Box 45 Biochemistry In Medicine

Death by Misfolding: The Prion Diseases

A misfolded protein appears to be the causative agent of a number of rare degenerative brain diseases in mammals. Perhaps the best known of these is mad cow disease (bovine spongiform encephalopathy, BSE), an outbreak of which made international headlines in the spring of 1996. Related diseases include kuru and Creutzfeldt-Jakob disease in humans, scrapie in sheep, and chronic wasting disease in deer and elk. These diseases are also referred to as spongiform encephalopathies, because the diseased brain frequently becomes riddled with holes (Fig. 1). Typical symptoms include dementia and loss of coordination. The diseases are fatal.

In the 1960s, investigators found that preparations of the disease-causing agents appeared to lack nucleic acids. At this time, Tikvah Alper suggested that the agent was a protein. Initially, the idea seemed heretical. All disease-causing agents known up to that time—viruses, bacteria, fungi, and so on—contained nucleic acids, and their virulence was related to genetic reproduction and propagation. However, four decades of investigations, pursued most notably by Stanley Prusiner, have provided evidence that spongiform encephalopathies are different.

The infectious agent has been traced to a single protein (Mr 28,000), which Prusiner dubbed prion (from proteinaceous infectious only) protein (PrP). Prion protein is a normal constituent of brain tissue in all mammals. Its role in the mammalian brain is not known in detail, but it appears to have a molecular signaling function. Strains of mice lacking the gene for PrP (and thus the protein itself) suffer no obvious ill effects. Illness occurs only when the normal cellular PrP, or PrPC, occurs in an altered conformation called PrPSc (Sc denotes scrapie). The interaction of PrPSc with PrPC converts the latter to PrPSc, initiating a domino effect in which more and more of the brain protein converts to the disease-causing form. The mechanism by which the presence of PrPSc leads to spongiform encephalopathy is not understood.

In inherited forms of prion diseases, a mutation in the gene encoding PrP produces a change in one amino acid residue that is believed to make the conversion of PrPC to PrPSc more likely. A complete understanding of prion diseases awaits new information about how prion protein affects brain function. Structural information about PrP is beginning to provide insights into the molecular process that allows the prion proteins to interact so as to alter their conformation (Fig. 2).

FIGURE 1 A stained section of the cerebral cortex from a patient with Creutzfeldt-Jakob disease shows spongiform (vacuolar) degeneration, the most characteristic neurohistological feature. The yellowish vacuoles are intracellular and occur mostly in pre- and postsynaptic processes of neurons. The vacuoles in this section vary in diameter from 20 to 100 ^m.

FIGURE 1 A stained section of the cerebral cortex from a patient with Creutzfeldt-Jakob disease shows spongiform (vacuolar) degeneration, the most characteristic neurohistological feature. The yellowish vacuoles are intracellular and occur mostly in pre- and postsynaptic processes of neurons. The vacuoles in this section vary in diameter from 20 to 100 ^m.

FIGURE 2 The structure of the globular domain of human PrP in monomeric (left) and dimeric (right) forms. The second subunit is gray to highlight the dramatic conformational change in the green a helix when the dimer is formed.

may have two stable domains joined by a segment with lower structural stability, or one small part of a domain may have a lower stability than the remainder. The regions of low stability allow a protein to alter its conformation between two or more states. As we shall see in the next two chapters, variations in the stability of regions within a given protein are often essential to protein function.

Some Proteins Undergo Assisted Folding

Not all proteins fold spontaneously as they are synthesized in the cell. Folding for many proteins is facilitated by the action of specialized proteins. Molecular chap-erones are proteins that interact with partially folded or improperly folded polypeptides, facilitating correct folding pathways or providing microenvironments in which folding can occur. Two classes of molecular chap-erones have been well studied. Both are found in organisms ranging from bacteria to humans. The first class, a family of proteins called Hsp70, generally have

FIGURE 4-30 Chaperones in protein folding. The cyclic pathway by which chaperones bind and release polypeptides is illustrated for the E. coli chaperone proteins DnaK and DnaJ, homologs of the eukary-otic chaperones Hsp70 and Hsp40. The chaperones do not actively promote the folding of the substrate protein, but instead prevent aggregation of unfolded peptides. For a population of polypeptides, some a molecular weight near 70,000 and are more abundant in cells stressed by elevated temperatures (hence, heat shock proteins of Mr 70,000, or Hsp70). Hsp70 proteins bind to regions of unfolded polypeptides that are rich in hydrophobic residues, preventing inappropriate aggregation. These chaperones thus "protect" proteins that have been denatured by heat and peptides that are being synthesized (and are not yet folded). Hsp70 proteins also block the folding of certain proteins that must remain unfolded until they have been translocated across membranes (as described in Chapter 27). Some chaperones also facilitate the quaternary assembly of oligomeric proteins. The Hsp70 proteins bind to and release polypeptides in a cycle that also involves several other proteins (including a class called Hsp40) and ATP hydrolysis. Figure 4-30 illustrates chaperone-assisted folding as elucidated for the chaperones DnaK and DnaJ in E. coli, homologs of the eukaryotic Hsp70 and Hsp40. DnaK and DnaJ were first identified as proteins required for in vitro replication of certain viral DNA molecules (hence the "Dna" designation).

fraction of the polypeptides released at the end of the cycle are in the native conformation. The remainder are rebound by DnaK or are diverted to the chaperonin system (GroEL; see Fig. 4-31). In bacteria, a protein called GrpE interacts transiently with DnaK late in the cycle (step (3)), promoting dissociation of ADP and possibly DnaJ. No eukaryotic analog of GrpE is known.

@ DnaJ binds to the unfolded or partially folded protein and then to DnaK.

@ DnaJ binds to the unfolded or partially folded protein and then to DnaK.

2 Pi

Coli Chaperones

GrpE

FIGURE 4-30 Chaperones in protein folding. The cyclic pathway by which chaperones bind and release polypeptides is illustrated for the E. coli chaperone proteins DnaK and DnaJ, homologs of the eukary-otic chaperones Hsp70 and Hsp40. The chaperones do not actively promote the folding of the substrate protein, but instead prevent aggregation of unfolded peptides. For a population of polypeptides, some

) ATP binds to DnaK and the protein dissociates.

) DnaJ stimulates ATP hydrolysis by DnaK. DnaK-ADP binds tightly to the unfolded protein.

GrpE

) ATP binds to DnaK and the protein dissociates.

) In bacteria, the nucleotide-exchange factor GrpE stimulates release of ADP.

The second class of chaperones is called chaper-onins. These are elaborate protein complexes required for the folding of a number of cellular proteins that do not fold spontaneously. In E. coli an estimated 10% to 15% of cellular proteins require the resident chaperonin system, called GroEL/GroES, for folding under normal conditions (up to 30% require this assistance when the cells are heat stressed). These proteins first became known when they were found to be necessary for the growth of certain bacterial viruses (hence the designation "Gro"). Unfolded proteins are bound within pockets in the GroEL complex, and the pockets are capped transiently by the GroES "lid" (Fig. 4-31). GroEL un dergoes substantial conformational changes, coupled to ATP hydrolysis and the binding and release of GroES, which promote folding of the bound polypeptide. Although the structure of the GroEL/GroES chaperonin is known, many details of its mechanism of action remain unresolved.

Finally, the folding pathways of a number of proteins require two enzymes that catalyze isomerization reactions. Protein disulfide isomerase (PDI) is a widely distributed enzyme that catalyzes the interchange or shuffling of disulfide bonds until the bonds of the native conformation are formed. Among its functions, PDI catalyzes the elimination of folding interme-

® Unfolded protein binds to the GroEL pocket not blocked by GroES.

® Unfolded protein binds to the GroEL pocket not blocked by GroES.

) ATP binds to each subunit of the GroEL heptamer.

) ATP hydrolysis leads to release of 14 ADP and GroES.

) ATP binds to each subunit of the GroEL heptamer.

Unfolded protein GroEL

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