A Simulated Intermediate State for Folding and Aggregation Provides Insights into ΔN6 β₂-Microglobulin Amyloidogenic Behavior

<div><p>A major component of <i>ex vivo</i> amyloid plaques of patients with dialysis-related amyloidosis (DRA) is a cleaved variant of β₂-microglobulin (ΔN6) lacking the first six N-terminal residues. Here we perform a computational study on ΔN6, which provides clues to understand the amyloidogenicity of the full-length β₂-microglobulin. Contrary to the wild-type form, ΔN6 is able to efficiently nucleate fibrillogenesis <i>in vitro</i> at physiological pH. This behavior is enhanced by a mild acidification of the medium such as that occurring in the synovial fluid of DRA patients. Results reported in this work, based on molecular simulations, indicate that deletion of the N-terminal hexapeptide triggers the formation of an intermediate state for folding and aggregation with an unstructured strand A and a native-like core. Strand A plays a pivotal role in aggregation by acting as a sticky hook in dimer assembly. This study further predicts that the detachment of strand A from the core is maximized at pH 6.2 resulting into higher aggregation efficiency. The structural mapping of the dimerization interface suggests that Tyr10, His13, Phe30 and His84 are hot-spot residues in ΔN6 amyloidogenesis.</p>