One of the most serious challenges facing medical science today is the development of drug resistance by bacteria and viruses. Almost as quickly as we can develop drugs that attack the machinery of infectious disease, evolution, aided in some cases by careless use, defeats our efforts. In some cases this is because the specific target of a drug changes in response to the challenge, as has happened in the evolution of resistance to rimantidine in influenza. Bacteria have an additional mechanism to attack our medicines, however, in the form of multidrug resistance genes. These proteins can recognize an array of toxic molecules, often using general properties, and expel them from the cell. As such, every single one of these genes can take out multiple medicines.
One of these multidrug resistance exporters is EmrE, a member of the small multidrug resistance (SMR) family of genes. EmrE is a proton-drug antiporter that pushes positively-charged polyaromatic molecules out of the cell while letting two protons in. The import of the protons provides the energy to expel the toxins against a concentration gradient. Today in Nature, a research group led by my friend Katie Henzler-Wildman published new details of EmrE’s mechanism and topology (1). Using NMR and fluorescence techniques, we show that EmrE does, or at least can, operate as an antiparallel, asymmetric dimer that exposes a single active site to alternating sides of the membrane by simultaneously switching the conformation of the monomers.
This was a long and difficult project, in which I played a small role. Unfortunately, multidrug resistance exporters like EmrE tend to be integrated into the bacterial membrane, which makes them challenging subjects for biophysical studies. In order to investigate proteins like this, we must reconstitute them in lipid environments that suitably mimic their natural setting, while maintaining sufficient purity and concentration to perform our experiments. The controversy over the effect of rimantidine on influenza’s M2 channel provides just one example of the difficulty of reliably recreating a membrane environment.
EmrE has also been embroiled in a controversy between structural biologists and biochemists. Although the minimal functional unit is agreed to be a dimer, biochemical studies have indicated that that the dimer is symmetric, and that the proteins have a parallel orientation in the membrane. That is, each EmrE protein has the same shape and is pointing the same way. Relatively low-resolution data from crystallography and electron microscopy, however, has suggested that the protein units are asymmetric and antiparallel. However, these studies were performed in lipid environments where the protein may not have been active, and at frozen temperatures far from physiological relevance. One would like to get a look at EmrE in a state where it is active and at a somewhat more reasonable temperature.
Caught in the Act
Solution NMR provides one way to achieve this goal. A protein can be embedded in a small bit of membrane, and allowed to tumble freely in an aqueous environment, allowing sufficient signal for us to make some kinds of measurements. Historically, micelles have been used for this, but multiple lines of evidence now suggest that they may produce artifacts due to the unnatural local curvature. Consequently, Katie and her student Emma worked out a system for observing EmrE in bicelles, which are small, flat-ish discs of lipids that still tumble freely enough to allow solution-state NMR measurements. They also established that EmrE in this bicelle preparation could still bind to tetraphenylphosphonium (TPP+), one of its ligands.
The NMR spectrum, however, was perplexing. As you can see in the HSQC to the right, the peaks in the spectrum are fairly spread out. That’s unusual for a protein composed entirely of α-helices, but because electron currents from the aromatic rings of TPP+ induce significant changes in chemical shift it’s still reasonable. What is more troubling, and perhaps less obvious, is that there are twice as many peaks in this spectrum as you would expect.
An HSQC of a 15N-labeled protein, in principle, shows one peak for every N-H in the protein, such that you get a two-dimensional spectrum showing the chemical shift of the nitrogen on one axis and its bonded proton on the other. This means there should be one peak per amino acid, except prolines. In addition, peaks usually appear for tryptophan indoles (they are at bottom left in the spectrum) and, depending on your setup, glutamine and asparagine side-chains. Other side-chains usually exchange with water too quickly to be seen. EmrE has about 100 residues, and the spectrum has about 200 peaks. This indicates that there are two different structures of EmrE in the sample.
We decided to ask whether EmrE switched between these two structures and how fast. Observing two peaks per residue, of roughly equal intensity, told us that if EmrE did change its structure, it was doing so slowly, at a rate of 10 times a second or less. So we used an experiment called ZZ-exchange, which is similar to the HSQC but includes a relatively long pause between determining the 15N chemical shift and the 1H chemical shift. If a significant proportion of the sample changes conformation during the pause, you will see a spectrum that includes all the HSQC peaks, as well as cross-peaks that have the 15N chemical shift of one structure and the 1H chemical shift of the other, producing a little rectangle of peaks. This ended up being tricky because the bicelle distorts the signals, but Katie, Greg DeKoster, and I managed to come up with a setup that got around this problem on the 800 at Brandeis, starting from a pulse sequence written by Art Palmer.
As you can see above, we observed cross peaks, shown in blue to differentiate them from the HSQC peaks. By varying the pause between chemical shift determinations, we were able to fit a rate of about 5 /s, which roughly correlates to a fluorescence fluctuation observed in previous experiments. In addition, experiments using paramagnetic relaxation enhancement agents show that the two states have different accessibility to water, suggesting that they represent a change in which side of the active site is open. This supports the conclusion that what we are seeing here is the fundamental conformational change inherent to EmrE’s function: the opening of the binding site to one side of the membrane, then the other.
The ABBA Model?
So now we have evidence for two distinct structures that interconvert during the export process. Two models can be consistent with these data, shown in the figure below. The most obvious possibility, consistent with almost all of the biochemical data, is that the structures represent two states of a symmetric, parallel dimer converting from an AA state to a BB state. Alternately, consistent with the crystallographic data, one could have an asymmetric, antiparallel dimer that exchanges from an AB state to a BA state.
The NMR data support the second model in two ways. The first is that peaks for the two states have almost equal intensity, which can only be the case if both states are almost equal in free energy. This happens automatically in the case of the asymmetric dimer, because each dimer contains one of each conformation, making the exchange to the alternate state energy-neutral. In the case of a symmetric dimer, it requires that each individual conformation have the same energy, which is unlikely, but not impossible. Also, in the NMR data, regions of the protein that show the largest difference in chemical shift between the two states also show the most significant conformational differences in the crystal structure of the asymmetric dimer. Unfortunately, these lines of evidence are not enough to be sure about what we’re seeing.
Flash in the Pan
To get a better idea of EmrE’s topology, Katie and her team performed a number of FRET and crosslinking experiments to establish the relative orientation of dimers in the membrane. In bulk FRET experiments, they fluorescently labeled EmrE that was in liposomes, as shown in Figure 3. In the first experiment, EmrE was exposed to one label while in liposomes, then broken out into bicelles and exposed to another. For antiparallel proteins, excitation of the green dye should result in fluorescent output from the red dye, and this is exactly what was observed. Also, EmrE in liposomes was exposed to both dyes simultaneously, which should result in an observation of FRET for parallel but not antiparallel dimers. Some FRET was observed, but it wasn’t clear whether this was due to dye leaking into the liposomes.
Katie answered this question using single-molecule FRET. EmrE dimers with a single cysteine mutated into them were labeled with fluorescent dye and then examined on a slide to determine the efficiency of energy transfer. Because there is only one labeling site, a high-efficiency transfer would imply that both fluorophores were on the same side of the membrane, and thus a parallel topology. However, the observed efficiency suggested a distance of 50 Å between the fluorophores, more consistent with an antiparallel topology where the labeling sites are separated by the membrane.
In one final experiment, Katie used a molecule that covalently links a lysine side chain to a cysteine side chain. There is only one lysine in EmrE, and Katie created a mutant that has a single cysteine on the opposite side of the membrane. This distance is too great for the linker molecule to bridge, so in a parallel dimer no cross-linking should be observed. Instead, the experiment resulted in nearly complete cross-linking, supporting an antiparallel topology.
How an Antiporter Works
Cumulatively, these results strongly support the model shown below, where EmrE swaps two protons for a drug molecule using a conformational exchange between energetically-equivalent asymmetric, antiparallel dimer states that are open to different sides of the membrane. In this model, there is a single binding site, consistent with the biochemical data, in the context of an antiparallel, asymmetric dimer, consistent with previous structural data. Because EmrE binds TPP+ with high affinity under our conditions, and because the cysteine mutations made for the FRET experiments did not significantly change the NMR spectra, we can be confident that these experiments plausibly reproduce normal protein behaviors. However, some mutational studies indicate that EmrE functions as a parallel dimer in vivo, and further experiments are necessary to either reconcile these observations or determine where the errors originate.
In terms of the implications for fighting drug resistance in bacteria, this is an early step on a long road. EmrE is not the only drug exporter in bacteria, nor is it the most critical. It is also too soon to say whether the particular mechanism outlined here is general to the SMR family or a peculiarity of this single protein. However, these results give us confidence that the crystal structures are reliable (Katie’s group is currently is working on improving them), and that we can cleanly measure exchange rates to determine what effect drug candidates are having. The goal would be to develop accessory drugs that attack the exporters while a primary drug attacks the bacterium’s basic functions. A great deal more work is necessary before we reach that point, but this is one strategy that may allow us to defeat drug resistance, or at least prolong the usefulness of our current antibiotic arsenal.
(1) Morrison, E., DeKoster, G., Dutta, S., Vafabakhsh, R., Clarkson, M.W., Bahl, A., Kern, D., Ha, T., & Henzler-Wildman, K. (2011). Antiparallel EmrE exports drugs by exchanging between asymmetric structures Nature, 481 (7379), 45-50 DOI: 10.1038/nature10703