7222 Structural and Mechanistic Studies of the Bioactive Anti-Müllerian Hormone Procomplex

Abstract Disclosure: J.A. Howard: None. L. Hok: None. N.J. Sanford: None. R.L. Cate: None. K. Hart: Employee; Self; Regeneron Pharmaceuticals. E. Leach: None. D. Pepin: None. P.K. Donahoe: None. T.B. Thompson: Advisory Board Member; Self; Oviva Therapeutics, Keros Therapeutics. The Anti-Mullerian hormone (AMH), a divergent member of the TGF-beta signaling superfamily, plays crucial roles in reproductive development and maintenance. Owing to its key role as a negative feedback regulator in folliculogenesis, AMH has garnered significant interest for therapeutic applications in contraception and oncofertility. The bioactive form of AMH is a noncovalent complex, comprising the TGFβ-like signaling domain and a dimeric prodomain whose structure remains largely unexplored. The prodomain component is necessary for the dimerization and secretion of the signaling domain, shuttling the ligand to autocrine, paracrine, and endocrine targets. In contrast, the structure and biochemistry of this domain remain poorly characterized, and its role in enhancing AMH signaling remains unclear. This gap in understanding significantly limits the enhancement and wider application of AMH-based protein therapeutics. Molecular modeling unveiled an unexpected AMH prodomain structure: an N-terminal dimerizing domain (NTD) linked to a novel C-terminal binding domain (CTD). This atypical design was affirmed by both small-angle X-ray scattering and negative-stain EM. The CTD introduces a unique TGFβ superfamily fold consisting of a four-helix bundle and an unstructured binding “belt”. The more prodomain-like NTD does not interact with the signaling ligand, nor does it consistently interact with the CTD. Both domains exhibit high levels of interspecies conservation as well as disease-causing mutations, such as those found in PMDS, PCOS, and POI. Using single-particle Cryo-EM we have elucidated the molecular mechanisms of the interaction between the AMH prodomain and signaling domain bound by mAb 6E11. Our 3.2Å cryo-EM structure confirmed the predicted architecture and binding function of the CTD and demonstrated a new dimension of conformational plasticity within the signaling ligand. We observed movements up to 5Å at the fingertips and 10Å in the outer helices of the CTD. More unexpectedly, the conformation of the AMH signaling ligand in the procomplex form is far more open and extended than has been observed in any other structure of a TGF-beta superfamily ligand, including the AMH ligand bound to its receptor AMHR2. We see that transitioning from a prodomain-bound to a receptor-bound state involves significant conformational remodeling of the signaling domain. This reorganization supports a conformational shift mechanism for AMH signaling in which bivalent binding of AMHR2 at the cell surface induces a >15Å and 38° closing of the ligand fingertips, leading to prodomain displacement and subsequent recruitment of type I receptors. Our findings correct earlier structural misconceptions and build a comprehensive model for interpreting existing functional data. This structure provides a foundation for understanding AMH dysregulation and developing advanced AMH therapeutics. Presentation: 6/1/2024