Cushing’s syndrome driver mutation disrupts protein kinase A allosteric network, altering both regulation and substrate specificity

Caitlin Walker, Yingjie Wang, Cristina Olivieri, Adak Karamafrooz, Jordan Casby, Kerstin Bathon, Davide Calebiro, Jiali Gao, David A. Bernlohr, Susan S. Taylor, Gianluigi Veglia

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19 Scopus citations


Genetic alterations in the PRKACA gene coding for the catalytic α subunit of the cAMP-dependent protein kinase A (PKA-C) are linked to cortisol-secreting adrenocortical adenomas, resulting in Cushing's syndrome. Among those, a single mutation (L205R) has been found in up to 67% of patients. Because the x-ray structures of the wild-type and mutant kinases are essentially identical, the mechanism explaining aberrant function of this mutant remains under active debate. Using NMR spectroscopy, thermodynamics, kinetic assays, and molecular dynamics simulations, we found that this single mutation causes global changes in the enzyme, disrupting the intramolecular allosteric network and eliciting losses in nucleotide/pseudo-substrate binding cooperativity. Remarkably, by rewiring its internal allosteric network, PKA-C L205R is able to bind and phosphorylate non-canonical substrates, explaining its changes in substrate specificity. Both the lack of regulation and change in substrate specificity reveal the complex role of this mutated kinase in the formation of cortisol-secreting adrenocortical adenomas.

Original languageEnglish (US)
Article numbereaaw9298
JournalScience Advances
Issue number8
StatePublished - Aug 28 2019

Bibliographical note

Funding Information:
NMR experiments were carried out at the Minnesota NMR Center, and MD calculations were performed at the Minnesota Supercomputing Institute. Funding: This work was supported by the National Institutes of Health (GM100310 and S10 OD021536 to G.V.) and the CRC/Transregio 166 (Project C1 to D.C.), as well the IZKF W?rzburg (grant B-281 to D.C.). K.B. was partially supported by a fellowship through a grant of the German Excellence Initiative to the Graduate School of Life Sciences, University of W?rzburg.

Publisher Copyright:
Copyright © 2019 The Authors, some rights reserved;

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't


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