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7/28/2019 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,
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The three-dimensional structure of the RND class proton antiporter AcrB,the integral IM component of the major E. coli drug efflux system,indicates a possible proton translocation pathway through the membraneand allows speculation on how substrates gain access to the effluxmachinery. The trimeric AcrB structure is used in this review to presenta preliminary model of the assembled drug pump.
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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
Elsevier recently announced that six million articles are now available on its premier electronic
platform, ScienceDirect. This milestone in electronic scientific, technical and medical publishingmeans that researchers around the globe will be able to access an unsurpassed volume ofinformation from the convenience of their desktop.
ScienceDirects extensive and unique full-text collection covers over 1900 journals, including titlessuch as The Lancet, Cell, Tetrahedron and the full suite of Trends and Current Opinion journals.With ScienceDirect, the research process is enhanced with unsurpassed searching and linking
functionality, all on a single, intuitive interface.
The rapid growth of the ScienceDirect collection is due to the integration of several prestigiouspublications as well as ongoing addition to the Backfiles heritage collections in a number ofdisciplines. The latest step in this ambitious project to digitize all of Elseviers journals back to
volume one, issue one, is the addition of the highly cited Cell Press journal collection onScienceDirect. Also available online for the first time are six Cell titles long-awaited Backfiles,
containing more than 12,000 articles highlighting important historic developments in the field oflife sciences.
The six-millionth article loaded onto ScienceDirect entitled Gene Switching and the Stability ofOdorant Receptor Gene Choice was authored by Benjamin M. Shykind and colleagues from theDept. of Biochemistry and Molecular Biophysics and Howard Hughes Medical Institute, College of
Physicians and Surgeons at Columbia University. The article appears in the 11 June issue ofElseviers leading journal Cell, Volume 117, Issue 6, pages 801-815.
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www.sciencedirect.com Current Opinion in Structural Biology 2004, 14:741747