Mutant PPM1D-induced NAPRT deficiency drives sensitivity to NAMPT inhibition. a Graphic model of enzymes (red) and metabolites (black) involved in NAD biosynthesis. NA nicotinic acid, NAAD nicotinic acid adenine dinucleotide, NAD nicotinamide adenine dinucleotide, NADP nicotinamide adenine dinucleotide phosphate, NAM nicotinamide, NAMN nicotinic acid mononucleotide, NAR nicotinic acid riboside, NMN nicotinamide mononucleotide, NR nicotinamide riboside, QA quinolinic acid, Trp tryptophan. b Heatmap of NAD-related metabolites in parental and two different PPM1Dtrnc. astrocyte cell lines. c NAD quantification in wild type and PPM1Dtrnc. astrocytes (n = 3 biological independent samples, ****p < 0.0001 by Student’s T test). d Relative fold change in NAD levels post 10 nM FK866 treatment (n = 3 biological independent samples, ***p < 0.001 by Student’s T test). e Bliss 3D surface plot modeling the antagonistic effects of NR on FK866 treatment in PPM1Dtrnc. astrocytes. f Cell viability analysis of parental astrocytes treated with either scrambled control (scrbl) or NAPRT siRNAs, followed by treatment with FK866 (n = 2 biological independent samples, ****p < 0.0001 by Student’s T test). g Immunoblot of isogenic astrocytes., and astrocytes stably-overexpressing WT and mutant PPM1D (OEFL and OEtrnc., respectively). Full length (full arrow), CRISPR-modified (black arrowhead), and ectopic mutant (white arrowhead) sizes of PPM1D displayed. h Viability assessment of isogenic astrocytes and stable NAPRT-expressing PPM1Dtrnc. astrocytes (PPM1Dtrnc. + NAPRT), after FK866 treatment (n = 4 biological independent samples, ***p < 0.001, ****p < 0.0001 by Student’s T test). i Immunoblot of previously described wild type and PPM1D mutant astrocytes, and patient-derived, SU-DIPG cell lines. j Viability assessment of SU-DIPG cell lines post 120 h treatment with FK866 (n = 3 biological independent samples). k Representative images from spheroid cultures in (j), untreated or treated with 10 nM FK866. All error bars represent standard deviation of the mean