Effet de chaperones pharmacologiques sur les formes mutantes du récepteur mélanocortine de type 4 responsables de l'obésité morbide précoce

Le récepteur mélanocortine de type 4 (MC4R) est un récepteur couplé aux protéines G impliqué dans la régulation de la prise alimentaire et de l’homéostasie énergétique. Quatre-vingt pour cent des mutants du MC4R reliés à l’obésité morbide précoce (OMP) sont retenus à l’intérieur de la cellule. Le système de contrôle de qualité (SCQ) est probablement responsable de cette rétention, par la reconnaissance d’une conformation inadéquate des mutants. Le rétablissement de l’expression à la surface cellulaire et de la fonctionnalité de ces mutants est donc d’intérêt thérapeutique. Dans cette optique, des composés lipophiles spécifiques pour le MC4R ont été sélectionnés sur la base de leur sélectivité. Nous avons démontré qu’ils agissent à titre de chaperone pharmacologique (CP) en rétablissant l’expression à la surface cellulaire et la fonctionnalité des récepteurs mutants S58C et R165W, et qu’ils favorisent leur N-glycosylation complexe (maturation). Le suivi par BRET du site d’action des CP du MC4R suggère une action en aval de l’interaction calnexine-MC4R. De manière générale, une CP peut avoir un effet différent selon le mutant traité en induisant des conformations distinctes du récepteur plus ou moins aptes à se dissocier du SCQ et à activer la voie de signalisation, et un mutant peut répondre différemment selon la CP utilisée par des différences d’affinité pour le ligand, la CP et les effecteurs. Une meilleure compréhension du mode d’action des CP pourrait aider au développement de nouvelles approches thérapeutiques non seulement pour l’OMP, mais aussi pour d’autres maladies conformationnelles causées par le mauvais repliement de protéines.

Misfolding of galactose 1-phosphate uridylyltransferase can result in type I galactosemia

Type I galactosemia is a genetic disorder that is caused by the impairment of galactose-1-phosphate uridylyltransferase (GALT; EC 2.7.7.12). Although a large number of mutations have been detected through genetic screening of the human GALT (hGALT) locus, for many it is not known how they cause their effects. The majority of these mutations are missense, with predicted substitutions scattered throughout the enzyme structure and thus causing impairment by other means rather than direct alterations to the active site. To clarify the fundamental, molecular basis of hGALT impairment we studied five disease-associated variants p.D28Y, p.L74P, p.F171S, p.F194L and p.R333G using both a yeast model and purified, recombinant proteins. In a yeast expression system there was a correlation between lysate activity and the ability to rescue growth in the presence of galactose, except for p.R333G. Kinetic analysis of the purified proteins quantified each variant's level of enzymatic impairment and demonstrated that this was largely due to altered substrate binding. Increased surface hydrophobicity, altered thermal stability and changes in proteolytic sensitivity were also detected. Our results demonstrate that hGALT requires a level of flexibility to function optimally and that altered folding is the underlying reason of impairment in all the variants tested here. This indicates that misfolding is a common, molecular basis of hGALT deficiency and suggests the potential of pharmacological chaperones and proteostasis regulators as novel therapeutic approaches for type I galactosemia.

FAD binding overcomes defects in activity and stability displayed by cancer-associated variants of human NQO1

NAD(P)H quinone oxidoreductase 1 is involved in antioxidant defence and protection from cancer, stabilizing the apoptosis regulator p53 towards degradation. Here, we studied the enzymological, biochemical and biophysical properties of two cancer-associated variants (p.R139W and p.P187S). Both variants (especially p.187S) have lower thermal stability and greater susceptibility to proteolysis compared to the wild-type. p.P187S also has reduced activity due to a lower binding affinity for the FAD cofactor as assessed by activity measurements and direct titrations. Native gel electrophoresis and dynamic light scattering also suggest that p.P187S has a higher tendency to populate unfolded states under native conditions. Detailed thermal stability studies showed that all variants irreversibly denature causing dimer dissociation, while addition of FAD restores the stability of the polymorphic forms to wild-type levels. The kinetic destabilization induced by polymorphisms as well as the kinetic protection exerted by FAD was confirmed by measuring denaturation kinetics at temperatures close to physiological. Our data suggest that the main molecular mechanisms associated with these cancer-related variants are their low binding affinity for FAD and/or kinetic instability. Thus, pharmacological chaperones may be useful in the treatment of patients bearing these polymorphisms.

The molecular basis of galactosemia - Past, present and future

Galactosemia, an inborn error of galactose metabolism, was first described in the 1900s by von Ruess. The subsequent 100years has seen considerable progress in understanding the underlying genetics and biochemistry of this condition. Initial studies concentrated on increasing the understanding of the clinical manifestations of the disease. However, Leloir's discovery of the pathway of galactose catabolism in the 1940s and 1950s enabled other scientists, notably Kalckar, to link the disease to a specific enzymatic step in the pathway. Kalckar's work established that defects in galactose 1-phosphate uridylyltransferase (GALT) were responsible for the majority of cases of galactosemia. However, over the next three decades it became clear that there were two other forms of galactosemia: type II resulting from deficiencies in galactokinase (GALK1) and type III where the affected enzyme is UDP-galactose 4'-epimerase (GALE). From the 1970s, molecular biology approaches were applied to galactosemia. The chromosomal locations and DNA sequences of the three genes were determined. These studies enabled modern biochemical studies. Structures of the proteins have been determined and biochemical studies have shown that enzymatic impairment often results from misfolding and consequent protein instability. Cellular and model organism studies have demonstrated that reduced GALT or GALE activity results in increased oxidative stress. Thus, after a century of progress, it is possible to conceive of improved therapies including drugs to manipulate the pathway to reduce potentially toxic intermediates, antioxidants to reduce the oxidative stress of cells or use of "pharmacological chaperones" to stabilise the affected proteins.

Conséquences fonctionnelles de mutations affectant le récepteur de la vasopressine de type 2 et implications thérapeutiques

Le récepteur de la vasopressine de type 2 (V2R) joue un rôle crucial dans l’homéostasie hydrique. Exprimé principalement au niveau du rein, son activation par l’hormone antidiurétique arginine-vasopressine (AVP) favorise la réabsorption d’eau, participant ainsi à diminuer la diurèse. Plus de 200 mutations dans le gène du V2R ont été associées au diabète néphrogénique insipide congénital (DINc), une maladie causée par une perte de fonction du récepteur. À l’opposé, trois mutations découvertes récemment induisent un gain de fonction du V2R, et sont la cause du syndrome néphrogénique de l’anti-diurèse inappropriée (NSIAD). Les travaux de cette thèse visent à mieux comprendre les bases moléculaires responsables de la perte ou du gain de fonction des récepteurs mutants associés à ces deux maladies. Dans plus de 50% des cas, les mutations faux-sens affectent négativement l’adoption d’une conformation native par le V2R, provoquant la reconnaissance et la rétention intracellulaire des mutants par le système de contrôle de qualité du réticulum endoplasmique. Nos résultats ont démontré que l’interaction entre les récepteurs mutants et le chaperon moléculaire calnexine est dépendante de N-glycosylation et que sa durée varie en fonction de la mutation. De plus, l’importance de cette modification co-traductionnelle et des interactions lectines-sucres dans le processus de maturation d’un mutant donné s’est avérée une caractéristique intrinsèque, puisque l’absence de N-glycosylation n’a pas affecté le mutant Y128S (phénotype léger) tandis que la maturation du mutant W164S (phénotype sévère) a été totalement abolie. Nos résultats suggèrent aussi que l’action des chaperons pharmacologiques (CP), molécules favorisant la maturation des mutants du V2R, peut survenir à différentes étapes au cours du processus de maturation, selon le mutant réchappé. Ces différences entre muta nts suggèrent des processus biosynthétiques ‘personnalisés’ dictés par la nature de la mutation impliquée et pourraient expliquer la différence de sévérité des manifestations cliniques chez les patients porteurs de ces mutations. Bien qu’une récupération de fonction ait été obtenue pour les mutants Y128S et W164S par un traitement au CP, il n’en est pas de même pour toutes les mutations occasionnant un défaut conformationnel. C’est ce que nous avons démontré pour le mutant V88M, affligé de deux défauts, soit une faible efficacité de maturation combinée à une basse affinité pour l’AVP. Dans ce cas, et malgré une augmentation du nombre de récepteurs mutants la surface cellulaire, la diminution de l’affinité apparente du récepteur mutant pour l’AVP a été exacerbée par la présence résiduelle de CP à son site de liaison, rendant impossible l’activation du récepteur aux concentrations physiologiques d’AVP. Les mutants R137C et R137L ont une activité constitutive élevée et mènent au NSIAD tandis que la substitution de cette même arginine par une histidine (R137H) mène au DINc. Ces trois mutants se sont avéré partager plusieurs caractéristiques, dont une efficacité de maturation réduite et une désensibilisation spontanée élevée. La seule différence iden tifiée entre ces mutants est leur niveau d’activité constitutive. Le CP utilisé dans nos études possède aussi la propriété d’agoniste inverse, mais n’a pourtant pas diminué l’activité constitutive des mutants R137C/L, suggérant une conformation active ‘figée’. Seul l’effet chaperon a été observé, entraînant la hausse de récepteurs à la surface cellulaire, qui se traduit par une augmentation de la production de second messager. Nous avons par contre suggéré l’utilisation d’AVP puisqu’il favorise l’endocytose des récepteurs R137/L sans promouvoir leur activation, diminuant ainsi le nombre de récepteurs actifs à la surface cellulaire. Nous avons identifié la première mutation occasionnant un gain de fonction du V2R qui n’implique pas l’arginine 137. Le mutant F229V a une activité constitutive élevée et, contrairement aux R137C et R137L, il n’est pas sujet à une désensibilisation spontanée accrue. L’observation que des agonistes inverses sont aptes à inhiber l’activité constitutive de ce nouveau mutant est une découverte importante puisque l’insuccès obtenu avec les mutations précédentes suggérait que ces molécules n’étaient pas utiles pour le traitement du NSIAD. Considérés globalement, ces travaux illustrent le caractère particulier des formes mutantes du V2R et l’importance de bien cerner les conséquences fonctionnelles des mutations afin d’apporter aux patients atteints de DINc ou NSIAD une thérapie personnalisée, et de développer de nouveaux agents thérapeutiques adaptés aux besoins.

Slower rescue of ER homeostasis by the unfolded protein response pathway associated with common variable immunodeficiency

Common variable immunodeficiency (CVID) is a primary immunodeficiency characterized by hypogammaglobulinemia and recurrent infections. Herein we addressed the role of unfolded protein response (UPR) in the pathogenesis of the disease. Augmented unspliced X-box binding protein 1 (XBP-1) mRNA concurrent with co-localization of IgM and BiP/GRP78 were found in one CVID patient. At confocal microscopy analysis this patient`s cells were enlarged and failed to present the typical surface distribution of IgM, which accumulated within an abnormally expanded endoplasmic reticulum. Sequencing did not reveal any mutation on XBP-1, neither on IRE-1 alpha that could potentially prevent the splicing to occur. Analysis of spliced XBP-1, IRE-1 alpha and BiP messages after LPS or Brefeldin A treatment showed that, unlike healthy controls that respond to these endoplasmic reticulum (ER) stressors by presenting waves of transcription of these three genes, this patient`s cells presented lower rates of transcription, not reaching the same level of response of healthy subjects even after 48 h of ER stress. Treatment with DMSO rescued IgM and IgG secretion as well as the expression of spliced XBP-1. Our findings associate diminished splicing of XBP-1 mRNA with accumulation of IgM within the ER and lower rates of chaperone transcription, therefore providing a mechanism to explain the observed hypogammaglobulinemia. (C) 2008 Elsevier Ltd. All rights reserved.

The effect of chaperone compounds on glucocerebrosidase stability and activity in fibroblasts from Gaucher Disease patients with different genotypes

Dissertação de mestrado, Ciências Biomédicas, Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, 2014

Chemical chaperones mediate increased secretion of mutant α1-antitrypsin (α1-AT) Z: A potential pharmacological strategy for prevention of liver injury and emphysema in α1-AT deficiency

In α1-AT deficiency, a misfolded but functionally active mutant α1-ATZ (α1-ATZ) molecule is retained in the endoplasmic reticulum of liver cells rather than secreted into the blood and body fluids. Emphysema is thought to be caused by the lack of circulating α1-AT to inhibit neutrophil elastase in the lung. Liver injury is thought to be caused by the hepatotoxic effects of the retained α1-ATZ. In this study, we show that several “chemical chaperones,” which have been shown to reverse the cellular mislocalization or misfolding of other mutant plasma membrane, nuclear, and cytoplasmic proteins, mediate increased secretion of α1-ATZ. In particular, 4-phenylbutyric acid (PBA) mediated a marked increase in secretion of functionally active α1-ATZ in a model cell culture system. Moreover, oral administration of PBA was well tolerated by PiZ mice (transgenic for the human α1-ATZ gene) and consistently mediated an increase in blood levels of human α1-AT reaching 20–50% of the levels present in PiM mice and normal humans. Because clinical studies have suggested that only partial correction is needed for prevention of both liver and lung injury in α1-AT deficiency and PBA has been used safely in humans, it constitutes an excellent candidate for chemoprophylaxis of target organ injury in α1-AT deficiency.

Uso terapêutico de chaperones em doenças conformacionais

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências Farmacêuticas

Stress-induced targeting of molecular chaperones in the yeast Saccharomyces cerevisiae

The eukaryotic stress response is an essential mechanism that helps protect cells from a variety of environmental stresses. Cell death can result if cells are not able to properly adapt and protect themselves against adverse stress conditions. Failure to properly deal with stress has implications in human diseases including neurodegenerative disorders and distinct cancers, emphasizing the importance of understanding the eukaryotic stress response in detail. As part of this response, expression of a battery of heat shock proteins (HSP) is induced, which act as molecular chaperones to assist in the repair or triage of unfolded proteins. The 90-kDa HSP (Hsp90) operates in the context of a multi-chaperone complex to promote the maturation of nuclear and cytoplasmic clients. I have discovered that Hsp90 and the co-chaperone Sba1 accumulate in the nucleus of quiescent Saccharomyces cerevisiae cells in a karyopherin-dependent manner. I isolated nuclear accumulation- defective HSP82 mutant alleles to probe the nature of this targeting event and identified a mutant with a single amino acid substitution (I578F) sufficient to prevent nuclear accumulation of Hsp90 in quiescent cells. Diploid hsp82-I578F cells exhibited pronounced defects in spore wall construction and maturation, resulting in catastrophic sporulation. The mislocalization and sporulation phenotypes were shared by another previously identified HSP82 mutant allele, further linking localization to Hsp90 functional status. Pharmacological inhibition of Hsp90 with macbecin in sporulating diploid cells also blocked spore formation, underscoring the importance of this chaperone in this developmental program. The yeast molecular chaperone Hsp104 is a member of the Hsp100 superfamily of AAA+ ATPases. Unlike the Hsp90 family of chaperones, Hsp104 is not restricted to a specific set of client proteins, but rather assists in reactivating stress-denatured proteins by solubilizing protein aggregates. I have discovered that Hsp104, along with the Hsp70 chaperone, Ssa1, and the sHSP Hsp26 accumulate into RNA processing bodies (P- bodies) and stress granules, sites of mRNA metabolism. I found that Hsp104 recruits both Ssa1 and Hsp26 to P-bodies and that these three chaperones are required for stress granule formation. These findings suggest a possible role for chaperones in mRNA metabolism by aiding in the assembly, disassembly or conversion of these enigmatic mRNP complexes. Taken together, the work presented in this dissertation serves to better understand the eukaryotic stress response by illustrating the importance of subcellular-chaperone localization in key biological processes.

Hsp110 chaperones control client fate determination in the hsp70-Hsp90 chaperone system.

Heat shock protein 70 (Hsp70) plays a central role in protein homeostasis and quality control in conjunction with other chaperone machines, including Hsp90. The Hsp110 chaperone Sse1 promotes Hsp90 activity in yeast, and functions as a nucleotide exchange factor (NEF) for cytosolic Hsp70, but the precise roles Sse1 plays in client maturation through the Hsp70-Hsp90 chaperone system are not fully understood. We find that upon pharmacological inhibition of Hsp90, a model protein kinase, Ste11DeltaN, is rapidly degraded, whereas heterologously expressed glucocorticoid receptor (GR) remains stable. Hsp70 binding and nucleotide exchange by Sse1 was required for GR maturation and signaling through endogenous Ste11, as well as to promote Ste11DeltaN degradation. Overexpression of another functional NEF partially compensated for loss of Sse1, whereas the paralog Sse2 fully restored GR maturation and Ste11DeltaN degradation. Sse1 was required for ubiquitinylation of Ste11DeltaN upon Hsp90 inhibition, providing a mechanistic explanation for its role in substrate degradation. Sse1/2 copurified with Hsp70 and other proteins comprising the "early-stage" Hsp90 complex, and was absent from "late-stage" Hsp90 complexes characterized by the presence of Sba1/p23. These findings support a model in which Hsp110 chaperones contribute significantly to the decision made by Hsp70 to fold or degrade a client protein.

Pharmacological modulation of heat shock factor 1 by antiinflammatory drugs results in protection against stress-induced cellular damage.

The activation of heat shock genes by diverse forms of environmental and physiological stress has been implicated in a number of human diseases, including ischemic damage, reperfusion injury, infection, neurodegeneration, and inflammation. The enhanced levels of heat shock proteins and molecular chaperones have broad cytoprotective effects against acute lethal exposures to stress. Here, we show that the potent antiinflammatory drug indomethacin activates the DNA-binding activity of human heat shock transcription factor 1 (HSF1). Perhaps relevant to its pharmacological use, indomethacin pretreatment lowers the temperature threshold of HSF1 activation, such that a complete heat shock response can be attained at temperatures that are by themselves insufficient. The synergistic effect of indomethacin and elevated temperature is biologically relevant and results in the protection of cells against exposure to cytotoxic conditions.

Non-pharmacological interventions in secondary schizophrenia

Schizophrenia may not be a single disease, but the result of a diverse set of related conditions. Modern neuroscience is beginning to reveal some of the genetic and environmental underpinnings of schizophrenia; however, an approach less well travelled is to examine the medical disorders that produce symptoms resembling schizophrenia. This book is the first major attempt to bring together the diseases that produce what has been termed 'secondary schizophrenia'. International experts from diverse backgrounds ask the questions: does this medical disorder, or drug, or condition cause psychosis? If yes, does it resemble schizophrenia? What mechanisms form the basis of this relationship? What implications does this understanding have for aetiology and treatment? The answers are a feast for clinicians and researchers of psychosis and schizophrenia. They mark the next step in trying to meet the most important challenge to modern neuroscience – understanding and conquering this most mysterious of human diseases.

Non-pharmacological interventions for breathlessness management in patients with lung cancer : A systematic review

The aim is to review the published scientific literature for studies evaluating nonpharmacological interventions for breathlessness management in patients with lung cancer. The following selection criteria were used to systematically search the literature: studies were to be published research or systematic reviews; they were to be published in English and from 1990 to 2007; the targeted populations were adult patients with dyspnoea/breathlessness associated with lung cancer; and the study reported on the outcomes from use of non-pharmacological strategies for breathlessness. This review retrieved five studies that met all inclusion criteria. All the studies reported the benefits of non-pharmacological interventions in improving breathlessness regardless of differences in clinical contexts, components of programmes and methods for delivery. Analysis of the available evidence suggests that tailored instructions delivered by nurses with sufficient training and supervision may have some benefits over other delivery approaches. Based on the results, non-pharmacological interventions are recommended as effective adjunctive strategies in managing breathlessness for patients with lung cancer. In order to refine such interventions, future research should seek to explore the core components of such approaches that are critical to achieving optimal outcomes, the contexts in which the interventions are most effective, and to evaluate the relative benefits of different methods for delivering such interventions.