Residues involved in proton-coupled transport of antimalarial drugs by PfCRT.

Abstract

A major setback in the fight against malaria has been the emergence of P. falciparum parasites resistant to chloroquine (CQ), the primary antimalarial drug. Neutral CQ enters the parasite's digestive vacuole (DV) and obtains two protons preventing its passive efflux through the membrane. The trapped CQ2+ kills the parasite by disrupting the detoxification process of heme released from proteolyzed host hemoglobin. CQ-resistant parasites show mutations in a DV membrane transporter, P. falciparum CQ resistance transporter (PfCRT), that enables active, proton-coupled efflux of CQ2+. While biochemical measurements established the coupling of PfCRT's transport function to the DV membrane proton gradient, the proton-coupled transport mechanism has remained elusive. Particularly it is still unclear what the proton binding site(s) is(are). Recently, the cryo-EM structure of PfCRT from a CQ-resistant variant was determined with a bound Fab fragment occupying its binding pocket. Using us-long all-atom molecular dynamics (MD) simulations we examined the stability of the transporter in the DV-open conformation in the absence of bound Fab fragments, discovering surprising protein stability upon removal of Fab. Next, utilizing constant pH (cpHMD) simulations at 7 different pH values, and considering Galvani potential offset corrections, we determined the pKa of the four titratable residues (H97, D137, D326, and D329) lining the binding pocket. These simulations allowed unambiguous determination of the primary site responding to DV's acidic environment. Finally, with protonation states compatible with the acidic pH of the DV for the aforementioned residues, we studied binding of CQ2+ to the transporter via a series of driven MD simulations. We then repeated the cpHMD simulations and determined the proton binding site in the presence of the bound CQ2+. Our results shed light on PfCRT's transport mechanism and open new possibilities to design new effective drugs against malaria.