Elucidating the molecular interactions between uremic toxins and the Sudlow II binding site of human serum albumin

Abstract

Protein bound uremic toxins (PBUTs) are known to bind strongly with the primary drug carrying sites of human serum albumin (HSA), Sudlow site I and Sudlow site II. A detailed energetic and structural description of PBUT interactions with these binding sites would provide useful insight into the design of materials that specifically displace and capture PBUTs. In this work, we used molecular dynamics (MD) simulations to study in atomistic detail 4 PBUTs bound in Sudlow site II. Specifically, we used the experimentally resolved X-ray structure of simulated indoxyl sulfate (IS) bound to Sudlow site II (PBD ID: 2BXH) to generate initial binding poses for p-cresyl sulfate (pCS), indole-3-acetic acid (IAA), and hippuric acid (HA). We calculated the interaction energy between toxin and protein in MD simulations and performed mean shift clustering on the collection of molecular structures from MD to identify the primary binding modes of each toxin. We find that all 4 toxins are primarily stabilized by electrostatic interactions between their anionic moiety and the hydrophilic residues in Sudlow site II. We observed transience in the strongest toxin-protein interaction, a charge-pairing with the positively charged R410 residue. We confirm the finding that the primary binding pose of IS in Sudlow site II is stabilized by a hydrogen bond with the carbonyl oxygen of L430, and find that this is also true for IAA. We provide insight into the chemical functional groups that might be incorporated to improve the specificity of synthetic materials for PBUT capture. This work represents a next step toward the de novo design of solutions to the problem of PBUT management in CKD patients. Significance StatementIn spite of their implication in poor clinical outcomes, surprisingly little information is available about the structure and mechanisms that govern the binding of protein bound uremic toxins to their primary carrier human serum albumin. To date, only the structure of indoxyl sulfate has been determined by experiment. This paper describes a comprehensive characterization of four toxins that are known to bind Sudlow site II using molecular dynamics simulations. Based on the experimental structure of indoxyl sulfate bound to HSA, the binding mode within Sudlow site II of three additional PBUTs was determined. The structures, energetic and mechanistic analysis provide substantial new information for the nephrology community about these toxins as well as new protocols to aid future studies of PBUTs.