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THE THEODOR BU
¨
CHER LECTURE
Molecular basisofcytokinesignalling–theme and
variations
Delivered on 8 July 2009 at the 34th FEBS Congress in Prague
Walter Sebald
1
, Joachim Nickel
1
, Jin-Li Zhang
2
and Thomas D. Mueller
3
1 Department of Physiological Chemistry II, Theodor-Boveri Institute for Life Sciences (Biocenter), University of Wuerzburg, Germany
2 Institute for Developmental Biology, University of Cologne, Germany
3 Department ofMolecular Plant Physiology and Biophysics, Julius-von-Sachs Institute, University of Wuerzburg, Germany
Introduction
In 1968 I attended the FEBS meeting in Prague as
Doktorand. I have lasting memories of the opening
ceremony in the opera house, which was initiated by
the fanfare of Janacek’s Sinfonietta. This is one of the
reasons why when I think of Prague I also think of
music. In the late 1960s, Theodor Bu
¨
cher gave a well-
Keywords
bone morphogenetic proteins (BMP); drug
development; interleukins; molecular
recognition; receptor oligomers
Correspondence
W. Sebald, Department of Physiological
Chemistry II, Theodor-Boveri Institute for
Life Sciences (Biocenter), University of
Wuerzburg, Am Hubland, 97074 Wuerzburg,
Germany
Fax: +49 931 8884113
Tel: +49 931 3188322
E-mail: sebald@biozentrum.uni-wuerzburg.de
(Received 27 July 2009, revised
28 September 2009, accepted 4 November
2009)
doi:10.1111/j.1742-4658.2009.07480.x
Cytokine receptors are crucial for the maintenance, regulation and growth
of cells in multicellular organisms. As a common theme in cytokine signal-
ling, single-span receptor chains are assembled in the cell membrane by a
ligand enabling cross-activation of the aligned cytoplasmic receptor
domains. Nature has created many variationsof how this general principle is
realized in a cell. Here we focus on cytokines of the four-helix bundle (inter-
leukins) and cystine knot (transforming growth factor-b ⁄ bone morphoge-
netic proteins) families. Upon activation, receptor chains can form duos,
trios, quartets and even larger assemblies. The structure of the extracellular
ligand-binding domain of a number of these receptor complexes has now
been elucidated, providing the molecularbasis for understanding the func-
tional relevance of mechanistic diversity in a cellular context. Biochemical
and structural data have revealed ligand recognition mechanisms. Contact
sites are usually large and rather flat. A limited number of contact residues
provide most of the binding free energy (hot spots). Leaks in hydrophobic
seals appear to provide a mechanism for adjusting the affinity of a hot spot
interaction (scalability). Bone morphogenetic protein ligands are often pro-
miscuous and interact not only with receptors, but also with a multitude of
modulator proteins, which inhibit or enhance bone morphogenetic protein
signalling. Cytokine receptor systems offer promising targets for drug devel-
opment. Information on the structure and the activation mechanism
provides leads for developing biologicals, such as engineered cytokines, cyto-
kine mutants acting as receptor antagonists and receptor extracellular ligand-
binding domain–Fc fusion proteins. Possible indications exist in the areas of
haematology, immunology, inflammation, cancer and tissue regeneration.
Abbreviations
BMP, bone morphogenetic proteins; CV-2, crossveinless-2; GDF, growth and differentiation factor; IL, interleukin; SMAD, homologs to the
protein from Caenorhabditis elegans SMA and Drosophila mothers against decplentaplegic; STAT, signal transducers and activators of
transcription; TGF, transforming growth factor; VWC, Von Willebrand factor type C; cc, common c chain.
106 FEBS Journal 277 (2010) 106–118 ª 2009 The Authors Journal compilation ª 2009 FEBS
received traditional Christmas lecture for the medical
students about the storage and realization of genetic
information. As a sounding illustration of this topic,
one of the Brandenburg Concertos was played and in
parallel the single pages of the partitur, the musical
score, were projected; I had to change the slides in har-
mony with the music. So this is one of the reasons
why when I think of Theodor Bu
¨
cher I also think of
music. Another reason, of course, is his close associa-
tion with the Munich Bach-Chor, which has been
catalysed by Ingrid Bu
¨
cher, who I would like to thank
for attending the Theodor Bu
¨
cher Lecture at the 34
th
FEBS Congress.
The present Theodor Bu
¨
cher Lecture on the mole-
cular basisofcytokine receptor signalling–theme and
variations – has three movements, like a sonata. First,
we will look at the basic mechanism and the many
variations realized in diverse receptor systems. Second,
we will discuss molecular recognition in these recep-
tors; this means the structural basis for affinity and
specificity. And, third, we will see how the accumu-
lated data on structure and mechanism aid in the
development of drugs.
Basic mechanism – receptor
oligomerization
For a long time it was a mystery how single-span
membrane proteins, like cytokine receptors, can signal
into a cell. These receptors have an extracellular bind-
ing domain, which is connected to a cytosolic domain
by only a short peptide segment probably folded in the
membrane as a single a-helix. It is difficult to conceive
how such a segment can transduce a signal from the
outside to the inside of a cell. How, therefore, can an
extracellular signal initiated by ligand binding be prop-
agated across the membrane?
It is clear now that single-span receptor chains
cannot signal a lo ne. They func tion as oligomers. Binding
of the ligand leads to an oligomeric state of the extra-
cellular domains, which is transmitted to the cytosolic
domains inside the cell. This general theme ‘signalling
by oligomerization’ has been the ‘Leitmotiv’ of recep-
tor research for many years. It was called ‘horizontal
signalling’ in a 2004 review by Stroud & Wells [1] to
set it apart from the ‘vertical signalling’ of multi-span
membrane receptors, such as G-protein coupled recep-
tors, which employ a transmembrane conformational
change (Fig. 1). In the most simplistic model, the
receptor chains diffuse freely in the membrane and are
bound together – oligomerized – in the presence of the
ligand. Recently, evidence has accumulated that some
single-span receptor chains can form complexes by
themselves, so-called preformed complexes, which are
inactive without a ligand [2–4]. Here, ligand binding
probably initiates a conformational change, which is
transmitted across the membrane. On the other hand,
some G-protein coupled receptors have been found to
oligomerize during signalling [5]. Thus, it seems that
there exist a variety of intermediate receptor states
between pure ‘horizontal’ and pure ‘vertical’ signalling.
This simple and elegant horizontal signalling mecha-
nism integrating the membrane as the organizing prin-
ciple was very successful during the evolution of
multicellular organisms. It is therefore not surprising
that the signalling receptor oligomers vary consider-
ably, differing in stoichiometry and topology. An olig-
omerization mechanism was postulated for the first
time by Schlessinger [6] for the epidermal growth
factor receptor. Here, the formation of homodimeric
receptors is triggered by the binding of two ligands.
However, Cunningham et al. [7] showed that a homod-
imeric growth hormone receptor is formed by binding
to a single ligand. Another renowned example for a
1 : 2 stoichiometry is the receptor for erythropoietin
[8]. In the growth hormone receptor, the two receptor
chains differ; they are bound to different ligand epi-
topes in a high- and a low-affinity mode. It is therefore
not unexpected that heterodimeric oligomers exist,
where two different receptor chains are bound by one
ligand, as in the interleukin-4 (IL-4) receptor [9,10].
This division of labour between different chains opens
AB
Fig. 1. Horizontal versus vertical receptor signalling [1]. Signalling
across membranes requires either a conformational change in a
receptor or a change in the oligomerization state of the receptor.
(A) Single-span transmembrane receptors are examples of so-called
horizontal signalling. Upon ligand binding to one receptor subunit a
binary complex intermediate is formed, in the subsequent step a
second (or further) receptor subunit is recruited into the complex,
leading to the activation of the cytoplasmic receptor parts, e.g. by
transphosphorylation of inherent or receptor-associated kinases. (B)
Vertical receptor signalling is initiated in a single receptor (or pre-
formed oligomer) by transducing a ligand-induced conformational
change from the extracellular to the intracellular side.
W. Sebald et al. Molecularbasisofcytokine signalling
FEBS Journal 277 (2010) 106–118 ª 2009 The Authors Journal compilation ª 2009 FEBS 107
up a whole range of new possibilities for cellular sig-
nalling. Even more complex oligomers are assembled
by dimeric ligands, such as the bone morphogenetic
proteins (BMPs) and other members of the transform-
ing growth factor-b (TGF-b) superfamily. Here, twice
heterodimeric receptors are assembled by the dimeric
ligand [11,12]. This can lead to avidity effects, where
ligand affinity is increased by binding simultaneously
to two receptor chains. The formation of heterodimeric
ligands and ⁄ or multiple receptor chains might allow
specific signalling modes, for instance during develop-
ment.
Receptor structures
Here we will discuss a few receptor structures, and
focus on the extracellular domains only, in particular
on the binding domains for the ligand. Although the
first structures were elucidated in the early 1990s, the
more complex ones have only recently been described.
The homodimeric complex of the growth hormone
receptor represents the prototype and the reference
structure for many other systems [13]. The growth hor-
mone ligand consists of a helix bundle. Site 1 consti-
tutes a high-affinity epitope and site 2 a low-affinity
epitope. Both bind the same receptor species. It is
unclear why this polarization into high- and low-affin-
ity sites originated. However, as a consequence, the
oligomerization is often considered an ordered sequen-
tial process (Fig. 2). Step 1 is the binding of the solute
ligand at the high-affinity site and in step 2 the second
chain is recruited in the membrane to form the signal-
ling oligomer. The cytosolic parts of the homodimer
carry tyrosine kinases, which transphosphorylate and
thus activate the twin chain. This creates docking sites
for signal transducers and activators of transcription
(STAT) proteins, which initiate and propagate the
signal within the cell. For the intracellular part, the
homodimer is symmetrical. Each chain can function as
a trigger, which transactivates, or as a driver, which
initiates intracellular signalling.
This symmetry is broken in the heterodimeric recep-
tors, as shown in Fig. 2 for the IL-4 receptor [14–16].
One chain, called the common c chain (cc), is the
trigger, which can only transactivate. The other chain,
IL-4Ra, is the driver, which can only initiate the intra-
cellular signal. The division of labour is indicated by
the cytosolic domains. The trigger, cc, contains only a
binding site for the tyrosine kinase Janus kinase 3
(JAK3), which transactivates. The driver, IL-4Ra,
contains a large cytosolic domain with binding motifs
for Janus kinase 1 (JAK1), the intracellular signalling
protein STAT6, the insulin-receptor-substrate 2, and
others. Again there exist a high-affinity chain, IL-4Ra,
B
A
Fig. 2. A two-step sequential binding mech-
anism allows for a simple design of antago-
nists [9]. Signal transduction of single
transmembrane receptors, e.g. cytokine
receptors, often follows a sequential binding
mechanism. (A) In the first step, the ligand
binds to its high-affinity receptor subunit
forming an intermediate binary complex. In
the second step, the low-affinity receptor
subunit is recruited into a ternary complex
(higher oligomeric states are also possible),
leading to intracellular receptor activation
(indicated by the star). (B) A mutated vari-
ant, which is not capable of binding to the
second receptor subunit but with unaltered
binding to its first receptor subunit, will still
form the binary complex, but cannot pro-
ceed to the second step and thus is unable
to activate the receptor [58,59,61,67]. This
antagonist is most efficient in blocking
receptor activation if binding affinity to the
second receptor subunit does not contribute
significantly to the overall ligand–receptor
binding affinity.
Molecular basisofcytokinesignalling W. Sebald et al.
108 FEBS Journal 277 (2010) 106–118 ª 2009 The Authors Journal compilation ª 2009 FEBS
and a low-affinity chain, cc. Therefore, the assembly
of the signalling receptor heterodimer proceeds in two
steps: First, solute IL-4 binds to IL-4Ra. The solute
IL-4 is concentrated 100- to 1000-fold at the membrane
surface. This concentration effect and also probably the
two-dimensional diffusion in the membrane, facilitate
the following recruitment of cc. The assembly of the
ternary IL-4 receptor complex can be simulated at a
biosensor surface [17]. The solute IL-4 at 1–10 nm
concentrations associates rapidly with the immobilized
IL-4Ra chain. Buffer alone results in a very slow
dissociation with a half-life of 5 min. When the
immobilized IL-4Ra has been first saturated with the
IL-4 ligand, more and more of the ternary complex can
be formed after the addition of increasing concentra-
tions of cc. Dissociation of cc is fast and its affinity to
IL-4 corresponds to a dissociation constant (K
D
)of
3 lm. This is more than 10 000-fold lower than the
affinity for IL-4Ra.
The IL-4Ra chain is shared by three receptor–ligand
complexes: two IL-4 receptors containing either ccor
IL-13Ra1 as a second chain, and one IL-13 receptor
containing IL-13Ra1 [18]. As a consequence, genetic
or pharmacological inactivation of the shared IL-4Ra
will abolish not only IL-4, but also IL-13 signalling.
This will be discussed further below. The cc family is
larger, with cc being shared by at least five receptors,
including the IL-2 receptor [14].
The receptor for IL-2 exists in two forms. A medium-
affinity heterodimeric receptor exists in natural killer
cells. Its architecture corresponds to the IL-4 receptor.
The driver is IL-2Rb, and cc again functions as the
trigger. A second high-affinity IL-2 receptor exists in
activated T-lymphocytes. It also contains the coreceptor
IL-2Ra, also called Tac [19]. This coreceptor enhances
affinity specifically for IL-2. In other cells, a different
coreceptor, IL-15Ra, co-operates with the same hetero-
dimer to provide enhanced affinity for IL-15. The struc-
ture of the tetrameric high-affinity IL-2 receptor shows
that the coreceptor IL-2Ra interacts only with the IL-2
ligand. It has no contacts with the other two chains.
This is a telling example of the importance of concen-
trating the ligand at the surface of the membrane. A
soluble IL-2Ra without membrane anchor functions as
an inhibitor of IL-2 signalling.
Finally, as a further variation of horizontal signalling
we will discuss the hexameric BMP receptors (Fig. 3).
These complexes are not true hexamers, as the BMP
ligand is a disulfide-bonded homodimer [11,12]. The
dimeric ligand assembles a heterodimeric receptor at
each end. The extracellular domains are small and
linked to the membrane-spanning segment by a short
peptide segment. This places the binding domains close
to the membrane. The binding domains of the receptor
chains have no contact with each other. They are bound
together solely by the BMP ligand. The BMP receptors
are set apart from the cytokine receptors described
above by employing a serine ⁄ threonine kinase (and not
tyrosine kinases) in their cytoplasmic domains and
homologs to the protein from Caenorhabditis elegans
SMA and Drosophila mothers against decplentaplegic
(SMAD) proteins (and not STAT proteins) as intracel-
lular signalling proteins. However, BMP receptors obey
the general rule that one chain (type II) is the transacti-
vating trigger and the other chain (type I) is the driver
activating the SMAD proteins by phosphorylation [20].
Several proteins have been identified that qualify as
A
B
Fig. 3. The ternary complex of BMP-2 ⁄ BMPR-IA ⁄ Act-RIIB forms a
heterohexameric complex. (A) A side view of the ternary complex
of BMP-2 (UniProtKB P12643; the BMP-2 dimer is indicated in blue
and yellow) bound to the extracellular domains of its type I receptor
BMPR-IA (UniProtKB P36894; green) and its type II receptor ActR-
IIB (UniProtKB Q13705; red). The membrane surface is indicated
by yellow spheres. The membrane-proximal C-termini of the recep-
tor ectodomains were missing in the crystal structure of the ternary
complex (PDB entry 2H64 [11]) and were therefore not modelled.
(B) A top view of (A) showing the two-fold symmetry of the ligand–
receptor complex imposed by the symmetrical ligand homodimer.
W. Sebald et al. Molecularbasisofcytokine signalling
FEBS Journal 277 (2010) 106–118 ª 2009 The Authors Journal compilation ª 2009 FEBS 109
coreceptors. For instance, repulsive guidance molecule
proteins determine affinity and specificity for certain
members of the BMP family [21], or b-glycan functions
as a coreceptor for TGF-b2, which belongs to the same
family as the BMPs [22,23]. However, no structures
comprising such coreceptors have been determined and
therefore we do not know in molecular detail how they
function. The binding of two trigger and two driver
chains to a dimeric ligand has profound consequences
for BMP signalling. Multiple interactions of the ligand
with membrane receptor chains provide new opportuni-
ties for a cell to determine and tune receptor affinity
and, therefore, specificity. Combinatorial assemblies of
heterodimeric BMPs and mixed receptor chains are
possible [24].
Molecular recognition
The structures of the complexes provide a wealth of
information on the mechanism ofcytokine receptor
signalling. As Theodor Bu
¨
cher put it: ‘Function is
structure in action’. Of particular importance is the
structural definition of the interfaces between a cyto-
kine and a receptor. In principle, these contact sites,
called structural epitopes, carry all the determinants
for the molecular recognition among these proteins,
i.e. for the affinity and the specificity of their interac-
tion. However, it is still a big challenge to understand
or even to predict how these structural epitopes create
binding free energy during association. One problem is
that these epitopes are large and flat [25]. They have
sizes between 800 and 1500 A
˚
2
and comprise 20–25
residues. This is similar to the interfaces of antibody–
antigen complexes. Often there exist no obvious knobs
or holes that could suggest geometric complementarity
and therefore binding.
It was an influential new concept that contact residues
are not of equal importance for binding. Clackson &
Wells [26] performed a mutational analysis of growth
hormone and receptor and could demonstrate that a few
contact residues contribute the major part of the binding
free energy. They coined the term ‘hot spots’, which is
now regularly used in the field. The functional binding
epitope defined by alanine mutations is smaller than the
structural epitope defined by the residues buried in
the contact. In the functional epitopes of the growth
hormone and the receptor exists one hot spot created by
two tryptophan residues (104 and 169) interacting with
complementary hydrophobic residues of the hormone.
The difference between a structural and a functional
epitope has now been established in numerous cyto-
kine–receptor contacts [27]. However, epitopes can be
mosaic in comprising several independent hot spots.
Also, there exist strong polar bonds. As an example,
the IL-4 receptor system will be discussed (Fig. 4), in
particular the interface between IL-4 and the high-
affinity IL-4Ra chain [16,28,29]. Two main binding
determinants are identified in IL-4: the acidic residue
Glu9 and the basic residue Arg88. Mutation of either
residues to alanine leads to 1000-fold loss in recep-
tor affinity. The crystal structure of the complex shows
that the Arg88 forms a perfect salt bond with receptor
Asp72 and that the Glu9 forms a hydrogen bond
B
A
Fig. 4. The hot spot of binding determinants in the IL-4 ⁄ IL-4Ra
complex are formed by a so-called ‘avocado cluster’ [16]. Two polar
bonds (a hydrogen bond or a salt bridge) comprise the main binding
determinants of the IL-4 ⁄ IL-4Ra ligand–receptor interaction, contrib-
uting more than 80% of the overall binding free energy. (A) The
side chain guanidinium group of Arg88 of IL-4 (UniProtKB P05112)
forms a bidentate salt bridge with the carboxylate group of Asp72
of IL-4Ra (UniProtKB P24394). This salt bridge is shielded from sol-
vent access due to the surrounding hydrophobic residues from the
receptor (Leu39, Phe41, Leu43 and Val69) as well as the ligand
(Y56 and K84). (B) The side chain of Glu9 of IL-4 forms several
hydrogen bonds to the main and side chain groups of IL-4Ra (Tyr13
OH, Ser70 main chain amide, Tyr183 OH). Similar to the salt bridge
formed by Arg88 of IL-4, the hydrogen bonds emanating from Glu9
are effectively shielded by the hydrophobic environment provided
by Ile5 (IL-4), Tyr13, Val69, Tyr127 and Tyr183 of IL-4Ra. The
shielding from solvent embeds the polar bonds into a vacuum-like
environment, thereby dramatically increasing the contribution of
these noncovalent bonds to the overall binding energy. Because
the embedding of a polar bond into a surrounding hydrophobic envi-
ronment is reminiscent of the placement of seeds in a fruit, this
setup was called the avocado cluster [16].
Molecular basisofcytokinesignalling W. Sebald et al.
110 FEBS Journal 277 (2010) 106–118 ª 2009 The Authors Journal compilation ª 2009 FEBS
network with three tyrosines of the receptor. These
bonds represent the hot spots in the receptor epitope.
A more thorough analysis by a double mutant cycle
indicated that the two hot spots bind independently of
each other and that each of them is surrounded by a
shell of hydrophobic side chains, which co-operate
with the polar core in binding. This motif has been
called an ‘avocado cluster’ in order to suggest that the
polar bond of the hot spot has to be shielded from the
bulk solvent by a hydrophobic shell. It has also been
called the ‘O-ring model’ by Bogan & Thorn [30] or
‘core ⁄ rim patches’ by Conte et al. [25].
The IL-4 contact with the IL-4Ra chain contains an
additional third element, which is positively charged at
IL-4 and negatively charged at the receptor [31].
Molecular dynamics calculations suggest that the very
highly charged interfaces of IL-4 and IL-4Ra – not the
avocado nature of the site – lead to electrostatic steer-
ing during the association of the two proteins and,
thus, to an 10-fold increase in the association rate
constant. This unusually fast association can be mea-
sured by Biacore interaction analysis, as described
above, and contributes to the high affinity of the IL-4
receptor corresponding to a very low dissociation
constant K
D
of 100 pm.
Sharing receptor chains is common among cytokines
[14,32]. cc functions with IL-2, IL-4 and several other
ILs, as discussed above. Other receptor families employ
the common b chain or the common gp130. Promiscu-
ity and sharing receptor chains also exist in the
BMP ⁄ growth and differentiation factor (GDF) ⁄ acti-
vin ⁄ TGF-b superfamily [33]. Of particular interest are
the type II activin receptor chains IIA and IIB. They
bind with high affinity to activins and certain GDFs
and with low affinity to BMPs. The structural epitopes
at the interfaces are largely hydrophobic with a single
serine at the core [11]. According to the structure, this
serine establishes a hydrogen bond with the receptor
Leu61 main chain. However, mutational analyses indi-
cate that this bond does not contribute to the binding
affinity of BMP-2. It does not represent a hot spot, not
even a minor determinant. Surprisingly, this hydrogen
bond is conserved in the receptor complexes with acti-
vin A and BMP-7. In the complex with BMP-2 and
BMP-7 it does not contribute to binding affinity. How-
ever, in the activin complex it is a hot spot of binding
energy, and it is responsible for the high-affinity inter-
action with this ligand. What makes this bond binding?
When the residues surrounding Ser88 are compared
in BMP-2 and activin A, a few differences are found.
Fortunately, swapping two activin residues, an aspartic
acid and a lysine, yielded a BMP-2 with activin-like
affinity. We know the structure of the complex
between the aspartic acid ⁄ lysine mutant of BMP-2 and
ActR-IIB. The structure does not indicate any new
bonds in trans between the ligand and the receptor.
The swapped side chains form an ion pair in cis, which
fixes the hydrophobic parts of the lysine in such a way
that it seals the Ser88 from the bulk solvent. Evidence
is accumulating that the sealing effect in an avocado
cluster is used by some receptors to scale affinity
according to the signalling requirements [18].
Inherited diseases demonstrate that small changes in
receptor affinity can be crucial for in vivo function
(Fig. 5). Human BMP-2 and human GDF-5 bind with
high affinity to the BMP receptor IB. BMP-2 has an
even slightly higher affinity for the IA subtype,
whereas GDF-5 affinity for IA is nearly 20 times
lower. Nickel et al. [34] identified the determinant for
this specificity as Arg57 occurring in a loop region of
GDF-5. A mutation of this large basic residue to an
alanine in GDF-5 causes a 20-fold gain in IA affinity.
A substitution of Arg57 by a leucine residue produces
an intermediate effect. In Berlin, Seemann et al. [35]
studied a family with inherited symphalangism. They
identified the very same Arg57Leu substitution in the
GDF-5 of the afflicted individuals. These observations
suggest that the gain of affinity in the GDF-5 mutant
leads to an inappropriate high signalling by the IA
subtype. The outcome is a hyperproliferation of chon-
drocytes and, as a consequence, a loss of certain joints.
The recently established structure of GDF-5 in com-
plex with the IB receptor [36] reveals the molecular
AB
Fig. 5. (A) Familial symphalangism caused by a gain-of-function
mutation in GDF-5 (UniProtKB P43026) [35]. Joints are replaced by
bone in finger V and defective in finger IV (see arrows). The R438L
mutation is located in the wrist epitope of GDF-5 (R57L in the
mature protein). The mutant GDF-5 has a several-fold increased
affinity for the BMPR-IA receptor. (B) A similar phenotype is pro-
duced by loss-of-function mutations in the NOG gene coding for
the BMP and GDF-5 inhibitor Noggin (UniProtKB Q13253). (Repro-
duced with kind permission of The Journal of Clinical Investigation
via the Copyright Clearance Center.)
W. Sebald et al. Molecularbasisofcytokine signalling
FEBS Journal 277 (2010) 106–118 ª 2009 The Authors Journal compilation ª 2009 FEBS 111
basis of receptor specificity and discrimination. A rigid
disulfide-stabilized loop has different orientations in
the subtypes. In the IA receptor, the loop occludes the
binding site and allows the binding of only a small ala-
nine side chain. In the BMP receptor IB, the loop is
oriented away and gives room for the bulky arginine
of GDF-5. In summary, small structural variations
leading to small and selective changes in affinity can
be of high functional importance and result, in
the case of GDF-5, in profound chondrodysplasias of
skeletal elements in vivo.
BMPs not only interact with receptors. A large vari-
ety of proteins occur in the extracellular compartment
that bind BMPs and regulate their activity [37,38].
These proteins provide fascinating paradigms for
molecular recognition, as they often interact with the
same epitope. Well-known representatives are Noggin,
follistatin and the members of the differential screen-
ing-selected gene aberative in neuroblastoma (DAN)
family. Numerous proteins belong to the Chordin
family, which typically contain one or multiple Von
Willebrand factor type C domains (VWC domains)
[39]. Members are Chordin itself, the Chordin-like pro-
teins 1 and 2, crossveinless-2 (CV-2), connective tissue
growth factor and others. These proteins are essential
during gastrulation for dorsal–ventral patterning and
neural induction [40]. They occur in the Spemann orga-
nizer (Chordin) and in the ventral centre (CV-2, twisted
gastrulation). Later in development they regulate organ
formation; in the adult they regulate the regeneration
of organs and tissues. The VWC domain is a versatile
protein module that occurs in many forms. Some of
them can bind BMPs or other proteins; some seem to
exert a purely structural role. Of particular interest is
VWC1 of CV-2. Zhang et al. [41,42] demonstrated that,
with zebrafish CV-2, out of the five modules present,
only VWC1 binds BMP-2. The affinity is high, compa-
rable with the BMP receptor IA. Two CV-2 proteins
can bind one BMP molecule.
The complex of VWC1 and BMP-2 has been iso-
lated. The crystal structure revealed how VWC1 inhib-
its BMP signalling [43] (Fig. 6). The small module of
only 66 residues is tripartite. A short N-terminal seg-
ment of eight residues occupies the binding epitope for
the IA receptor; a subdomain SD1 of 34 residues binds
to the epitope for the type II receptor; the C-terminal
subdomain SD2 points away from the complex and
has no contacts with BMP-2. Most of the binding
energy is provided by the SD1 part. This hydrophobic
interaction alone has a micromolar K
D
. The N-termi-
nal segment extends across the small ridge, like a paper
clip, onto the other side of BMP-2 and provides a
1000-fold increase in affinity. The SD1 and the clip
together compete efficiently for receptor binding and
therefore prevent BMP-2 signalling. The BMP inhibi-
tor Noggin uses a similar trick for the generation of
high-affinity binding [44]. This beautiful structure has
been elucidated by Groppe et al. [44]. It shows that
Noggin also uses an N-terminal extension to block the
binding epitope of BMP-7 for the type I BMP recep-
tors. Thus, a clip-like extension to generate an addi-
tional binding epitope might represent a more general
mechanism to increase affinity.
Drug design and development
When working in the Bu
¨
cher Institute, I experienced
not only the atmosphere of competitive and ambitious
basic research, but there was also always a readiness
to improve or to invent something. A major stimulus,
of course, was the invention and the design of the
Eppendorff system. The Eppendorff caps, pipettes,
centrifuges, incubators and photometers have estab-
lished a worldwide standard for equipment in aca-
demic, industrial and clinical laboratories. A keen
sense for industrial applications is also a hallmark of
cytokine research. Cytokinesignalling is vital for the
growth, maintenance and repair of cells and tissues in
our body. Dysregulation ofcytokine function can
result in serious and widespread diseases. Not surpris-
ingly, therefore, cytokines andcytokine receptors are
promising targets for drug design and development.
Basic research has generated a remarkable spin-off of
new drugs. Several of them are already very successful
on the pharmaceutical market. Most of these therapeu-
tics are, however, biologicals; this means they are
recombinant proteins. The development of synthetic
drugs is made difficult by the architecture of the
binding epitopes and the activation mechanism, in par-
ticular of heteromeric receptors, as discussed above.
Recombinant erythropoietin [45] and granulocyte
colony-stimulating factor (Neupogen) [46] are now
well-established therapeutics. New players in tissue
engineering and regenerative medicine are the BMPs
[47], which induce the formation of new bone at criti-
cal size defects that otherwise would not heal. Recom-
binant BMP-2 is a powerful protein that allowed the
repair of a 5 cm defect in the mandible of a Go
¨
ttingen
minipig [48] (Fig. 7). A functional, mechanically stable
and vascularized new bone formed in situ within
8–12 weeks. Spinal fusion, bone augmentations and
the treatment of nonhealing fractures represent major
clinical applications of BMPs. In the USA alone, more
than 100 000 patients with unstable or collapsed verte-
bral bodies were treated last year. Mechanical load
during healing is essential. After ectopic application of
Molecular basisofcytokinesignalling W. Sebald et al.
112 FEBS Journal 277 (2010) 106–118 ª 2009 The Authors Journal compilation ª 2009 FEBS
BMP, for instance in a muscle pouch, the induced
bone is resorbed at later stages when transplanted in a
functional site under mechanical stress. Thus, the culti-
vation of artificial bone with a certain desired shape is
science fiction at the present state of the art.
Soluble receptor ectodomains are specific inhibitors
of their genuine cytokine ligands. Fusion proteins con-
sisting of the constant Fc part of an immunoglobulin
and two receptor domains are even more potent, as
the cytokine can be bound at two sites. They function
as efficient ligand traps. The Fc-fusion protein with
the ectodomain of the activin receptor IIA is a power-
ful inhibitor of its high-affinity ligands, in particular
activin A. ActRIIA–Fc induces an increase in bone
mass in ovariectomized mice [49]. A clinical study has
recently shown that the human fusion protein provides
an effective treatment of osteoporotic bone loss in
postmenopausal women [50]. Most importantly, the
inhibition of ActR-IIA ligands stimulates bone forma-
tion by osteoblasts and therefore increases bone mass.
Treatment with, for instance, biphosphonates inhibits
bone degradation by osteoclasts and thus at best
preserves the status quo.
Following the same approach, an Fc-fusion protein
with the ectodomain of the activin receptor IIB was
developed. The IIB receptor subtype has two ligands:
GDF-8 and the very similar GDF-11. These GDFs are
bound with even higher affinities than the activins.
The signallingof GDF-8 and -11 is inhibited by the
fusion protein ActR-RIIB ⁄ Fc at the very low IC
50
of
100 pm [51]. GDF-8 has also been called myostatin.
This protein became well known because disruption of
the myostatin gene in mice [52], cattle [53] and man
[54] leads to a dramatic increase in muscle mass, the
so-called double-muscling phenotype. The ActR-IIB
fusion protein when injected into mice produces an
A
B
C
Fig. 6. Clip-like structures gain binding strength by co-operative interactions. (A) A schematic representation of the binding mechanism of
the BMP modulator proteins ⁄ domains Noggin and CV-2 (UniProtKB Q5D734) VWC1 to BMPs. An N-terminal extension (clip) binds into the
epitope for the type I receptor of the ligand, whereas the main core structure binds into the epitope for the type II receptor of the BMP
ligand. Therefore, the binding of the receptors of both subtypes is blocked and BMP activity is effectively suppressed. Because of the strong
co-operativity of both interfaces (clip and core structure) the contribution of the individual binding interfaces can be small. (B) The binding of
two N-terminal VWC domains of CV-2 (grey, left in surface representation) to the dimeric BMP-2 (blue and yellow) resembles the stacking
of a paperclip (VWC1 of CV-2) to a sheet of paper (BMP-2) (PDB entry 3BK3 [43]). (C) The binding of Noggin to BMP-7 (PDB entry 1M4U
[44]) follows a similar mechanism as in (B). An N-terminal clip folds into the type I receptor-binding site of BMP-7, whereas the core
structure blocks the type II receptor binding. The much higher binding affinity of Noggin for BMP ligands can possibly be explained by the
homodimeric nature resulting in four binding interfaces for a single Noggin molecule.
W. Sebald et al. Molecularbasisofcytokine signalling
FEBS Journal 277 (2010) 106–118 ª 2009 The Authors Journal compilation ª 2009 FEBS 113
even more pronounced muscle phenotype, possibly
because it neutralizes both GDF-8 and GDF-11 [53].
The fusion protein also increases muscle mass in an
mdx mouse, an animal model of muscular dystrophy.
Thus, it represents a promising drug candidate for the
treatment of diseases associated with muscle loss or
wasting.
Another type of inhibitor has been generated by
mutating cytokine ligands. An IL-4 mutein, Aerovant,
is now in clinical phase IIB trials as a drug candidate
for the treatment of allergic asthma [55]; a growth
hormone mutein, Pegvisomant, is already in clinical
use for the treatment of acromegaly [56].
Allergies and asthma represent a nuisance in the case
of seasonal rhinitis or conjunctivitis and a life-threat-
ening condition in anaphylactic shock and asthma.
IL-4 and IL-13 are the hormones that make us allergic.
During the sensitization phase, IL-4 triggers the forma-
tion of type 2 T helper lymphocytes. Type 2 T helper
cells then secrete cytokines that initiate the formation
of IgE in B cells, which finally leads to the symptoms
of a delayed hypersensitivity reaction. In the effector
phase, IL-4 co-operates with IL-13.
A rational drug design is straightforward on the
basis of the activation mechanism (see Fig. 2) and of
the functional epitopes [57] (Fig. 8). As discussed
above, there exist two IL-4 receptors and one IL-13
receptor, all of which use the IL-4 receptor a chain as
the essential driver. An inhibition of the a chain will
therefore inhibit IL-4 as well as IL-13 signalling. Two
mutations of IL-4 are necessary to disrupt the interac-
tion with the low-affinity chains cc and IL-13Ra1 [58].
The double mutein binds with nearly unchanged affin-
ity to the cellular IL-4 receptor, as the low-affinity
chains contribute only marginally to the affinity. The
double mutein, Aerovant, is therefore a potent antago-
nist of IL-4 and IL-13. Animal studies have shown
that the IL-4 mutein effectively inhibits an anaphylac-
tic shock in mice when applied during the sensitization
phase [59]. Recently, clinical trials have shown that
Aerovant can also ameliorate allergic asthma in human
patients [55].
Following the same rationale, an antagonist of
growth hormone has been designed and developed
[60]. Increased growth hormone production by, for
instance, a pituitary adenoma, leads to a phenotype
called acromegaly, which is typically associated with
large body size and, among other symptoms, a promi-
nent supraorbital ridge and a large nose and jaw. In
the homodimeric growth hormone receptor, the second
chain is bound with low affinity to the ligand, as
described above. This interaction can be abolished by
introducing a mutation in the functional epitope,
substituting a small glycine with a large arginine. This
mutein has efficiently inhibited growth hormone action
in an animal model. However, large amounts had to
be applied, as the affinity of the mutein for the cellular
A
B
C
Fig. 7. Direct reconstitution of the mandible bone of a minipig [48].
(A) X-ray control taken immediately postoperative. (B) A critical size
5 cm defect in the mandible was treated with carrier material plus
recombinant BMP-2. Full regeneration of the mandible with a
mechanically stable bone is visible in the X-ray taken after 8 weeks.
The control defect treated with carrier alone formed a pseudar-
those and the defect was filled with connective tissue. (C) Explant-
ed mandible bone shown in (B) (12 weeks postoperative)
demonstrates complete reconstitution of the bone. (Reproduced
with kind permission of Springer Science+Business Media.)
Molecular basisofcytokinesignalling W. Sebald et al.
114 FEBS Journal 277 (2010) 106–118 ª 2009 The Authors Journal compilation ª 2009 FEBS
receptor was severely reduced compared with normal
growth hormone. Therefore, six additional mutations
were introduced, which increased affinity of the mutein
to wild-type levels. In addition, the mutein was pegy-
lated (i.e. covalently modified with polyethyleneglycol),
in order to prolong the half-life of the protein in the
body. This engineered and modified growth hormone
antagonist (pegvisomant) is in clinical use for the treat-
ment of acromegaly.
Cytokine signalling still provides a fertile ground
for the development of biologicals – protein drugs.
However, it is still a big challenge to find chemical
compounds that bind to functional epitopes of cyto-
kines or their receptors. It appears that small
peptides can function as agonists in homodimeric
receptors, such as in the receptor for erythropoietin
[61]. Chemicals have been found that inhibit IL-2,
but, surprisingly, they bind outside the functional
epitope. The compound Ro26-4550 distorts the
conformation of IL-2 and therefore destroys the
receptor-binding epitope [62]. An elegant method
called ‘fragment tethering’ has been invented by
Erlanson et al. [63] to screen for ligands with very
low affinities. The future will show whether such
ligands may be used as lead structures for further
drug development. Other approaches involve large
synthetic chemicals, such as dendromers or foldamers
[64,65], which can expose large surfaces similar to
the binding epitopes ofcytokine receptors. So, the
quest continues to reach high-hanging fruit [66].
Acknowledgement
W. Sebald wishes to thank the organizers of the 34
th
FEBS Congress. It was a great privilege to present the
Theodor Bu
¨
cher Lecture.
AB C
D
EF
Fig. 8. An electrostatic mismatch is the basisof the antagonistic property of the IL-4 variant Y124D [67]. (A) The first step of IL-4
receptor activation is the binding of IL-4 (green) to its high-affinity receptor IL-4Ra (cyan). (B) The binary complex then recruits the low-
affinity receptor subunit cc (orange surface representation) into a heterotrimeric complex (C) (PDB entry 3BPL [15]). In the case of the
IL-4 antagonist variant Y124D the formation of the ternary complex is blocked (D). Circles mark the interaction of the tyrosine residue
of IL-4 with residues of cc. (E) Closer inspection of this area reveals that the side chain of Tyr124 of IL-4 is embedded in a hydro-
phobic cleft formed by the residues His159, Cys160, Leu208 and Cys209 of cc, with both cysteine residues forming a disulfide bond.
(F) A model of this interaction with IL-4Y124D instead of wild-type IL-4 shows that the negatively charged carboxylate group of Asp124
would be placed in the centre of the hydrophobic interface, thereby causing electrostatic repulsion, which explains the loss of binding
of IL-4Y124D to cc [67].
W. Sebald et al. Molecularbasisofcytokine signalling
FEBS Journal 277 (2010) 106–118 ª 2009 The Authors Journal compilation ª 2009 FEBS 115
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cular basis of cytokine receptor signalling – theme and
variations – has three movements, like a sonata. First,
we will look at the basic mechanism and the. THE THEODOR BU
¨
CHER LECTURE
Molecular basis of cytokine signalling – theme and
variations
Delivered on 8 July 2009 at the 34th FEBS