Crystal structure of a "nonfoldable" insulin. Impaired folding efficiency despite native activity

Protein evolution is constrained by folding efficiency ("foldability") and the implicit threat of toxic misfolding. A model is provided by proinsulin, whose misfolding is associated with β-cell dysfunction and diabetes mellitus. An insulin analogue containing a subtle core substitution (Leu^A16 → Val) is biologically active, and its crystal structure recapitulates that of the wild-type protein. As a seeming paradox, however, Val^A16 blocks both insulin chain combination and the in vitro refolding of proinsulin. Disulfide pairing in mammalian cell culture is likewise inefficient, leading to misfolding, endoplasmic reticular stress, and proteosome-mediated degradation. Val^A16 destabilizes the native state and so presumably perturbs a partial fold that directs initial disulfide pairing. Substitutions elsewhere in the core similarly destabilize the native state but, unlike Val^A16, preserve folding efficiency. We propose that Leu^A16 stabilizes nonlocal interactions between nascent α-helices in the A- and B-domains to facilitate initial pairing of Cys^A20 and Cys^B19, thus surmounting their wide separation in sequence. Although Val^A16 is likely to destabilize this proto-core, its structural effects are mitigated once folding is achieved. Classical studies of insulin chain combination in vitro have illuminated the impact of off-pathway reactions on the efficiency of native disulfide pairing. The capability of a polypeptide sequence to fold within the endoplasmic reticulum may likewise be influenced by kinetic or thermodynamic partitioning among on- and off-pathway disulfide intermediates. The properties of [Val^A16]insulin and [Val^A16]proinsulin demonstrate that essential contributions of conserved residues to folding may be inapparent once the native state is achieved.