Abstract

Risdiplam is the first approved small-molecule splicing modulator for the treatment of spinal muscular atrophy (SMA). Previous studies demonstrated that risdiplam analogues have two separate binding sites in exon 7 of the SMN2 pre-mRNA: (i) the 5′-splice site and (ii) an upstream purine (GA)-rich binding site. Importantly, the sequence of this GA-rich binding site significantly enhanced the potency of risdiplam analogues. In this report, we unambiguously determined that a known risdiplam analogue, SMN-C2, binds to single-stranded GA-rich RNA in a sequence-specific manner. The minimum required binding sequence for SMN-C2 was identified as GAAGGAAGG. We performed all-atom simulations using a robust Gaussian accelerated molecular dynamics (GaMD) method, which captured spontaneous binding of a risdiplam analogue to the target nucleic acids. We uncovered, for the first time, a ligand-binding pocket formed by two sequential GAAG loop-like structures. The simulation findings were highly consistent with experimental data obtained from saturation transfer difference (STD) NMR and structure-affinity-relationship studies of the risdiplam analogues. Together, these studies illuminate us to understand the molecular basis of single-stranded purine-rich RNA recognition by small-molecule splicing modulators with an unprecedented binding mode.

Highlights

  • Spinal muscular atrophy (SMA) is one of the most common lethal genetic diseases in new-borns [1,2]

  • Applying different-length RNAs and DNAs at 50 ␮M, we found that a 9-nt sequence (i.e. GAAGGAAGG) is the minimum length required for survival of motor neuron (SMN)-C2 binding (Figure 2B)

  • Our results reveal a new type of small molecule–RNA recognition mechanism that is relevant to the mechanism of action of a recently approved drug, risdiplam

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Summary

Introduction

Spinal muscular atrophy (SMA) is one of the most common lethal genetic diseases in new-borns [1,2]. The cause of SMA in most type I patients is a recessive homozygous deletion within the survival of motor neuron (SMN) 1 gene in chromosome 5 [1,2]. Earlier studies demonstrated that a single C-to-T nucleotide (nt) substitution at the +6 position in exon 7 of SMN2 leads to this exon being skipped ∼85% of the time [4], resulting in an inactive SMN isoform. This C-to-T substitution facilitates the preferential binding of a splicing inhibitor, heterogeneous nuclear ribonucleoproteins (hnRNP) A1 [5], over a splicing activator, serine and arginine rich splicing factor 1 (SRSF1) [6].

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