Cell biology

Philosophy

Neuroscience

Biology

Small molecule

Modulation (music)

Extracellular

Alzheimer's disease

Biochemistry

Computational biology

Drug discovery

Aesthetics

Binding site

Enzyme

Amyloid precursor protein

Amyloid precursor protein secretase

Allosteric regulation

Presenilin

Medicine

Biophysics

Disease

Pathology

Cell

Development of γ-secretase inhibitors (GSIs) and modulators (GSMs) represents an attractive therapeutic opportunity for Alzheimer’s disease (AD) and cancers. However, how these GSIs and GSMs target γ-secretase has remained largely unknown. Here, we report the cryoelectron microscopy (cryo-EM) structures of human γ-secretase bound individually to two GSI clinical candidates, Semagacestat and Avagacestat, a transition state analog GSI L685,458, and a classic GSM E2012, at overall resolutions of 2.6–3.1 Å. Remarkably, each of the GSIs occupies the same general location on presenilin 1 (PS1) that accommodates the β strand from amyloid precursor protein or Notch, interfering with substrate recruitment. L685,458 directly coordinates the two catalytic aspartate residues of PS1. E2012 binds to an allosteric site of γ-secretase on the extracellular side, potentially explaining its modulating activity. Structural analysis reveals a set of shared themes and variations for inhibitor and modulator recognition that will guide development of the next-generation substrate-selective inhibitors.

Structural basis of γ-secretase inhibition and modulation by small molecule drugs