Pharmacological chaperones improve intra-domain stability and inter-domain assembly via distinct binding sites to rescue misfolded CFTR

Cell Mol Life Sci. 2021 Dec;78(23):7813-7829. doi: 10.1007/s00018-021-03994-5. Epub 2021 Oct 29.

Abstract

Protein misfolding is involved in a large number of diseases, among which cystic fibrosis. Complex intra- and inter-domain folding defects associated with mutations in the cystic fibrosis transmembrane regulator (CFTR) gene, among which p.Phe508del (F508del), have recently become a therapeutical target. Clinically approved correctors such as VX-809, VX-661, and VX-445, rescue mutant protein. However, their binding sites and mechanisms of action are still incompletely understood. Blind docking onto the 3D structures of both the first membrane-spanning domain (MSD1) and the first nucleotide-binding domain (NBD1), followed by molecular dynamics simulations, revealed the presence of two potential VX-809 corrector binding sites which, when mutated, abrogated rescue. Network of amino acids in the lasso helix 2 and the intracellular loops ICL1 and ICL4 allosterically coupled MSD1 and NBD1. Corrector VX-445 also occupied two potential binding sites on MSD1 and NBD1, the latter being shared with VX-809. Binding of both correctors on MSD1 enhanced the allostery between MSD1 and NBD1, hence the increased efficacy of the corrector combination. These correctors improve both intra-domain folding by stabilizing fragile protein-lipid interfaces and inter-domain assembly via distant allosteric couplings. These results provide novel mechanistic insights into the rescue of misfolded proteins by small molecules.

Keywords: Binding site; Chemical chaperone; Cystic fibrosis; Molecular dynamics; Protein folding.

MeSH terms

  • Aminopyridines / pharmacology*
  • Benzodioxoles / pharmacology*
  • Binding Sites
  • Chloride Channel Agonists / pharmacology
  • Cystic Fibrosis / drug therapy*
  • Cystic Fibrosis / genetics
  • Cystic Fibrosis / metabolism
  • Cystic Fibrosis / pathology
  • Cystic Fibrosis Transmembrane Conductance Regulator / chemistry*
  • Cystic Fibrosis Transmembrane Conductance Regulator / genetics
  • Drug Therapy, Combination
  • HEK293 Cells
  • Humans
  • Mutation*
  • Protein Domains
  • Protein Folding / drug effects*
  • Protein Structure, Tertiary
  • Pyrazoles / pharmacology*
  • Pyridines / pharmacology*
  • Pyrrolidines / pharmacology*

Substances

  • Aminopyridines
  • Benzodioxoles
  • CFTR protein, human
  • Chloride Channel Agonists
  • Pyrazoles
  • Pyridines
  • Pyrrolidines
  • Cystic Fibrosis Transmembrane Conductance Regulator
  • lumacaftor
  • elexacaftor