Small-molecule correctors divert CFTR-F508del from ERAD by stabilizing sequential folding states

Mol Biol Cell. 2024 Feb 1;35(2):ar15. doi: 10.1091/mbc.E23-08-0336. Epub 2023 Nov 29.

Abstract

Over 80% of people with cystic fibrosis (CF) carry the F508del mutation in the cystic fibrosis transmembrane conductance regulator (CFTR), a chloride ion channel at the apical plasma membrane (PM) of epithelial cells. F508del impairs CFTR folding causing it to be destroyed by endoplasmic reticulum associated degradation (ERAD). Small-molecule correctors, which act as pharmacological chaperones to divert CFTR-F508del from ERAD, are the primary strategy for treating CF, yet corrector development continues with only a rudimentary understanding of how ERAD targets CFTR-F508del. We conducted genome-wide CRISPR/Cas9 knockout screens to systematically identify the molecular machinery that underlies CFTR-F508del ERAD. Although the ER-resident ubiquitin ligase, RNF5 was the top E3 hit, knocking out RNF5 only modestly reduced CFTR-F508del degradation. Sublibrary screens in an RNF5 knockout background identified RNF185 as a redundant ligase and demonstrated that CFTR-F508del ERAD is robust. Gene-drug interaction experiments illustrated that correctors tezacaftor (VX-661) and elexacaftor (VX-445) stabilize sequential, RNF5-resistant folding states. We propose that binding of correctors to nascent CFTR-F508del alters its folding landscape by stabilizing folding states that are not substrates for RNF5-mediated ubiquitylation.

MeSH terms

  • Benzodioxoles / pharmacology
  • Benzodioxoles / therapeutic use
  • Cystic Fibrosis Transmembrane Conductance Regulator* / metabolism
  • Cystic Fibrosis* / drug therapy
  • Endoplasmic Reticulum-Associated Degradation
  • Humans
  • Ligases / genetics
  • Ligases / metabolism
  • Mitochondrial Proteins / metabolism
  • Mutation
  • Protein Folding
  • Ubiquitin-Protein Ligases / metabolism

Substances

  • Cystic Fibrosis Transmembrane Conductance Regulator
  • Ligases
  • Benzodioxoles
  • CFTR protein, human
  • RNF185 protein, human
  • Mitochondrial Proteins
  • Ubiquitin-Protein Ligases