Stichodactyla toxin (ShK, ShkT) is a 35-residue
basic
BASIC (Beginners' All-purpose Symbolic Instruction Code) is a family of general-purpose, high-level programming languages designed for ease of use. The original version was created by John G. Kemeny and Thomas E. Kurtz at Dartmouth College ...
peptide
Peptides (, ) are short chains of amino acids linked by peptide bonds. Long chains of amino acids are called proteins. Chains of fewer than twenty amino acids are called oligopeptides, and include dipeptides, tripeptides, and tetrapeptides. ...
from the sea anemone ''
Stichodactyla helianthus'' that blocks a number of
potassium channel
Potassium channels are the most widely distributed type of ion channel found in virtually all organisms. They form potassium-selective pores that span cell membranes. Potassium channels are found in most cell types and control a wide variety of c ...
s. Related peptides form a conserved
family
Family (from la, familia) is a group of people related either by consanguinity (by recognized birth) or affinity (by marriage or other relationship). The purpose of the family is to maintain the well-being of its members and of society. Idea ...
of
protein domains
In molecular biology, a protein domain is a region of a protein's polypeptide chain that is self-stabilizing and that folds independently from the rest. Each domain forms a compact folded three-dimensional structure. Many proteins consist of se ...
known as the ShkT domain. Another well-studied toxin of the family is BgK from ''
Bunodosoma granulifera''.
An analogue of ShK called ShK-186 or Dalazatide is in human trials as a therapeutic for
autoimmune disease
An autoimmune disease is a condition arising from an abnormal immune response to a functioning body part. At least 80 types of autoimmune diseases have been identified, with some evidence suggesting that there may be more than 100 types. Nearly ...
s.
History

''Stichodactyla helianthus'' is a species of
sea anemone (Phylum:
Cnidaria
Cnidaria () is a phylum under kingdom Animalia containing over 11,000 species of aquatic animals found both in Fresh water, freshwater and Marine habitats, marine environments, predominantly the latter.
Their distinguishing feature is cnidocyt ...
) belonging to the family ''
Stichodactylidae
Stichodactylidae is a family of sea anemones that contains the genera ''Stichodactyla'' (carpet anemones) and ''Heteractis''. These sea anemones exclusively reside within the shallow waters of the tropical Indo-Pacific area and are in the main ...
''. ''Helianthus'' comes from the
Greek
Greek may refer to:
Greece
Anything of, from, or related to Greece, a country in Southern Europe:
*Greeks, an ethnic group.
*Greek language, a branch of the Indo-European language family.
**Proto-Greek language, the assumed last common ancestor ...
words helios meaning sun, and anthos meaning flower, which corresponds to the species' common name "sun anemone". It is sessile and uses potent
neurotoxin
Neurotoxins are toxins that are destructive to nerve tissue (causing neurotoxicity). Neurotoxins are an extensive class of exogenous chemical neurological insultsSpencer 2000 that can adversely affect function in both developing and matur ...
s for defense against its primary predator, the
spiny lobster
Spiny lobsters, also known as langustas, langouste, or rock lobsters, are a family (Palinuridae) of about 60 species of achelate crustaceans, in the Decapoda Reptantia. Spiny lobsters are also, especially in Australia, New Zealand, Ireland, S ...
. The venom contains, among other components, numerous
ion channel-blocking peptides. In 1995, a group led by Olga Castaneda and Evert Karlsson
isolated
Isolation is the near or complete lack of social contact by an individual.
Isolation or isolated may also refer to:
Sociology and psychology
*Isolation (health care), various measures taken to prevent contagious diseases from being spread
**Is ...
ShK, a potassium channel-blocking 35-residue peptide from ''S. helianthus''. The same year, William Kem and his collaborator Michael Pennington
synthesized and
folded ShK, and showed it blocked
neuron
A neuron, neurone, or nerve cell is an membrane potential#Cell excitability, electrically excitable cell (biology), cell that communicates with other cells via specialized connections called synapses. The neuron is the main component of nervous ...
al and
lymphocyte
A lymphocyte is a type of white blood cell (leukocyte) in the immune system of most vertebrates. Lymphocytes include natural killer cells (which function in cell-mediated, cytotoxic innate immunity), T cells (for cell-mediated, cytotoxic ad ...
voltage-dependent potassium channels. In 1996, Ray Norton determined the
three-dimensional structure of ShK.
In 2005–2006, George Chandy, Christine Beeton and Michael Pennington developed ShK-170 and ShK-186 (ShK-L5), selective blockers of
Kv1.3.
ShK-186, now called Dalazatide, was advanced to
human trials
This page is a list of the episodes of ''The Outer Limits'', a 1995 science fiction/ dark fantasy television series. The series was broadcast on Showtime from 1995 to 2000, and on the Sci Fi Channel in its final year (2001–2002).
Series overvi ...
in 2015-2017 by Shawn Iadonato and Eric Tarcha, as the first-in-man K
v1.3 blocker for autoimmune disease.
Structure
ShK is cross-linked by three
disulfide bridges
In biochemistry, a disulfide (or disulphide in British English) refers to a functional group with the structure . The linkage is also called an SS-bond or sometimes a disulfide bridge and is usually derived by the coupling of two thiol groups. In ...
: Cys3-Cys35, Cys12-Cys28, and Cys17-Cys32. The
solution structure of ShK reveals two short
α-helices
The alpha helix (α-helix) is a common motif in the secondary structure of proteins and is a right hand-helix conformation in which every backbone N−H group hydrogen bonds to the backbone C=O group of the amino acid located four residues earli ...
comprising residues 14-19 and 21–24; the
N-terminal
The N-terminus (also known as the amino-terminus, NH2-terminus, N-terminal end or amine-terminus) is the start of a protein or polypeptide, referring to the free amine group (-NH2) located at the end of a polypeptide. Within a peptide, the amin ...
eight residues adopt an extended conformation, followed by a pair of interlocking turns that resemble a
310 helix; the
C-terminal
The C-terminus (also known as the carboxyl-terminus, carboxy-terminus, C-terminal tail, C-terminal end, or COOH-terminus) is the end of an amino acid chain (protein or polypeptide), terminated by a free carboxyl group (-COOH). When the protein is ...
Cys35 residue forms a nearly head-to-tail cyclic structure through a disulfide bond with Cys3.
Phylogenetic relationships of ShK and ShK domains
The
SMART database at the
EMBL
The European Molecular Biology Laboratory (EMBL) is an intergovernmental organization dedicated to molecular biology research and is supported by 27 member states, two prospect states, and one associate member state. EMBL was created in 1974 and ...
, as of May 2018, lists 3345
protein domain
In molecular biology, a protein domain is a region of a protein's polypeptide chain that is self-stabilizing and that folds independently from the rest. Each domain forms a compact folded three-dimensional structure. Many proteins consist o ...
s with
structural resemblance to ShK in 1797 proteins (1 to 8 domains/protein), many in the worm ''
Caenorhabditis elegans
''Caenorhabditis elegans'' () is a free-living transparent nematode about 1 mm in length that lives in temperate soil environments. It is the type species of its genus. The name is a blend of the Greek ''caeno-'' (recent), ''rhabditis'' (r ...
'' and
venomous snake
Venomous snakes are species of the suborder Serpentes that are capable of producing venom, which they use for killing prey, for defense, and to assist with digestion of their prey. The venom is typically delivered by injection using hollow or ...
s.
The majority of these domains are in
metallopeptidase
A metalloproteinase, or metalloprotease, is any protease enzyme whose catalytic mechanism involves a metal. An example is ADAM12 which plays a significant role in the fusion of muscle cells during embryo development, in a process known as myogen ...
s, whereas others are in
prolyl 4-hydroxylase
Procollagen-proline dioxygenase, commonly known as prolyl hydroxylase, is a member of the class of enzymes known as alpha-ketoglutarate-dependent hydroxylases. These enzymes catalyze the incorporation of oxygen into organic substrates through a me ...
s,
tyrosinase
Tyrosinase is an oxidase that is the rate-limiting enzyme for controlling the production of melanin. The enzyme is mainly involved in two distinct reactions of melanin synthesis otherwise known as the Raper Mason pathway. Firstly, the hydroxyl ...
s,
peroxidase
Peroxidases or peroxide reductases ( EC numberbr>1.11.1.x are a large group of enzymes which play a role in various biological processes. They are named after the fact that they commonly break up peroxides.
Functionality
Peroxidases typically ca ...
s,
oxidoreductase
In biochemistry, an oxidoreductase is an enzyme that catalyzes the transfer of electrons from one molecule, the reductant, also called the electron donor, to another, the oxidant, also called the electron acceptor. This group of enzymes usually ...
s, or proteins containing
epidermal growth factor-like domains,
thrombospondin-type repeats, or
trypsin-like serine protease domains.
The only human proteins containing ShK-like domains are
MMP-23 (matrix metalloprotease 23) and
MFAP-2 (microfibril-associated glycoprotein 2).
Channel targets
The ShK peptide blocks potassium (K
+) ion channels
Kv1.1,
Kv1.3,
Kv1.6,
Kv3.2 and
KCa3.1 with nanomolar to picomolar potency, and has no effect on the HERG (
Kv11.1) cardiac potassium channel.
The neuronal K
v1.1 channel and the T lymphocyte K
v1.3 channel are most potently inhibited by ShK.
Binding configuration in K+ channels
ShK and its analogues are blockers of the channel pore. They bind to all four subunits in the K
+ channel tetramer by interacting with the shallow 'vestibule' at the outer entrance to the channel pore.
These peptides are anchored in the external vestibule by two key interactions. The first is Lys22, which protrudes into and occludes the channel's pore like a "cork in a bottle" and blocks the passage of potassium ions through the channel pore.
The second is the neighboring Tyr23, which together with Lys22 forms a “functional dyad” required for channel block.
Many K
+ channel-blocking peptides contain such a dyad of a lysine and a neighboring aromatic or aliphatic residue.
Some K
+ channel-blocking peptides lack the functional dyad, but even in these peptides a lysine physically blocks the channel, regardless of the position of the lysine in the peptide sequence. Additional interactions anchor ShK and its analogues in the external vestibule and contribute to potency and selectivity.
For example, Arg11 and Arg29 in ShK interact with two Asp386 residues in adjacent subunits in the mouse K
v1.3 external vestibule (corresponds to Asp433 in human K
v1.3).
Analogues that block the Kv1.3 channel
Several ShK analogues have been generated to enhance specificity for the K
v1.3 channel over the neuronal K
v1.1 channel and other closely related channels.
- ShK-Dap22: This was the first analogue that showed some degree of specificity for Kv1.3. The pore-occluding lysine22 of ShK is replaced by diaminopropionic acid (Dap) in ShK-Dap22.
Dap is a non-natural lysine analogue with a shorter side chain length (2.5 Å from Cα) than lysine (6.3 Å). Dap22 interacts with residues further out in the external vestibule in contrast to lysine22, which interacts with the channel's selectivity filter. As a consequence, the orientations of ShK and ShK-Dap22 in the external vestibule are significantly different. ShK-Dap22 exhibits >20-fold selectivity for Kv1.3 over closely related channels in whole-cell patch clamp
The patch clamp technique is a laboratory technique in electrophysiology used to study ionic currents in individual isolated living cells, tissue sections, or patches of cell membrane. The technique is especially useful in the study of excitabl ...
experiments, but in equilibrium binding assays it binds Kv1.1-Kv1.2 heterotetramers with almost the same potency as ShK, which is not predicted from the study of homotetrameric Kv1.1 or Kv1.2 channels. - ShK-F6CA: Attaching a
fluorescein
Fluorescein is an organic compound and dye based on the xanthene tricyclic structural motif, formally belonging to triarylmethine dyes family. It is available as a dark orange/red powder slightly soluble in water and alcohol. It is widely use ...
to the N-terminus
The N-terminus (also known as the amino-terminus, NH2-terminus, N-terminal end or amine-terminus) is the start of a protein or polypeptide, referring to the free amine group (-NH2) located at the end of a polypeptide. Within a peptide, the ami ...
of the peptide via a hydrophilic AEEA linker (2-aminoethoxy-2-ethoxy acetic acid; mini-PEG) resulted in a peptide, ShK-F6CA (fluorescein-6-carboxyl), with 100-fold specificity for Kv1.3 over Kv1.1 and related channels. Attachment of a tetramethylrhodamine or a biotin via the AEEA linker to ShK's N-terminus did not increase specificity for Kv1.3 over Kv1.1. The enhanced specificity of ShK-F6CA might be explained by differences in charge: F6CA is negatively charged; tetramethylrhodamine is positively charged; and biotin is neutral. Subsequent studies with other analogues suggest that the negatively charged F6CA likely interacts with residues on the turret of the Kv1.3 channel as shown for ShK-192 and ShK-EWSS.
*ShK-170, ShK-186, ShK-192 and ShK-EWSS: Based on ShK-F6CA, additional analogues were made. Attaching a L-
phosphotyrosine
-Tyrosine or tyrosine (symbol Tyr or Y) or 4-hydroxyphenylalanine is one of the 20 standard amino acids that are used by cells to synthesize proteins. It is a non-essential amino acid with a polar side group. The word "tyrosine" is from the G ...
to the N-terminus of ShK via an AEEA linker resulted in a peptide, ShK-170, with 100-1000-fold specificity for K
v1.3 over related channels. ShK-186 (a.k.a. SL5; a.k.a. Dalazatide) is identical to ShK-170 except the C-terminal carboxyl is replaced by an amide. ShK-186 blocks K
v1.3 with an IC
50 of 69 pM and exhibits the same specificity for K
v1.3 over closely related channels as ShK-170.
The L-phosphotyrosine of ShK-170 and ShK-186 rapidly gets
dephosphorylated ''in vivo'' generating an analogue, ShK-198, with reduced specificity for K
v1.3.
To overcome this problem, ShK-192 and ShK-EWSS were developed. In ShK-192, the N-terminal L-phosphotyrosine is replaced by a non-hydrolyzable
para-phosphonophenylalanine (Ppa), and Met21 is replaced by the non-natural amino acid
norleucine
Norleucine (abbreviated as Nle) is an amino acid with the formula CH3(CH2)3CH(NH2)CO2H. A systematic name for this compound is 2-aminohexanoic acid. The compound is an isomer of the more common amino acid leucine. Like most other α-amino acids ...
to avoid
methionine oxidation
Methionine sulfoxide is the organic compound with the formula CH3S(O)CH2CH2CH(NH2)CO2H. It is an amino acid that occurs naturally although it is formed post-translationally.
Oxidation of the sulfur of methionine results in methionine sulfoxide ...
.
In ShK-EWSS, the AEEA linker and L-phosphotyrosine are replaced by the residues glutamic acid (E), tryptophan (W) and two serines (S).
Both ShK-192 and ShK-EWSS are highly specific for K
v1.3 over related channels.
*ShK-K18A:
Docking and
molecular dynamics
Molecular dynamics (MD) is a computer simulation method for analyzing the physical movements of atoms and molecules. The atoms and molecules are allowed to interact for a fixed period of time, giving a view of the dynamic "evolution" of th ...
simulations on K
v1.3 and K
v1.1 followed by
umbrella sampling simulations, paved the way to the selective Kv1.3 inhibitor ShK-K18A.
*ShK-related peptides in parasitic worms: AcK1, a 51-residue peptide from hookworms ''
Ancylostoma caninum
''Ancylostoma caninum'' is a species of nematode known as a hookworm, which principally infects the small intestine of dogs. The result of ''A. caninum'' infection ranges from asymptomatic cases to death of the dog; better nourishment, increasi ...
'' and ''
Ancylostoma ceylanicum
''Ancylostoma ceylanicum'' is a parasitic roundworm belonging to the genus ''Ancylostoma''. It is a hookworm both of humans and of other mammals such as dogs, cats, and golden hamsters. It is the only zoonotic hookworm species that is able to pro ...
'', and BmK1, the C-terminal domain of a
metalloprotease
A metalloproteinase, or metalloprotease, is any protease enzyme whose catalytic mechanism involves a metal. An example is ADAM12 which plays a significant role in the fusion of muscle cells during embryo development, in a process known as myog ...
from
filarial worm
Filariasis is a parasitic disease caused by an infection with roundworms of the Filarioidea type. These are spread by blood-feeding insects such as black flies and mosquitoes. They belong to the group of diseases called helminthiases.
These ...
''
Brugia malayi
''Brugia malayi'' is a filarial (arthropod-borne) nematode (roundworm), one of the three causative agents of lymphatic filariasis in humans. Lymphatic filariasis, also known as elephantiasis, is a condition characterized by swelling of the lowe ...
'', adopt helical structures closely resembling ShK.
AcK1 and BmK1 block
Kv1.3 channels at nanomolar-micromolar concentrations, and they suppress rat effector memory
T cell
A T cell is a type of lymphocyte. T cells are one of the important white blood cells of the immune system and play a central role in the adaptive immune response. T cells can be distinguished from other lymphocytes by the presence of a T-cell ...
s without affecting naïve and central memory T cell subsets.
Further, they suppress
IFN-g
Interferon gamma (IFN-γ) is a dimerized soluble cytokine that is the only member of the type II class of interferons. The existence of this interferon, which early in its history was known as immune interferon, was described by E. F. Wheelock ...
production by human T cells and they inhibit the
Delayed-type hypersensitivity response caused by skin-homing effector memory T cells.
''
Teladorsagia circumcincta
''Teladorsagia circumcincta'' is a nematode that is one of the most important parasites of sheep and goats. It was previously known as ''Ostertagia circumcincta'' and is colloquially known as the brown stomach worm. It is common in cool, tempera ...
'' is an economically important parasite that infects sheep and goats. TcK6, a 90-residue protein with a C-terminal ShK-related domain, is upregulated during the mucosal dwelling larval stage of this parasite.
TcK6 causes modest suppression of
thapsigargin
Thapsigargin is a non-competitive inhibitor of the sarco/endoplasmic reticulum Ca2+ ATPase (SERCA). Structurally, thapsigargin is classified as a guaianolide, and is extracted from a plant, '' Thapsia garganica''. It is a tumor promoter in m ...
-triggered IFN-g production by sheep T cells, suggesting that the parasite use this protein for immune evasion by modulating mucosal T cells.
Extending circulating half-life
Due to their low molecular mass, ShK and its analogues are prone to rapid renal elimination. In rats, the half-life is ~6 min for ShK-186 and ~11 min for ShK-198, with a clearance rate of ~950 ml/kg·min.
In monkeys, the half-life is ~12 min for ShK-186 and ~46 min for ShK-198, with a clearance rate of ~80 ml/kg·min.
PEGylation of ShK: Conjugation of polyethylene glycol (PEG) to ShK
16K
16K resolution is a display resolution with approximately 16,000 pixels horizontally. The most commonly discussed 16K resolution is , which doubles the pixel count of 8K UHD in each dimension, for a total of four times as many pixels. This resolu ...
an ShK analogue, increased its molecular mass and thereby reduced renal clearance and extended plasma half-life to 15 h in mice and 64 h in cynomolgus monkeys.
PEGylation can also decrease immunogenicity and protect a peptide from proteolysis and non-specific adsorption to inert surfaces. PEGylated ShK
16K
16K resolution is a display resolution with approximately 16,000 pixels horizontally. The most commonly discussed 16K resolution is , which doubles the pixel count of 8K UHD in each dimension, for a total of four times as many pixels. This resolu ...
prevented adoptive-transfer experimental autoimmune encephalomyelitis in rats, a model for multiple sclerosis.
*Conjugation of ShK to larger proteins: The circulating half-life of peptides can be prolonged by coupling them to larger proteins or protein domains.
By screening a combinatorial ShK peptide library, novel analogues were identified, which when fused to the C-termini of IgG1-Fc retained picomolar potency, effectively suppressed ''in vivo'' delayed type hypersensitivity and exhibited a prolonged circulating half-life.
*Prolonged effects despite rapid plasma clearance: SPECT/CT imaging studies with a
111In-DOTA-conjugate of ShK-186 in rats and squirrel monkeys revealed a slow release from the injection site and blood levels above the channel blocking dose for 2 and 7 days, respectively.
Studies on human peripheral blood T cells showed that a brief exposure to ShK-186 was sufficient to suppress cytokine responses.
These findings suggest that ShK-186, despite its short circulating half-life, may have a prolonged therapeutic effect. In rats, the peptide is effective in treating disease in animal models of autoimmune diseases when administered once a day to once in 3 days.
In humans, subcutaneous injections twice a week are sufficient to ameliorate disease in patients with plaque psoriasis.
Peptide delivery
The low molecular mass of ShK and its analogues, combined with their high isoelectric points, makes it unlikely that these peptides will be absorbed from the stomach or intestine following oral administration. Sub-lingual delivery is a possibility. A fluorescent ShK analogue was absorbed into the blood stream at pharmacological concentrations following sublingual administration with a mucoadhesive chitosan-based gel, with or without the penetration enhancer cetrimide. Delivery of the peptide as an aerosol through the lung, or across the skin, or as eye drops are also possibilities.
Modulation of T cell function
During T cell-activation, calcium enters lymphocytes through store-operated CRAC channels (calcium release activated channel) formed as a complex of Orai and Stim proteins.
The rise in intracellular calcium initiates a signaling cascade culminating in cytokine production and proliferation.
The K
v1.3 K
+ channel and the calcium-activated K
Ca3.1 K
+ channel in T cells promote calcium entry into the cytoplasm through CRAC by providing a counterbalancing cation efflux.
Blockade of K
v1.3 depolarizes the membrane potential of T cells, suppresses calcium signaling and IL-2 production, but not IL2-receptor expression.
K
v1.3 blockers have no effect on activation pathways that are independent of a rise in intracellular calcium (e.g. anti-CD28, IL-2).
Expression of the K
v1.3 and K
Ca3.1 channels varies during T cell activation and differentiation into memory T cells.
When naïve T cells and central memory T cells (T
CM) are activated they upregulate K
Ca3.1 expression to ~500 per cell without significant change in K
v1.3 numbers.
In contrast, when terminally differentiated effector memory subsets (T
EM, T
EMRA effector memory re-expressing CD45RA are activated, they upregulate K
v1.3 to 1500 per cell without changes in K
Ca3.1.
The K
v1.3 channel number increases and the K
Ca3.1 channel number decreases as T cells are chronically activated.
As a result of this differential expression, blockers of K
Ca3.1 channels preferentially suppress the function of naïve and T
CM cells, while ShK and its analogues that selectively inhibit K
v1.3 channels preferentially suppress the function of chronically activated effector memory T cells (T
EM, T
EMRA).
Of special interest are the large number of ShK analogues developed at Amgen that suppressed interleukin-2 and interferon gamma production by T cells.
This inhibitory effect of K
v1.3 blockers is partial and stimulation strength dependent, with reduced inhibitory efficacy on T cells under strengthened anti-CD3/CD28 stimulation. Chronically activated CD28
null effector memory T cells are implicated in autoimmune diseases (e.g. lupus, Crohn's disease, rheumatoid arthritis, multiple sclerosis).
Blockade of K
v1.3 channels in these chronically activated T cells suppresses calcium signaling, cytokine production (interferon gamma, interleukin-2, interleukin 17), and cell proliferation.
Effector memory T cells that are CD28
+ are refractory to suppression by K
v1.3 blockers when they are co-stimulated by anti-CD3 and anti-CD28 antibodies, but are sensitive to suppression when stimulated by anti-CD3 antibodies alone.
''In vivo'', ShK-186 paralyzes effector-memory T cells at the site of an inflammatory delayed type hypersensitivity response and prevents these T cells from activating in the inflamed tissue.
In contrast, ShK-186 does not affect the homing and motility of naive and T
CM cells to and within lymph nodes, most likely because these cells express the K
Ca3.1 channel and are therefore protected from the effect of K
v1.3 blockade.
Effects on microglia
K
v1.3 plays an important role in microglial activation. ShK-223, an analogue of ShK-186, decreased lipopolysaccharide (LPS) induced focal adhesion formation by microglia, reversed LPS-induced inhibition of microglial migration, and inhibited LPS-induced upregulation of EH domain containing protein 1 (EHD1), a protein involved in microglia trafficking. Increased K
v1.3 expression was reported in microglia in Alzheimer plaques. K
v1.3 inhibitors may have use in the management of Alzheimer's disease, as reported in a proof-of-concept study in which a small molecule K
v1.3 blocker (PAP-1) alleviated Alzheimer's disease-like characteristics in a mouse model of AD.
Efficacy of analogues in animal models of human diseases
Experimental autoimmune encephalomyelitis (EAE), a model for multiple sclerosis
ShK, ShK-Dap
22, ShK-170 and PEGylated ShK-Q16K prevent adoptive-transfer EAE in Lewis rats, a model of multiple sclerosis.
Since multiple sclerosis is a relapsing-remitting disease, ShK-186 and ShK-192 were evaluated in a relapsing-remitting EAE model in DA (Dark Agouti) rats. Both prevented and treated disease when administered once a day to once in three days.
Thus, K
v1.3 inhibitors are effective in treating disease in rat models of multiple sclerosis when administered alone,
and therapeutic effectiveness does not appear to be compromised by compensatory over-expression of K
Ca3.1 channels.
Pristane-induced arthritis (PIA), a model for rheumatoid arthritis
ShK-186 was effective in treating PIA when administered every day or on alternate days.
A scorpion toxin inhibitor of K
V1.3 was also effective in this model. In both these studies, blockade of K
v1.3 alone was sufficient to ameliorate disease and simultaneous blockade of K
Ca3.1 was not necessary as has been suggested.
Rat models of atopic dermatitis
Most infiltrating T-cells in skin lesions from patients with moderate-to-severe atopic dermatitis (AD) express high levels of K
v1.3, suggesting that inhibitors of K
v1.3 may be effective in treating AD.
Ovalbumin-induced delayed type hypersensitivity and oxazolone-induced dermatitis are considered to be models of atopic dermatitis.
ShK, ShK-170, ShK-186, ShK-192 and ShK-IgG-Fc were all effective in the ovalbumin-induced delayed type hypersensitivity model,
while a topical formulation of ShK-198 was effective in treating oxazolone-induced dermatitis.
Even where compensation by K
Ca3.1 channels was reported to over-ride K
V1.3 block, ShK administered alone suppressed delayed type hypersensitivity significantly in 2 of 3 studies, albeit modestly.
Psoriasis
Psoriasis is a severe autoimmune disease of the skin that afflicts many people worldwide. Despite the success of recent biologics in ameliorating disease, there is still a search for safe and effective drugs for psoriasis. K
V1.3 inhibitors (ShK, PAP-1) have been reported to treat disease in psoriasiform (psoriasis-like) SCID (severe combined immunodeficiency) mouse model. In a Phase 1b placebo-controlled clinical study in patients with plaque psoriasis, ShK-186 administered twice a week (30 or 60 mg/dose/patient) by subcutaneous injection caused improvements with a statistically significant reduction in their PASI (Psoriasis Area and Severity Index) score between baseline and day 32.
These patients also exhibited reduced plasma levels of multiple inflammation markers and decreased expression of T cell activation markers on peripheral blood memory T cells.
Diet-induced obesity and fatty liver disease
Obesity and diabetes are major healthcare problems globally. There is need for safe drugs for these metabolic diseases. In a mouse model of diet-induced obesity, ShK-186 counteracted the negative effects of increased caloric intake. It reduced weight gain, adiposity, and fatty liver; decreased blood levels of cholesterol, sugar, HbA1c, insulin, and leptin; and enhanced peripheral insulin sensitivity.
Genetic deletion of the K
v1.3 gene has the same effect, indicating that ShK-186's effect is due to K
v1.3 blockade.
At least two mechanisms contribute to ShK-186's therapeutic benefits. The high calorie diet induced K
v1.3 expression in brown fat tissues.
By blocking K
v1.3, ShK-186 doubled glucose uptake and increased β-oxidation of fatty acids, glycolysis, fatty acid synthesis and uncoupling protein 1 expression by brown fat.
As a consequence of brown fat activation, oxygen consumption and energy expenditure were augmented.
The obesity diet also induced K
v1.3 expression in the liver, and ShK-186 caused profound alterations in energy and lipid metabolism in the liver. ShK, its analogues or other K
v1.3 blockers may have use in controlling the negative consequences of high calorie diets.
Arousal and anesthesia
The mechanisms of general anesthesia involve multiple molecular targets and pathways that are not completely understood.
Sevoflurane is a common anesthetic used to induce general anesthesia during surgery.
Rats continually exposed to sevoflurane lose their righting reflex as an index of loss of consciousness. In these rats, microinfusion of ShK into the central medial thalamic nucleus (CMT) reversed sevoflurane-induced anesthesia in rodents.
ShK-treated rats righted themselves fully (restored consciousness) despite being continually exposed to sevoflurane.
ShK-microinfusion into neighboring regions of the brain did not have this effect.
Sevoflurane enhanced potassium currents in the CMT, while ShK and ShK-186 countered this effect.
These studies suggest that ShK-sensitive K
+ channels in the CMT are important for suppressing arousal during anesthesia.
Preventing brain damage following therapeutic brain radiation
Brain radiation is used to treat tumors of the head, neck, and brain, but this treatment carries a significant risk of neurologic injury. Injury is, in part, due to the activation of microglia and microglia-mediated damage of neurons. Neuroprotective therapies for radiation-induced brain injury are still limited. In a mouse model of brain radiation, ShK-170 reversed neurological deficits, and protected neurons from radiation-induced brain injury by suppressing microglia.
Toxicity of ShK and its analogues
ShK and ShK-Dap22
ShK peptide has a low toxicity profile in mice. ShK is effective in treating autoimmune diseases at 10 to 100 mg/kg bodyweight. It has a median paralytic dose of approximately 25 mg/kg bodyweight (250-2500 higher than the pharmacological dose). In rats the therapeutic safety index is greater than 75-fold. ShK-Dap
22 displayed a lower toxicity profile.
A 1.0 mg dose did not induce any hyperactivity, seizures or mortality in rats. The median paralytic dose for ShK-Dap
22 is about 200 mg/kg bodyweight (2000-20000 higher than pharmacological dose).
PEGylated
PEGylation (or pegylation) is the process of both covalent and non-covalent attachment or amalgamation of polyethylene glycol (PEG, in pharmacy called macrogol) polymer chains to molecules and macrostructures, such as a drug, therapeutic protein ...
ShK
16K
16K resolution is a display resolution with approximately 16,000 pixels horizontally. The most commonly discussed 16K resolution is , which doubles the pixel count of 8K UHD in each dimension, for a total of four times as many pixels. This resolu ...
showed no adverse toxicity in monkeys over a period of several months.
ShK-186/Dalazatide
ShK-186 also displays a low toxicity profile in rats. Daily administration of ShK-170 or ShK-186 (100 μg/kg/day) by subcutaneous injection over 4 weeks in rats does not induce any changes in blood counts, blood chemistry or histopathology.
By virtue of suppressing only T
EM and T
EMRA cells, ShK-186 did not compromise protective immune responses to
influenza virus
''Orthomyxoviridae'' (from Greek ὀρθός, ''orthós'' 'straight' + μύξα, ''mýxa'' ' mucus') is a family of negative-sense RNA viruses. It includes seven genera: '' Alphainfluenzavirus'', '' Betainfluenzavirus'', '' Gammainfluenzavirus' ...
and
chlamydial infection
Chlamydia, or more specifically a chlamydia infection, is a sexually transmitted infection caused by the bacterium ''Chlamydia trachomatis''. Most people who are infected have no symptoms. When symptoms do appear they may occur only several we ...
in rats, most likely because naïve and T
CM cells unaffected by K
v1.3 blockade mounted effective immune responses.
ShK-186 is poorly immunogenic and did not elicit anti-ShK antibodies in rats repeatedly administered the peptide.
This is possibly because the peptide's disulfide-bonded structure hinders processing and antigen presentation by antigen-presenting cells. ShK-186 also shares sequence and structural similarity to a ShK-like domain in matrix metalloprotease 23,
which may cause the immune system to assume it is a normal protein in the body. ShK-186 was safe in non-human primates. In Phase 1a and 1b trials in healthy human volunteers, ShK-186 was well tolerated, no grade 3 or 4 adverse effects or laboratory abnormalities were noted, and the predicted range of drug exposures were achieved.
The most common adverse events were temporary mild (Grade 1)
hypoesthesia
Hypoesthesia or numbness is a common side effect of various medical conditions that manifests as a reduced sense of touch or sensation, or a partial loss of sensitivity to sensory stimuli. In everyday speech this is generally referred to as num ...
and
paresthesia
Paresthesia is an abnormal sensation of the skin (tingling, pricking, chilling, burning, numbness) with no apparent physical cause. Paresthesia may be transient or chronic, and may have any of dozens of possible underlying causes. Paresthesias ar ...
involving the hands, feet, or perioral area. Mild muscle spasms, sensitivity of teeth, and injection site pain were also observed.
Functions of ShK-like proteins
MMP-23
MMP-23 belongs to the family of zinc- and calcium-dependent matrix metalloproteases. It is anchored in the cell membrane by an N-terminal prodomain, and it contains three extracellular domains: catalytic metalloprotease domain, ShK domain and immunoglobulin-like cell adhesion molecule (
Ig-CaM) domain.
The prodomain traps the voltage-gated potassium channel K
V1.3, but not the closely related K
V1.2 channel, in the endoplasmic reticulum.
Studies with chimeras suggest that the prodomain interacts with the K
V1.3 region from the S5 transmembrane segment to the C terminus.
NMR studies of the prodomain reveal a single trans-membrane alpha-helix, joined by a short linker to a juxta-membrane alpha-helix, which is associated with the surface of the membrane.
The prodomain shares topological similarity with proteins (KCNE1, KCNE2, KCNE4) known to trap potassium channels in the secretory pathway, suggesting a shared mechanism of channel regulation.
MMP-23's catalytic domain displays structural homology with catalytic domains in other metalloproteases, and likely functions as an endopeptidase. MMP-23's ShK domain lies immediately after the catalytic domain and is connected to the IgCAM domain by a short proline-rich linker. It shares phylogenetic relatedness to sea anemone toxins and
ICR-CRISP domains, being most similar to the BgK toxin from sea anemone ''Bunodosoma granulifera''.
This ShK domain blocks voltage-gated potassium channels (K
V1.6 > K
V1.3 > K
V1.1 = K
V3.2 > K
v1.4, in decreasing potency) in the nanomolar to low micromolar range.
K
V1.3 is required for sustaining calcium signaling during activation of human T cells.
By trapping K
V1.3 in the endoplasmic reticulum via the prodomain, and by blocking the K
V1.3 channel with the ShK domain, MMP-23 may serve as an immune checkpoint to reduce excessive T cell activation during an immune response. In support, increased expression of MMP-23 in melanoma cancer cells decreases tumor-infiltrating lymphocytes, and is associated with cancer recurrence and shorter periods of progression-free survival.
However, in melanomas, expression of MMP-23 does not correlate with K
v1.3 expression, suggesting that MMP-23's deleterious effect in melanomas may not be connected with its K
v1.3 channel-modulating function.
MMP-23's C-terminal IgCAM domain shares sequence similarity with IgCAM domains in proteins known to mediate protein-protein and protein-lipid interactions (e.g.
CDON
Cell adhesion molecule-related/down-regulated by oncogenes is a protein that in humans is encoded by the ''CDON'' gene.
CDON and BOC are cell surface receptors of the immunoglobulin (Ig)/fibronectin type III ( FNIII) repeat family involved in my ...
, human
Brother of CDO,
ROBO1-4,
hemicentin,
NCAM1
Neural cell adhesion molecule (NCAM), also called CD56, is a homophilic binding glycoprotein expressed on the surface of neurons, glia and skeletal muscle. Although CD56 is often considered a marker of neural lineage commitment due to its discover ...
and
NCAM2
Neural cell adhesion molecule (NCAM), also called CD56, is a homophilic binding glycoprotein expressed on the surface of neurons, glia and skeletal muscle. Although CD56 is often considered a marker of neural lineage commitment due to its discover ...
).
In summary, the four domains of MMP-23 may work synergistically to modulate immune responses ''in vivo''.
Mab7
In male ''
Caenorhabditis elegans
''Caenorhabditis elegans'' () is a free-living transparent nematode about 1 mm in length that lives in temperate soil environments. It is the type species of its genus. The name is a blend of the Greek ''caeno-'' (recent), ''rhabditis'' (r ...
'' worms, the absence of a protein called Mab7 () results in malformed sensory rays that are required for mating.
Introduction of Mab7 into these male worms restores normal development of normal sensory rays.
Introduction of Mab7 proteins lacking the ShK domain does not correct the defect of sensory rays, suggesting a role for the ShK-domain of Mab7 in sensory ray development.
HMP2 and PMP1
HMP2 and PMP-1 are
astacin
Astacins are a family of multidomain metalloendopeptidases which are either secreted or membrane-anchored. These metallopeptidases belong to the MEROPS peptidase family M12, subfamily M12A (astacin family, clan MA(M)). The protein fold of the pep ...
metalloproteinases from the Cnidarian ''
Hydra vulgaris
''Hydra vulgaris'', the fresh-water polyp, is a small animal freshwater hydroid with length from 10 mm to 30 mm and width about 1 mm.
Description
The hydra have four to twelve tentacles that protrude from just outside the mouth. They feed b ...
'' and the jellyfish ''
Podocoryne carnea'' that contain ShK-like domains at their C-termini.
Both these ShK-domains contain the critical pore-occluding lysine required for K
+ channel block.
HMP2 plays a critical role in foot regeneration of ''Hydra'',
while PMP-1 is found in the feeding organ of the jelly fish and the ShK-domain may paralyze prey after they are ingested.
CRISPs

More distantly related are
Cysteine-rich secretory protein
Cysteine-rich secretory proteins, often abbreviated as CRISPs, are a group of glycoproteins. They are a subgroup of the CRISP, antigen 5 and Pr-1 (CAP) protein superfamily and also contain a domain related to the ShK toxins. They are substantially ...
s (CRISPs), which contain a ShK-like 'Cystine-rich domain' as well as a larger
CAP-like 'Pathogenesis related 1' domain.
These proteins are involved in
mammalian reproduction
Most mammals are viviparous, giving birth to live young. However, the five species of monotreme, the platypuses and the echidnas, lay eggs. The monotremes have a sex determination system different from that of most other mammals. In particular, t ...
as well as in the
venoms
Venom or zootoxin is a type of toxin produced by an animal that is actively delivered through a wound by means of a bite, sting, or similar action. The toxin is delivered through a specially evolved ''venom apparatus'', such as fangs or a sti ...
of some snakes.
In both cases, the mechanism is believed to involve inhibition of ion channel activity.
References
External links
* {{PDBe-KB2, P29187, Kappa-stichotoxin-She3a
Ion channel toxins
Neurotoxins
Cysteine-rich proteins