Deciphering the Impact of Mutations on PfDHPS Active Site and Sulfadoxine Binding: Structural Insights from Molecular Dynamics Simulations.

The antimalarial combination of sulfadoxine-pyrimethamine is used as a preventive treatment in pregnant women and children in Africa. Sulfadoxine inhibits the Plasmodium falciparum dihydropteroate synthase (PfDHPS), but resistance has emerged through point mutations in this enzyme. In this study, we investigate the impact of mutations on the structural and dynamic properties of PfDHPS using molecular dynamics simulations. Our results show that PfDHPS maintains overall structural integrity across various combinations of resistance-associated mutations. However, significant differences emerge in ligand binding. Sulfadoxine binding is particularly impacted and shows reduced stability in the mutant systems compared to the wild-type enzyme, while the natural substrate generally maintains stable or even enhanced binding affinity. A key finding is the critical role of the D2 loop, whose conformational flexibility influences ligand retention. In mutant enzymes, the disruption of interactions between the D2 loop and the natural substrate correlates with decreased affinity. In contrast, specific mutations in the loop are associated with an increased affinity. Conversely, sulfadoxine binding is associated with an open D2 loop conformation, facilitating its release from the active site. Finally, the intrinsic flexibility of sulfadoxine emerges as an important determinant of this process. Together, these results provide molecular-level insights into the mechanisms of resistance in PfDHPS and establish a structural and dynamic framework for future investigations into its catalytic function and inhibitor design.