A conformational fingerprint for amyloidogenic light chains

Reviewer #1 (Public review):

The study investigates light chains (LCs) using three distinct approaches, with a focus on identifying a conformational fingerprint to differentiate amyloidogenic light chains from multiple myeloma light chains. The study's major contribution is the identification of a low-populated "H state," which the authors propose as a unique marker for AL-LCs. While this finding is promising, the review highlights several strengths and weaknesses. Strengths include the valuable contribution of identifying the H state and the use of multiple approaches, which provide a comprehensive understanding of LC structural dynamics. Weaknesses include a lack of physical insights explaining the changes.

Reviewer #2 (Public review):

Summary:

This well-written manuscript addresses an important but recalcitrant problem - molecular mechanism of protein misfolding in Ig light chain (LC) amyloidosis (AL), a major life-threatening form of systemic human amyloidosis. The authors use expertly recorded and analyzed small-angle X-ray scattering (SAXS) data as a restraint for molecular dynamics simulations (called M&M). Six patient-based LC proteins are explored, including four AL and two non-AL. The authors report a partially populated "H-state" determined computationally, wherein the two domains in an LC molecule acquire a straight rather than bent conformation, with an extended interdomain linker; this H-state distinguishes AL from non-AL LCs. H-D exchange mass spectrometry is used to support this conclusion. This is a novel and interesting finding with potentially important translational implications.

Strengths:

Expertly recorded and analyzed SAXS data combined with clever M&M simulations lead to a novel and interesting conclusion, which is supported by limited H-D exchange data.
Stabilization of the CL-CL interface is a good idea that may help protect a subset of AL LCs from misfolding in amyloid.

Computational M&M evidence is convincing and is supported by SAXS data, which are used as restraints for simulations. Although Kratky plots reported in the main MS Fig. 1 show significant differences between the data and the structural model for only one AL protein, AL-55, H-state is also inferred for other AL proteins.

Apparent limitations:

HDX MS results show that residues 35-50 from VL-VL and VL-CL dimerization interface are less protected in AL vs. non-AL proteins, which is consistent with the H-state. However, the small number of proteins yielding useful HDX data (three AL and one non-AL) suggests that this conclusion should be treated with caution. It is unclear whether the conformational heterogeneity depicted in M&M simulations is consistent with HDX results, and whether prior HDX studies of AL and MM LCs are consistent with the conclusions that a particular domain-domain interface is weakened in AL vs. non-AL LCs. The butterfly plots in Fig. 5 could benefit from the X-axis labeling with the peptide fragments.

Reviewer #3 (Public review):

Summary:

This study identifies confirmational fingerprints of amylodogenic light chains, that set them apart from the non-amylodogenic ones.

Strengths:

The research employs a comprehensive combination of structural and dynamic analysis techniques, providing evidence that conformational dynamics at VL-CL interface and structural expansion are distinguished features of amylodogenic LCs.

Weaknesses:

The sample size is limited, which may affect the generalizability of the findings. Additionally, the study could benefit from deeper analysis of specific mutations driving this unique conformation to further strengthen therapeutic relevance.

Furthermore. p-value (statistical significance) of Rg difference should be computer. Finally, significance of mutations (SHM?) at the interface, such as A40G should be compared with previous observations. (Garofalo et al., 2021)

Reviewer #1 (Public review):

The study investigates light chains (LCs) using three distinct approaches, with a focus on identifying a conformational fingerprint to differentiate amyloidogenic light chains from multiple myeloma light chains. The study's major contribution is the identification of a low-populated "H state," which the authors propose as a unique marker for AL-LCs. While this finding is promising, the review highlights several strengths and weaknesses. Strengths include the valuable contribution of identifying the H state and the use of multiple approaches, which provide a comprehensive understanding of LC structural dynamics. Weaknesses include a lack of physical insights explaining the changes.

Reviewer #2 (Public review):

Summary:

This well-written manuscript addresses an important but recalcitrant problem - molecular mechanism of protein misfolding in Ig light chain (LC) amyloidosis (AL), a major life-threatening form of systemic human amyloidosis. The authors use expertly recorded and analyzed small-angle X-ray scattering (SAXS) data as a restraint for molecular dynamics simulations (called M&M). Six patient-based LC proteins are explored, including four AL and two non-AL. The authors report a partially populated "H-state" determined computationally, wherein the two domains in an LC molecule acquire a straight rather than bent conformation, with an extended interdomain linker; this H-state distinguishes AL from non-AL LCs. H-D exchange mass spectrometry is used to support this conclusion. This is a novel and interesting finding with potentially important translational implications.

Strengths:

Expertly recorded and analyzed SAXS data combined with clever M&M simulations lead to a novel and interesting conclusion, which is supported by limited H-D exchange data.
Stabilization of the CL-CL interface is a good idea that may help protect a subset of AL LCs from misfolding in amyloid.

Computational M&M evidence is convincing and is supported by SAXS data, which are used as restraints for simulations. Although Kratky plots reported in the main MS Fig. 1 show significant differences between the data and the structural model for only one AL protein, AL-55, H-state is also inferred for other AL proteins.

Apparent limitations:

HDX MS results show that residues 35-50 from VL-VL and VL-CL dimerization interface are less protected in AL vs. non-AL proteins, which is consistent with the H-state. However, the small number of proteins yielding useful HDX data (three AL and one non-AL) suggests that this conclusion should be treated with caution. It is unclear whether the conformational heterogeneity depicted in M&M simulations is consistent with HDX results, and whether prior HDX studies of AL and MM LCs are consistent with the conclusions that a particular domain-domain interface is weakened in AL vs. non-AL LCs. The butterfly plots in Fig. 5 could benefit from the X-axis labeling with the peptide fragments.

Reviewer #3 (Public review):

Summary:

This study identifies confirmational fingerprints of amylodogenic light chains, that set them apart from the non-amylodogenic ones.

Strengths:

The research employs a comprehensive combination of structural and dynamic analysis techniques, providing evidence that conformational dynamics at VL-CL interface and structural expansion are distinguished features of amylodogenic LCs.

Weaknesses:

The sample size is limited, which may affect the generalizability of the findings. Additionally, the study could benefit from deeper analysis of specific mutations driving this unique conformation to further strengthen therapeutic relevance.

Furthermore. p-value (statistical significance) of Rg difference should be computer. Finally, significance of mutations (SHM?) at the interface, such as A40G should be compared with previous observations. (Garofalo et al., 2021)