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Pore formation by GSDMD is the effector mechanism of pyroptosis Moritz M Gaidt & Veit Hornung

Pyroptosis is a unique, pro-inflammatory form of lytic cell death that is initiated by the activation of inflammatory caspases. The caspase substrate gasdermin D (GSDMD) plays a critical function in pyroptosis, yet the precise mode of action of this molecule in cell death execution remained unclear. Several recent reports, including a The EMBO Journal article, show that the caspasematured N-terminal fragment of GSDMD is recruited to lipid membranes to form pore-like structures, which constitutes the key effector mechanism of pyroptotic cell death.

See also: L Sborgi et al (August 2016)

T

he term pyroptosis (pyro greek for fire or fever) has been originally coined to describe the non-apoptotic, caspase-1-dependent cell death of Salmonella-infected macrophages that would alarm and recruit neighboring cells to the site of infection (Cookson & Brennan, 2001). Later it became apparent that the activation of caspase-1 to induce pyroptosis is controlled by a subset of PRRs that can induce inflammasome activation (e.g. NLRP3, AIM2 or NLRC4/NAIP). Upon recognition of their cognate ligands, these sensors seed the prion-like assembly of the inflammasome adapter ASC into a high molecular weight cytosolic complex to which caspase-1 becomes recruited and is activated by. Auto-processed caspase-1 then matures the cytokines IL-1b and IL-18 to render them bioactive and induce pyroptotic cell death. Besides this canonical inflammasome activation leading to caspase-1 maturation, other pro-inflammatory caspases,

murine caspase-11 and human caspase-4 and caspase-5, directly sense cytosolic LPS to induce pyroptosis and activate the NLRP3 inflammasome via the so-called noncanonical pathway (Broz & Dixit, 2016). Recently, GSDMD was found to be a substrate of inflammatory caspases, critically required for the induction of pyroptosis. Its maturation unleashed the pro-pyroptotic N-terminal fragment from auto-inhibition by the C-terminal part. With regard to inflammasome activation, it was found that GSDMD cleavage was strictly required for the secretion, but not for the maturation of caspase-1 and IL-1b (He et al, 2015; Kayagaki et al, 2015; Shi et al, 2015). However, the precise mode of action of GSDMD in pyroptosis induction remained to be determined. In a recent issue of the EMBO Journal, Sborgi et al (2016) show that the N-terminal part of GSDMD is capable of forming porelike structures in lipid membranes and thus constitutes the direct and sole effector of pyroptosis. Whereas under steady-state conditions full-length GSDMD was exclusively localized to the cytosol, the N-terminal part re-localized to membraneassociated and insoluble cytosolic fractions upon maturation. Using a cell-free approach, the authors further observed that the in vitro cleaved, recombinant N-terminal fragment of GSDMD could associate with liposomes, indicating that GSDMD itself could mediate its recruitment to membranes. Furthermore, cleaved GSDMD was capable of permeabilizing respective liposomes, thereby mediating the release of fluorophores with a Stokes radius of up to 8.5 nm. Utilizing cryoelectron microscopy, recombinant GSDMD could be visualized to form round, pore-like

structures on liposomes (20 nm inner diameter). Further characterization using atomic force microscopy elegantly demonstrated that these pores are indeed open and thus could allow the efflux of cytosolic content from pyroptosing cells. In summary, the work of Sborgi et al (2016) characterizes GSDMD as the sole pyroptosis effector molecule that is capable of building pores in lipid membranes. The highlighted publication by Sborgi et al (2016) is part of a series of reports on the role of GSDMD in pyroptosis (Aglietti et al, 2016; Ding et al, 2016; Liu et al, 2016). All studies come to the conclusion that the pore-forming property of the N-terminal fragment of GSDMD is the driver of pyroptotic cell death. Structural evidence supports the view that the C-terminal GSDMD domain exerts an auto-inhibitory function by targeting residues of the N-terminal part that are crucial for membrane association and pore formation (Ding et al, 2016). This auto-inhibition is overcome upon cleavage by inflammatory caspases, enabling membrane association of the Nterminal domain presumably utilizing the conserved, positively charged residues RKRR (Liu et al, 2016). Although results on the lipid-binding properties of GSDMD N-term differ substantially between individual studies, presumably owed to different experimental conditions, it can be concluded that the GSDMD N-term only associates with lipids of the inner leaflet of the plasma membrane, thus explaining why GSDMD only lyses from within the cell. Intriguingly, GSDMD also binds cardiolipin, a component of prokaryotic and also mitochondrial membranes, which may explain its proposed bactericidal in trans activity (Liu et al,

Gene Center and Department of Biochemistry, Ludwig-Maximilians-Universität München, Munich, Germany. E-mail: [email protected] DOI 10.15252/embj.201695415 | Published online 29 August 2016

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2016). However, further evidence that endogenous levels of GSDMD exert antibacterial functions in vivo is still required. Overall, the picture emerges that GSDMD cleavage by inflammatory caspases leads to

Moritz M Gaidt & Veit Hornung

see below). The influx of water driven by oncotic pressure induces cell swelling and pyroptotic rupture of the plasma membrane, which releases all cytosolic content (including LDH) (Fig 1).

translocation of the N-terminal fragment to the plasma membrane. Subsequent pore formation dissipates ion gradients and enables efflux of cytosolic proteins that fit through the pore (like IL-1b and caspase-1,

Bacterium

Binding of extracellular GSDMD to Cardiolipin

Permeabilization of bacteria Secretion of whole cytosolic content EXTRACELLULAR SPACE

Secretion of small proteins through pores?

Rupture of plasma membrane

Influx of H2O due to oncotic pressure

+

Covalent binding?

Na – Cl

Cell swelling

H2O H2O H2O H2O LDH

Membrane insertion? N

K+

? ?

GSDMD N-terminal fragments

CYTOSOL

GSDMD N-terminal fragment

IL-1β

Active Caspase-1

Pro-IL-1β

CELL MEMBRANE

Phosphatidylethanolamine Outer leaflet

Phosphatidylcholine Sphingomyelin Phosphatidylethanolamine

Inflammasome Pro-caspase-1

Inner leaflet

Active Caspase-1

Cleavage N

LPS Caspase-4 Caspase-5 Caspase-11

Phosphatidylinositol

RKRR N

C

Phosphatidylserine

? GSDMD N-terminal fragment

Gasdermin D GSDMD

Mitochondrial and bacterial membranes only Cardiolipin Cardiolipin?

Active Caspase-4 Caspase-5 Caspase-11

Figure 1. GSDMD-mediated pore formation induces pyroptotic cell death. Upon activation, inflammatory caspases cleave cytosolic GSDMD to release the auto-inhibition of the C-terminal part. The cleaved N-terminal fragment translocates to the plasma membrane to bind phospholipids of the inner leaflet presumably utilizing the conserved RKRR motif. At the same time, cardiolipin binding may enable recruitment of N-terminal GSDMD to mitochondria. Pore assembly at the plasma membrane enables breakdown of ion gradients and efflux of cytosolic proteins that are small enough to pass through the pores. Subsequently, water influx driven by oncotic pressure induces cell swelling and rupture of the plasma membrane, which releases the cytosolic content. Released N-terminal GSDMD may exhibit extracellular in trans bactericidal activity. Of note, occurrence of phospholipids at the plasma membrane does not represent the actual quantitative distribution.

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Moritz M Gaidt & Veit Hornung

Besides exciting new insight into the biology of pyroptosis, these advances have important implications for our understanding of the inflammasome-associated IL-1b secretion. The overall inner diameter of the pore was determined to be around 15 nm (arithmetic mean of all four studies), and should theoretically suffice for the release of matured IL-1b and caspase-1 through the nascent pore independently of the subsequent rupture of the plasma membrane. Although formal proof is still missing, this notion is supported by observations made with pharmacological blockade of pyroptosis. As such, inhibition of pyroptosis downstream of pore formation by PEG and glycine treatment inhibits release of LDH but does not affect caspase-1 or IL-1b secretion (Fink & Cookson, 2006; Liao & Mogridge, 2009). It is important to note, however, that release through GSDMD pores is not the only form of IL-1b secretion. In fact, IL-1b can be secreted from cells that are not competent in pyroptosis (Conos et al, 2016), and from immune cells in the absence of pyroptosis (Gaidt et al, 2016; Wolf et al, 2016; Zanoni et al, 2016). In particular, after activation of the alternative inflammasome that omits the induction of pyroptosis (Gaidt et al, 2016), IL-1b secretion from viable cells has to rely on GSDMD-independent secretion pathways. Intriguingly, other members of the GSDM protein family have similar pro-pyroptotic effector functions (Shi et al, 2015). Since they are not controlled by inflammatory caspases, other post-translational modifications may regulate their activity. Considering their association with rare genetic diseases, it will be of special interest to determine their role in a potentially pyroptotic cell death in these conditions. In light of these new insights into biology of the GSDMD and the GSDM family, its members

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GSDMD pores induce pyroptosis

can be attributed to the family of poreforming proteins. In summary, the here mentioned series of publications have finally shed light on the execution of pyroptosis by defining GSDMD as the sole effector molecule and by elucidating its pore-forming activity as the key mechanism of this pro-inflammatory cell death. Yet, further, especially structural, insights are required to address the biology of pore formation within the plasma membrane and the lipid-binding specification.

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Pore formation by GSDMD is the effector mechanism of pyroptosis.

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