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== Diseases ==
== Diseases ==


Because Piezo1 is implicated in the functioning of many cells and organs, modifications on its structure lead to diseases. For instance, Hereditary Xerocytosis (HX) is a rare disease, also called  [https://en.wikipedia.org/wiki/Hereditary_stomatocytosis Dehydrated hereditary stomatocytosis] (DHS). This genetic disease leads to impaired red blood cell (RBC) membrane properties that affect intracellular cation concentrations.<ref name="Dehydrated"> DOI 10.1038/ncomms2899</ref> The RBCs are abnormally shaped and they result in [https://en.wikipedia.org/wiki/Hemolytic_anemia haemolytic anaemia]. Those modifications are due to mutations on the FAM38A gene on chromosome 16 which encodes for Piezo 1. Piezo1 is expressed in the plasma membranes of RBCs, and its role is to control RBCs’ osmolarity. It also plays a prevalent role in the [https://en.wikipedia.org/wiki/Erythropoiesis erythroid differentiation]. Mutations in Piezo1 distort mechanosensitive channel regulation, leading to increased cation transport in erythroid cells. Six gain-of-function mutations, gathered in the central core region of the Piezo channel structure, are directly linked to the decrease of inactivation rate of the channel.
Because Piezo1 is implicated in the functioning of many cells and organs, modifications on its structure lead to diseases.  
 
For instance, Hereditary Xerocytosis (HX) is a rare disease, also called  [https://en.wikipedia.org/wiki/Hereditary_stomatocytosis Dehydrated hereditary stomatocytosis] (DHS). This genetic disease leads to impaired red blood cell (RBC) membrane properties that affect intracellular cation concentrations.<ref name="Dehydrated"> DOI 10.1038/ncomms2899</ref> The RBCs are abnormally shaped and they result in [https://en.wikipedia.org/wiki/Hemolytic_anemia haemolytic anaemia]. Those modifications are due to mutations on the FAM38A gene on chromosome 16 which encodes for Piezo 1. Piezo1 is expressed in the plasma membranes of RBCs, and its role is to control RBCs’ osmolarity. It also plays a prevalent role in the [https://en.wikipedia.org/wiki/Erythropoiesis erythroid differentiation]. Mutations in Piezo1 distort mechanosensitive channel regulation, leading to increased cation transport in erythroid cells. Those mutations affect different parts of the channel. For instance, six gain-of-function mutations, gathered in the central core region of the Piezo channel structure, are directly linked to the decrease of inactivation rate of the channel. Mutations in the N-terminal part of the protein also have a role in channel gating. Therefore, not every channel is affected in the same way and by the same mutation. Indeed it depends on the environment, the permeability of RBC and the combination of mutations.  
Those mutations could provoke increases in permeability of cations in RBC by different mechanisms. It could induce mechanically activated currents that inactivate more slowly than wild-type currents. They could also affect the inactivation process by either destabilising the inactivated state or stabilising the channel in the open state. As a result, the open to inactivated state equilibrium shifts towards open. Na+ and Ca2+ ion influx consequently increase, and the intracellular K+ concentration decreases in a steady state. The evolution of Piezo1’s function steams from a change in its 3D structure.  
Those mutations could provoke increases in permeability of cations in RBC by different mechanisms. It could induce mechanically activated currents that inactivate more slowly than wild-type currents. They could also affect the inactivation process by either destabilising the inactivated state or stabilising the channel in the open state. As a result, the open to inactivated state equilibrium shifts towards open. Na+ and Ca2+ ion influx consequently increase, and the intracellular K+ concentration decreases in a steady state. The evolution of Piezo1’s function steams from a change in its 3D structure.  


Lymphatic dysplasia is also a disease linked to loss of function mutations on Piezo1. The lymphatic system is independent from the vascular one, and its role is to transport antigens responsible of the immune response. If the interstitial fluid is not drained correctly back to the blood, it leads to local inflammation. The mutations on Piezo1 inactivate the channel gate and in this case the concentration of calcium is not increased. The protein isn’t sensible to the pressure anymore.


== Potential therapeutic target ==
== Potential therapeutic target ==


Piezo1 is a protein discovered recently. Therefore, its potential in medicine is in constant evolution.
Piezo1 can be used as diagnostic biomarkers because it detects different mechanical forces and triggers a specific response adapted to the changes in the environment. For instance, it is sensitive to shear stress which has a major role in cardiovascular physiology.
This mechanosensitive receptor is a candidate for therapeutic innovation more specifically in the case of cardiovascular and neurodegenerative diseases.
These new therapies could be based on Piezo1 pharmacological modulators. Recently, several modulators have been found.
- Antagonists like peptide GsMTx4 prevent the induction of demyelination, playing therefore a neuroprotective role. This peptide is an inhibitor of Piezo1.
- Agonists like Yoda1 (a synthetic small molecule) enhance channels opening leading to demyelination and damaging the central nervous system. This molecule can activate the Piezo1 channel without mechanical stimulation. However, it can be useful to suppress the migration of transformed cells like fibroblasts.  Jedi2 is another chemical activator of Piezo1, but it doesn’t act on the same site as Yoda1.
- Tubeimoside 1 (TBMS1) is an inhibitor of Yoda1 allowing a decrease of the activity of Piezo 1 channels in endothelial cells. The mechanism is still unclear but according to studies, TBMS1 might be a competitive inhibitor, meaning that it fixes itself on the same binding site as Yoda1 and is specific to Piezo1 channels.
Discovering those modulators allows a better understanding of the mechanisms of Piezo1 channels and highlights its usefulness in the pharmacological field.
 


== Relevance ==
== Relevance ==

Revision as of 13:56, 15 January 2022

Structure of the mechanosensitive Piezo1 channel 1 from PBD

Drag the structure with the mouse to rotate

References