β-2 microglobulin (β2m) is the protein responsible for amyloid deposition in Dialysis-Related Amyloidosis (DRA). Aggregation can be induced by various solution conditions including exposure to divalent metal, incubation at acidic pH, and limited proteolysis. Using Cu 2+ as a trigger, we have trapped, isolated, and crystallized a stable oligomer of β2m that is populated under amyloidogenic solution conditions (Calabrese et al. Nat Struct Mol Biol 2008; 15:965-71). This structure reveals that Cu 2+ -binding is associated with dramatic conformational rearrangements. This has allowed us to postulate a set of structural changes common to all β2m aggregation pathways. Cu 2+ serves as a potential trigger in other aggregation systems such as Aβ, α-synuclein, and mammalian Prion (PrP). A comparison of Cu 2+ binding to β2m and PrP reveals common features. Therefore, in addition to providing insight into DRA, induction of structure by Cu 2+ binding appears to be a recurring structural motif for pathological changes in conformation.
Backgroundβ2m is the 99 residue, 12 kDa non-covalent light chain of the Class I Major Histocompatibility Complex (MHC). Its function is to ensure proper folding and cell-surface expression of the MHC. 1 In the course of normal turnover, β2m is released to the serum and catabolized by the kidneys. In patients suffering from endstage renal disease who are treated with hemodialysis therapy, β2m levels rise and amyloid plaques develop throughout the joints and connective tissue. 2 Although an elevated serum level of β2m may be necessary for aggregation, it is not sufficient as β2m remains stably folded at > 1 mM concentration at 37 °C. 3,4 Furthermore, it can be reversibly folded in vitro 5-7 and amyloid is not reported in other diseases with elevated levels in serum. 8,9 Therefore, aggregation must be triggered by features unique to hemodialysis therapy.As β2m exists as a stable monomer under near physiological conditions, 3,10 much effort has been focused on understanding the molecular mechanism by which self association is triggered. Many approaches have been used to induce β2m aggregation. These include limited proteolysis, 11 incubation at acidic pH, 12 and exposure to detergents or organic solvents. 13,14 In 2001, we discovered that β2m is a Cu 2+ -binding protein. 4 Whereas β2m apo is not amyloidogenic, β2m holo is aggregation-prone.
Cu 2+ Mediated OligomerizationWe are interested in Cu 2+ -dependent aggregation of β2m for several reasons. First, hemodialysis patients may be exposed to elevated levels of divalent cation as a consequence of therapy. This is apparent in the historical use of Cu 2+ in the preparation of dialysis membranes, and in water quality standards which permit as much as 1.6 μM Cu 2+ in hemodialysate. 15 This is comparable to the ~3 μM affinity of β2m measured in vitro. 4 Second, early experiments revealed that although Cu 2+ is necessary to initiate aggregation, mature fibers remain stable in the presence of a metal chelate. 10 This allowed the possibility that Cu 2+ acti...