Abstract

Amyloid formation of the human plasma protein transthyretin (TTR) is associated with several human disorders, including familial amyloidotic polyneuropathy (FAP) and senile systemic amyloidosis. Dissociation of TTR’s native tetrameric assembly is the rate-limiting step in the conversion into amyloid, and this feature presents an avenue for intervention because binding of an appropriate ligand to the thyroxin hormone binding sites of TTR stabilizes the native tetrameric assembly and impairs conversion into amyloid. The desired features for an effective TTR stabilizer include high affinity for TTR, high selectivity in the presence of other proteins, no adverse side effects at the effective concentrations, and a long half-life in the body. In this study we show that the commonly used flame retardant tetrabromobisphenol A (TBBPA) efficiently stabilizes the tetrameric structure of TTR. The X-ray crystal structure shows TBBPA binding in the thyroxine binding pocket with bromines occupying two of the three halogen binding sites. Interestingly, TBBPA binds TTR with an extremely high selectivity in human plasma, and the effect is equal to the recently approved drug tafamidis and better than diflunisal, both of which have shown therapeutic effects against FAP. TBBPA consequently present an interesting scaffold for drug design. Its absorption, metabolism, and potential side-effects are discussed.

Highlights

  • Transthyretin (TTR) is a homotetrameric plasma protein involved in the transport of thyroxine hormone (T4) and retinol-binding protein

  • We have recently shown that the selectivity of TTR binders in human plasma varies considerably and that many drugs, despite a very high affinity for TTR in vitro, frequently require a very high stoichiometric excess relative to the TTR protein in order to effectively maintain the tetrameric form of TTR [34]

  • Using a recently developed assay to evaluate the selectivity of TTR-stabilizing drugs in human plasma [34], we show that tetrabromobisphenol A (TBBPA) exhibits an extraordinarily high selectivity and that an essentially complete stabilization is observed already at a stoichiometric ratio

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Summary

Introduction

Transthyretin (TTR) is a homotetrameric plasma protein involved in the transport of thyroxine hormone (T4) and retinol-binding protein. TTR has amyloidogenic features and is associated with several different disorders, including familial amyloidotic polyneuropathy (FAP) [2,3,4], familial amyloidotic cardiomyopathy [5], and senile systemic amyloidosis [6,7]. TTR amyloid has recently been suggested to play a role in spinal lumbar stenosis [8] and preeclampsia [9,10]. The formation of amyloid from TTR is initiated through dissociation of its native tetramer, which is the rate-limiting step in the conversion of the native protein into amyloid [11,12].

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