Component Structures Bring a Closer View of Tripartite Drug Efflux Pumps

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    Threes company: component structures bring a closerview of tripartite drug efflux pumpsJeyanthy Eswaran1, Eva Koronakis1, Matthew K Higgins1,2,

    Colin Hughes

    1

    and Vassilis Koronakis

    1,3

    Bacterial multidrug resistance is a serious clinical problem

    and is commonly conferred by tripartite efflux pumps in the

    prokaryotic cell envelope. Crystal structures of the three

    components of a drug efflux pump have now been solved:

    the outer membrane TolC exit duct in the year 2000, the inner

    membrane AcrB antiporter in 2002 and the periplasmic

    adaptor MexA in 2004. These structures have enhanced our

    understanding of the principles underlying pump assembly

    and operation, and present pumps as new drug targets.

    Addresses1Cambridge University Department of Pathology, Tennis Court Road,

    Cambridge CB2 1QP, UK2Current address: MRC Laboratory of Molecular Biology, Hills Road,

    Cambridge CB2 2QH, UK3e-mail: [email protected]

    Current Opinion in Structural Biology 2004, 14:741747

    This review comes from a themed issue on

    Proteins

    Edited by Wim GJ Hol and Natalie C Strynadka

    0959-440X/$ see front matter

    # 2004 Published by Elsevier Ltd.

    DOI 10.1016/j.sbi.2004.10.003

    Abbreviations

    FAD flavin adenine dinucleotide

    IM inner membrane

    ITC isothermal calorimetry

    MFS major facilitator superfamilyOM outer membrane

    RND resistance nodulation division

    TM transmembrane

    IntroductionGram-negative pathogens such as Escherichia coli and

    Pseudomonas aeruginosa employ membrane efflux systems

    to export antibacterial drugs and other small noxious

    chemicals, as well as large protein toxins, from the cell[13]. This requires translocation across both the inner

    (cell) and outer membranes (IM and OM), and the

    intervening periplasmic space. Multidrug efflux pumps

    comprise three components, each a member of an exten-

    sive protein family [47]. An energy-providing integral

    IM protein, either an ABC transporter or more often a

    proton antiporter of the resistance nodulation division

    (RND) or major facilitator superfamily (MFS) [7], coop-

    erates with a protein of the TolC exit duct family, which

    is anchored in the OM and projects across the periplasm.

    The third essential component of active pumps is an

    adaptor protein, which is largely periplasmic and

    anchored to the IM by a single transmembrane (TM)

    helix or an N-terminal lipid moiety. Pathogenic bacteria

    typically have several tripartite pumps with broad and

    often overlapping substrate specificities; for example, P.

    aeruginosa has at least four distinct major efflux (Mex)

    systems [8], whereas the major efflux pump of E. coli,

    AcrAArcBTolC, determines resistance to antibiotics,

    dyes, detergents, bile salts and organic solvents [9,10].

    The crystal structures of the pump components MexA,

    AcrB and TolC have now been solved. In this review, we

    discuss how the components might assemble into an

    active tripartite drug efflux pump in the bacterial cell

    envelope and how such pumps may operate to expel

    drugs from the cell.

    Structure of the tripartite pump componentsAcrB: an energy-providing, substrate-binding

    component in the inner membrane

    The architecture of the E. coli 1049 amino acid protonantiporter AcrB, a drug efflux transporter of the RND

    family, has been solved at 3.5 A [11,12] (Figure 1).

    AcrB is a trimer with a 50 A long and 100 A diameter TM

    domain comprising 36 a helices (12 from each mono-

    mer). There is minimal contact between monomers in

    the TM domain, forming a chamber thought to be filled

    with lipid. At the core of this domain, TM helices 4 and10 are suggested to form the proton translocation path-

    way, in which residues Asp407, Asp408 and Lys940 are

    possibly central to gating. On the membrane-exposed

    surface of the domain is a vertical groove between

    helices TM7 and TM8, at the base of which is tilted

    helix TM9, perhaps providing access for membrane-located substrates. In the large periplasmic domain,

    the monomers, each 700 amino acids, are tightly inter-

    locked and form a closed central pore. An internal cavity

    open to the periplasm could provide access to periplas-

    mic substrates, allowing RND transporters to act as

    cytosolic membrane and periplasmic vacuum cleaners.

    The top of the periplasmic domain forms a funnel-like

    structure with an internal diameter of30 A, similar to

    the diameter of the modelled open state of the TolC

    entrance, and has been termed the TolC-docking

    domain (Figure 1).

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    TolC: an exit duct for polypeptide and drug substrates

    At 2.1 A resolution, the TolC homotrimer (Figure 1) is

    seen as a tapered cylinder 140 A in length. This comprisesa 40 A long OM b barrel, which anchors a contiguous a-

    helical barrel projecting 100 A across the periplasmic

    space [13,14]. A third domain, a mixed a/b structure,

    forms a strap around the mid-section of the a-helical

    barrel. The average accessible interior diameter of the

    single central TolC pore is 19.8 A. Three TolC monomerseach contribute four b strands to form the twelve-

    stranded b barrel, which is constitutively open to the cell

    exterior. The periplasmic a barrel comprises twelve anti-

    parallel a helices (two continuous long helices and two

    pairs of shorter helices from each monomer) that pack

    laterally side-by-side and form two separate interfaces.

    The helices follow a left-handed superhelical twist that

    tends to be underwound in the upper half compared to

    helices in a conventional two-stranded coiled coil,

    enabling the helices to lie on the surface of a cylinder

    [15]. In the lower half of the a barrel, neighbouring

    helices form six pairs of regular two-stranded coiled coils,

    but one from each monomer folds inwards at the peri-

    plasmic end. This constricts the entrance to establish aresting closed state with an effective diameter of approxi-

    mately 3.9 A; this is reflected in the small conductance of

    TolC in lipid bilayers [16,17].

    MexA: a periplasmic adaptor linking the inner and

    outer membrane componentsThe structure of approximately two-thirds of the 360-

    residue mature MexA protein from P. aeruginosa has been

    solved (the 28 N-terminal and 101 C-terminal residues

    were not ordered in the crystal) [18,19]. The monomer(Figure 1) has an elongated structure of three linearly

    arranged subdomains; a b barrel, a lipoyl domain, and a

    47 A (64-residue) a-helical hairpin comprising a straight

    C-terminal helix and an N-terminal helix with a left-

    handed superhelical twist. The exposed faces of the two

    helices, directly opposite the core of the hairpin, contain

    conserved residues, such as alanine in the f position of the

    742 Proteins

    Figure 1

    Structures of the three drug efflux pump components. The solved AcrB, TolC and MexA structures are shown as ribbon diagrams.

    Protomers of the trimeric AcrB and TolC proteins are coloured blue, red and green, whereas the MexA monomer is coloured by secondary

    structure: a helices red, b strands green and loops blue. The dashed lines in MexA indicate the unsolved structure (28 residues of the N terminus

    and 101 residues of the C terminus); the asterisk indicates the fatty acid modification. A surface representation of the MexA monomer is shownat far right. Small conserved residues in the hairpin domain are coloured light green, whereas the larger hydrogen-bonding residues at either end

    of the a-helical hairpin are coloured dark green.

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    helical heptad, and serine and glutamic acid in the c

    position (Figure 1). At either end of the a-helical hairpin

    lie large hydrophilic residues with the potential to engage

    in hydrogen bonding. Flanking the hairpin are elements

    structurally homologous to the lipoyl domains of pyruvate

    dehydrogenase; their carbonyl chains have a root meansquare deviation (rmsd) of only 1.6 A [20]. Each lipoyl

    domain comprises two interlocking motifs of four b

    strands, but although these are conserved throughout

    the family of adaptor proteins, they are separated by

    variable lengths of intervening sequence, which forms

    the a-helical hairpin [5]. MexA has four heptad repeats

    in each of its helices; other adaptor proteins have five or

    six heptads and will form longer hairpins. The third

    subdomain contains six antiparallel b strands, forming a

    b barrel with a single a helix situated at one entrance tothe barrel. This structural element has been found in

    diverse contexts, such as the FAD-binding domain of

    flavodoxin reductase [21], odorant-binding domains [22],

    isomerase FKBP [23] and the pleckstrin homology (PH)

    domain [24].

    Assembly of the efflux pumpsInteractions between the three components were initially

    established for the closely related type I protein export

    machinery [25]. In vivo chemical cross-linking showed

    that, when the IM transport ATPaseadaptor complex

    is engaged by substrate, it recruits TolC to establish acontiguous structure spanning the envelope. Assembly

    of this tripartite machinery is transient; once the large

    substrate is translocated, the components disengage

    and revert to the resting state [25]. By contrast, the AcrA

    adaptorAcrB antiporterTolC efflux machinery appearsconstitutively assembled (i.e. independent of the drug

    substrate) [26]. This apparent difference between the

    export and efflux systems possibly reflects the require-

    ments imposed by the different substrates. Whereas

    polypeptide export systems translocate substrates of

    1000 amino acids or more, it is estimated that approx-

    imately 500 toxic ethidium molecules are expelled persecond by each P. aeruginosa MexABOprM pump [27].

    Frequent assembly and disassembly of the drug efflux

    pumps might be energetically inappropriate.

    The periplasmic contact between the IM and OM com-

    ponents has been suggested to involve the TolC entrancecoils and the apex of the AcrB antiporter (Figure 1),

    whether restricted to the six hairpins at the tip [11]

    or extending further down the antiporter structure. How-

    ever, although AcrB and TolC can be isolated as a com-plex after in vivo cross-linking, no interaction is seen

    when the two purified proteins are studied by isothermal

    calorimetry (ITC) [26]. By contrast, ITC confirms that

    the AcrA adaptor establishes energetically favourable

    interactions with both AcrB and TolC. This is compatible

    with the view that, although the periplasmic domains of

    AcrB and TolC are in close proximity in vivo, they cannot

    alone form a stable interaction, illustrating the central

    role of the adaptor protein in bridging the integral IM and

    OM components and stabilizing their assembly. The

    elongated modular structure of periplasmic adaptors

    would allow contact with the OM exit duct via their long

    periplasmic hairpin, while using a distinct C-terminaldomain to interact with cognate IM transporter compo-

    nents [26,28].

    Structural model of the assembled pumpThe direct efflux of drugs and other substrates across the

    Gram-negative cell envelope requires assembly of a con-

    tiguous proteinacious structure that allows passage from

    the cell cytosol or membrane to the outside medium,

    without leakage into the periplasmic space. A preliminary

    model of a complete pump must reflect the known

    component structures, interactions and stoichiometries;

    that in Figure 2 illustrates a 870 kDa transenvelope

    Drug efflux pumps Eswaran et al. 743

    Figure 2

    Model of the assembled tripartite drug efflux pump. This possible

    model of an RND class drug efflux pump is based on the open-state

    model of TolC (red) forming a minimal contact interface with the six

    hairpins at the apex of AcrB (green). A ring of nine MexA molecules (blue)

    is modelled to form a sheath around AcrB and the a barrel of TolC

    (MexA is a close homologue of AcrA, the natural partner of AcrB/TolC).

    Variants of the model might include a lower order oligomer of MexA

    [19], and more extensive interaction between AcrB and TolC.

    Models of assembled pumps containing distinct IM transporters, such

    as traffic ATPases or MFS class antiporters, will presumably differ,

    especially as they have smaller periplasmic domains.

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    complex over 270 A long. Although the solved adaptor

    protein structure is that of P. aeruginosa MexA, this

    protein is closely related to AcrA, the adaptor in the

    AcrAAcrBTolC drug efflux pump ofE. coli. The MexA

    structure is therefore included with the AcrB and TolC

    structures to depict a possible model of the completepump assembly.

    TolC and AcrB are clearly trimeric proteins located in the

    OM and IM, respectively, but the oligomeric state of

    the adaptor in active pumps is not known. The adaptor

    is monomeric in solution, and oligomerisation may be

    induced by contact with one or both of the other mem-

    brane components. During assembly of the active efflux

    pump, the hairpins of the adaptor could directly engage

    the inner and/or outer coiled coils of the TolC a-helicalbarrel, compatible with the adaptor assembling into tri-

    mers or hexamers. Cross-linking of in vivo complexes

    using the short-arm chemical cross-linker DSG (disucci-

    nimidyl glutarate) has identified adaptor trimers in both

    the drug efflux and protein export systems [25,29],

    whereas a hexamer has been suggested on the basis of

    the relative cellular abundance of the components [27].

    On the other hand, in the MexA crystal, molecules pack

    side-by-side to form two twisted arcs of six and seven

    monomers (Figure 3) [18,19], with interaction inter-

    faces formed by the stripes of conserved residues that lie

    on the exposed faces of the a-helical hairpins (Figure 1).Based on this propensity of MexA to pack side-by-side, a

    ring formed from nine MexA molecules can be modelled.

    This would have a curvature similar to that observed in

    the crystal packing (Figure 3), and would be sufficiently

    large to form a sheath around the open-state model of

    TolC [13] and so provide a seal against the periplasm.

    This ninefold symmetry might correlate with the nine

    short a helices that are located within the flexible equa-torial domain around the TolC a barrel. Notwithstanding

    these possibilities, the stoichiometry of the adaptor in the

    pumps and details of adaptor interaction with TolC

    remain uncertain. Indeed, conservation of the a-helical

    hairpin among adaptors has encouraged comparison with

    viral membrane fusion proteins [10,30]. The suggested

    mode of action would require that the adaptor spans the

    periplasm, with the N terminus anchored in the IM and

    the C terminus interacting with TolC or the OM. Hairpin

    formation would occur reversibly, with the two long ahelices acting to draw together the IM and OM. However,

    the MexA structure shows that residues 29 and 259 lie

    within 5 A of each other in the b-barrel domain, position-

    ing the C terminus in close proximity to the N terminus,

    not near the OM, and reversible disruption of the three

    stable subdomains of the adaptor seems unlikely.

    Substrate binding and translocationDrug efflux substrates could enter the transenvelope

    efflux conduit via AcrB, from either side of the cytoplas-

    mic membrane or from the periplasm. Soaking AcrB

    crystals with efflux substrates suggested that they bindat different positions in the TM domain [31], although this

    view was not confirmed by similar experiments [32] and

    analysis of hybrid transporters indicates that the antiporter

    periplasmic domain plays a major role in substrate speci-

    ficity [33,34]. In the protein export system, the largesubstrate is not only engaged by the IM traffic ATPase,

    but also contacts the short cytoplasmic domain of the

    adaptor [35]. A signal must be transduced to triggerrecruit-

    mentand openingof TolC. In the constitutively assembled

    drug efflux pumps, it is specifically the TolC opening step

    that wouldneedto be substrate responsive. Howthismight

    be coordinated with opening of the AcrB pore domain isone of manyopen questions. As AcrB-type antiporters have

    a cavity that appears to communicate with the periplasm

    via the vestibules [12], it is unclear how drugs are pre-

    vented from escaping back into the periplasm.

    Once past the AcrBTolC junction, substrates encounterthe electronegative interior surface of TolC [13,14],

    which may have implications for transport. A pulse of

    cations (protons) early in transport might favour the

    entry of acidic and hydrophobic substrates into the chan-nel, whereas later it might catalyse the release of basic

    molecules.

    Twist to open access to TolC byrealignment of entrance helicesAccess through the TolC periplasmic entrance is a key

    event in the function of export and efflux machineries.

    744 Proteins

    Figure 3

    Comparison of oligomeric MexA and trimeric TolC. The oligomeric

    crystal packing of MexA, with seven monomers forming a twisted

    spiral-arc (top), is compared to the diameter of trimeric TolC

    (bottom), both shown in top view.

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    A proposed allosteric mechanism for entrance opening is

    based on the small differences in superhelical twist

    between the inner and outer coiled coils, suggesting that

    opening occurs by inducing realignment ofthe inner coils

    with respect to the outer coils (Figure 4) [13]. Experi-

    mental disruption of three intermolecular and intramo-

    lecular links that constrain the three inner coils in the

    closed conformation allows enlargement of the aperture

    diameter, as seen by increased conductivity of theseengineered TolC variants in planar lipid bilayers [36].

    Furthermore, when movement of these helices is con-

    strained by introducing disulfide bonds, translocation of

    polypeptide substrate is abolished [37], further support-

    ing a model in which transition to the TolC open stateis achieved by an iris-like realignment of the entrance

    helices. Electrophysiology shows that the open state may

    be unstable [36]; if so, it might be stabilized by repacking

    the disrupted open-state TolC helices to those of the

    adaptor or by interaction with the antiporter. It remains

    possible that opening to a large aperture is required only

    for the transport of high molecular weight polypeptidesubstrates.

    Perspective efflux pumps as targets inmultidrug-resistant bacteria?The combined biochemical and structural data have

    provided a closer vision of the assembly and operationof the large efflux machines spanning the Gram-negative

    cell envelope. Further studies will pursue details of the

    underlying dynamics (e.g. key coiled-coil interactions and

    channel gating) and visualization of the entire tripartitestructure. Such knowledge will also facilitate the design

    of potential antibacterial agents for the treatment of

    multidrug-resistant infections. Pump function could be

    inhibited at several points, including drug-binding sites in

    the IM transporter AcrB, the component interactions

    underlying assembly and the energy cycle of the IM

    transporter. An obvious target is the periplasmic entrance

    of TolC. This is the sole constriction of the exit duct and

    is lined by an electronegative ring of six aspartate resi-

    dues, Asp371 and Asp374 from each monomer, which

    determine a high-affinity metal-binding site [38,39].

    TolC function in artificial lipid bilayers is severely inhib-

    ited by divalent cations, and trivalent cations such as Cr3+,

    Tb3+ and hexammine cobalt block the TM ion flux at

    nanomolar concentrations. When the entrance aspartates

    are substituted, high-affinity binding is abolished andblocking of the membrane pore is alleviated [38,39]. A

    crystal structure of the TolCCo(NH3)63+ complex (Fig-

    ure 4) confirms a ligand molecule bound at this site [39].

    This first biochemical and structural characterisation of

    an in vitro inhibitor of TolC may suggest a strategy todevelop bioactive molecules, especially as the electro-

    negative entrance is widely conserved throughout pumps

    central to virulence and drug resistance.

    AcknowledgementsOur work is supported by the Medical Research Council andWellcome Trust.

    References and recommended readingPapers of particular interest, published within the annual period ofreview, have been highlighted as:

    of special interest of outstanding interest

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    Figure 4

    States of the TolC periplasmic entrance (all viewed from the periplasm). Space-filled depictions of the closed and modelled open states of TolC,

    and a ribbon representation of the Co(NH3)63+-blocked a-barrel entrance, with the bound ligand in the centre coloured red. Pictured far

    right is the ligand coordinated by Asp374 sidechains.

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    The structure of the third essential component of tripartite drug effluxpumps, the adaptor protein, postulated to bridge the IM and OM pumpsubunits. A possible oligomeric structure is presented, derived fromthe observed packing in the crystal. The adaptor protein MexA fromP. aeruginosa is closely related to AcrA of E. coli and its structure istherefore included in this review to depict a possible model of thecomplete pump assembly.

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    This determination of the MexA crystal structure con firms the unusualcrystal packing of 13 monomers in a spiral-shaped double cylinder [18].Two alternative options for assembly in the complete drug pump arepresented: onea wrap-around version of theadaptor oligomer,as seen inthe crystal spiral-arc, the other suggesting that three dimers of MexAinteract with theperiplasmichelices of theOprM exit duct, thestructure ofwhich is modelled from that of TolC.

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    The first demonstration, byin vivo cross-linking, that the E. colidrug effluxproteins AcrA, AcrB and TolC assemble into a tripartite complex in vivo,similar to the previously reported TolCHlyBHlyD protein export system[25]. AcrAAcrBTolC assembly appeared constitutive rather than rever-sible. Underlying bilateral contacts of component proteins were analysedby in vivo cross-linking and their interaction characteristics analysed byITC. This revealed limitations of cross-linking analyses and indicated

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    32. Pos KM, Schiefner A, Seeger MA, Diederichs K: Crystallographicanalysis of AcrB. FEBS Lett 2004, 564:333-339.

    33. Middlemiss JK, Poole K: Differential impact of MexB mutationson substrate selectivity of the MexAB-OprM multidrugefflux pump of Pseudomonas aeruginosa. J Bacteriol 2004,186:1258-1269.

    34. Mao W, Warren MS, Black DS, Satou T, Murata T, Nishino T,Gotoh N, Lomovskaya O: On the mechanism of substratespecificity by resistance nodulation division (RND)-type

    746 Proteins

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    multidrug resistance pumps: the large periplasmic loops ofMexD from Pseudomonas aeruginosa are involved insubstrate recognition. Mol Microbiol 2002, 46:889-901.

    35. Balakrishnan L, Hughes C, Koronakis V: Substrate-triggeredrecruitment of the TolC channel-tunnel during type I export ofhemolysin by Escherichia coli. J Mol Biol 2001, 313:501-510.

    36. Andersen C, Koronakis E, Bokma E, Eswaran J, Humphreys D,Hughes C, Koronakis V: Transition to the open state of the TolCperiplasmic tunnel entrance. Proc Natl Acad Sci USA 2002,99:11103-11108.

    37. Eswaran J, Hughes C, Koronakis V: Locking TolC entrancehelices to prevent protein translocation by the bacterial type Iexport apparatus. J Mol Biol 2003, 327:309-315.

    38.

    Andersen C, Koronakis E, Hughes C, Koronakis V: An aspartatering at the TolC tunnel entrance determines ion selectivity andpresents a target for blocking by large cations. Mol Microbiol2002, 44:1131-1139.

    This study used protein reconstituted in black lipid bilayers to identify ahigh-affinity metal-binding site located at the TolC entrance constriction.The site is determined by six aspartate residues that form a highlyelectronegative gate. A series of divalent and trivalent cations were

    shown to bind with nanomolar affinities and, in one case, cause irrever-sible blocking of the TM pore.

    39. Higgins M, Eswaran J, Edwards P, Schertler G, Hughes C,Koronakis V: Structure of the ligand-blocked periplasmicentrance of the bacterial multidrug efflux protein TolC.J Mol Biol 2004, 342:697-702.

    Drug efflux pumps Eswaran et al. 747

    ScienceDirect collection reaches six million full-text articles

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