref>). This model implies that CARS2 may contribute not only to persulfide biogenesis but also to mitochondrial respiration, functioning upstream of the sulfide oxidation pathway involving SQOR, ETHE1 and TST. However, the precise catalytic mechanism underlying CARS-mediated persulfide formation remains unresolved (<xref ref-type="bibr" rid="B46">Kasamatsu and Ihara, 2021</xref>; <xref ref-type="bibr" rid="B72">Ogata et al., 2023</xref>; <xref ref-type="bibr" rid="B89">Vignane and Filipovic, 2023</xref>). To date, no inhibitor specifically targeting the CPERS activity of CARS has been reported.</p>
</sec>
<sec id="s3-5">
<title>SQOR</title>
<p>SQOR is an inner mitochondrial membrane-associated flavoprotein that catalyzes the two-electron oxidation of H<sub>2</sub>S using CoQ as an electron acceptor and a low-molecular-weight sulfur acceptor, most likely GSH (<xref ref-type="bibr" rid="B57">Landry et al., 2021</xref>). The first crystal structure of human SQOR was reported in 2019 by <xref ref-type="bibr" rid="B39">Jackson et al. (2019)</xref>, who found that two redox-active cysteine residues (Cys201 and Cys379) are bridged by a sulfane sulfur, forming an internal cysteine trisulfide species. This intermediate was previously proposed to represent an inactive form of the enzyme, which may be slowly formed in the absence of an external sulfur acceptor (<xref ref-type="bibr" rid="B38">Jackson et al., 2012</xref>). In contrast, Landry et al. proposed in the same year that the trisulfide species is the catalytically active form and represents the resting state of the enzyme, based on detailed structural and kinetic experiments (<xref ref-type="bibr" rid="B55">Landry et al., 2019</xref>). In agreement with this proposal, disruption of the trisulfide bridge by cyanide treatment led to destabilization and inactivation of the enzyme (<xref ref-type="bibr" rid="B56">Landry et al., 2020</xref>). Landry et al. also predicted, based on computational modeling and molecular dynamics simulations, that nucleophilic addition of sulfide to the trisulfide is approximately 10<sup>5</sup>-fold faster than that to the disulfide within the enzyme (<xref ref-type="bibr" rid="B56">Landry et al., 2020</xref>). In fact, the <italic>k</italic>
<sub>cat</sub>/<italic>K</italic>
<sub>m</sub> of SQOR toward H<sub>2</sub>S was estimated to be of the order of 10<sup>7</sup> M<sup>-1</sup>s<sup>-1</sup> (<xref ref-type="bibr" rid="B38">Jackson et al., 2012</xref>), which is more than10<sup>7</sup>-fold higher than the rate constant for sulfide addition to disulfide in solution at pH 7.4 and 25 &#xb0;C (0.6 M<sup>-1</sup>s<sup>-1</sup>) (<xref ref-type="bibr" rid="B22">Cuevasanta et al., 2015</xref>).</p>
<p>In the proposed catalytic cycle, sulfide first attacks the trisulfide bridge of the enzyme, generating persulfides at both Cys201 and Cys379. Next, the persulfide at Cys201 attacks the C4a position of FAD, whereas the sulfur on Cys379 is transferred to an external sulfur acceptor. FAD is then fully reduced to FADH<sub>2</sub> upon nucleophilic attack by Cys379 on the disulfide linkage between Cys201 and the FAD adduct, thereby reforming the initial trisulfide bridge. Finally, the electrons from FADH<sub>2</sub> are transferred to CoQ, resulting in regeneration of oxidized FAD (<xref ref-type="fig" rid="F9">Figure 9</xref>) (<xref ref-type="bibr" rid="B57">Landry et al., 2021</xref>; <xref ref-type="bibr" rid="B55">Landry et al., 2019</xref>). Early kinetic analyses suggested that sulfite is a preferred sulfur acceptor in this reaction, as it exhibits a high <italic>k</italic>
<sub>cat</sub>/<italic>K</italic>
<sub>m</sub> (2.9 &#xd7; 10<sup>7</sup> M<sup>-1</sup> s<sup>-1</sup>) (<xref ref-type="bibr" rid="B38">Jackson et al., 2012</xref>). However, due to the low intracellular concentration of free sulfite (&#x3c;20 nM) compared with its <italic>K</italic>
<sub>m</sub> value (&#x223c;200 &#x3bc;M), it is now considered that the physiologically most relevant sulfur acceptor is GSH. GSH exists at a concentration of 1&#x2013;10 mM in cells and shows a <italic>K</italic>
<sub>m</sub> of 8 mM and a <italic>k</italic>
<sub>cat</sub>/<italic>K</italic>
<sub>m</sub> of 1.6 &#xd7; 10<sup>4</sup> M<sup>-1</sup> s<sup>-1</sup> in the SQOR-catalyzed reaction (<xref ref-type="bibr" rid="B57">Landry et al., 2021</xref>; <xref ref-type="bibr" rid="B54">Landry et al., 2017</xref>).</p>
<fig id="F9" position="float">
<label>FIGURE 9</label>
<caption>
<p>Proposed catalytic mechanism of SQOR.</p>
</caption>
<graphic xlink:href="fphys-17-1764165-g009.tif">
<alt-text content-type="machine-generated">Chemical reaction diagram illustrating the transformation of FAD to FADH2 through several states: resting state, charge transfer complex, and 4a-adduct. Key elements include cysteine residues Cys201 and Cys379 in SQOR, arrows indicating reactions with SH and GS-, forming GSSH, and the role of CoQ converting to CoQH2.</alt-text>
</graphic>
</fig>
<p>For many years, no selective small-molecule inhibitor of SQOR was known, which limited pharmacological studies of this enzyme. In 2021, however, Baugh et al. identified the first potent inhibitors of human SQOR (<xref ref-type="bibr" rid="B15">Baugh et al., 2021</xref>). They screened 41,000 compounds and synthesized 120 analogs to study the structure-activity relationships. As a result, a 2,4-diphenylpyridine derivative, later named STI1 (<xref ref-type="bibr" rid="B40">Jackson et al., 2022</xref>), was found to be the best inhibitor of human SQOR, exhibiting an IC<sub>50</sub> value of 29 nM with suitable physicochemical properties and good cell permeability (<xref ref-type="fig" rid="F10">Figure 10</xref>) (<xref ref-type="bibr" rid="B15">Baugh et al., 2021</xref>). Docking simulations of STI1 to a ligand-free SQOR crystal structure indicated that it binds within the CoQ-binding pocket (<xref ref-type="bibr" rid="B15">Baugh et al., 2021</xref>). Steady-state kinetic studies further confirmed that STI1 competitively inhibits CoQ binding, thereby blocking the catalytic cycle of SQOR (<xref ref-type="bibr" rid="B40">Jackson et al., 2022</xref>). STI1 exhibited high selectivity for the SQOR-catalyzed reaction compared with other CoQ-dependent reactions; specifically, the off-target IC<sub>50</sub> values for the respiratory complexes I, II, and III, dihydroorotate dehydrogenase, and electron transferring flavoprotein:ubiquinone oxidoreductase were all at least 1,000-fold higher than the IC<sub>50</sub> for SQOR (<xref ref-type="bibr" rid="B40">Jackson et al., 2022</xref>). Moreover, low cytotoxicity of STI1 was demonstrated in a rat ventricular cardiomyoblast cell line (H9c2 cells; half-maximal cytotoxic concentration, CC<sub>50</sub>, of 56 &#x3bc;M) and in neonatal rat ventricular cardiomyocytes (CC<sub>50</sub> of 26 &#x3bc;M). Finally, STI1 was applied in a pressure-overload-induced heart failure model in mice. Pharmacological inhibition of SQOR with STI1 preserved cardiac function and prevented adverse remodeling. These results indicate that SQOR is an attractive target for therapeutic modulation of endogenous H<sub>2</sub>S signaling (<xref ref-type="bibr" rid="B40">Jackson et al., 2022</xref>).</p>
<fig id="F10" position="float">
<label>FIGURE 10</label>
<caption>
<p>Inhibitor of SQOR. Chemical structure of STI1 and its inhibitory mechanism, i.e., competition with CoQ binding to SQOR.</p>
</caption>
<graphic xlink:href="fphys-17-1764165-g010.tif">
<alt-text content-type="machine-generated">Chemical structure of CoQ with an arrow pointing to a CoQ-binding site on SQOR, depicted as a blue circle. Below, the chemical structure of STI1 is shown, positioned to inhibit the CoQ-binding site interaction.</alt-text>
</graphic>
</fig>
</sec>
<sec id="s3-6">
<title>ETHE1</title>
<p>ETHE1 is a mononuclear non-heme iron persulfide dioxygenase localized in the mitochondrial matrix. It catalyzes the molecular oxygen (O<sub>2</sub>)-dependent oxidation of GSSH, yielding sulfite and GSH. Thus, ETHE1 catalyzes the second step of the mitochondrial H<sub>2</sub>S oxidation pathway downstream of SQOR. The crystal structure of human ETHE1 was reported in 2015 by Pettinati et al. (<xref ref-type="bibr" rid="B79">Pettinati et al., 2015</xref>). The enzyme harbors a mononuclear Fe(II) center coordinated by His79, His135 and Asp154, together with three water molecules, resulting in an octahedral geometry. It has a substrate-binding channel leading to the active site that is sufficiently large to accommodate GSSH.</p>
<p>In 2016, Lin et al. proposed a mechanism for GSSH oxidation catalyzed by ETHE1 based on quantum mechanics/molecular mechanics (QM/MM) calculations (<xref ref-type="bibr" rid="B61">Lin et al., 2016</xref>). GSSH first displaces one water ligand and positions its terminal sulfur for coordination to Fe(II). Subsequent O<sub>2</sub> binding yields an Fe(III)-superoxo species that is in resonance with a formulation in which the coordinated sulfur bears a partial radical character. Recombination of this superoxo/sulfur radical pair produces a cyclic peroxo&#x2013;sulfur intermediate, which then undergoes O&#x2013;O bond homolysis to give a sulfoxy cation and an Fe(II)-bound oxo species. Hydrolysis of the perthiosulfinic intermediate (GS&#x2013;SO<sub>2</sub>H) by an iron-bound water molecule releases sulfite and GSH, returning the enzyme to its resting state (<xref ref-type="fig" rid="F11">Figure 11</xref>) (<xref ref-type="bibr" rid="B61">Lin et al., 2016</xref>; <xref ref-type="bibr" rid="B45">Kabil et al., 2018</xref>). Mutation of Cys247, located near the active-site iron, abolished the dioxygenase activity, indicating that this residue plays an important role in the catalysis or stability of the enzyme (<xref ref-type="bibr" rid="B43">Jung et al., 2016</xref>). Interestingly, Cys247 was found to be oxidized to cysteinyl sulfinic acid in the crystal structure, and this modification was proposed to be either catalytically relevant or to represent a non-productive damaged form of the protein (<xref ref-type="bibr" rid="B79">Pettinati et al., 2015</xref>). In 2016, Jung et al. showed that most cysteine residues in ETHE1 were endogenously polysulfidated by using a PEG-maleimide-based gel-shift assay and LC&#x2013;MS/MS (<xref ref-type="bibr" rid="B43">Jung et al., 2016</xref>). They further demonstrated that the C247S mutant markedly reduced the polysulfidation levels, leading them to propose that polysulfidation of Cys247 and subsequent intramolecular sulfide transfer are important for regulating ETHE1 activity, although the mechanism has not yet been clarified in detail (<xref ref-type="bibr" rid="B43">Jung et al., 2016</xref>).</p>
<fig id="F11" position="float">
<label>FIGURE 11</label>
<caption>
<p>Proposed catalytic mechanism of ETHE1.</p>
</caption>
<graphic xlink:href="fphys-17-1764165-g011.tif">
<alt-text content-type="machine-generated">Diagram illustrating the catalytic cycle of the ETHE1 enzyme. The scheme shows binding of glutathione persulfide (GSS-) to the iron center coordinated by histidine (His) and aspartate (Asp), followed by oxygen (O&#x2082;) binding to form the catalytically active complex. Subsequent steps proceed through enzyme&#x2013;substrate intermediates, with release of sulfite and glutathione (GSH) as products.</alt-text>
</graphic>
</fig>
<p>With respect to pharmacological tools, in 2018, Kabil et al. reported <italic>&#x3b3;</italic>-glutamyl-homocysteinyl-glycine (GHcySH) as a mechanism-based ETHE1 inhibitor (<xref ref-type="bibr" rid="B45">Kabil et al., 2018</xref>). In this GSSH analog, the cysteinyl residue of GSH is replaced by homocysteine. ETHE1 recognizes GHcySH as an alternative substrate and oxidizes it to the corresponding sulfinic acid (GHcy-SO<sub>2</sub>H), which mimics the putative GSH perthiosulfinic acid (GS-SO<sub>2</sub>H) intermediate formed from GSSH (<xref ref-type="fig" rid="F12">Figure 12</xref>). However, since GHcy-SO<sub>2</sub>H contains a C&#x2013;S bond rather than an S&#x2013;S bond, it cannot undergo the final hydrolytic step of the catalytic cycle and instead accumulates as a dead-end product, leading to time-dependent inactivation of the enzyme (<xref ref-type="bibr" rid="B45">Kabil et al., 2018</xref>). To date, GHcySH represents the best-characterized small-molecule probe for ETHE1. However, its use in cells or whole bodies has not yet been fully explored. Given that GHcySH is a close structural analogue of GSH, careful evaluation of potential off-target effects on other sulfur-metabolizing enzymes and GSH-processing enzymes, such as <italic>&#x3b3;</italic>-glutamyl transpeptidase (<xref ref-type="bibr" rid="B67">Mitri&#x107; and Castellano, 2023</xref>), will be required.</p>
<fig id="F12" position="float">
<label>FIGURE 12</label>
<caption>
<p>Inhibitor of ETHE1. Chemical structure of GHcySH and its inhibitory mechanism.</p>
</caption>
<graphic xlink:href="fphys-17-1764165-g012.tif">
<alt-text content-type="machine-generated">Chemical reaction diagram showing glutamyl-homocysteine thiol (GHcySH) and oxygen (O&#x2082;) binding at the ETHE1 active site. ETHE1 contains an Fe(II) center coordinated by histidine (His) and aspartate (Asp). The scheme depicts GHcySH acting as an inhibitor by engaging the iron center (and O&#x2082;) to form an enzyme-bound intermediate, rather than being fully turned over to sulfite.</alt-text>
</graphic>
</fig>
</sec>
<sec id="s3-7">
<title>TST</title>
<p>TST, also known as rhodanese, is a mitochondrial matrix enzyme that participates in both cyanide detoxification and mitochondrial sulfide oxidation (<xref ref-type="bibr" rid="B19">Buonvino et al., 2022</xref>). Historically, TST was characterized in relation to the former process, in which it transfers a sulfur atom from thiosulfate to cyanide, producing thiocyanate and sulfite (<xref ref-type="bibr" rid="B58">Leininger and Westley, 1968</xref>; <xref ref-type="bibr" rid="B92">Way, 1984</xref>). Current understanding of this enzyme, at least under physiological conditions, is that it preferentially catalyzes sulfur transfer from GSSH to sulfite, producing thiosulfate and GSH in the mitochondrial sulfide oxidation pathway (<xref ref-type="bibr" rid="B59">Libiad et al., 2014</xref>; <xref ref-type="bibr" rid="B19">Buonvino et al., 2022</xref>; <xref ref-type="bibr" rid="B60">Libiad et al., 2015</xref>). In this context, TST acts downstream of SQOR and ETHE1, which generate GSSH and sulfite, respectively, and thereby contributes to mitochondrial H<sub>2</sub>S catabolism.</p>
<p>The TST-catalyzed reaction follows a classical double-displacement (ping&#x2013;pong) mechanism mediated by an active-site cysteine residue, similar to that of the 3MST-catalyzed reaction. In the first half-reaction, Cys248 attacks GSSH to form an enzyme-bound cysteine persulfide intermediate, releasing GSH. In the second half-reaction, a sulfite molecule attacks the terminal sulfur atom of this persulfide, yielding thiosulfate and regenerating free Cys248 at the active site (<xref ref-type="fig" rid="F13">Figure 13</xref>) (<xref ref-type="bibr" rid="B59">Libiad et al., 2014</xref>; <xref ref-type="bibr" rid="B19">Buonvino et al., 2022</xref>; <xref ref-type="bibr" rid="B60">Libiad et al., 2015</xref>). In 2014, Libiad et al. reported a detailed kinetic analysis, showing that the <italic>k</italic>
<sub>cat</sub>/<italic>K</italic>
<sub>m</sub> value for the TST-catalyzed reaction with GSSH as a sulfur donor and sulfite as a sulfur acceptor was nearly 1,000-fold higher than that for the reverse reaction with thiosulfate as a sulfur donor and GSH as a sulfur acceptor (<xref ref-type="bibr" rid="B59">Libiad et al., 2014</xref>). Structural characterization of bovine TST (rhodanese) has been extensively performed (<xref ref-type="bibr" rid="B52">Kruithof et al., 2020</xref>), and this bovine enzyme exhibits 90% amino acid sequence identity to human TST (<xref ref-type="bibr" rid="B29">Gliubich et al., 1998</xref>). In 2022, the first crystal structure of human TST was reported (Protein Data Bank (PDB) ID: 8AGF), and it aligns well with the bovine rhodanese structure, as expected from the high sequence similarity.</p>
<fig id="F13" position="float">
<label>FIGURE 13</label>
<caption>
<p>Proposed catalytic mechanism of TST.</p>
</caption>
<graphic xlink:href="fphys-17-1764165-g013.tif">
<alt-text content-type="machine-generated">Chemical reaction diagram illustrating the catalytic cycle of thiosulfate sulfurtransferase (TST), highlighting the catalytic cysteine at position 247. The scheme shows glutathione persulfide (GSSH) reacting to form a persulfidated enzyme intermediate (Cys247-SSH) with release of glutathione (GSH). Sulfite then reacts with Cys247-SSH, resulting in release of thiosulfate and regeneration of the catalytic cysteine.</alt-text>
</graphic>
</fig>
<p>To date, no selective small-molecule inhibitor of TST suitable for mechanistic analysis in cells or tissues has been reported. Thiol-reactive reagents such as <italic>N</italic>-ethylmaleimide, iodoacetic/iodoacetamide derivatives and nitric oxide donors can inactivate TST by modifying the catalytic cysteine via <italic>S</italic>-alkylation or <italic>S</italic>-nitrosylation, but they are not specific to this enzyme (<xref ref-type="bibr" rid="B19">Buonvino et al., 2022</xref>; <xref ref-type="bibr" rid="B90">Wang and Volini, 1968</xref>; <xref ref-type="bibr" rid="B34">Horowitz and Criscimagna, 1982</xref>; <xref ref-type="bibr" rid="B53">Kwiec et al., 2003</xref>). Similarly, sodium 2-propenyl thiosulfate (2-PTS), a metabolite of allyl sulfur compounds, was shown to bind in the active site of <italic>Azotobacter vinelandii</italic> rhodanese (RhdA) and inhibit its activity (<xref ref-type="bibr" rid="B82">Sabelli et al., 2008</xref>). This compound acts as a thiosulfate analog and forms a 2-propenyl disulfide adduct on the active-site cysteine. Since RhdA shows similar kinetic behavior and high structural similarity to bovine rhodanese, 2-PTS is likely to inhibit the activity of human TST as well. The induction of apoptosis observed in cancer cells upon exposure to 2-PTS might be caused, at least in part, by inactivation of TST, though off-target effects cannot be excluded (<xref ref-type="bibr" rid="B82">Sabelli et al., 2008</xref>). 2-Methyl-1,4-naphthoquinone (menadione) is another compound reported to reduce the activity of TST in cells (<xref ref-type="bibr" rid="B94">Wr&#xf3;bel and Jurkowska, 2007</xref>). However, this compound reacts directly with GSH and H<sub>2</sub>S and likely causes the reactive oxygen species-mediated oxidation of cysteine residues in a non-specific manner (<xref ref-type="bibr" rid="B63">Mauzeroll et al., 2004</xref>; <xref ref-type="bibr" rid="B21">Croppi et al., 2020</xref>). Thus, no selective TST inhibitor for biological applications has yet been found.</p>
</sec>
</sec>
<sec id="s4">
<title>Summary and conclusion</title>
<p>Enzymatic generation and regulation of RSS are important for redox signaling, metabolic regulation and stress responses in mammalian systems. CBS, CSE, 3MST, CARS, SQOR, ETHE1 and TST work together as a network to maintain RSS homeostasis in cells (<xref ref-type="fig" rid="F1">Figure 1</xref>). In this review, we have summarized structural and mechanistic studies to clarify how these enzymes work at the molecular level and have also described available inhibitors, focusing on their mechanisms and selectivity toward the target enzymes.</p>
<p>As discussed in the earlier sections of this review, the molecular mechanisms of the inhibitors have been proposed on the basis of the reaction kinetics and structural analyses. In particular, X-ray crystal structures of enzyme&#x2013;inhibitor complexes provide direct evidence for elucidating the modes of inhibition. The enzyme&#x2013;inhibitor complexes described in this review and deposited in the PDB are summarized in <xref ref-type="table" rid="T1">Table 1</xref>. Three of the five structures (CBS&#x2013;AOAA, CSE&#x2013;CPC and CSE&#x2013;oxamic hydrazide) are oxime-, imine- or oxamic hydrazone-type complexes with PLP in the active site of CBS or CSE (<xref ref-type="bibr" rid="B78">Petrosino et al., 2022</xref>; <xref ref-type="bibr" rid="B98">Yadav et al., 2019</xref>; <xref ref-type="bibr" rid="B23">Echizen et al., 2023</xref>). One structure captures a covalent adduct at the active-site tyrosine residue (CSE&#x2013;PAG) (<xref ref-type="bibr" rid="B86">Sun et al., 2009</xref>), and the remaining structure reveals a unique long-distance electrostatic interaction between the active-site cysteine persulfide anion and the positively charged carbonyl carbon of the inhibitor (3MST&#x2013;I3MT-3) (<xref ref-type="bibr" rid="B31">Hanaoka et al., 2017</xref>). Given these structures and the stability of the oxime, <italic>O</italic>-alkyl and oxamic hydrazone complexes, AOAA, PAG and oxamic hydrazide are likely to inhibit their target enzymes in an irreversible manner. In contrast, CPC, which forms an imine (Schiff base) with PLP, has been reported as a reversible inhibitor of CSE (<xref ref-type="bibr" rid="B98">Yadav et al., 2019</xref>). I3MT-3, which binds to active-site residues in a non-covalent manner and shows a <italic>K</italic>
<sub>d</sub> value of 0.5 &#x3bc;M, is also considered a reversible inhibitor (<xref ref-type="bibr" rid="B31">Hanaoka et al., 2017</xref>).</p>
<table-wrap id="T1" position="float">
<label>TABLE 1</label>
<caption>
<p>Enzyme&#x2013;inhibitor complexes described in this review.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="center">Enzyme</th>
<th align="center">Inhibitor</th>
<th align="center">PDB ID</th>
<th align="center">Notes</th>
<th align="center">References</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="center">CBS</td>
<td align="center">AOAA</td>
<td align="center">7QGT</td>
<td align="left">PLP&#x2013;oxime dead-end complex</td>
<td align="center">
<xref ref-type="bibr" rid="B78">Petrosino et al. (2022)</xref>
</td>
</tr>
<tr>
<td rowspan="3" align="center">CSE</td>
<td align="center">PAG</td>
<td align="center">3COG</td>
<td align="left">Covalent adduct on tyrosine (irreversible inhibitor)</td>
<td align="center">
<xref ref-type="bibr" rid="B86">Sun et al. (2009)</xref>
</td>
</tr>
<tr>
<td align="center">CPC</td>
<td align="center">6NBA</td>
<td align="left">PLP-bound amino acrylate complex (reversible inhibitor)</td>
<td align="center">
<xref ref-type="bibr" rid="B98">Yadav et al. (2019)</xref>
</td>
</tr>
<tr>
<td align="center">Oxamic hydrazide</td>
<td align="center">8J6N</td>
<td align="left">PLP&#x2013;oxamic hydrazone</td>
<td align="center">
<xref ref-type="bibr" rid="B23">Echizen et al. (2023)</xref>
</td>
</tr>
<tr>
<td align="center">3MST</td>
<td align="center">I3MT-3 (HMPSNE)</td>
<td align="center">5WQK</td>
<td align="left">Interacts with active-site cysteine persulfide</td>
<td align="center">
<xref ref-type="bibr" rid="B31">Hanaoka et al. (2017)</xref>
</td>
</tr>
</tbody>
</table>
</table-wrap>
<p>Extensive efforts have been undertaken to identify potent inhibitors of the enzymes involved in RSS biogenesis and regulation, using chemical synthesis and high-throughput screening (HTS) of large chemical libraries (<xref ref-type="bibr" rid="B83">Sasaki et al., 2023</xref>). As a result, numerous inhibitors targeting these enzymes have been reported. However, many of them are not highly selective, or their selectivity has not been sufficiently characterized, or they have not been applied to biological samples such as cells, tissues or animals. For example, even in the case of AOAA, historically the most commonly used CBS inhibitor, concerns have repeatedly been raised about its severe off-target effects on other PLP-dependent enzymes (<xref ref-type="bibr" rid="B93">Whiteman et al., 2011</xref>; <xref ref-type="bibr" rid="B10">Asimakopoulou et al., 2013</xref>; <xref ref-type="bibr" rid="B103">Zuhra et al., 2020</xref>). We summarize the current knowledge about key inhibitors of CBS, CSE, 3MST, CARS, SQOR, ETHE1 and TST discussed in this review in <xref ref-type="table" rid="T2">Table 2</xref>. Oxamic hydrazide, I3MT-3 and STI1 appear to be relatively reliable and selective inhibitors of CSE, 3MST and SQOR, respectively (<xref ref-type="bibr" rid="B23">Echizen et al., 2023</xref>; <xref ref-type="bibr" rid="B31">Hanaoka et al., 2017</xref>; <xref ref-type="bibr" rid="B40">Jackson et al., 2022</xref>). In contrast, no selective inhibitors are currently available for CBS or TST, and the selectivity of GHcySH for ETHE1 over other GSH-relating enzymes remains unknown. Moreover, despite the increasing number of studies demonstrating the biological importance of CARS (<xref ref-type="bibr" rid="B70">Nishimura et al., 2024</xref>; <xref ref-type="bibr" rid="B101">Zainol et al., 2023</xref>; <xref ref-type="bibr" rid="B72">Ogata et al., 2023</xref>), the molecular mechanism underlying its CPERS activity has not yet been elucidated, and no small-molecule inhibitor has been reported.</p>
<table-wrap id="T2" position="float">
<label>TABLE 2</label>
<caption>
<p>Inhibitors of enzymes involved in RSS biogenesis and regulation.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Enzyme</th>
<th align="left">Inhibitor</th>
<th align="left">Type/mechanism</th>
<th align="left">Selectivity/issues</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td rowspan="2" align="center">CBS</td>
<td align="center">AOAA</td>
<td align="left">PLP-directed covalent inhibitor (oxime formation)</td>
<td align="left">Broad-spectrum PLP inhibitor</td>
</tr>
<tr>
<td align="center">CH004</td>
<td align="left">Competitive inhibitor</td>
<td align="left">More selective than AOAA, but not CBS-specific</td>
</tr>
<tr>
<td rowspan="3" align="center">CSE</td>
<td align="center">PAG</td>
<td align="left">Mechanism-based irreversible inhibitor</td>
<td align="left">Inhibits other PLP enzymes at higher doses</td>
</tr>
<tr>
<td align="center">CPC</td>
<td align="left">Competitive inhibitor (cystathionine analog)</td>
<td align="left">Limited off-target effects reported</td>
</tr>
<tr>
<td align="center">Oxamic hydrazide</td>
<td align="left">PLP-dependent reversible inhibitor</td>
<td align="left">Higher selectivity for CSE vs. other PLP enzymes</td>
</tr>
<tr>
<td align="center">3MST</td>
<td align="center">I3MT-3 (HMPSNE)</td>
<td align="left">Persulfide-state&#x2013;selective inhibitor</td>
<td align="left">3MST-selective, known off-target inhibition to caspase-1</td>
</tr>
<tr>
<td align="center">CARS</td>
<td align="center">&#x2014;</td>
<td align="center">&#x2014;</td>
<td align="left">No CPERS-selective inhibitor reported</td>
</tr>
<tr>
<td align="center">SQOR</td>
<td align="center">STI1</td>
<td align="left">CoQ-site competitive inhibitor</td>
<td align="left">High selectivity among CoQ-dependent enzymes</td>
</tr>
<tr>
<td align="center">ETHE1</td>
<td align="center">GHcySH</td>
<td align="left">Mechanism-based inhibitor (GSSH analog)</td>
<td align="left">Potential off-target effects on GSH-utilizing enzymes</td>
</tr>
<tr>
<td align="center">TST</td>
<td align="center">&#x2014;</td>
<td align="center">&#x2014;</td>
<td align="left">No TST-selective inhibitor reported</td>
</tr>
</tbody>
</table>
</table-wrap>
<p>Overall, the current series of inhibitors allow reasonably detailed studies of RSS-generating and regulating enzymes, but its scope remains insufficiently comprehensive. Selective CBS inhibitors with minimal off-target effects on other PLP-dependent enzymes, CPERS-specific CARS modulators, and highly selective ETHE1 and TST inhibitors have not yet been reported. Integrating chemical insights into the unique reactivity of persulfides and polysulfides with conventional HTS approaches should facilitate the development of more selective and efficient inhibitors and lead to a deeper understanding of RSS biology, as well as having the potential to provide novel therapeutic strategies for cancer, cardiovascular and metabolic diseases, and mitochondrial disorders in which RSS play a critical role.</p>
</sec>
</body>
<back>
<sec sec-type="author-contributions" id="s5">
<title>Author contributions</title>
<p>KoH: Data curation, Writing &#x2013; original draft, Writing &#x2013; review and editing. ES: Writing &#x2013; original draft, Writing &#x2013; review and editing, Funding acquisition, Conceptualization, Data curation. HO: Writing &#x2013; review and editing. OT: Writing &#x2013; review and editing. SY: Writing &#x2013; review and editing. KeH: Funding acquisition, Conceptualization, Supervision, Writing &#x2013; review and editing.</p>
</sec>
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<title>Conflict of interest</title>
<p>The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
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<bold>Edited by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/233705/overview">Khosrow Kashfi</ext-link>, City University of New York, United States</p>
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