Structure of CFTR bound to (R)-BPO-27 unveils a pore-blockage mechanism

Abstract Hyperactivation of the cystic fibrosis transmembrane conductance regulator (CFTR) contributes to secretory diarrhea, a major cause of pediatric mortality worldwide, and autosomal dominant polycystic kidney disease (ADPKD), the most common inherited cause of end-stage renal disease. Selectiv...

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Main Authors: Paul G. Young, Karol Fiedorczuk, Jue Chen
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-62199-7
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author Paul G. Young
Karol Fiedorczuk
Jue Chen
author_facet Paul G. Young
Karol Fiedorczuk
Jue Chen
author_sort Paul G. Young
collection DOAJ
description Abstract Hyperactivation of the cystic fibrosis transmembrane conductance regulator (CFTR) contributes to secretory diarrhea, a major cause of pediatric mortality worldwide, and autosomal dominant polycystic kidney disease (ADPKD), the most common inherited cause of end-stage renal disease. Selective CFTR inhibition is a potential therapeutic strategy, with (R)-BPO-27 emerging as a promising candidate. Here, we present a cryo-EM structure of CFTR bound to (R)-BPO-27 at an overall resolution of 2.1 Å. Contrary to the previous hypothesis that it inhibits CFTR current by competition with ATP, we demonstrate that (R)-BPO-27 instead directly occludes the chloride-conducting pore while permitting ATP hydrolysis, thus uncoupling the two activities. Furthermore, we find that inhibitor binding requires some degree of NBD separation, as the inhibition rate inversely correlates with the probability NBD dimerization. These findings clarify the compound’s mechanism and provide a molecular basis for optimizing its clinical potential.
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spelling doaj-art-d8c237cf45f74a51b85aa65c3fc1f3342025-08-20T03:46:15ZengNature PortfolioNature Communications2041-17232025-08-011611910.1038/s41467-025-62199-7Structure of CFTR bound to (R)-BPO-27 unveils a pore-blockage mechanismPaul G. Young0Karol Fiedorczuk1Jue Chen2Laboratory of Membrane Biology and Biophysics, The Rockefeller UniversityLaboratory of Membrane Biology and Biophysics, The Rockefeller UniversityLaboratory of Membrane Biology and Biophysics, The Rockefeller UniversityAbstract Hyperactivation of the cystic fibrosis transmembrane conductance regulator (CFTR) contributes to secretory diarrhea, a major cause of pediatric mortality worldwide, and autosomal dominant polycystic kidney disease (ADPKD), the most common inherited cause of end-stage renal disease. Selective CFTR inhibition is a potential therapeutic strategy, with (R)-BPO-27 emerging as a promising candidate. Here, we present a cryo-EM structure of CFTR bound to (R)-BPO-27 at an overall resolution of 2.1 Å. Contrary to the previous hypothesis that it inhibits CFTR current by competition with ATP, we demonstrate that (R)-BPO-27 instead directly occludes the chloride-conducting pore while permitting ATP hydrolysis, thus uncoupling the two activities. Furthermore, we find that inhibitor binding requires some degree of NBD separation, as the inhibition rate inversely correlates with the probability NBD dimerization. These findings clarify the compound’s mechanism and provide a molecular basis for optimizing its clinical potential.https://doi.org/10.1038/s41467-025-62199-7
spellingShingle Paul G. Young
Karol Fiedorczuk
Jue Chen
Structure of CFTR bound to (R)-BPO-27 unveils a pore-blockage mechanism
Nature Communications
title Structure of CFTR bound to (R)-BPO-27 unveils a pore-blockage mechanism
title_full Structure of CFTR bound to (R)-BPO-27 unveils a pore-blockage mechanism
title_fullStr Structure of CFTR bound to (R)-BPO-27 unveils a pore-blockage mechanism
title_full_unstemmed Structure of CFTR bound to (R)-BPO-27 unveils a pore-blockage mechanism
title_short Structure of CFTR bound to (R)-BPO-27 unveils a pore-blockage mechanism
title_sort structure of cftr bound to r bpo 27 unveils a pore blockage mechanism
url https://doi.org/10.1038/s41467-025-62199-7
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