Review
The Structural Basis of Necroptotic Cell Death Signaling

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Highlights

Structures of component signaling modules in all known necroptosis effectors – RIPK1, RIPK3, and MLKL – have been reported over the past 5 years.

Recent NMR studies have provided insights into how RIPK1 and RIPK3 form high-molecular-weight fibrils via their RHIM motifs.

Recent structural and biophysical data highlight interspecies differences in the terminal effector MLKL. MLKL assembles into higher-order complexes: mouse MLKL forms trimers while the human protein is tetrameric. Structural differences in the executioner 4HB domain and the regulatory pseudokinase domain between mouse and human MLKL may reflect mechanistic differences.

Several models have been proposed to describe the mechanism by which MLKL permeabilizes the plasma membrane, leading to debate about the nature of the membrane aperture. Recent studies suggest a role for necroptotic coeffectors in regulating the susceptibility of membranes to MLKL-mediated permeabilization.

The recent implication of the cell death pathway, necroptosis, in innate immunity and a range of human pathologies has led to intense interest in the underlying molecular mechanism. Unlike the better-understood apoptosis pathway, necroptosis is a caspase-independent pathway that leads to cell lysis and release of immunogens downstream of death receptor and Toll-like receptor (TLR) ligation. Here we review the role of recent structural studies of the core machinery of the pathway, the protein kinases receptor-interacting protein kinase (RIPK)1 and RIPK3, and the terminal effector, the pseudokinase mixed lineage kinase domain-like protein (MLKL), in shaping our mechanistic understanding of necroptotic signaling. Structural studies have played a key role in establishing models that describe MLKL’s transition from a dormant monomer to a killer oligomer and revealing important interspecies differences.

Section snippets

The Dying Code

In multicellular organisms orchestrated signaling pathways control the manner in which cells die and communicate information to the surrounding live cells as cues to dictate their responses. The best understood programmed cell death pathway, apoptosis (see Glossary), is generally immunologically silent, in keeping with its developmental roles, and is characterized by cell shrinking and plasma membrane blebbing without the release of cellular contents. By contrast, lytic cell death modes, such

The Protein Modules Controlling Necroptosis

At the molecular level, structural studies have played a crucial role in advancing our mechanistic understanding of the necroptosis pathway. The domains comprising the core components of the pathway – the protein kinases RIPK1 and RIPK3 and the pseudokinase MLKL – serve crucial functions in mediating protein–protein interactions in addition to the conventional catalytic activities mediated by the RIPK1 and RIPK3 protein kinase domains (Figure 2A).

Phospholipid Binding by MLKL

The MLKL 4HB has been established as a phosphatidylinositol phosphate (PIP)-binding domain, with binding interfaces mapped by NMR 45, 46 and mutational studies 35, 41, 49, 50 to clusters centered on the α1 and α2 helices and on the α3 and α4 helices, both of which are necessary for cell death 35, 41. While mutation of basic residues in the α4 helix abrogates PIP binding and cell killing, mutation of acidic and aliphatic residues in the α4 helix also perturbs cell killing 35, 41, suggesting that

Oligomerization of MLKL

The appearance of phosphorylated MLKL oligomers at the plasma membrane of a cell is typical of cells undergoing necroptosis. The structure of oligomeric MLKL has remained elusive and a point of contention in the literature, with trimers 34, 41, tetramers [35], hexamers [50], octamers [51], and polymers [52] reported. Biophysical analyses of recombinant MLKL using analytical ultracentrifugation, small-angle X-ray scattering, and native mass spectrometry indicate that mouse MLKL assembles into

Transition of MLKL from Dormant to Necroptotic Conformation

What governs the transition from a dormant monomeric MLKL form (Figure 3F) to a necroptotic oligomer (Figure 3G) in cells? Recent data suggest that divergent mechanisms are likely to exist between species (Figure 4). In the case of mouse MLKL, transient interaction with, and phosphorylation by, RIPK3 is sufficient to induce MLKL oligomerization and translocation to membranes and cell death 14, 31 (Figure 4A). Modification of mouse MLKL, or mutation of the pseudokinase domain to mimic

The Harbinger of Doom

The presence of phosphorylated MLKL oligomers at the plasma membrane is considered a hallmark of cells undergoing necroptosis. Nonetheless, several studies have revealed a time lag between when phosphorylated MLKL oligomers are detected at the plasma membrane and phosphatidylserine exposure occurs on the cell surface, to when plasma membrane integrity is lost to the point of cell death 48, 56, 57. One explanation for this lag can be accommodated by a number of proposed models (previously

Scrambling to Be ESCRTed from a Dying Cell

MLKL-directed lipid scrambling and cell-surface exposure of phosphatidylserine was recently linked to the formation of small bubbles on the plasma membrane, which are subsequently released as extracellular vesicles 56, 57, 61. The formation of these extracellular vesicles was linked to the endosomal sorting complex required for transport (ESCRT)-III machinery 56, 61, which was proposed to deliver activated MLKL forms from endosomes to the plasma membrane in a CHMP2A- and CHMP4B-dependent

Concluding Remarks and Future Perspectives

Fuelled by structural studies, our understanding of the molecular basis of necroptotic cell death executed by the kinases RIPK1 and RIPK3 and the pseudokinase MLKL has advanced enormously over the past 5 years. Each effector comprises modular signaling domains, with recent structures providing insights into how these domains mediate the formation of higher-order assemblies and the transmission of necroptotic signals and how MLKL can be triggered to kill cells. Nevertheless, the precise

Acknowledgments

We thank the National Health and Medical Research Council of Australia for their support of our studies via fellowships to P.E.C. (1079700) and J.M.M. (1105754), project grants on this subject (1124735, 1124737), and infrastructure funding (IRIISS 9000433). We are grateful to the Victorian State Government Operational Infrastructure Scheme and to the Australian Synchrotron for enabling structural studies reviewed herein. We apologize to our colleagues whose work we were unable to cite owing to

Glossary

4HB domain
a helical domain at the N terminus of MLKL responsible for membrane permeabilization; predicted to resemble the HeLo-like domains of HET-s fungal and plant proteins.
Apoptosis
a caspase-dependent cell death pathway important for development in multicellular organisms.
Autophosphorylation
phosphorylation of the kinase itself in cis (to the same molecule) or in trans (to another copy of the same kinase).
Brace helices
a two-helix connector between the 4HB and pseudokinase domains of MLKL.

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