The polyol pathway is a biological mechanism utilized by tissues to convert glucose to fructose through converting glucose into an intermediary compound, sorbitol (Brownlee 2005). Sorbitol is the alcohol counterpart of glucose (Bhagavan 2002). Its structure effectively traps glucose within a cell, where it is then converted to fructose through the help of the enzyme sorbitol dehydrogenase (SORD) (Hodgson et al., 2017) (LeRoith et al., 2004) (Safi et al., 2014). Tissues with insufficient sorbitol dehydrogenase suffer from intracellular sorbitol accumulation, which subsequently causes osmotic damage. Excess sorbitol may deposit in the eyes, causing cataracts or retinopathy or manifest as peripheral neuropathy, similar to the effect of chronic hyperglycemia in diabetes (Jedziniak et al., 1981) (Burg and Kador, 1988).
Sorbitol dehydrogenase deficiencies currently affect one in 100,000 individuals and primarily manifest as the most common form of autosomal recessive peripheral neuropathy (Coretese et al., 2020). In patients with diabetes, excess glucose in the blood significantly increases the production of sorbitol and can lead to cell lesions. In the lens of the eye, diabetic patients can develop cataracts up to 20 years earlier (Vinson, 2006) because of osmotic imbalance from excess sorbitol and oxidative damage (Hashim and Zarina, 2012). These conditions can have drastic effects on quality of life and will require lifestyle changes and long-term management if not addressed in a timely manner.
To address the ophthalmic and neurological pathologies associated with sorbitol dehydrogenase deficiency, we propose a protein capable of binding sorbitol with high affinity and specificity. This protein, the adenosine triphosphate-binding cassette (ABC) transporter solute binding protein (SBP), is derived from the microbe Agrobacterium vitis (also known as Allorhizobium vitis), a Gram-negative, motile, plant pathogen that infects grapevines (Proteomes, 2021). The ABC transporter SBP itself has a ‘Venus flytrap’-like mechanism that allows for large conformational changes in its binding domains to allow for the encapsulation of ligands (Yadava et al. 2016). The structure of the ABC transporter SBP is specific for organic compounds such as allitol or the amino sugars glucosamine and galactosamine (Yadava et al. 2016) (Vetting et al. 2014).
Figure 1. Polyol Pathway. The metabolic pathway that converts glucose to fructose.
The small molecule allitol (synonymously referred to as D-allitol) has a molecular formula of \({C}_{6}{H}_{14}{O}_{6}\) and is a natural ligand for the ABC transporter SBP. Sorbitol is another small molecule and has the same molecular formula as allitol, \({C}_{6}{H}_{14}{O}_{6}\). Both molecules are six-carbon chains with each carbon having an attached hydroxyl (\(-OH\)) group. The difference between allitol and sorbitol is simply the stereochemistry of a single hydroxyl group at the third carbon position, as seen in Fig. 2. The similarity in the overall structures of allitol and sorbitol suggest that with minor modifications to the binding pocket of the ABC transporter SBP, the protein can be used as a molecular sponge that preferentially binds sorbitol over allitol for the purpose of removing sorbitol from tissue.
Figure 2. Ligands. A. Allitol is the naturally bound ligand of the ABC transporter SBP. B. Sorbitol, which differs in stereochemistry from allitol only at the third carbon hydroxyl group, is the ligand that the ABC transporter SBP can be engineered to preferentially bind to.
In this work we will design a new protein based on the adenosine triphosphate-binding cassette transporter solute binding protein to be used as a molecular sponge that can exchange its bound ligand allitol for a target ligand sorbitol. This new protein has the potential to be used as a drug for the treatment of cataracts, retinopathy, or peripheral neuropathy in individuals suffering from sorbitol dehydrogenase deficiency. Physiologically, the molecular sponge could decrease excess intracellular sorbitol and provide relief to individuals from the adverse effects associated with this condition.