Chaperone therapy for homocystinuria: the rescue of CBS mutations by heme arginate

J Inherit Metab Dis. 2015 Mar;38(2):287-94. doi: 10.1007/s10545-014-9781-9. Epub 2014 Oct 21.

Abstract

Classical homocystinuria is caused by mutations in the cystathionine β-synthase (CBS) gene. Previous experiments in bacterial and yeast cells showed that many mutant CBS enzymes misfold and that chemical chaperones enable proper folding of a number of mutations. In the present study, we tested the extent of misfolding of 27 CBS mutations previously tested in E. coli under the more folding-permissive conditions of mammalian CHO-K1 cells and the ability of chaperones to rescue the conformation of these mutations. Expression of mutations in mammalian cells increased the median activity 16-fold and the amount of tetramers 3.2-fold compared with expression in bacteria. Subsequently, we tested the responses of seven selected mutations to three compounds with chaperone-like activity. Aminooxyacetic acid and 4-phenylbutyric acid exhibited only a weak effect. In contrast, heme arginate substantially increased the formation of mutant CBS protein tetramers (up to sixfold) and rescued catalytic activity (up to ninefold) of five out of seven mutations (p.A114V, p.K102N, p.R125Q, p.R266K, and p.R369C). The greatest effect of heme arginate was observed for the mutation p.R125Q, which is non-responsive to in vivo treatment with vitamin B(6). Moreover, the heme responsiveness of the p.R125Q mutation was confirmed in fibroblasts derived from a patient homozygous for this genetic variant. Based on these data, we propose that a distinct group of heme-responsive CBS mutations may exist and that the heme pocket of CBS may become an important target for designing novel therapies for homocystinuria.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Arginine / pharmacology*
  • CHO Cells
  • Catalytic Domain
  • Cricetulus
  • Cystathionine beta-Synthase / genetics*
  • Cystathionine beta-Synthase / metabolism
  • Female
  • Fibroblasts / drug effects*
  • Fibroblasts / enzymology
  • Genetic Predisposition to Disease
  • Heme / pharmacology*
  • Homocystinuria / diagnosis
  • Homocystinuria / drug therapy*
  • Homocystinuria / enzymology
  • Homocystinuria / genetics
  • Homozygote
  • Humans
  • Models, Molecular
  • Molecular Chaperones / pharmacology*
  • Mutation*
  • Phenotype
  • Protein Conformation
  • Protein Folding
  • Proteostasis Deficiencies / diagnosis
  • Proteostasis Deficiencies / drug therapy*
  • Proteostasis Deficiencies / enzymology
  • Proteostasis Deficiencies / genetics
  • Structure-Activity Relationship
  • Substrate Specificity
  • Transfection

Substances

  • Molecular Chaperones
  • Heme
  • Arginine
  • Cystathionine beta-Synthase
  • heme arginate