Nanoscale Dynamics of Methylene Blue at the PD-1/SHP2 Interface: Evidence for Non-Specific Protein-protein Interaction Disruption
DOI:
https://doi.org/10.5281/zenodo.20990989Keywords:
PD-1, SHP2, Methylene Blue, Protein-protein interaction, Small-molecule inhibitors, PAINS, Nanoscale interactionsAbstract
The clinical success of monoclonal antibodies targeting programmed cell death protein 1/programmed death-ligand 1 (PD-1/PD-L1) has transformed cancer immunotherapy. However, resistance, immune-related toxicity, limited tumor penetration, and prolonged systemic exposure continue to motivate complementary therapeutic strategies. The intracellular recruitment of Src homology 2 (SH2) domain-containing protein tyrosine phosphatase 2 (SHP2/PTPN11) to phosphorylated motifs in the PD-1 cytoplasmic tail represents an attractive but pharmacologically challenging point of intervention because it links extracellular checkpoint engagement to T-cell exhaustion. Methylene blue (MB), a clinically used phenothiazinium dye, has been proposed as a small-molecule modulator of the PD-1/SHP2 interaction. Preclinical studies suggest that MB can reduce SHP2 recruitment, restore cytotoxic T-lymphocyte function, and suppress tumor growth. However, characterizing MB as a target-selective immunotherapeutic agent remains uncertain. Pharmacological studies have also reported MB activity against structurally unrelated protein–protein interactions (PPIs), including viral and cytokine-related interfaces, within overlapping low-micromolar ranges. This hypothesis-driven critical narrative review examines the mechanistic biology of the PD-1/SHP2 signalosome and evaluates evidence supporting and challenging MB as a PD-1/SHP2 modulator. Available evidence supports the possibility that MB activity may involve broad physicochemical PPI-interference mechanisms in addition to, or instead of, target-selective PD-1/SHP2 modulation, depending on assay context. Therefore, MB may be useful as a mechanistic probe for intracellular checkpoint modulation, but its classification as a selective PD-1/SHP2 inhibitor requires orthogonal structural, biophysical, and functional validation. Finally, we propose a target-validation framework to distinguish genuine PPI disruption from chemical or assay-related artifacts and to guide the rational development of next-generation small-molecule checkpoint modulators.
References
[1] Wu, Q., et al., Small molecule inhibitors targeting the PD-1/PD-L1 signaling pathway. Acta Pharmacol Sin, 2021. 42(1): p. 1-9.
[2] Moore, E.K., M. Strazza, and A. Mor, Combination Approaches to Target PD-1 Signaling in Cancer. Front Immunol, 2022. 13: p. 927265.
[3] Sharma, P., et al., Primary, Adaptive, and Acquired Resistance to Cancer Immunotherapy. Cell, 2017. 168(4): p. 707-723.
[4] Ramos-Casals, M., et al., Immune-related adverse events of checkpoint inhibitors. Nat Rev Dis Primers, 2020. 6(1): p. 38.
[5] Cruz, E. and V. Kayser, Monoclonal antibody therapy of solid tumors: clinical limitations and novel strategies to enhance treatment efficacy. Biologics, 2019. 13: p. 33-51.
[6] Centanni, M., et al., Clinical Pharmacokinetics and Pharmacodynamics of Immune Checkpoint Inhibitors. Clin Pharmacokinet, 2019. 58(7): p. 835-857.
[7] Lipinski, C.A., et al., Experimental and computational approaches to estimate solubility and permeability in drug discovery and development settings. Adv Drug Deliv Rev, 2001. 46(1-3): p. 3-26.
[8] Patsoukis, N., et al., Interaction of SHP-2 SH2 domains with PD-1 ITSM induces PD-1 dimerization and SHP-2 activation. Commun Biol, 2020. 3(1): p. 128.
[9] Marasco, M., et al., Molecular mechanism of SHP2 activation by PD-1 stimulation. Sci Adv, 2020. 6(5): p. eaay4458.
[10] Fan, Z., et al., Blocking interaction between SHP2 and PD-1 denotes a novel opportunity for developing PD-1 inhibitors. EMBO Mol Med, 2020. 12(6): p. e11571.
[11] Boussiotis, V.A., Molecular and Biochemical Aspects of the PD-1 Checkpoint Pathway. N Engl J Med, 2016. 375(18): p. 1767-1778.
[12] Yuan, X., et al., Recent Advances of SHP2 Inhibitors in Cancer Therapy: Current Development and Clinical Application. J Med Chem, 2020. 63(20): p. 11368-11396.
[13] Sodir, N.M., et al., SHP2: A Pleiotropic Target at the Interface of Cancer and Its Microenvironment. Cancer Discov, 2023. 13(11): p. 2339-2355.
[14] Chen, Y.N., et al., Allosteric inhibition of SHP2 phosphatase inhibits cancers driven by receptor tyrosine kinases. Nature, 2016. 535(7610): p. 148-52.
[15] Arkin, M.R., Y. Tang, and J.A. Wells, Small-molecule inhibitors of protein-protein interactions: progressing toward the reality. Chem Biol, 2014. 21(9): p. 1102-14.
[16] Bojadzic, D., O. Alcazar, and P. Buchwald, Methylene Blue Inhibits the SARS-CoV-2 Spike-ACE2 Protein-Protein Interaction-a Mechanism that can Contribute to its Antiviral Activity Against COVID-19. Front Pharmacol, 2021. 11: p. 600372.
[17] Chuang, S.T., et al., Methylene Blue Is a Nonspecific Protein-Protein Interaction Inhibitor with Potential for Repurposing as an Antiviral for COVID-19. Pharmaceuticals (Basel), 2022. 15(5).
[18] Akselrod, M.S., L. Bøtter-Jensen, and S.W.S. McKeever, Optically stimulated luminescence and its use in medical dosimetry. Radiation Measurements, 2006. 41: p. S78-S99.
[19] Tojjari, A., et al., Overcoming Immune Checkpoint Therapy Resistance with SHP2 Inhibition in Cancer and Immune Cells: A Review of the Literature and Novel Combinatorial Approaches. Cancers (Basel), 2023. 15(22).
[20] Zak, K.M., et al., Structural basis for small molecule targeting of the programmed death ligand 1 (PD-L1). Oncotarget, 2016. 7(21): p. 30323-35.
[21] Ganesan, A., et al., Comprehensive in vitro characterization of PD-L1 small molecule inhibitors. Sci Rep, 2019. 9(1): p. 12392.
[22] Musielak, B., et al., CA-170 - A Potent Small-Molecule PD-L1 Inhibitor or Not? Molecules, 2019. 24(15).
[23] Schirmer, R.H., et al., "Lest we forget you--methylene blue...". Neurobiol Aging, 2011. 32(12): p. 2325 e7-16.
[24] Oz, M., et al., Cellular and molecular actions of Methylene Blue in the nervous system. Med Res Rev, 2011. 31(1): p. 93-117.
[25] Baell, J.B. and G.A. Holloway, New substructure filters for removal of pan assay interference compounds (PAINS) from screening libraries and for their exclusion in bioassays. J Med Chem, 2010. 53(7): p. 2719-40.
[26] U.S. Food & Drug Administration, PROVAYBLUE (methylene blue) injection, USP [Package Insert], C.f.D.E.a. Research, Editor. Revised 02/2024.
[27] Bradberry, S., Methaemoglobinaemia. Medicine, 2016. 44(2): p. 91-92.
[28] Ginimuge, P.R. and S.D. Jyothi, Methylene blue: revisited. J Anaesthesiol Clin Pharmacol, 2010. 26(4): p. 517-20.
[29] Baddeley, T.C., et al., Complex disposition of methylthioninium redox forms determines efficacy in tau aggregation inhibitor therapy for Alzheimer's disease. J Pharmacol Exp Ther, 2015. 352(1): p. 110-8.
[30] Baell, J. and M.A. Walters, Chemistry: Chemical con artists foil drug discovery. Nature, 2014. 513(7519): p. 481-3.
[31] Bojadzic, D., et al., Small-Molecule Inhibitors of the Coronavirus Spike: ACE2 Protein-Protein Interaction as Blockers of Viral Attachment and Entry for SARS-CoV-2. ACS Infect Dis, 2021. 7(6): p. 1519-1534.
[32] Ganesan, L., et al., The food colorant erythrosine is a promiscuous protein-protein interaction inhibitor. Biochem Pharmacol, 2011. 81(6): p. 810-8.
[33] Ramsay, R.R., C. Dunford, and P.K. Gillman, Methylene blue and serotonin toxicity: inhibition of monoamine oxidase A (MAO A) confirms a theoretical prediction. Br J Pharmacol, 2007. 152(6): p. 946-51.
[34] Kovalenko, I., et al., Interaction of Methylene Blue with Severe Acute Respiratory Syndrome Coronavirus 2 Envelope Revealed by Molecular Modeling. Int J Mol Sci, 2023. 24(21).
[35] Seo, D.H., et al., Mechanism of Methylene Blue Inducing the Disulfide Bond Formation of Tubulin-Associated Unit Proteins. JACS Au, 2024. 4(7): p. 2451-2455.
[36] Day, C.J., et al., Multidisciplinary Approaches Identify Compounds that Bind to Human ACE2 or SARS-CoV-2 Spike Protein as Candidates to Block SARS-CoV-2-ACE2 Receptor Interactions. mBio, 2021. 12(2).
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Journal of NanoScience in Advanced Materials

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2026-06-07
Published 2026-06-30