Tolcapone, a potent aggregation inhibitor for the treatment of familial leptomeningeal amyloidosis

Hereditary transthyretin amyloidosis (ATTR) is a disease characterized by the extracellular deposition of transthyretin (TTR) amyloid fibrils. Highly destabilizing TTR mutations cause leptomeningeal amyloidosis, a rare, but fatal, disorder in which TTR aggregates in the brain. The disease remains in...

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Autores: Garcia de Carvalho Pinheiro, Francisca|||0000-0003-3778-1528, Varejão, Nathalia|||0000-0002-6952-8896, Esperante, Sebastián|||0000-0002-5778-6871, Santos Suárez, Jaime|||0000-0001-9045-7765, Velázquez-Campoy, Adrián|||0000-0001-5702-4538, Reverter Cendrós, David|||0000-0002-5347-0992, Pallarès i Goitiz, Irantzu|||0000-0002-8205-2060, Ventura, Salvador|||0000-0002-9652-6351
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:323744
Acceso en línea:https://ddd.uab.cat/record/323744
https://dx.doi.org/urn:doi:10.1111/febs.15339
Access Level:acceso abierto
Palabra clave:Amyloidosis
Crystal structures
Protein aggregation
Tolcapone
Transthyretin
Descripción
Sumario:Hereditary transthyretin amyloidosis (ATTR) is a disease characterized by the extracellular deposition of transthyretin (TTR) amyloid fibrils. Highly destabilizing TTR mutations cause leptomeningeal amyloidosis, a rare, but fatal, disorder in which TTR aggregates in the brain. The disease remains intractable, since liver transplantation, the reference therapy for systemic ATTR, does not stop mutant TTR production in the brain. In addition, despite current pharmacological strategies have shown to be effective against in vivo TTR aggregation by stabilizing the tetramer native structure and precluding its dissociation, they display low brain permeability. Recently, we have repurposed tolcapone as a molecule to treat systemic ATTR. Crystal structures and biophysical analysis converge to demonstrate that tolcapone binds with high affinity and specificity to three unstable leptomeningeal TTR variants, stabilizing them and, consequently, inhibiting their aggregation. Because tolcapone is an FDA-approved drug that crosses the blood-brain barrier, our results suggest that it can translate into a first disease-modifying therapy for leptomeningeal amyloidosis.