HLA-DM is required for efficient peptide exchange on class II MHC molecules, but its mechanism of action is controversial. We trapped an intermediate state of class II MHC HLA-DR1 by substitution of αF54, resulting in a protein with increased HLA-DM binding affinity, weakened MHC-peptide hydrogen bonding as measured by hydrogen-deuterium exchange mass spectrometry, and increased susceptibility to DM-mediated peptide exchange. Structural analysis revealed a set of concerted conformational alterations at the N-terminal end of the peptide-binding site. These results suggest that interaction with HLA-DM is driven by a conformational change of the MHC II protein in the region of the α-subunit 3 10 helix and adjacent extended strand region, and provide a model for the mechanism of DM-mediated peptide exchange.antigen presentation | antigen processing | major histocompatibility proteins | chaperone | protein folding H LA-DM (DM) facilitates peptide exchange on class II MHC (MHC II) proteins, and is required for efficient peptide loading in vivo (1). MHC II molecules assemble in the endoplasmic reticulum with the class II-associated invariant chain chaperone, which is subsequently cleaved by endosomal proteases leaving a short fragment known as CLIP bound in the MHC peptidebinding groove (2). DM facilitates the exchange of CLIP for peptides generated by digestion of endogenous and exogenous proteins, resulting in a library of peptide antigens bound to MHC II proteins that are transported to the cell surface (3, 4). In vitro experiments have corroborated the roles for DM as a peptideexchange factor (5, 6) and as a molecular chaperone that prevents peptide-free MHC II molecules from becoming inactive and from forming aggregates (7,8).The mechanism by which DM mediates these effects has received much attention (7-17). Peptides are released by DM with different rates (18), with DM susceptibility a major factor in whether or not a particular peptide is recognized by the cellular immune system (19-21). Understanding the mechanism of DMmediated peptide release would promote efforts to predict immunogenicity of known and emerging pathogens. Moreover, the mechanism involves catalysis of a protein conformational change (16), and its elucidation would have implications for our understanding of protein-folding processes. However, despite intensive investigation and crystal structures of both MHC II and DM proteins, the mechanism of DM-facilitated MHC-peptide binding and exchange is not understood. Part of the difficulty in developing an understanding of the interaction of DM and MHC II may be because of the presence of multiple conformers of DM (22), as well as MHC II (10, 23). Previous studies using directed screens (11,14) and tethering approaches (24, 25) have identified residues from both DM and MHC II that are critical for the functional interaction. These residues include a cluster of acidic residues on DM (14) and several residues in the vicinity of the P1 pocket of MHC II (9,11,15). Models for the DM-MHC II complex that pla...