Knowledge about the protein targets of therapeutic agents is critical for understanding drug mode of action. Described here is a mass spectrometry-based proteomics method for identifying the protein target(s) of drug molecules that is potentially applicable to any drug compound. The method, which involves making thermodynamic measurements of protein-folding reactions in complex biological mixtures to detect protein-drug interactions, is demonstrated in an experiment to identify yeast protein targets of the immunosuppressive drug, cyclosporin A (CsA). Two of the ten protein targets identified in this proof of principle work were cyclophilin A and UDP-glucose-4-epimerase, both of which are known to interact with CsA, the former through a direct binding event (K d ∼ 70 nM) and the latter through an indirect binding event. These two previously known protein targets validate the methodology and its ability to detect both the on-and off-target effects of protein-drug interactions. The other eight protein targets discovered here, which include several proteins involved in glucose metabolism, create a new framework in which to investigate the molecular basis of CsA side effects in humans.cyclosporine | liquid chromatography-mass spectrometry | ligand binding | protein folding | thermodynamics K nowledge about protein-drug interactions is critical for understanding the therapeutic effects and pleiotropic activities of drugs. Whereas genome-and proteome-based expression profiling studies of organisms and cell lines grown in the presence of drugs can provide valuable information about the functional analysis of drugs (e.g., the physiological processes and biological pathways impacted by both the on-and off-target effects of drug action), such expression profiling studies do not provide a readout of the specific protein interactions involved in a drug's mode of action. The comprehensive analysis of such drug-induced protein interactions requires the ability to assay all the proteins in a proteome for drug binding and to quantitatively assess their affinity for the drug target.Several protein ligand-binding assays, such as the yeast twohybrid assay (1, 2) and affinity chromatography techniques coupled with mass spectrometry (3-6), exist for the large-scale analysis of protein-protein interactions. However, generic protein ligand-binding assays are lacking for the detection of protein-drug interactions on the proteomic scale. Although applications of the yeast two-hybrid assay and affinity chromatography techniques to nonprotein ligands have been reported (7-9), these approaches are frequently problematic with nonprotein ligands (e.g., small drug molecules) due to the inherent difficulties associated with conjugating such ligands to the necessary bait protein in the yeast-based assay and to the necessary solid support in the affinity chromatography and mass spectrometry-based assay. Conventional protein ligand-binding assays (e.g., those based on calorimetric and spectroscopic techniques) are also not amenable to analyses on ...