CFTR function, pathology and pharmacology at single-molecule resolution

Jesper Levring1, Daniel S Terry2, Zeliha Kilic2

  • 1Laboratory of Membrane Biology and Biophysics, The Rockefeller University, New York, NY, USA.

Nature
|March 23, 2023
PubMed

Insights

Cystic fibrosis transmembrane conductance regulator (CFTR) NBDs dimerize before opening, controlling chloride flow. This mechanism explains how CFTR potentiators work and informs new cystic fibrosis therapies.

Area of Science:

  • Biophysics
  • Molecular Biology
  • Ion Channel Physiology

Background:

  • The cystic fibrosis transmembrane conductance regulator (CFTR) is a crucial anion channel regulating epithelial salt and fluid balance.
  • Dysfunction of CFTR leads to cystic fibrosis, a severe, incurable genetic disorder.
  • Previous studies analyzed CFTR's electrophysiology and determined its structure in distinct conformations, but lacked direct functional correlations.

Purpose of the Study:

  • To elucidate the gating mechanism of the human CFTR channel.
  • To correlate CFTR's structure with its function in regulating ion transport.
  • To understand how disease-causing mutations and potentiator drugs affect CFTR function.

Main Methods:

  • Ensemble functional measurements
  • Single-molecule fluorescence resonance energy transfer (smFRET)
  • Electrophysiology
  • Kinetic simulations

Main Results:

  • The two nucleotide-binding domains (NBDs) of CFTR dimerize prior to channel opening.
  • CFTR operates via an allosteric gating mechanism involving NBD dimerization and ATP hydrolysis.
  • Potentiators like ivacaftor increase channel activity by enhancing pore opening during NBD dimerization.
  • Disease-associated mutations (G551D, L927P) impair NBD dimerization efficiency.

Conclusions:

  • A detailed gating mechanism for CFTR has been proposed, involving NBD dimerization as a key step.
  • Understanding this mechanism provides insights into the action of potentiator drugs.
  • These findings pave the way for developing more effective therapeutic strategies for cystic fibrosis.