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DR. LINGWOOD:
      Okay, this figure is, again another format of the receptor Globotriaosyl ceramide, and you can see here the three sugars. See, I've told you that the last two, the galactose alpha one-four beta one-four galactose structure is a recognition unit. But this is a very interesting system and is telling us a lot about how the proteins interact with these types of carbohydrates in general, which is one of the reasons why I'm so interested in it. Although the toxin binds in this area, if you remove this, you clip Gb3 in half here and you lose this lipid part, then there's no receptor activity.
      So somehow the part that's in the cell membrane affects the ability to bind. And it's not only the structure of the lipid that affects binding, but when it's in a membrane you can imagine lots of other hydrophobic structures here which would be the plane of the membrane that also affect the ability of the toxin to bind, here. So this is an incredibly dynamic situation.
      People had thought before that this kind of interaction was just the toxin binding to the sugars and that's it, but it's not. There's an incredible amount of modulation of affinity. And we don't really know what is going on in terms of molecular structure, here. But we have a few ideas and they are revolutionizing the way we think about the ability of proteins to bind to carbohydrate when it's on a cell surface.
      And that effect is that because it's such a complex situation, there's such a lot of influence on whether the actual toxin can bind here, that these kinds of structures, the lipid structure, the membrane environment all become, if you like, risk factor for HUS because they play an important role in determining whether the toxin can bind cells.
      And as I will show you later, even that's only half the story because once the toxin has bound, it has to get inside the cell to kill the cell and that, again, is a variable system. There are several choices. And the choices, again, seem to be related to the lipid structure rather than the carbohydrate of Gb3.
     




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