Solvent accessibility of E1α and E1β residues with known missense mutations causing pyruvate dehydrogenase complex (PDC) deficiency: Impact on PDC‐E1 structure and function

Pyruvate dehydrogenase complex deficiency is a major cause of primary lactic acidemia resulting in high morbidity and mortality, with limited therapeutic options. PDHA1 mutations are responsible for >82% of cases. The E1 component of PDC is a symmetric dimer of heterodimers (αβ/α′β′) encoded by PDHA1 and PDHB. We measured solvent accessibility surface area (SASA), utilized nearest‐neighbor analysis, incorporated sequence changes using mutagenesis tool in PyMOL, and performed molecular modeling with SWISS‐MODEL, to investigate the impact of residues with disease‐causing missense variants (DMVs) on E1 structure and function. We reviewed 166 and 13 genetically resolved cases due to PDHA1 and PDHB, respectively, from variant databases. We expanded on 102 E1α and 13 E1β nonduplicate DMVs. DMVs of E1α Arg112‐Arg224 stretch (exons 5‐7) and of E1α Arg residues constituted 40% and 39% of cases, respectively, with invariant Arg349 accounting for 22% of arginine replacements. SASA analysis showed that 86% and 84% of residues with nonduplicate DMVs of E1α and E1β, respectively, are solvent inaccessible (“buried”). Furthermore, 30% of E1α buried residues with DMVs are deleterious through perturbation of subunit‐subunit interface contact (SSIC), with 73% located in the Arg112‐Arg224 stretch. E1α Arg349 represented 74% of buried E1α Arg residues involved in SSIC. Structural perturbations resulting from residue replacements in some matched neighboring pairs of amino acids on different subunits involved in SSIC at 2.9‐4.0 Å interatomic distance apart, exhibit similar clinical phenotype. Collectively, this work provides insight for future target‐based advanced molecular modeling studies, with implications for development of novel therapeutics for specific recurrent DMVs of E1α.