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Enteral nutrition is the delivery of specially formulated nutrients, called enteral preparations, either orally or via tubes to meet patients' nutritional needs and avoid malnutrition. These feeds can be life-changing or lifesaving for patients. There are three broad enteral feed types: polymeric; pre-digested and disease-specific; and immune-enhancing. This article outlines the importance and involvement of nurses in the enteral feed process, including the selection and administration of enteral feeds, as well as presenting a summary of enteral preparations, their safety and evidence-based efficacy. Nurses should work within a well-coordinated multidisciplinary team, use existing knowledge and resources and refer to national guidelines, as well as practising in line with their professional roles and responsibilities to select and administer enteral preparations and continually monitor patients receiving enteral nutrition. Research has identified that enteral nutrition intolerance is an issue, particularly among critically ill patients. However, polymeric formula has been found to improve daily energy intake and tolerance and it is more cost-effective compared with semi-elemental formula in brain-injured critically ill patients. Immune-enhancing enteral nutrition could improve the immune function in patients with severe neurological diseases. While these findings are promising and can support enteral nutrition, there is a need for more research into the efficacy of specific formulas for certain conditions and for continuing to address enteral nutrition intolerance.

Health writer Gemma Harris provides an overview of this year's NHS influenza vaccination programme, including key goals and lessons learnt from the COVID-19 vaccine rollout.

The periplasmic chaperone SilF has been identified as part of an Ag(I) detoxification system in Gram negative bacteria. Sil proteins also bind Cu(I), but with reported weaker affinity, therefore leading to the designation of a specific detoxification system for Ag(I). Using isothermal titration calorimetry we show that binding of both ions is not only tighter than previously thought, but of very similar affinities. We investigated the structural origins of ion binding using molecular dynamics and QM/MM simulations underpinned by structural and biophysical experiments. The results of this analysis showed that the binding site adapts to accommodate either ion, with key interactions with the solvent in the case of Cu(I). The implications of this are that Gram negative bacteria do not appear to have evolved a specific Ag(I) efflux system but take advantage of the existing Cu(I) detoxification system. Therefore, there are consequences for how we define a particular metal resistance mechanism and understand its evolution in the environment.

Negligible direct cell killing ability by i129G1 on low to moderate binding cancer cell lines compared to the high-binding COLO205

IEDB screen for MHC class II binding epitopes

Sensorgrams of real-time glycan-HSA binding by parental and improved mAb constructs

Overview of the kinetic binding parameters of the parental 88 mAbs

Individual tumor growth curves from mice included in the in vivo COLO205 xenograft model

Murine IgG3 glycan-targeting mAb often induces direct cell killing in the absence of immune effector cells or complement via a proinflammatory mechanism resembling oncotic necrosis. This cancer cell killing is due to noncovalent association between Fc regions of neighboring antibodies, resulting in enhanced avidity. Human isotypes do not contain the residues underlying this cooperative binding mode; consequently, the direct cell killing of mouse IgG3 mAb is lost upon chimerization or humanization. Using the Lewisa/c/x -targeting 88mAb, we identified the murine IgG3 residues underlying the direct cell killing and increased avidity via a series of constant region shuffling and subdomain swapping approaches to create improved (“i”) chimeric mAb with enhanced tumor killing in vitro and in vivo. Constant region shuffling identified a major CH3 and a minor CH2 contribution, which was further mapped to discontinuous regions among residues 286–306 and 339–378 that, when introduced in 88hIgG1, recapitulated the direct cell killing and avidity of 88mIgG3. Of greater interest was the creation of a sialyl-di-Lewisa–targeting i129G1 mAb via introduction of these selected residues into 129hIgG1, converting it into a direct cell killing mAb with enhanced avidity and significant in vivo tumor control. The human iG1 mAb, termed Avidimabs, retained effector functions, paving the way for the proinflammatory direct cell killing to promote antibody-dependent cellular cytotoxicity and complement-dependent cytotoxicity through relief of immunosuppression. Ultimately, Fc engineering of human glycan-targeting IgG1 mAb confers proinflammatory direct cell killing and enhanced avidity, an approach that could be used to improve the avidity of other mAb with therapeutic potential.Significance:Fc engineering enhances avidity and direct cell killing of cancer-targeting anti-glycan antibodies to create superior clinical candidates for cancer immunotherapy.

Cartoon representation of the key Fc-engineered constructs

Transanal irrigation (TAI) is a safe and effective treatment but should not be carried out before less invasive treatment options have been trialled. A thorough assessment of the patient and consideration of their preferences and tolerance should determine TAI suitability and system choice. The range of available TAI) equipment can be overwhelming. Therefore, to aid health professionals, this article presents a summary of the latest available TAI devices on the market, as well as guidance on how to select a suitable device. TAI devices can be categorised into low- or high-volume; cones, catheters or balloon inflating devices; manual, electric pump or gravity-fed systems; and bed systems. Determining whether a low or high volume of water is required is a good starting point for device selection. Nurses should be aware of available devices and select one most suitable for a patient, as well as adequately train them in its usage and provide followup support. Nurses should communicate the potential improvement to quality of life TAI can offer and encourage adherence to avoid premature discontinuation.

The wide choice of available probiotics has the potential to make selecting a suitable product for a patient overwhelming. This article aims to lighten this burden and highlights the factors that need to be considered, as well as the safety and the evidence-based efficacy of the use of probiotics for specific gastrointestinal conditions, to help inform probiotic product selection and recommendation. The range of probiotics on the market is expanding, available over the counter or via prescription. Probiotics are generally deemed safe for healthy individuals, but can cause harmful side effects for severely ill or immunocompromised patients. Not all probiotic bacteria achieve the same results, and not all probiotics will help with all symptoms or conditions. Probiotics have been proven to help treat irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), but further research into this is warranted. Nurses should review new and existing evidence-based trials of efficacy of probiotics before making product recommendations.

Health writer Gemma Harris highlights the need to take a holistic approach to the management of skin conditions.

Altered eIF4A1 activity promotes translation of highly structured, eIF4A1-dependent oncogene mRNAs at root of oncogenic translational programmes. It remains unclear how these mRNAs recruit and activate eIF4A1 unwinding specifically to facilitate their preferential translation. Here, we show that single-stranded RNA sequence motifs specifically activate eIF4A1 unwinding allowing local RNA structural rearrangement and translation of eIF4A1-dependent mRNAs in cells. Our data demonstrate that eIF4A1-dependent mRNAs contain AG-rich motifs within their 5’UTR which specifically activate eIF4A1 unwinding of local RNA structure to facilitate translation. This mode of eIF4A1 regulation is used by mRNAs encoding components of mTORC-signalling and cell cycle progression, and renders these mRNAs particularly sensitive to eIF4A1-inhibition. Mechanistically, we show that binding of eIF4A1 to AG-rich sequences leads to multimerization of eIF4A1 with eIF4A1 subunits performing distinct enzymatic activities. Our structural data suggest that RNA-binding of multimeric eIF4A1 induces conformational changes in the RNA resulting in an optimal positioning of eIF4A1 proximal to the RNA duplex enabling efficient unwinding. Our data proposes a model in which AG-motifs in the 5’UTR of eIF4A1-dependent mRNAs specifically activate eIF4A1, enabling assembly of the helicase-competent multimeric eIF4A1 complex, and positioning these complexes proximal to stable localised RNA structure allowing ribosomal subunit scanning.

Staphylococcus aureus and Staphylococcus epidermidis are frequently associated with medical device infections that involve establishment of a bacterial biofilm on the device surface. Staphylococcal surface proteins Aap, SasG, and Pls are members of the Periscope Protein class and have been implicated in biofilm formation and host colonization; they comprise a repetitive region ("B region") and an N-terminal host colonization domain within the "A region," predicted to be a lectin domain. Repetitive E-G5 domains (as found in Aap, SasG, and Pls) form elongated "stalks" that would vary in length with repeat number, resulting in projection of the N-terminal A domain variable distances from the bacterial cell surface. Here, we present the structures of the lectin domains within A regions of SasG, Aap, and Pls and a structure of the Aap lectin domain attached to contiguous E-G5 repeats, suggesting the lectin domains will sit at the tip of the variable length rod. We demonstrate that these isolated domains (Aap, SasG) are sufficient to bind to human host desquamated nasal epithelial cells. Previously, proteolytic cleavage or a deletion within the A domain had been reported to induce biofilm formation; the structures suggest a potential link between these observations. Intriguingly, while the Aap, SasG, and Pls lectin domains bind a metal ion, they lack the nonproline cis peptide bond thought to be key for carbohydrate binding by the lectin fold. This suggestion of noncanonical ligand binding should be a key consideration when investigating the host cell interactions of these bacterial surface proteins.

Gemma Harris discusses strategies to increase vaccine uptake as the UK undertakes its largest influenza vaccination programme ever, amid a global pandemic.

A core aim in stoma care is to ensure the appliance (also known as a pouch or bag) establishes and maintains a secure seal, and so identifying the appropriate appliance for an individual ostomate is vital. This article presents a summary of the latest available range of stoma appliances on the market. There are two types of pouching systems: one and two piece. There are three main types of stoma appliances: closed, drainable and urostomy. Stoma care nurses need to be well informed about stoma appliance innovation, so that they can advise patients on what appliance is best for them. It is also the role of a stoma care nurse to educate patients on the technique for appliance application. If a patient is wearing an inappropriate appliance or they have a poor application technique, this can result in stoma complications, such as leakage and/or sore peristomal skin.

Gemma Harris explains how training clinicians to recognise and address eating disorders could improve access to early intervention and prevent acute services becoming overwhelmed.

Oncogenic translational programmes underpin cancer development and are often driven by dysregulation of oncogenic signalling pathways that converge on the eukaryotic translation initiation (eIF) 4F complex. Altered eIF4F activity promotes translation of oncogene mRNAs that typically contain highly structured 5’UTRs rendering their translation strongly dependent on RNA unwinding by the DEAD-box helicase eIF4A1 subunit of the eIF4F complex. While eIF4A1-dependent mRNAs have been widely investigated, it is still unclear how highly structured mRNAs recruit and activate eIF4A1 unwinding specifically to facilitate their preferential translation.Here, we show that RNA sequence motifs regulate eIF4A1 unwinding activity in cells. Our data demonstrate that eIF4A1-dependent mRNAs contain AG-rich motifs within their 5’UTR which recruit and stimulate eIF4A1 unwinding of localised RNA structure to facilitate mRNA translation. This mode of eIF4A1 regulation is used by mRNAs encoding components of mTORC-signalling and cell cycle progression and renders these mRNAs particularly sensitive to eIF4A1-inhibition. Mechanistically, we show that binding of eIF4A1 to AG-rich sequences leads to multimerization of eIF4A1 with eIF4A1 subunits performing distinct enzymatic activities. Our structural data suggest that RNA-binding of multimeric eIF4A1 induces conformational changes in the RNA substrate resulting in an optimal positioning of eIF4A1 proximal to the RNA duplex region that supports efficient unwinding.Hence, we conclude a model in which mRNAs utilise AG-rich sequences to specifically recruit eIF4A1, enabling assembly of the helicase-active multimeric eIF4A1 complex, and positioning these complexes proximal to stable localised RNA structure allowing ribosomal subunit scanning.

Transanal irrigation (TAI) is safe and effective treatment for constipation and faecal incontinence, but it should not be carried out before less invasive options have been tried. A thorough patient assessment and consideration of their preferences and tolerance should determine suitability and system choice. The range of available TAI equipment can be overwhelming. Therefore, to aid health professionals, this article presents a summary of the latest available devices on the market, as well as guidance on how to select a suitable device. TAI devices can be categorised into low-or high-volume; cones, catheters or balloon inflating devices; manual, electric pump or gravity-fed systems; and bed systems. Determining whether a low or high volume of water is required is a good starting point for device selection. Nurses should be aware of available devices and select one most suitable for a patient, as well as adequately train them in its usage and provide follow-up support. Nurses should communicate the potential improvement to quality of life TAI can offer and encourage adherence to avoid premature discontinuation.

Gemma Harris provides an overview of common treatments for psoriasis and discusses whether ultraviolet therapy still has a place in the management of this condition.

Murine IgG3 glycan-targeting mAb often induces direct cell killing in the absence of immune effector cells or complement via a proinflammatory mechanism resembling oncotic necrosis. This cancer cell killing is due to noncovalent association between Fc regions of neighboring antibodies, resulting in enhanced avidity. Human isotypes do not contain the residues underlying this cooperative binding mode; consequently, the direct cell killing of mouse IgG3 mAb is lost upon chimerization or humanization. Using the Lewisa/c/x -targeting 88mAb, we identified the murine IgG3 residues underlying the direct cell killing and increased avidity via a series of constant region shuffling and subdomain swapping approaches to create improved (“i”) chimeric mAb with enhanced tumor killing in vitro and in vivo. Constant region shuffling identified a major CH3 and a minor CH2 contribution, which was further mapped to discontinuous regions among residues 286–306 and 339–378 that, when introduced in 88hIgG1, recapitulated the direct cell killing and avidity of 88mIgG3. Of greater interest was the creation of a sialyl-di-Lewisa–targeting i129G1 mAb via introduction of these selected residues into 129hIgG1, converting it into a direct cell killing mAb with enhanced avidity and significant in vivo tumor control. The human iG1 mAb, termed Avidimabs, retained effector functions, paving the way for the proinflammatory direct cell killing to promote antibody-dependent cellular cytotoxicity and complement-dependent cytotoxicity through relief of immunosuppression. Ultimately, Fc engineering of human glycan-targeting IgG1 mAb confers proinflammatory direct cell killing and enhanced avidity, an approach that could be used to improve the avidity of other mAb with therapeutic potential. Significance: Fc engineering enhances avidity and direct cell killing of cancer-targeting anti-glycan antibodies to create superior clinical candidates for cancer immunotherapy.

The UK is facing a malnutrition emergency in hospitals that will place further strain on the NHS if action is not taken and guidelines are not followed. The coronavirus pandemic is increasing the pressure to take action. Effectively identifying and managing malnutrition can improve lives and save money.

Technology has become an increasingly vital aspect of healthcare, but its impact on pathology has been particularly profound. Gemma Harris discusses these developments and their potential to transform the nature of the field.

Individuals with disabilities and chronic conditions often face discrimination on both a personal and institutional level. Sadly, such discrimination is pervasive in the NHS. Gemma Harris highlights the barriers that many healthcare workers face as a result of anti-disability prejudice and how these can be addressed.

Social media platforms are increasingly turned to for health information, advice and community, but lack of regulation has allowed harmful misinformation to spread. Gemma Harris discusses this phenomenon, the potential risks to the public and the steps that healthcare professionals can take to counteract these effects.

Gemma Harris looks at new evidence that survival rates of meningococcal B – one of the most common causes of meningococcal meningitis – are increasing, and discusses what needs to be done to improve this further and the cost-effectiveness of current treatment for the NHS.

Carbonic anhydrase catalyses the interconversion of carbon dioxide and water to bicarbonate and protons. It was unknown if the industrial-relevant acetogen Clostridium autoethanogenum possesses these enzymes. We identified two putative carbonic anhydrase genes in its genome, one of the β class and one of the γ class. Carbonic anhydrase activity was found for the purified β class enzyme, but not the γ class candidate. Functional complementation of an Escherichia coli carbonic anhydrase knock-out mutant showed that the β class carbonic anhydrase could complement this activity, but not the γ class candidate gene. Phylogenetic analysis showed that the β class carbonic anhydrase of Clostridium autoethanogenum represents a novel sub-class of β class carbonic anhydrases that form the F-clade. The members of this clade have the shortest primary structure of any known carbonic anhydrase. Electronic supplementary material The online version of this article (10.1007/s00253-019-10015-w) contains supplementary material, which is available to authorized users.

Isothermal titration calorimetry (ITC) has become one of the mainstays of determining the affinity of small molecules with macromolecules. As such there has been a resurgence in interest in the underlying processes that contribute to a ‘good’ ITC experiment. In this article we discuss the thermodynamic origins of the data seen in an ITC experiment, some of the background theory and exemplars of what good data look like. We also discuss the origins of more complex phenomena seen with ITC, and how these may be interpreted.

Nontypeable Haemophilus influenzae (NTHi) is a significant pathogen in respiratory disease and otitis media. Important for NTHi survival, colonization and persistence in vivo is the Sap (sensitivity to antimicrobial peptides) ABC transporter system. Current models propose a direct role for Sap in heme and antimicrobial peptide (AMP) transport. Here, the crystal structure of SapA, the periplasmic component of Sap, in a closed, ligand bound conformation, is presented. Phylogenetic and cavity volume analysis predicts that the small, hydrophobic SapA central ligand binding cavity is most likely occupied by a hydrophobic di- or tri- peptide. The cavity is of insufficient volume to accommodate heme or folded AMPs. Crystal structures of SapA have identified surface interactions with heme and dsRNA. Heme binds SapA weakly (Kd 282 μM) through a surface exposed histidine, while the dsRNA is coordinated via residues which constitute part of a conserved motif (estimated Kd 4.4 μM). The RNA affinity falls within the range observed for characterized RNA/protein complexes. Overall, we describe in molecular-detail the interactions of SapA with heme and dsRNA and propose a role for SapA in the transport of di- or tri-peptides.

Staufen is a dsRNA-binding protein involved in many aspects of RNA regulation, such as mRNA transport, Staufen-mediated mRNA decay and the regulation of mRNA translation. It is a modular protein characterized by the presence of conserved consensus amino acid sequences that fold into double-stranded RNA binding domains (RBDs) as well as degenerated RBDs that are instead involved in protein–protein interactions. The variety of biological processes in which Staufen participates in the cell suggests that this protein associates with many diverse RNA targets, some of which have been identified experimentally. Staufen binding mediates the recruitment of effectors via protein–protein and protein–RNA interactions. The structural determinants of a number of these interactions, as well as the structure of full-length Staufen, remain unknown. Here, we present the first solution structure models for full-length hStaufen155, showing that its domains are arranged as beads-on-a-string connected by flexible linkers. In analogy with other nucleic acid-binding proteins, this could underpin Stau1 functional plasticity.

The gastric peptide hormone human PYY3–36 is a target for the development of therapeutics, especially for treatment of obesity. The conformation and aggregation behavior of PEGylated and lipidated derivatives of this peptide are examined using a combination of fluorescence dye assays, circular dichroism (CD) spectroscopy, analytical ultracentrifugation (AUC) measurements, small-angle X-ray scattering (SAXS) and cryogenic-transmission electron microscopy (cryo-TEM). The behavior of two PYY3–36 derivatives lipidated (with octyl chains) in different positions is compared to that of two derivatives with PEG attached at different residues and to that of the native peptide. We find that, unexpectedly, PYY3–36 forms amyloid fibril structures above a critical aggregation concentration. Formation of these structures is suppressed by PEGylation or lipidation. PEGylation significantly reduces the (reversible) loss of α-helix content observed on heating PYY3–36. The PEG conjugates form mainly monomeric structures in ...

Summary Streptococcus pneumoniae is dependent on carbohydrate uptake for colonization and pathogenesis, and dedicates over a third of its transport systems to their uptake. The ability of the pneumococcus to utilize fructooligosaccharides (FOSs) is attributed to the presence of one of two types of FOS ATP-binding cassette (ABC) transporters. Strains encoding SfuABC are only able to utilize short-chain FOSs, while strains encoding FusABC can utilize both short- and long-chain FOSs. The crystal structures of the substrate-binding protein FusA in its open and closed conformations bound to FOSs, and solution scattering data of SfuA, delineate the structural basis for import of short- and long-chain FOSs. The structure of FusA identifies an EF hand-like calcium-binding motif. This is shown to be essential for translocation of FOSs in FusABC and forms the basis for the definition of a new class of substrate-binding proteins that regulate substrate translocation by calcium., Graphical Abstract, Highlights • A new cluster of substrate-binding proteins is structurally defined • An EF hand-like calcium-binding site regulates substrate translocation • Specificity toward short- and long-chain fructooligosaccharides elucidated, Culurgioni et al. define the structural basis for uptake of short- and long-chain fructooligosaccharides in pneumococcus. They describe a new structural cluster of substrate-binding proteins that share a common calcium-binding motif. They propose that regulation of substrate translocation is mediated by calcium for this subfamily.

A stronger focus on nutrition could have myriad benefits for health services, reducing rates of preventable illness, obesity and mortality. Gemma Harris discusses reports from the World Health Organization, which set out what this stronger focus might entail for healthcare providers and the positive changes that could be achieved.

With the number of people aged over 60 years rising rapidly, technological developments which can reduce the need for healthcare interventions among older people are a welcome sight. In this article, Gemma Harris discusses the new NHS-approved apps designed to facilitate self-care among the ageing population.

Schistosomes express a variety of aspartyl proteases (APs) with distinct roles in the helminth pathophysiology, among which degradation of host haemoglobin is key, since it is the main amino acid source for these parasites. A cathepsin D-like AP from Schistosoma mansoni (SmCD1) has been used as a model enzyme for vaccine and drug development studies in schistosomes and yet a reliable expression system for readily producing the recombinant enzyme in high yield has not been reported. To contribute to further advancing the knowledge about this valuable antischistosomal target, we developed a transient expression system in HEK 293T mammalian cells and performed a biochemical and biophysical characterization of the recombinant enzyme (rSmCD1). It was possible to express a recombinant C-terminal truncated form of SmCD1 (rSmCD1ΔCT) and purify it with high yield (16 mg/L) from the culture supernatant. When analysed by Size-Exclusion Chromatography and multi-angle laser light scattering, rSmCD1ΔCT behaved as a dimer at neutral pH, which is unusual for cathepsins D, turning into a monomer after acidification of the medium. Through analytical ultrancentrifugation, the dimer was confirmed for free rSmCD1ΔCT in solution as well as stabilization of the monomer during interaction with pepstatin. The mammalian cell expression system used here was able to produce rSmCD1ΔCT with high yields allowing for the first time the characterization of important kinetic parameters as well as initial description of its biophysical properties.

Aminoacyl-tRNA synthetases are ubiquitous and essential enzymes for protein synthesis and also a variety of other metabolic processes, especially in bacterial species. Bacterial aminoacyl-tRNA synthetases represent attractive and validated targets for antimicrobial drug discovery if issues of prokaryotic versus eukaryotic selectivity and antibiotic resistance generation can be addressed. We have determined high resolution X-ray crystal structures of the Escherichia coli and Staphylococcus aureus seryl-tRNA synthetases in complex with aminoacyl adenylate analogues and applied a structure-based drug discovery approach to explore and identify a series of small molecule inhibitors that selectively inhibit bacterial seryl-tRNA synthetases with greater than two orders of magnitude compared to their human homologue, demonstrating a route to selective chemical inhibition of these bacterial targets.

Group 21 and 5 allergens are homologous house dust mite proteins known as mid-tier allergens. To reveal the biological function of group 21 allergens and to understand better the allergenicity of the rDer f 21 allergen, we determined the 1.5 Å crystal structure of rDer f 21 allergen from Dermatophagoides farinae. The rDer f 21 protein consists of a three helical bundle, similar to available structures of group 21 and homologous group 5 allergens. The rDer f 21 dimer forms a hydrophobic binding pocket similar to the one in the Der p 5 allergen, which indicates that both of the homologous groups could share a similar function. By performing structure-guided mutagenesis, we mutated all 38 surface-exposed polar residues of the rDer f 21 allergen and carried out immuno-dot blot assays using 24 atopic sera. Six residues, K10, K26, K42, E43, K46, and K48, which are located in the region between the N-terminus and the loop 1 of rDer f 21 were identified as the major IgE epitopes of rDer f 21. Epitope mapping of all potential IgE epitopes on the surface of the rDer f 21 crystal structure revealed heterogeneity in the sIgE recognition of the allergen epitopes in atopic individuals. The higher the allergen-sIgE level of an individual, the higher the number of epitope residues that are found in the allergen. The results illustrate the clear correlation between the number of specific major epitope residues in an allergen and the sIgE level of the atopic population.

Graphical abstract, Highlights • The Fab structures of two cattle antibodies (B4 and B13) that neutralise bRSV have been solved. • The light chain plays a critical role in the folding and positioning of CDR H3 of the heavy chains. • The H3 loop plays a dominant role in antigen-binding., Cattle antibodies have unusually long CDR3 loops in their heavy chains (HCs), and limited light chain (LC) diversity, raising the question of whether these mask the effect of LC variation on antigen recognition. We have investigated the role of the LC in the structure and activity of two neutralizing cattle antibodies (B4 and B13) that bind the F protein of bovine respiratory syncytial virus (bRSV). Recombinant Fab fragments of B4 and B13 bound bRSV infected cells and showed similar affinities for purified bRSV F protein. Exchanging the LCs between the Fab fragments produced hybrid Fabs: B13* (B13 HC/B4 LC) and B4* (B4 HC/B13 LC). The affinity of B13* to the F protein was found to be two-fold lower than B13 whilst the binding affinity of B4* was reduced at least a hundred-fold compared to B4 such that it no longer bound to bRSV infected cells. Comparison of the structures of B4 and B13 with their LC exchanged counterparts B4* and B13* showed that paratope of the HC variable domain (VH) of B4 was disrupted on pairing with the B13 LC, consistent with the loss of binding activity. By contrast, B13 H3 adopts a similar conformation when paired with either B13 or B4 LCs. These observations confirm the expected key role of the extended H3 loop in antigen-binding by cattle antibodies but also show that the quaternary LC/HC subunit interaction can be crucial for its presentation and thus the LC variable domain (VL) is also important for antigen recognition.

The Hippo pathway is an important regulator of cell growth, proliferation, and migration. TEAD transcription factors, which lie at the core of the Hippo pathway, are essential for regulation of organ growth and wound repair. Dysregulation of TEAD and its regulatory cofactor Yes-associated protein (YAP) have been implicated in numerous human cancers and hyperproliferative pathological processes. Hence, the YAP–TEAD complex is a promising therapeutic target. Here, we use in silico molecular docking using Bristol University Docking Engine to screen a library of more than 8 million druglike molecules for novel disrupters of the YAP–TEAD interaction. We report the identification of a novel compound (CPD3.1) with the ability to disrupt YAP–TEAD protein–protein interaction and inhibit TEAD activity, cell proliferation, and cell migration. The YAP–TEAD complex is a viable drug target, and CPD3.1 is a lead compound for the development of more potent TEAD inhibitors for treating cancer and other hyperproliferative pathologies.