Antonella Caputo, Marco Di Duca, Nicoletta Pedemonte, Nicole Arous, Alexandre Hinzpeter, Pascale Fanen, Emanuela Caci, Olga Zegarra-Moran, Luis J. V. Galietta, Caputo, Antonella, Hinzpeter, Alexandre, Caci, Emanuela, Pedemonte, Nicoletta, Arous, Nicole, Di Duca, Marco, Zegarra-Moran, Olga, Fanen, Pascale, and Galietta, Luis J. V.
The cystic fibrosis transmembrane conductance regulator (CFTR) is a plasma membrane channel permeable to Cl- and other anions (Sheppard and Welsh, 1999). Each single CFTR polypeptide is composed of (from the amino to the carboxyl terminus) a transmembrane domain, a nucleotide-binding domain (NBD-1), a regulatory R region, a second transmembrane domain, and a second nucleotide-binding domain (NBD-2). The two transmembrane domains, each one having six segments that cross completely the phospholipid bilayer, contribute to the formation of the hydrophilic channel through which anions are transported (Dawson et al., 1999). NDB-1 and NDB-2 are exposed instead to the cytosol. They possess particular sequences, called Walker A, Walker B, and LSGGQ motifs, highly conserved among ATP-binding cassette transporters (Gottesman and Ambudkar, 2001). Such motifs form together the binding sites for ATP, two binding sites per CFTR molecule (Kidd et al., 2004). Under resting conditions, the CFTR channel is closed. It is believed that phosphorylation of CFTR at the R domain by cAMP-dependent protein kinase A favors the interaction between the two NBDs (Mense et al., 2006). Two ATP-binding sites are then generated at the interface between the NBD domains. Binding of ATP to NBDs allows the opening of the CFTR channel and consequently anion transport (Ikuma and Welsh, 2000). Mutations in the CFTR gene are the cause of the genetic disease, cystic fibrosis (CF), in which defective Cl- transport is responsible for impaired mucociliary clearance and bacterial colonization of the airways (McAuley and Elborn, 2000). There are more than 1500 CF mutations that can be grouped in five classes according to the mechanisms through which they cause CFTR loss of function (Welsh and Smith, 1993; McAuley and Elborn, 2000). In particular, class III includes mutations that strongly reduce CFTR activity even in the presence of a maximal cAMP stimulus. Such mutations cause an alteration in channel gating so that the mutant protein remains in the closed state for a much longer time compared with wild-type CFTR. The most studied class III mutations are G551D and G1349D (Gregory et al., 1991; Bompadre et al., 2007), which alter two highly conserved glycines in the LSGGQ motif of the NBD1 and NBD2, respectively. ΔF508, the most frequent CF mutation, is also localized in NBD1 and causes both a severe impairment of CFTR maturation, with entrapment of the mutant protein in the endoplasmic reticulum (Gregory et al., 1991), and a gating defect (Dalemans et al., 1991). The gating defect of ΔF508, G551D, and G1349D can be corrected pharmacologically by small molecules called CFTR potentiators (Galietta and Moran, 2004; Verkman et al., 2006). Such compounds, which include flavonoids (genistein, apigenin), fluorescein derivatives, xanthines, benzimidazolones, phenylglycines, sulfonamides, 1,4-dihydropyridines, and tetrahydrobenzothiophenes (Illek et al., 1999; Bulteau et al., 2000; Al-Nakkash et al., 2001; Cai and Sheppard, 2002; Yang et al., 2003; Pedemonte et al., 2005a,b), enhance mutant CFTR activity through a decrease in the time spent by the channel in the closed state (Pedemonte et al., 2005a,b). The mechanism of action of CFTR potentiators is unknown but it has been hypothesized that they bind CFTR at the level of NBDs, possibly at the interface between them (Zegarra-Moran et al., 2007), thus promoting NBD dimerization and favoring CFTR opening. This mechanism may counteract the effects of ΔF508, G551D, and G1349D that instead alter NBD function. Mutations lying outside the NBDs, in particular, in the CFTR intracellular loops (ICL1–ICL4), which connect the transmembrane segments, also cause a gating defect (Seibert et al., 1996, 1997). ICLs now are considered particularly interesting because they may couple changes in NBD conformation to movements of transmembrane segments, thus allowing gating of the CFTR pore (Mendoza and Thomas, 2007; He et al., 2008; Mornon et al., 2008; Serohijos et al., 2008). In the present study, we have investigated the ability of CFTR potentiators to overcome the gating defect caused by ICL mutations. For this purpose, we have chosen felodipine, PG-01, and SF-01, representative of three different classes of potentiators: 1,4-dihydropyridines, phenylglycines, and sulfonamides, respectively (Pedemonte et al., 2005a,b). Our results demonstrate that potentiators are also effective on ICL mutants, thus indicating that their action is not restricted to NBDs but involves changes in protein conformation that also affect other CFTR regions. However, we also found differences in potency and effectiveness among potentiators with respect to CF mutations, thus suggesting the possible existence of more than one binding site and/or mechanism of action.