<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Archiving and Interchange DTD with MathML3 v1.2 20190208//EN"  "JATS-archivearticle1-mathml3.dtd"><article xmlns:ali="http://www.niso.org/schemas/ali/1.0/" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" article-type="research-article" dtd-version="1.2"><front><journal-meta><journal-id journal-id-type="nlm-ta">elife</journal-id><journal-id journal-id-type="publisher-id">eLife</journal-id><journal-title-group><journal-title>eLife</journal-title></journal-title-group><issn publication-format="electronic" pub-type="epub">2050-084X</issn><publisher><publisher-name>eLife Sciences Publications, Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">83053</article-id><article-id pub-id-type="doi">10.7554/eLife.83053</article-id><article-categories><subj-group subj-group-type="display-channel"><subject>Research Article</subject></subj-group><subj-group subj-group-type="heading"><subject>Structural Biology and Molecular Biophysics</subject></subj-group></article-categories><title-group><article-title>Structures of ferroportin in complex with its specific inhibitor vamifeport</article-title></title-group><contrib-group><contrib contrib-type="author" equal-contrib="yes" id="author-292260"><name><surname>Lehmann</surname><given-names>Elena Farah</given-names></name><contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0002-6112-933X</contrib-id><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="fn" rid="equal-contrib1">†</xref><xref ref-type="fn" rid="con1"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" equal-contrib="yes" id="author-292261"><name><surname>Liziczai</surname><given-names>Márton</given-names></name><contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0002-6673-9209</contrib-id><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="fn" rid="equal-contrib1">†</xref><xref ref-type="fn" rid="con2"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-174833"><name><surname>Drożdżyk</surname><given-names>Katarzyna</given-names></name><contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0001-6288-4735</contrib-id><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="fn" rid="con3"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-292267"><name><surname>Altermatt</surname><given-names>Patrick</given-names></name><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="fn" rid="con4"/><xref ref-type="fn" rid="conf2"/></contrib><contrib contrib-type="author" id="author-301097"><name><surname>Langini</surname><given-names>Cassiano</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="fn" rid="con5"/><xref ref-type="fn" rid="conf3"/></contrib><contrib contrib-type="author" id="author-292264"><name><surname>Manolova</surname><given-names>Vania</given-names></name><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="fn" rid="con6"/><xref ref-type="fn" rid="conf4"/></contrib><contrib contrib-type="author" id="author-292265"><name><surname>Sundstrom</surname><given-names>Hanna</given-names></name><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="fn" rid="con7"/><xref ref-type="fn" rid="conf5"/></contrib><contrib contrib-type="author" id="author-292266"><name><surname>Dürrenberger</surname><given-names>Franz</given-names></name><contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0002-1443-1181</contrib-id><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="fn" rid="con8"/><xref ref-type="fn" rid="conf6"/></contrib><contrib contrib-type="author" corresp="yes" id="author-5758"><name><surname>Dutzler</surname><given-names>Raimund</given-names></name><contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0002-2193-6129</contrib-id><email>dutzler@bioc.uzh.ch</email><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="other" rid="fund1"/><xref ref-type="fn" rid="con9"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" corresp="yes" id="author-158217"><name><surname>Manatschal</surname><given-names>Cristina</given-names></name><contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0002-4907-7303</contrib-id><email>c.manatschal@bioc.uzh.ch</email><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="fn" rid="con10"/><xref ref-type="fn" rid="conf1"/></contrib><aff id="aff1"><label>1</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/02crff812</institution-id><institution>Department of Biochemistry, University of Zurich</institution></institution-wrap><addr-line><named-content content-type="city">Zürich</named-content></addr-line><country>Switzerland</country></aff><aff id="aff2"><label>2</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/0185z7g17</institution-id><institution>CSL Vifor</institution></institution-wrap><addr-line><named-content content-type="city">St. Gallen</named-content></addr-line><country>Switzerland</country></aff></contrib-group><contrib-group content-type="section"><contrib contrib-type="editor"><name><surname>Maduke</surname><given-names>Merritt</given-names></name><role>Reviewing Editor</role><aff><institution-wrap><institution-id institution-id-type="ror">https://ror.org/00f54p054</institution-id><institution>Stanford University School of Medicine</institution></institution-wrap><country>United States</country></aff></contrib><contrib contrib-type="senior_editor"><name><surname>Aldrich</surname><given-names>Richard W</given-names></name><role>Senior Editor</role><aff><institution-wrap><institution-id institution-id-type="ror">https://ror.org/00hj54h04</institution-id><institution>The University of Texas at Austin</institution></institution-wrap><country>United States</country></aff></contrib></contrib-group><author-notes><fn fn-type="con" id="equal-contrib1"><label>†</label><p>These authors contributed equally to this work</p></fn></author-notes><pub-date publication-format="electronic" date-type="publication"><day>21</day><month>03</month><year>2023</year></pub-date><pub-date pub-type="collection"><year>2023</year></pub-date><volume>12</volume><elocation-id>e83053</elocation-id><history><date date-type="received" iso-8601-date="2022-08-30"><day>30</day><month>08</month><year>2022</year></date><date date-type="accepted" iso-8601-date="2023-02-27"><day>27</day><month>02</month><year>2023</year></date></history><pub-history><event><event-desc>This manuscript was published as a preprint at bioRxiv.</event-desc><date date-type="preprint" iso-8601-date="2022-08-29"><day>29</day><month>08</month><year>2022</year></date><self-uri content-type="preprint" xlink:href="https://doi.org/10.1101/2022.08.29.505642"/></event></pub-history><permissions><copyright-statement>© 2023, Lehmann, Liziczai et al</copyright-statement><copyright-year>2023</copyright-year><copyright-holder>Lehmann, Liziczai et al</copyright-holder><ali:free_to_read/><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><ali:license_ref>http://creativecommons.org/licenses/by/4.0/</ali:license_ref><license-p>This article is distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>, which permits unrestricted use and redistribution provided that the original author and source are credited.</license-p></license></permissions><self-uri content-type="pdf" xlink:href="elife-83053-v1.pdf"/><self-uri content-type="figures-pdf" xlink:href="elife-83053-figures-v1.pdf"/><abstract><p>A central regulatory mechanism of iron homeostasis in humans involves ferroportin (FPN), the sole cellular iron exporter, and the peptide hormone hepcidin, which inhibits Fe<sup>2+</sup> transport and induces internalization and degradation of FPN. Dysregulation of the FPN/hepcidin axis leads to diverse pathological conditions, and consequently, pharmacological compounds that inhibit FPN-mediated iron transport are of high clinical interest. Here, we describe the cryo-electron microscopy structures of human FPN in complex with synthetic nanobodies and vamifeport (VIT-2763), the first clinical-stage oral FPN inhibitor. Vamifeport competes with hepcidin for FPN binding and is currently in clinical development for β-thalassemia and sickle cell disease. The structures display two distinct conformations of FPN, representing outward-facing and occluded states of the transporter. The vamifeport site is located in the center of the protein, where the overlap with hepcidin interactions underlies the competitive relationship between the two molecules. The introduction of point mutations in the binding pocket of vamifeport reduces its affinity to FPN, emphasizing the relevance of the structural data. Together, our study reveals conformational rearrangements of FPN that are of potential relevance for transport, and it provides initial insight into the pharmacological targeting of this unique iron efflux transporter.</p></abstract><kwd-group kwd-group-type="author-keywords"><kwd>cryo-electron microscopy</kwd><kwd>iron transport protein</kwd><kwd>pharmacology</kwd></kwd-group><kwd-group kwd-group-type="research-organism"><title>Research organism</title><kwd>Human</kwd></kwd-group><funding-group><award-group id="fund1"><funding-source><institution-wrap><institution-id institution-id-type="FundRef">http://dx.doi.org/10.13039/501100001711</institution-id><institution>Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung</institution></institution-wrap></funding-source><award-id>NCCR TransCure</award-id><principal-award-recipient><name><surname>Dutzler</surname><given-names>Raimund</given-names></name></principal-award-recipient></award-group><funding-statement>The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.</funding-statement></funding-group><custom-meta-group><custom-meta specific-use="meta-only"><meta-name>Author impact statement</meta-name><meta-value>The structure of the human iron exporter ferroportin in complex with its inhibitor vamifeport, which is currently in clinical development against β-thalassemia and sickle cell disease, provides insight into pharmacological mechanisms.</meta-value></custom-meta></custom-meta-group></article-meta></front><body><sec id="s1" sec-type="intro"><title>Introduction</title><p>The ability of iron to alter its oxidation state and to form coordinative interactions with free electron pairs makes it an essential cofactor of numerous proteins involved in the catalysis of redox reactions and the transport of oxygen. However, its reactivity is harmful if present in excess and distributed inappropriately (<xref ref-type="bibr" rid="bib22">Galaris et al., 2019</xref>). Since a regulated excretion pathway of iron does not exist in mammals, its uptake, recycling, and redistribution are tightly regulated processes (<xref ref-type="bibr" rid="bib37">Nemeth and Ganz, 2021</xref>). Dysregulated iron homeostasis leads to anemia or iron overload and has also been linked to numerous other disorders such as cancers, neurodegenerative and age-related diseases (<xref ref-type="bibr" rid="bib11">Crielaard et al., 2017</xref>). Consequently, the targeting of proteins involved in iron metabolism constitutes a promising but somewhat underexplored pharmacological strategy for the treatment of such disorders (<xref ref-type="bibr" rid="bib11">Crielaard et al., 2017</xref>).</p><p>While iron can be imported into cells as either Fe<sup>2+</sup> or Fe<sup>3+</sup> via several mechanisms involving transporters of the SLC11/NRAMP family, heme transporters and by transferrin-mediated endocytosis, cellular iron export solely proceeds via Ferroportin (FPN), a divalent metal ion transporter present in most cells, with high expression levels found in enterocytes of the duodenum, hepatocytes, and macrophages (<xref ref-type="bibr" rid="bib23">Ganz, 2013</xref>; <xref ref-type="bibr" rid="bib35">Montalbetti et al., 2013</xref>). Consequently, a central mechanism to control the systemic iron concentration proceeds via the regulation of FPN levels at the cell surface. This is accomplished by the peptide hormone hepcidin, which comprises 25 amino acids (<xref ref-type="bibr" rid="bib36">Nemeth et al., 2004</xref>). Hepcidin binds FPN on its extracellular side, thereby reducing iron export by inhibition of the transporter and by promoting its ubiquitination, leading to internalization and degradation (<xref ref-type="bibr" rid="bib4">Aschemeyer et al., 2018</xref>; <xref ref-type="bibr" rid="bib6">Billesbølle et al., 2020</xref>; <xref ref-type="bibr" rid="bib40">Pan et al., 2020</xref>; <xref ref-type="bibr" rid="bib44">Qiao et al., 2012</xref>).</p><p>The transport properties of FPN have been studied using iron efflux assays in <italic>Xenopus laevis</italic> oocytes and mammalian cells for the human ortholog (hsFPN) (<xref ref-type="bibr" rid="bib15">Deshpande et al., 2018</xref>; <xref ref-type="bibr" rid="bib32">Manolova et al., 2019</xref>; <xref ref-type="bibr" rid="bib34">Mitchell et al., 2014</xref>) and by proteoliposome-based in-vitro assays for hsFPN, its ortholog from the primate Philippine tarsier (tsFPN) and for a distant bacterial homolog from <italic>Bdellovibrio bacteriovorus</italic> (bbFPN; <xref ref-type="bibr" rid="bib6">Billesbølle et al., 2020</xref>; <xref ref-type="bibr" rid="bib7">Bonaccorsi di Patti et al., 2015</xref>; <xref ref-type="bibr" rid="bib40">Pan et al., 2020</xref>; <xref ref-type="bibr" rid="bib52">Taniguchi et al., 2015</xref>). These studies revealed that extracellular Ca<sup>2+</sup> stimulates iron transport (<xref ref-type="bibr" rid="bib15">Deshpande et al., 2018</xref>) and that besides Fe<sup>2+</sup>, FPN also transports other transition metal ions including Co<sup>2+</sup>, Zn<sup>2+</sup>, and Ni<sup>2+</sup> (<xref ref-type="bibr" rid="bib34">Mitchell et al., 2014</xref>). Its transport mechanism as an electroneutral H<sup>+</sup>/Me<sup>2+</sup> antiporter likely facilitates cellular export of the positively charged substrate ion despite the negative resting membrane potential (<xref ref-type="bibr" rid="bib40">Pan et al., 2020</xref>).</p><p>Insight into the molecular mechanisms of iron transport and its regulation by hepcidin was provided by various structures of the prokaryotic bbFPN and its mammalian homologs tsFPN and hsFPN (<xref ref-type="bibr" rid="bib6">Billesbølle et al., 2020</xref>; <xref ref-type="bibr" rid="bib15">Deshpande et al., 2018</xref>; <xref ref-type="bibr" rid="bib40">Pan et al., 2020</xref>; <xref ref-type="bibr" rid="bib52">Taniguchi et al., 2015</xref>). FPN belongs to the major facilitator superfamily (MFS), whose members translocate their substrates by traversing between conformations where the substrate binding site, commonly located in the center of the transporter, is alternately accessible from either side of the membrane (<xref ref-type="bibr" rid="bib1">Abramson et al., 2003</xref>; <xref ref-type="bibr" rid="bib17">Drew et al., 2021</xref>). The transition between outward- and inward-open conformations proceeds via occluded states, where the substrate is shielded from the surrounding aqueous environment from both sides. These conformational rearrangements involve the concerted movement of structurally similar N- and C-terminal domains (termed N- and C-domain), each comprising a bundle of six transmembrane α-helices that are both oriented in the same direction with respect to the membrane (<xref ref-type="bibr" rid="bib17">Drew et al., 2021</xref>).</p><p>The bacterial homolog bbFPN was crystallized in outward- and inward-facing conformations in the absence and presence of divalent metal ions, thus providing insight into the conformational transitions during transport (<xref ref-type="bibr" rid="bib15">Deshpande et al., 2018</xref>; <xref ref-type="bibr" rid="bib52">Taniguchi et al., 2015</xref>). The cryo-electron microscopy (cryo-EM) structures of hsFPN and tsFPN have revealed structures of the apo-state of the transporter and of its complexes with Co<sup>2+</sup> and hepcidin in outward-facing conformations (<xref ref-type="bibr" rid="bib6">Billesbølle et al., 2020</xref>; <xref ref-type="bibr" rid="bib40">Pan et al., 2020</xref>). Together, these studies suggest that, distinct from other MFS-transporters, FPN likely contains two conserved substrate binding sites. The first site resides within the N-domain (S1) and comprises an aspartate and a histidine on α1 (i.e. Asp39 and His 43) in both hsFPN and tsFPN. A metal ion binds nearby, between α1 and α6, in the prokaryotic bbFPN. A second site that is confined to mammalian transporters is contained within the C-domain (S2) and bridges a conserved cysteine (Cys 326) on α7 with a histidine on α11 (i.e. His 507 in hsFPN and His 508 in tsFPN). Compared to other MFS transporters, α7 comprises an unusually long unwound part of around 10 residues in its center. Notably, hepcidin protrudes deeply into the outward-facing pocket, thereby occluding the iron efflux pathway and preventing conformational transitions, which explains its inhibitory activity (<xref ref-type="bibr" rid="bib6">Billesbølle et al., 2020</xref>; <xref ref-type="bibr" rid="bib40">Pan et al., 2020</xref>). Moreover, the carboxy-terminus of hepcidin was found to coordinate the bound metal ion at the S2 site, which might enable hepcidin to selectively target FPN engaged in iron transport (<xref ref-type="bibr" rid="bib6">Billesbølle et al., 2020</xref>).</p><p>Owing to the central role of hepcidin in regulating iron homeostasis, compounds that either mimic or block its function are of high therapeutic interest, and several agents are currently in clinical development for the treatment of anemia or iron overload conditions in different disorders (<xref ref-type="bibr" rid="bib10">Casu et al., 2018</xref>; <xref ref-type="bibr" rid="bib11">Crielaard et al., 2017</xref>; <xref ref-type="bibr" rid="bib29">Katsarou and Pantopoulos, 2018</xref>). Among those agents, the first orally available FPN inhibitor vamifeport (VIT-2763) is now in clinical trials for the treatment of β-thalassemia and sickle cell disease (<xref ref-type="bibr" rid="bib32">Manolova et al., 2019</xref>; <xref ref-type="bibr" rid="bib39">Nyffenegger et al., 2022</xref>). On the molecular level, vamifeport was shown to compete with hepcidin for FPN binding with an IC<sub>50</sub> value in the low nanomolar range (<xref ref-type="bibr" rid="bib32">Manolova et al., 2019</xref>). Moreover, similar to hepcidin, vamifeport induced FPN ubiquitination, internalization, and degradation, albeit to a lower extent and with slower kinetics compared to the peptide hormone. In cellular efflux assays, vamifeport blocked iron export by FPN in a dose-dependent manner with a potency comparable to hepcidin (<xref ref-type="bibr" rid="bib32">Manolova et al., 2019</xref>).</p><p>To shed light on the structural details of inhibitor interactions, we have determined cryo-EM structures of hsFPN in complex with vamifeport and synthetic nanobodies. The structures reveal outward-facing and occluded states of hsFPN with vamifeport located in the center of the transporter in vicinity of the S2 substrate site. The binding site is flanked by two hydrophobic pockets that accommodate the terminal aromatic moieties of the inhibitor. One of these pockets overlaps with the known site of hepcidin, which explains the competitive relationship between the two molecules. Mutations in the observed binding site reduce the affinity of vamifeport to hsFPN, validating the results from our structural data. Together, our results provide insight into the interaction of hsFPN with a compound of promising therapeutic potential.</p></sec><sec id="s2" sec-type="results"><title>Results</title><sec id="s2-1"><title>Characterization of the hsFPN – vamifeport interaction</title><p>To characterize the interaction between vamifeport and hsFPN, we have transiently expressed the transporter in HEK293 cells and found it to be monodisperse and stable when purified in the detergent N-dodecyl-β-D-Maltoside (DDM) with an apparent melting temperature (T<sub>m</sub>) of 47°C as determined in a thermal stability assay (<xref ref-type="fig" rid="fig1s1">Figure 1—figure supplement 1A, B</xref>). When reconstituted into liposomes and assayed with the metal ion sensitive fluorophore calcein, hsFPN displayed a robust Co<sup>2+</sup> transport activity (<xref ref-type="fig" rid="fig1">Figure 1A</xref>, <xref ref-type="fig" rid="fig1s1">Figure 1—figure supplement 1C</xref>) with an apparent K<sub>M</sub> in the low μM range. In presence of vamifeport, the apparent melting temperature (T<sub>m</sub>) of hsFPN is increased by about 5°C, reflecting the stabilizing effect of the inhibitor (<xref ref-type="fig" rid="fig1s1">Figure 1—figure supplement 1B</xref>). To further assess the binding properties of vamifeport toward purified hsFPN, we exploited its capability to displace TMR-hepcidin, a fluorescent derivative of the peptide hormone (<xref ref-type="bibr" rid="bib18">Dürrenberger et al., 2013</xref>). The quantification of TMR-hepcidin binding by titrating hsFPN to a constant amount of the labeled peptide and monitoring the change in fluorescence polarization (FP), yielded a K<sub>D</sub> of 100±4 nM (<xref ref-type="fig" rid="fig1">Figure 1B</xref>). The incomplete saturation at high hsFPN concentrations reflects unspecific binding of TMR-hepcidin with one order of magnitude lower affinity. Subsequently, we performed displacement experiments with unlabeled hepcidin and vamifeport. As expected, bound TMR-hepcidin could be readily displaced by hepcidin-25 in a dose-dependent manner with an IC<sub>50</sub> of ca 700 nM, while hepcidin-20, lacking the first 5 N-terminal amino acids necessary for FPN binding, was inactive (<xref ref-type="fig" rid="fig1">Figure 1C</xref>). Vamifeport displaced TMR-hepcidin with higher potency with an IC<sub>50</sub> value of ca 130 nM (<xref ref-type="fig" rid="fig1">Figure 1C</xref>). To convert obtained IC<sub>50</sub> values to K<sub>D</sub>s, we fitted our displacement data to a competition binding model, yielding K<sub>D</sub> values of around 150 nM for hepcidin-25 and 25 nM for vamifeport. Taken together, these data show that our purified hsFPN is stable and functional and that it competitively binds hepcidin and vamifeport with K<sub>D</sub> values in the nanomolar range.</p><fig-group><fig id="fig1" position="float"><label>Figure 1.</label><caption><title>Functional characterization of hsFPN.</title><p>(<bold>A</bold>) Fluorescence-based uptake of Co<sup>2+</sup> into proteoliposomes containing reconstituted hsFPN. Metal ion influx is monitored with the fluorophore calcein that is trapped inside the liposomes (six measurements for 0 μM Co<sup>2+</sup>, 1 μM Co<sup>2+</sup>, and 10 μM Co<sup>2+</sup> and eight measurements for 50 μM Co<sup>2+</sup> and 200 μM Co<sup>2+</sup> from four independent reconstitutions). (<bold>B</bold>) Binding of fluorescently labeled hepcidin-25 (TMR-hepcidin) to increasing concentrations of hsFPN as monitored by the change in the fluorescence polarization of the peptide (six measurements from two independent experiments). (<bold>C</bold>) Competition of bound TMR-hepcidin with vamifeport and unlabeled hepcidin-20 and hepcidin-25 (six measurements for vamifeport and hepcidin-25 from three independent experiments and four measurements for hepcidin-20 from two independent experiments). (<bold>A–C</bold>) Data show mean of the indicated number of measurements, and errors are SEM.</p><p><supplementary-material id="fig1sdata1"><label>Figure 1—source data 1.</label><caption><title>Proteoliposome-based in-vitro transport data of hsFPN, TMR-hepcidin fluorescence polarization direct binding and displacement data of hsFPN.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-83053-fig1-data1-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig1-v1.tif"/></fig><fig id="fig1s1" position="float" specific-use="child-fig"><label>Figure 1—figure supplement 1.</label><caption><title>Biochemical properties of purified hsFPN.</title><p>(<bold>A</bold>) Size-exclusion chromatography (SEC) profile of the purified protein on a Superdex 200 column. Inset (right) shows SDS-PAGE of peak fractions with indicated molecular weight of marker proteins (kDa). (<bold>B</bold>) Thermal stability of hsFPN in absence and presence of vamifeport determined by fluorescence-detection SEC (4–5 measurements from four independent experiments in absence of vamifeport and three measurements from two independent experiments in presence of vamifeport). (<bold>C</bold>) Unspecific leak of Co<sup>2+</sup> into empty proteoliposomes (three measurements from three independent reconstitutions). (<bold>B and C</bold>) Data show mean of the indicated number of experiments, and errors are SEM.</p><p><supplementary-material id="fig1s1sdata1"><label>Figure 1—figure supplement 1—source data 1.</label><caption><title>Size-exclusion chromatography data of hsFPN and corresponding SDS-PAGE gels, thermal stability data, and proteoliposome-based in-vitro transport data of empty liposomes.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-83053-fig1-figsupp1-data1-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig1-figsupp1-v1.tif"/></fig><fig id="fig1s2" position="float" specific-use="child-fig"><label>Figure 1—figure supplement 2.</label><caption><title>Characterization of sybodies binding hsFPN.</title><p>(<bold>A</bold>) Alignment of sybody sequences. Complementary determining regions (CDRs) are indicated, and aromatic residues are labeled in light blue. (<bold>B</bold>) Size-exclusion chromatography (SEC) profiles of the purified sybodies on an SRT-100 column and SDS-PAGE of peak fractions (right). (<bold>C–G</bold>) Affinity determination by surface plasmon resonance (SPR) experiments using immobilized hsFPN and varying concentrations of Sy1 (<bold>C</bold>), Sy3 (<bold>D</bold>), Sy8 (<bold>E</bold>), Sy11 (<bold>F</bold>), and Sy12 (<bold>G</bold>). Individual traces of the association and dissociation of sybodies and dashed lines representing the fit to a 1:1 binding model are shown in distinct colors. K<sub>D</sub> values are indicated.</p><p><supplementary-material id="fig1s2sdata1"><label>Figure 1—figure supplement 2—source data 1.</label><caption><title>Size-exclusion chromatography data of all sybodies and corresponding SDS-PAGE gels, surface plasmon resonance (SPR) binding data of all sybodies.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-83053-fig1-figsupp2-data1-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig1-figsupp2-v1.tif"/></fig><fig id="fig1s3" position="float" specific-use="child-fig"><label>Figure 1—figure supplement 3.</label><caption><title>Biochemical properties of sybody-hsFPN complexes.</title><p>Size-exclusion chromatography (SEC) profiles of hsFPN in complex with Sy3 (<bold>A</bold>) and Sy12 (<bold>B</bold>). A sample of hsFPN was incubated with five times molar excess of the respective sybody in the absence and presence of a large excess of vamifeport (1 mM) and analyzed on a Superdex 200 column. For comparison, the SEC profile of hsFPN without binders is displayed as a dashed black line. The peak fractions were analyzed on SDS-PAGE (right) to detect the individual components (hsFPN and the respective sybodies).</p><p><supplementary-material id="fig1s3sdata1"><label>Figure 1—figure supplement 3—source data 1.</label><caption><title>Size-exclusion chromatography data of sybody-hsFPN complexes and corresponding SDS-PAGE gels.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-83053-fig1-figsupp3-data1-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig1-figsupp3-v1.tif"/></fig></fig-group></sec><sec id="s2-2"><title>Selection and characterization of synthetic nanobodies targeting human FPN</title><p>To resolve the molecular details of the interaction between hsFPN and vamifeport, we proceeded with the structural characterization of complexes containing both components. Although single particle cryo-EM has successfully been used to determine high-resolution structures of membrane proteins in complex with comparably small ligands like vamifeport (<xref ref-type="bibr" rid="bib14">de Oliveira et al., 2021</xref>), hsFPN with a molecular weight of only 65 kDa and lacking cytosolic or extracellular domains is of insufficient size for proper particle alignment during the 2D and 3D classification. We therefore set out to generate binding proteins as a strategy to circumvent the described limitations. To this end, we performed a selection of nanobodies from synthetic libraries (sybodies) optimized for membrane proteins (<xref ref-type="bibr" rid="bib58">Zimmermann et al., 2020</xref>). This process has led to the identification of 19 unique binders that recognized hsFPN based on ELISA, five of which showed promising biochemical properties in terms of expression levels and aggregation behavior (<xref ref-type="fig" rid="fig1s2">Figure 1—figure supplement 2A, B</xref>). Binding affinities were subsequently quantified using surface plasmon resonance (SPR) measurements. While the sybodies 1, 8, and 11 interacted with hsFPN with low-micromolar affinity, sybodies 3 and 12 (Sb3<sup>FPN</sup> and Sb12<sup>FPN</sup>, short Sy3 and Sy12) bound hsFPN with K<sub>D</sub>s in the high-nanomolar range (i.e. 500 nM for Sy3 and 308 nM for Sy12; <xref ref-type="fig" rid="fig1s2">Figure 1—figure supplement 2C–G</xref>). Binding of the latter two sybodies to detergent-solubilized hsFPN resulted in a complex that eluted as monodisperse peak during size-exclusion chromatography (SEC) at a similar elution volume as hsFPN alone (<xref ref-type="fig" rid="fig1s3">Figure 1—figure supplement 3A, B</xref>). Both sybody complexes also remained intact and co-eluted with hsFPN on SEC after the incubation with an excess of vamifeport, indicating that the interaction with the compound did not interfere with their binding (<xref ref-type="fig" rid="fig1s3">Figure 1—figure supplement 3A, B</xref>).</p></sec><sec id="s2-3"><title>hsFPN structures in complex with Sy3 and Sy12</title><p>For structural studies, we prepared complexes of hsFPN with either Sy12 or Sy3 in the presence of vamifeport and in the latter case also in the absence of the compound and collected cryo-EM data that allowed the reconstruction of cryo-EM maps at 3.9, 3.2, and 4.1 Å resolution, respectively (<xref ref-type="fig" rid="fig2s1">Figure 2—figure supplements 1</xref>–<xref ref-type="fig" rid="fig2s3">3</xref>, <xref ref-type="table" rid="table1">Table 1</xref>). In the obtained structures, both sybodies bind to distinct epitopes on the extracellular side (<xref ref-type="fig" rid="fig2">Figure 2A and B</xref>). The isotropic distribution of particles in the data of hsFPN/Sy3 complexes has yielded high-quality maps for both samples that are well defined for the entire structure but better resolved in the vamifeport complex (<xref ref-type="fig" rid="fig2">Figure 2B</xref>, <xref ref-type="fig" rid="fig2s2">Figure 2—figure supplements 2</xref>–<xref ref-type="fig" rid="fig2s4">4</xref>). In contrast, the quality of the map of the hsFPN/Sy12/vamifeport complex is to some degree compromised by a preferential orientation of the particles and difficulties to reconstruct and refine a 3D model as a consequence of the binding of Sy12 to a flexible loop region at the periphery of the protein (<xref ref-type="fig" rid="fig2">Figure 2A</xref>, <xref ref-type="fig" rid="fig2s1">Figure 2—figure supplement 1</xref>). Still, even in latter case, the map was sufficiently well resolved to permit its interpretation by an atomic model for the bulk of the transporter (<xref ref-type="fig" rid="fig2">Figure 2A</xref>, <xref ref-type="fig" rid="fig2s1">Figure 2—figure supplements 1</xref> and <xref ref-type="fig" rid="fig2s4">4</xref>). As defined previously, hsFPN consists of two topologically related domains with equivalent orientation in the membrane (<xref ref-type="bibr" rid="bib6">Billesbølle et al., 2020</xref>; <xref ref-type="bibr" rid="bib40">Pan et al., 2020</xref>; <xref ref-type="fig" rid="fig2">Figure 2C</xref>, <xref ref-type="fig" rid="fig2s5">Figure 2—figure supplement 5</xref>). The N-domain comprises α1–α6 and the C-domain α7–α12 with α7 being unwound in the center and preceded by an amphipathic helix that is oriented parallel to the intracellular membrane plane (<xref ref-type="fig" rid="fig2">Figure 2C</xref>). For both complexes, the respective N- and C-termini (about 20–30 residues each), the extended intracellular loop 3 bridging the N- and C-domain, and the extracellular loop 5 connecting α9 and α10 (about 50 residues each) are not resolved. Although the cryo-EM density of Sy12 is insufficiently well defined for a detailed interpretation, it permitted the placement of a model consisting of the conserved part of the binder as rigid unit (<xref ref-type="fig" rid="fig2">Figure 2A</xref>, <xref ref-type="fig" rid="fig2s4">Figure 2—figure supplement 4</xref>). In this position, the interaction with the extracellular loop connecting α3 and α4 located at the periphery of the N-domain is apparent (<xref ref-type="fig" rid="fig2">Figure 2A</xref>, <xref ref-type="fig" rid="fig2s6">Figure 2—figure supplement 6A</xref>). Notably, the same loop is recognized by Fab45D8, which was used to determine hsFPN structures in a previous study (<xref ref-type="fig" rid="fig2s6">Figure 2—figure supplement 6B</xref>; <xref ref-type="bibr" rid="bib6">Billesbølle et al., 2020</xref>). In contrast to the moderate quality of Sy12, the density of Sy3 in its complex with hsFPN is well resolved in both structures obtained in the absence and presence of vamifeport and has allowed the accurate interpretation of all three complementary determining regions (CDRs; <xref ref-type="fig" rid="fig2">Figure 2B</xref>, <xref ref-type="fig" rid="fig2s2">Figure 2—figure supplements 2</xref> and <xref ref-type="fig" rid="fig2s4">4</xref>). In its interaction with hsFPN, Sy3 buries an area of 2010 Å<sup>2</sup> of the combined molecular surface, with CDR-1 and CDR-2 binding to the periphery of α7, α8, and α10 and CDR-3 making extensive contacts with a pocket located between the two subdomains of the transporter (involving helices α1, α5, α7b, and α8; <xref ref-type="fig" rid="fig2">Figure 2D</xref>, <xref ref-type="fig" rid="fig2s6">Figure 2—figure supplement 6C</xref>). CDR-3 occupies a similar location as hepcidin, although the latter protrudes deeper into the pocket toward the center of the transporter, thereby establishing more extended contacts with α1 (<xref ref-type="fig" rid="fig2">Figure 2E</xref>).</p><fig-group><fig id="fig2" position="float"><label>Figure 2.</label><caption><title>Structure of hsFPN/sybody complexes.</title><p>Cryo-electron microscopy (cryo-EM) density (left) and ribbon model (right) of (<bold>A</bold>), the hsFPN/Sy12/vamifeport and (<bold>B</bold>), the hsFPN/Sy3/vamifeport complex. N- and C-domains of hsFPN and the respective sybodies are labeled and shown in unique colors. Bound vamifeport is displayed in space-filling representation. (<bold>C</bold>) Schematic depiction of membrane-spanning helices (top) and topology of hsFPN (bottom). Ribbon representation of (<bold>D</bold>), the binding region of Sy3 and (<bold>E</bold>), hepcidin (obtained from PDBID: 6WBV). Secondary structure elements are labeled.</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig2-v1.tif"/></fig><fig id="fig2s1" position="float" specific-use="child-fig"><label>Figure 2—figure supplement 1.</label><caption><title>Cryo-electron microscopy (cryo-EM) reconstruction of the hsFPN/Sy12/vamifeport complex.</title><p>(<bold>A</bold>) Representative micrograph (of a total of 13,730) of the hsFPN/Sy12/vamifeport dataset. (<bold>B</bold>) 2D class averages of the hsFPN/Sy12/vamifeport complex. (<bold>C</bold>) Data-processing workflow. Particles were extracted and subjected to 2D classification, and generated 2D class averages were subsequently used as templates for particle picking. After extraction, the novel set of particles was subjected to a second round of 2D classification. Based on 2D class averages, particles were selected for two ab initio reconstructions. A generated model displaying protein features (yellow) and a ‘decoy’ model lacking such features (gray) were both used for several rounds of heterogenous refinement followed by non-uniform refinement yielding a map at 3.9 Å resolution. (<bold>D</bold>) Heatmap displaying the angular distribution of particle orientations. (<bold>E</bold>) FSC plot of the final refined spherical map (orange), corrected mask (purple), tight mask (red), loose mask (green), and unmasked (blue) cryo-EM density map of the hsFPN/Sy12/vamifeport complex. The dotted line indicates the resolution at which the FSC drops below the 0.143 threshold. (<bold>F</bold>) The final 3D reconstruction in indicated orientations colored according to the local resolution.</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig2-figsupp1-v1.tif"/></fig><fig id="fig2s2" position="float" specific-use="child-fig"><label>Figure 2—figure supplement 2.</label><caption><title>Cryo-electron microscopy (cryo-EM) reconstruction of the hsFPN/Sy3/vamifeport complex.</title><p>(<bold>A</bold>) Representative micrograph (of a total of 8752) of the hsFPN/Sy3/vamifeport dataset. (<bold>B</bold>) 2D class averages of the hsFPN/Sy3/vamifeport complex. (<bold>C</bold>) Data-processing workflow. Particles were extracted and subjected to 2D classification, and the obtained 2D class averages were subsequently used as templates for particle picking. After extraction, the novel set of particles was subjected to a second 2D classification round. Based on 2D class averages, particles were selected for two ab initio reconstructions. A generated model displaying protein features (yellow) and a ‘decoy’ model lacking such features (gray) were both used for several rounds of heterogenous refinement followed by non-uniform refinement yielding a map at 3.4 Å resolution. The particles were imported into RELION for Bayesian polishing. The polished particles were imported back to cryoSPARC for a final round of non-uniform refinement resulting in a map at 3.2 Å resolution. (<bold>D</bold>) Heatmap displaying the angular distribution of particle orientations. (<bold>E</bold>) FSC plot of the final refined spherical map (orange), corrected mask (purple), tight mask (red), loose mask (green), and unmasked (blue) cryo-EM density map of the hsFPN/Sy3/vamifeport complex. The dotted line indicates the resolution at which the FSC drops below the 0.143 threshold. (<bold>F</bold>) The final 3D reconstruction at indicated orientations is colored according to the local resolution.</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig2-figsupp2-v1.tif"/></fig><fig id="fig2s3" position="float" specific-use="child-fig"><label>Figure 2—figure supplement 3.</label><caption><title>Cryo-electron microscopy (cryo-EM) reconstruction of the hsFPN/Sy3 complex.</title><p>(<bold>A</bold>) Representative micrograph (of a total of 4384) of the hsFPN/Sy3 dataset. (<bold>B</bold>) 2D class averages of the hsFPN/Sy3 complex. (<bold>C</bold>) Data-processing workflow. Particles were extracted and subjected to 2D classification, and the obtained 2D class averages were subsequently used as templates for particle picking. After extraction, the new set of particles was subjected to a second round of 2D classification. Based on 2D class averages, particles were selected for two ab initio reconstructions. A generated model displaying protein features (yellow) and a ‘decoy’ model lacking such features (gray) were both used for several rounds of heterogenous refinement, followed by non-uniform refinement yielding a map at 4.1 Å resolution. (<bold>D</bold>) Heatmap displaying the angular distribution of particle orientations. (<bold>E</bold>) FSC plot of the final refined spherical map (orange), corrected mask (purple), tight mask (red), loose mask (green), and unmasked (blue) cryo-EM density map of the hsFPN/Sy3 complex. The dotted line indicates the resolution at which the FSC drops below the 0.143 threshold. (<bold>F</bold>) The final 3D reconstruction at indicated orientations is colored according to the local resolution.</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig2-figsupp3-v1.tif"/></fig><fig id="fig2s4" position="float" specific-use="child-fig"><label>Figure 2—figure supplement 4.</label><caption><title>Cryo-electron microscopy (cryo-EM) density of hsFPN/sybody complexes.</title><p>Cryo-EM density of specified hsFPN complexes superimposed on selected regions of the protein with secondary structure elements indicated. (<bold>A</bold>) hsFPN/Sy3/vamifeport complex at 3.2 Å. Sharpened density (b=−100, contoured at 6.5 σ) is superimposed on the model. ‘Sy3’ refers to the binding epitope of Sy3. (<bold>B</bold>) hsFPN/Sy3 complex at 4.1 Å. Sharpened density (b=−50, contoured at 6.0 σ) is superimposed on the model. (<bold>C</bold>) hsFPN/Sy12/vamifeport complex at 3.9 Å. Sharpened density (b=−30, contoured at 5 σ) is superimposed on the model. ‘Sy12’ displays the envelope of the blurred electron density (b=50, contoured at 5 σ), which defines the orientation of Sy12, superimposed on a Cα-trace of the sybody.</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig2-figsupp4-v1.tif"/></fig><fig id="fig2s5" position="float" specific-use="child-fig"><label>Figure 2—figure supplement 5.</label><caption><title>FPN sequence.</title><p>(<bold>A</bold>) Amino acid sequence of hsFPN (GenBank: AAF36697.1). Secondary structure elements are indicated below. Residues of the metal binding site S1 are highlighted in cyan, residues of the metal binding site S2, which also interact with vamifeport, in green. Additional residues that contact vamifeport are highlighted in yellow. (<bold>B</bold>) Superposition of the vamifeport interacting region of selected FPN sequences (<italic>H. sapiens</italic>, GenBank: AAF36697.1; <italic>X. laevis</italic>, GenBank: <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/protein/XP_018122848.2?report=genbank&amp;log%24=prottop&amp;blast_rank=1&amp;RID=S14TBHX5016">XP_018122848.2</ext-link>; <italic>D. rerio</italic>: Q9I9R3.2; <italic>G. gallus</italic>, GenBank: NP_001012931.1; <italic>R. norvegicus</italic>, GenBank: AAK77858.2; <italic>M. musculus</italic>, GenBank: XP_006496200.1; <italic>S. scrofa</italic>, GenBank: <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/protein/XP_003483749.1?report=genbank&amp;log%24=prottop&amp;blast_rank=1&amp;RID=S14YEFEV013">XP_003483749.1</ext-link>; <italic>C. syrichita</italic>, GenBank: <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/protein/XP_008060857.1?report=genbank&amp;log%24=prottop&amp;blast_rank=1&amp;RID=S15BKMNE013">XP_008060857.1</ext-link>). Color coding of highlighted residues is as in <bold>A</bold>. (<bold>A and B</bold>) Residues in contact with vamifeport that also participate in the interaction with hepcidin are labeled (●).</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig2-figsupp5-v1.tif"/></fig><fig id="fig2s6" position="float" specific-use="child-fig"><label>Figure 2—figure supplement 6.</label><caption><title>hsFPN/sybody interactions.</title><p>Interaction regions of (<bold>A</bold>) Sy12 and (<bold>B</bold>) the Fv-part of Fab45D8 (PDBID 6WBV) on the outward-facing conformations of hsFPN. (<bold>C</bold>) Binding interface between Sy3 and hsFPN as defined in the hsFPN/Sy3/vamifeport complex. Shown are two orientations parallel to the membrane (left) and from the extracellular side (right). The protein is shown as Cα-trace with interacting side chains displayed as sticks. Insets (top left) show the corresponding views of the same interaction site as ribbon representation. (<bold>A–C</bold>) Secondary structure elements are indicated.</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig2-figsupp6-v1.tif"/></fig></fig-group><table-wrap id="table1" position="float"><label>Table 1.</label><caption><title>Cryo-electron microscopy (cryo-EM) data collection, refinement, and validation statistics.</title></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="bottom"/><th align="left" valign="bottom">Dataset 1hsFPN/Sy3(EMDB-16353)(PDB 8C02)</th><th align="left" valign="bottom">Dataset 2hsFPN/Sy3-vamifeport(EMDB-16345)(PDB 8BZY)</th><th align="left" valign="bottom">Dataset 3hsFPN/Sy12-vamifeport(EMDB-16354)(PDB 8C03)</th></tr></thead><tbody><tr><td align="left" valign="bottom"><bold>Data collection and processing</bold></td><td align="left" valign="bottom" colspan="3"/></tr><tr><td align="left" valign="bottom">Microscope</td><td align="left" valign="bottom">FEI Titan Krios</td><td align="left" valign="bottom">FEI Titan Krios</td><td align="left" valign="bottom">FEI Titan Krios</td></tr><tr><td align="left" valign="bottom">Camera</td><td align="left" valign="bottom">Gatan K3 GIF</td><td align="left" valign="bottom">Gatan K3 GIF</td><td align="left" valign="bottom">Gatan K3 GIF</td></tr><tr><td align="left" valign="bottom">Magnification</td><td align="left" valign="bottom">130,000</td><td align="left" valign="bottom">130,000</td><td align="left" valign="bottom">130,000</td></tr><tr><td align="left" valign="bottom">Voltage (kV)</td><td align="left" valign="bottom">300</td><td align="left" valign="bottom">300</td><td align="left" valign="bottom">300</td></tr><tr><td align="left" valign="bottom">Electron exposure (e–/Å<sup>2</sup>)</td><td align="left" valign="bottom">66</td><td align="left" valign="bottom">61/70.795</td><td align="left" valign="bottom">69.559/70.766</td></tr><tr><td align="left" valign="bottom">Defocus range (μm)</td><td align="left" valign="bottom">–2.4 to –1</td><td align="left" valign="bottom">–2.4 to –1</td><td align="left" valign="bottom">–2.4 to –1</td></tr><tr><td align="left" valign="bottom">Pixel size (Å)</td><td align="left" valign="bottom">0.651 (0.3255)</td><td align="left" valign="bottom">0.651 (0.3255)</td><td align="left" valign="bottom">0.651 (0.3255)</td></tr><tr><td align="left" valign="bottom">Symmetry imposed</td><td align="left" valign="bottom">C1</td><td align="left" valign="bottom">C1</td><td align="left" valign="bottom">C1</td></tr><tr><td align="left" valign="bottom">Initial particle images (no.)</td><td align="left" valign="bottom">1,927,334</td><td align="left" valign="bottom">1,820,142</td><td align="left" valign="bottom">3,045,873</td></tr><tr><td align="left" valign="bottom">Final particle images (no.)</td><td align="left" valign="bottom">139,011</td><td align="left" valign="bottom">320,701</td><td align="left" valign="bottom">387,990</td></tr><tr><td align="left" valign="bottom">Map resolution (Å)<break/>FSC threshold 0.143</td><td align="left" valign="bottom">4.09 Å</td><td align="left" valign="bottom">3.24 Å</td><td align="left" valign="bottom">3.89 Å</td></tr><tr><td align="left" valign="bottom">Map sharpening b-factor (Å<sup>2</sup>)</td><td align="left" valign="bottom">–201.2</td><td align="left" valign="bottom">–160.5</td><td align="left" valign="bottom">–202.1</td></tr><tr><td align="left" valign="bottom"><bold>Refinement</bold></td><td align="left" valign="bottom" colspan="3"/></tr><tr><td align="left" valign="bottom">Model resolution (Å)<break/>FSC threshold 0.5</td><td align="left" valign="bottom">4.3</td><td align="left" valign="bottom">3.4</td><td align="left" valign="bottom">4.1</td></tr><tr><td align="left" valign="bottom">Non-hydrogen atoms</td><td align="left" valign="bottom">4245</td><td align="left" valign="bottom">4314</td><td align="left" valign="bottom">3331</td></tr><tr><td align="left" valign="bottom">Protein residues</td><td align="left" valign="bottom">549</td><td align="left" valign="bottom">549</td><td align="left" valign="bottom">429</td></tr><tr><td align="left" valign="bottom">Ligand</td><td align="left" valign="bottom">0</td><td align="left" valign="bottom">2</td><td align="left" valign="bottom">1</td></tr><tr><td align="left" valign="bottom">Water</td><td align="left" valign="bottom">0</td><td align="left" valign="bottom">0</td><td align="left" valign="bottom">0</td></tr><tr><td align="left" valign="bottom"><italic>B</italic> factors (Å<sup>2</sup>) protein</td><td align="left" valign="bottom">162.30</td><td align="left" valign="bottom">168.28</td><td align="left" valign="bottom">130.63</td></tr><tr><td align="left" valign="bottom"><italic>B</italic> factors (Å<sup>2</sup>) ligand</td><td align="left" valign="bottom">---</td><td align="left" valign="bottom">116.10</td><td align="left" valign="bottom">63.72</td></tr><tr><td align="left" valign="bottom">RMSD Bond lengths (Å)</td><td align="left" valign="bottom">0.004 (0)</td><td align="left" valign="bottom">0.005 (0)</td><td align="left" valign="bottom">0.004 (0)</td></tr><tr><td align="left" valign="bottom">RMSD Bond angles (°)</td><td align="left" valign="bottom">0.634 (0)</td><td align="left" valign="bottom">0.732 (0)</td><td align="left" valign="bottom">0.645 (0)</td></tr><tr><td align="left" valign="bottom">MolProbity score</td><td align="left" valign="bottom">1.88</td><td align="left" valign="bottom">1.63</td><td align="left" valign="bottom">2.00</td></tr><tr><td align="left" valign="bottom">Clashscore</td><td align="left" valign="bottom">10.16</td><td align="left" valign="bottom">7.02</td><td align="left" valign="bottom">6.37</td></tr><tr><td align="left" valign="bottom">Poor rotamers (%)</td><td align="left" valign="bottom">1.10</td><td align="left" valign="bottom">1.10</td><td align="left" valign="bottom">4.46</td></tr><tr><td align="left" valign="bottom">CaBLAM outliers (%)</td><td align="left" valign="bottom">2.59</td><td align="left" valign="bottom">1.31</td><td align="left" valign="bottom">0.96</td></tr><tr><td align="left" valign="bottom">Ramachandran outliers (%)</td><td align="left" valign="bottom">0.00</td><td align="left" valign="bottom">0.00</td><td align="left" valign="bottom">0.00</td></tr><tr><td align="left" valign="bottom">Ramachandran allowed (%)</td><td align="left" valign="bottom">4.64</td><td align="left" valign="bottom">3.33</td><td align="left" valign="bottom">2.84</td></tr><tr><td align="left" valign="bottom">Ramachandran favored (%)</td><td align="left" valign="bottom">95.36</td><td align="left" valign="bottom">96.67</td><td align="left" valign="bottom">97.16</td></tr></tbody></table></table-wrap><p>In the Sy12 complex, hsFPN adopts a familiar outward-facing conformation (<xref ref-type="fig" rid="fig3">Figure 3A</xref>) that was previously observed in structures of the hsFPN-Fab45D8 (PDBID 6W4S) and tsFPN-Fab11F9 (PDBID 6VYH) complexes in the absence of bound hepcidin (with RMSDs of Cα positions of 0.939 Å and 0.944 Å, respectively, <xref ref-type="fig" rid="fig3s1">Figure 3—figure supplement 1</xref>; <xref ref-type="bibr" rid="bib6">Billesbølle et al., 2020</xref>; <xref ref-type="bibr" rid="bib40">Pan et al., 2020</xref>). Conversely, in both hsFPN/Sy3 complexes, α7b and the upper part of α8 have rearranged to approach the N-terminal domain by 3–4 Å relative to the hsFPN/Sy12/vamifeport complex, thus displaying a novel conformation of the transporter (<xref ref-type="fig" rid="fig3">Figure 3B–D</xref>). In this structure, residues on α7b (including Tyr 333) contact α1 and the connecting loop to α2 to increase interactions between both domains (<xref ref-type="fig" rid="fig3">Figure 3D and E</xref>). In addition, the lower part of the α7b helix unfolds with the extended α7a-b loop mediating additional contacts to α1 and α5 to occlude the access to the spacious aqueous pocket located in the center of the transporter (<xref ref-type="fig" rid="fig3">Figure 3D and E</xref>), whereas the intracellular part of the protein is unchanged (<xref ref-type="fig" rid="fig3">Figure 3C</xref>). Collectively, our structural data display hsFPN in two distinct conformations, an outward-open conformation in the hsFPN/Sy12/vamifeport complex and an occluded conformation in hsFPN/Sy3 complexes in the absence and presence of vamifeport. The latter are stabilized by the binding of Sy3 to a cleft at the interface between both domains (<xref ref-type="fig" rid="fig2">Figure 2B and D</xref>).</p><fig-group><fig id="fig3" position="float"><label>Figure 3.</label><caption><title>Features of hsFPN conformations.</title><p>(<bold>A</bold>) Outward-facing conformation of hsFPN as observed in the hsFPN/Sy12/vamifeport complex. (<bold>B</bold>) Occluded conformation of hsFPN as observed in the hsFPN/Sy3/vamifeport complex. (<bold>A and B</bold>) The molecular surface of the outward-facing and occluded cavities harboring the substrate binding sites is shown in magenta. (<bold>C</bold>) Cα representation of a superposition of both conformations of hsFPN. (<bold>A–C</bold>) Views are from within the membrane (top) and from the outside (bottom). (<bold>D</bold>) Comparison of both conformations in the region showing the largest differences. (<bold>E</bold>) Interaction between α7b and α2 and α3 closing the extracellular access to the substrate binding site (left). To further illustrate the occlusion by residues of the α7a–α7b region, the occluded model is superimposed on a surface representation of the outward-facing structure (right). (<bold>C and D</bold>) The outward-facing structure is colored in gray for comparison. (<bold>A–E</bold>) Secondary structure elements are labeled. The coloring is as in <xref ref-type="fig" rid="fig1">Figure 1A</xref>.</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig3-v1.tif"/></fig><fig id="fig3s1" position="float" specific-use="child-fig"><label>Figure 3—figure supplement 1.</label><caption><title>Superposition of outward-facing conformations.</title><p>Cα traces of the outward-facing conformation of hsFPN in the hsFPN/Sy12/vamifeport complex compared to the known structures of the (<bold>A</bold>), hsFPN/Fab45D8 complex (PDBID 6W4S) and (<bold>B</bold>), the tsFPN/Fab11F9/Co<sup>2+</sup> complex (PDBID 6VYH). (<bold>A and B</bold>) The two sub-domains of hsFPN are colored as in Figure 2, and previously determined structures are shown in gray. Inset (right) shows blow-up of regions connecting helices α7a and α7b.</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig3-figsupp1-v1.tif"/></fig></fig-group></sec><sec id="s2-4"><title>Structural characterization of the vamifeport binding site</title><p>In the hsFPN/Sy3 map obtained from a sample containing vamifeport, we noticed a pronounced elongated density of appropriate size and shape of the inhibitor that is not present in a structure of the same protein complex obtained in its absence, where also the proximal α7a–α7b loop appears more mobile (<xref ref-type="fig" rid="fig4">Figure 4A</xref>, <xref ref-type="fig" rid="fig4s1">Figure 4—figure supplement 1A–D</xref>). Residual density at an equivalent location is also observed in the outward-facing structure of the hsFPN/Sy12 complex obtained in the presence of vamifeport (<xref ref-type="fig" rid="fig4s1">Figure 4—figure supplement 1E, F</xref>). However, the density is, in this case, less well defined, which likely reflects a preferred binding of the molecule to the occluded state, although it might in part also be a consequence of the lower resolution of the map and the compromised quality resulting from the described preferential orientation of particles.</p><fig-group><fig id="fig4" position="float"><label>Figure 4.</label><caption><title>Structural basis of vamifeport binding.</title><p>(<bold>A</bold>) Chemical structure of vamifeport and its fit into the corresponding cryo-electron microscopy (cryo-EM) density of the hsFPN/Sy3/vamifeport complex. (<bold>B</bold>) Ribbon representation of the occluded conformation of FPN observed in the hsFPN/Sy3/vamifeport complex with the cryo-EM density attributed to vamifeport shown to illustrate its location within the transporter. Inset (right) shows blow-up of the binding region. (<bold>A and B</bold>) Cryo-EM density is contoured at 6.5 σ. (<bold>C</bold>) Location of vamifeport within the occluded cavity of hsFPN and (<bold>D</bold>), blowup of the binding pocket. (<bold>D and E</bold>) The molecular surface of the cavity is shown in gray. (<bold>E</bold>) Protein inhibitor interactions in the vamifeport binding site and interactions in (<bold>F</bold>) the N-pocket and (<bold>G</bold>) the C-pocket. (<bold>E–G</bold>) Side chains of interacting residues are shown as sticks and labeled.</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig4-v1.tif"/></fig><fig id="fig4s1" position="float" specific-use="child-fig"><label>Figure 4—figure supplement 1.</label><caption><title>Density in the vamifeport binding site.</title><p>Sections of the cryo-electron microscopy (cryo-EM) densities surrounding the vamifeport binding site. (<bold>A</bold>) Vamifeport interactions in the hsFPN/Sy3/vamifeport complex and (<bold>B</bold>) density around α-helix 7 of the same complex (cryo-EM density is contoured at 6.5 σ). (<bold>C</bold>) The equivalent region in the hsFPN/Sy3 complex not containing vamifeport does not show any comparable density. (<bold>D</bold>) Density around α-helix 7 of the same complex (cryo-EM density is contoured at 6.0 σ). (<bold>E</bold>) Density in the binding region of the hsFPN/Sy12/vamifeport complex indicates vamifeport binding to the equivalent region in the outward-facing conformation that is less well defined. (<bold>F</bold>) Density around α-helix 7 of the same complex (cryo-EM density is contoured at 6.0 σ). (<bold>A, C, and E</bold>) Top views show cryo-EM density of the binding region (displayed in gray) with density surrounding the location of vamifeport in the hsFPN/Sy3/vamifeport complex (<bold>A and C</bold>) and the hsFPN/Sy12/vamifeport complex (<bold>E</bold>) colored in red. Bottom shows a view of the density surrounding the vamifeport location from the cytoplasm. In <bold>C</bold>, vamifeport obtained from the hsFPN/Sy3/vamifeport complex is shown as reference. (<bold>B, D, and F</bold>) Insets show blow-up of the loop connecting α7a and α7b in indicated orientation.</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig4-figsupp1-v1.tif"/></fig><fig id="fig4s2" position="float" specific-use="child-fig"><label>Figure 4—figure supplement 2.</label><caption><title>Hepcidin interactions.</title><p>(<bold>A</bold>) Location of the hepcidin binding site in hsFPN (obtained from PDBID 6WBV) relative to the metal ion binding sites S1 and S2. (<bold>B</bold>) Details of hsFPN-hepcidin interactions with the side chains of interacting residues shown as sticks and labeled. (<bold>A and B</bold>) Bound metal ions are indicated as yellow spheres. In <bold>B</bold>, a water molecule coordinating the metal is shown as red sphere. (<bold>C</bold>) Overlap in the binding site of hepcidin and vamifeport (obtained from a superposition of the respective complexes). (<bold>D</bold>) Closeup of the overlapping region of vamifeport and hepcidin with sidechains interacting with both molecules shown as sticks. Sidechain conformations are obtained from the hsFPN/hepcidin complex.</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig4-figsupp2-v1.tif"/></fig><fig id="fig4s3" position="float" specific-use="child-fig"><label>Figure 4—figure supplement 3.</label><caption><title>Alternative vamifeport binding mode.</title><p>(<bold>A</bold>) Vamifeport placed into its cryo-electron microscopy (cryo-EM) density in the hsFPN/Sy3/vamifeport complex (contoured at 6.5 σ) in opposite orientation. (<bold>B</bold>) Molecular interactions of the oppositely oriented vamifeport model with its binding site in hsFPN. (<bold>C</bold>) Selected interactions of vamifeport with protein side chains (left) and fit of the inhibitor into the binding pocket (right) in its original orientation displayed in <xref ref-type="fig" rid="fig4">Figure 4</xref>. (<bold>D</bold>) Schematic drawing of inhibitor interactions in the original orientation. (<bold>E</bold>) Selected interactions of vamifeport with protein side chains (left) and fit of the inhibitor into the binding pocket (right) in its alternative orientation defined in panels A and B. (<bold>D</bold>) Schematic drawing of inhibitor interactions in the alternative orientation. Although both orientations of the inhibitor would fit into the binding pocket, the chemical interactions with the protein are more favorable in the original orientation.</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig4-figsupp3-v1.tif"/></fig><fig id="fig4s4" position="float" specific-use="child-fig"><label>Figure 4—figure supplement 4.</label><caption><title>Evaluation of vamifeport interactions.</title><p>(<bold>A</bold>) Representative conformations of vamifeport in its original binding position. Inset (bottom, right) shows a superposition of the minimum-energy poses of vamifeport from 20 docking runs, which deviate marginally from the original position defined in the cryo-electron microscopy (cryo-EM) structure (mean ligand heavy-atom RMSD of 0.61 Å). (<bold>B</bold>) Representative conformations of vamifeport in its alternative binding position. Inset (bottom, right) shows a superposition of the minimum-energy vamifeport poses from 20 docking runs, which show some deviation from their original position defined in the cryo-EM structure resulting in two clusters of poses. Cluster 2 (green, 11 poses) is closer to the alternative position as defined in the cryo-EM density (mean ligand heavy-atom RMSD of 1.03 Å), and cluster 1 (red, nine poses) has somewhat deviated from this position to improve the interaction energy (mean ligand heavy-atom RMSD of 1.17 Å). (<bold>A and B</bold>) Shown are superpositions of minimum-energy conformations of short simulations of a restrained system as described in the methods. (<bold>C</bold>) Relative differences in the interaction energies of vamifeport in original and alternative orientations (compared to the median of the energy of the system in the original conformation). Shown are the differences in van der Waals (vdW, left), solvation (sum of direct mean field interaction [DMFI] and screened electrostatic terms, center), and total energy (right). Results of individual simulations are depicted as dots, and the two clusters of vamifeport positions in the alternative orientation are indicated. (<bold>D</bold>) Table of energy differences obtained from the data shown in <bold>C</bold> calculated for both clusters of vamifeport positions in the alternative orientation with respect to the original orientation. Mean and SD values in kcal/mol are reported.</p><p><supplementary-material id="fig4s4sdata1"><label>Figure 4—figure supplement 4—source data 1.</label><caption><title>Total energies of hsFPN-vamifeport complex in original and alternative conformation obtained by docking calculations and CAMPARI keyword files and input and output files for docking calculations.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-83053-fig4-figsupp4-data1-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig4-figsupp4-v1.tif"/></fig><fig id="fig4s5" position="float" specific-use="child-fig"><label>Figure 4—figure supplement 5.</label><caption><title>Interactions in the metal ion binding sites.</title><p>(<bold>A</bold>) Residues constituting the observed metal ion binding sites S1 (top) and S2 (bottom) in different FPN structures. Models are from: FPN/hepcidin/Co<sup>2+</sup>, PDBID 6WBV; FPN/Co<sup>2+</sup>, PDBID 6VYH; FPN/outw/vamifeport, hsFPN/Sy12/vamifeport complex; FPN/occl/vamifeport, hsFPN/Sy3/vamifeport complex. (<bold>B</bold>) Superposition of the ion binding Site S2 in different conformations illustrating the large spread of the location of C326 in different structures. (<bold>A and B</bold>) The protein is shown as Cα-trace, bound ions are displayed as yellow spheres and vamifeport and selected side chains as sticks.</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig4-figsupp5-v1.tif"/></fig></fig-group><p>The density attributed to vamifeport is located toward the center of FPN directly below the α7a–7b loop at the extracellular rim of a spacious occluded cavity where it is surrounded by residues on α2, α7a, α10, and α11 (<xref ref-type="fig" rid="fig4">Figure 4B–D</xref>). In this position, it overlaps with the binding site of hepcidin, which locks the transporter in its outward-facing state (<xref ref-type="fig" rid="fig4s2">Figure 4—figure supplement 2</xref>). The density, although strong throughout, is most pronounced at its ends defining the position of the two peripheral aromatic groups of the compound, which are both located in predominantly hydrophobic pockets (<xref ref-type="fig" rid="fig4">Figure 4A and E</xref>). The pocket located in the N-domain of hsFPN (N-pocket) involves the same residues that also contact the N-terminal part of hepcidin (i.e. Tyr 64, Val 68 on α2 and Tyr 501 and Phe 508 on α11; <xref ref-type="fig" rid="fig4">Figure 4E and F</xref>, <xref ref-type="fig" rid="fig4s2">Figure 4—figure supplement 2B</xref>). The connecting linker containing the aromatic oxazole ring is within 3–4 Å distance to the side chains of Asp 504 and His 507 on α11, Cys 326, Thr 329, and several backbone carbonyl groups on the α7a–7b loop and Arg 466 on α10, all of which are also involved in hepcidin binding (<xref ref-type="fig" rid="fig4">Figure 4E–G</xref>, <xref ref-type="fig" rid="fig4s2">Figure 4—figure supplement 2B–D</xref>). In contrast, the pocket in the C-terminal domain (C-pocket) is surrounded by residues most of which are not involved in hepcidin binding, including Leu 314, Leu 317, Tyr 318, and Thr 320 on α7a and Leu 469, Trp 470 and Asp 473 on α10 (<xref ref-type="fig" rid="fig4">Figure 4E and G</xref>).</p><p>Vamifeport can also be modeled into this density in an alternative orientation, with the terminal fluoro-pyridine and benzimidazole groups located in the opposite pockets (<xref ref-type="fig" rid="fig4s3">Figure 4—figure supplement 3A, B</xref>). Between both possible binding modes of the compound, the initially described one with the benzimidazole group in the N-pocket and the fluoro-pyridine group in the C-pocket allows for a larger number of interactions with the protein (<xref ref-type="fig" rid="fig4">Figure 4E</xref>, <xref ref-type="fig" rid="fig4s3">Figure 4—figure supplement 3B–F</xref>). In this mode, the carbonyl of the amide between the fluoro-pyridine and the oxazole group would interact with the side chain of Arg 466, and the oxazole group would be placed in a region with more pronounced density in contact with Thr 320 (<xref ref-type="fig" rid="fig4s3">Figure 4—figure supplement 3C, D</xref>). The secondary amine group on the linker, which is likely protonated, and one of the nitrogen atoms on the benzimidazole group would reside in proximity to Asp 504, whereas the other nitrogen in the heterocycle would contact Cys 326 and Thr 329 (<xref ref-type="fig" rid="fig4s3">Figure 4—figure supplement 3C, D</xref>). In the alternative binding mode of vamifeport, the benzimidazole group would bind to the C-pocket with one of its nitrogen atoms and the secondary amine of the linker located in proximity to the Arg 466 side chain leading to a potential electrostatic repulsion, which renders this interaction less favorable (<xref ref-type="fig" rid="fig4s3">Figure 4—figure supplement 3E, F</xref>). The preferred interactions in the initially described orientation of vamifeport are also reflected in the 12–20 kcal/mol lower docking energy of the compound, which is dominated by the more favorable polar interactions established with the protein (<xref ref-type="fig" rid="fig4s4">Figure 4—figure supplement 4</xref>).</p><p>Besides overlapping with the hepcidin binding site, vamifeport is located in close proximity to the S2 metal binding site with His 507 on α11 and Cys 326 on the α7a–α7b loop acting as coordinating residues (<xref ref-type="fig" rid="fig4">Figure 4F</xref>, <xref ref-type="fig" rid="fig4s5">Figure 4—figure supplement 5A</xref>). In all present mammalian FPN structures, the position of His 507 displays only small variations, whereas the position of Cys 326 on the flexible loop shows large differences (<xref ref-type="fig" rid="fig4s5">Figure 4—figure supplement 5A, B</xref>). In the presence of bound metal ions, His 507 and Cys 326 are located about 3.5 Å from each other, while in the same outward-facing conformation in the absence of substrates, the separation increases to 6 Å. In case of both hsFPN/Sy3 structures, Cys 326 moves even further toward the N-terminal domain and extends the distance to His 507 to 7–9 Å, which likely prohibits the concomitant binding of vamifeport and a divalent metal ion at the S2 site (<xref ref-type="fig" rid="fig4s5">Figure 4—figure supplement 5A, B</xref>).</p></sec><sec id="s2-5"><title>Functional characterization of the vamifeport binding site</title><p>To validate the binding mode of vamifeport, we have mutated residues of the protein that are in contact with the compound and employed our TMR-hepcidin displacement assay to determine whether these mutants would weaken binding to hsFPN. To this end, we have introduced point mutations in 10 amino acids lining the binding site (i.e. Tyr 64, Val 68, Tyr 501, Phe 508, Leu 314, Leu 317, Tyr 318, Leu 469, Trp 470, and Asp 473). These residues were mutated to alanine and serine to either truncate the side chain or introduce a polar moiety. In most cases, the expression levels of respective mutants were reduced compared to wild type (WT), and in case of Tyr 318, neither mutant was expressed (<xref ref-type="fig" rid="fig5s1">Figure 5—figure supplement 1</xref>). In addition, we have mutated Arg 466 and Asp 504 to alanine, with the former being well expressed and the latter at about one third of the WT level (<xref ref-type="fig" rid="fig5s1">Figure 5—figure supplement 1</xref>).</p><p>For displacement assays, we selected V68S and Y501S of the N-pocket, L469A, L469S, and W470S of the C-pocket, and R466A and D504A contacting the linker region. We first determined whether these mutants would still bind TMR-hepcidin by titrating the tagged peptide hormone and monitoring its FP (<xref ref-type="fig" rid="fig5s2">Figure 5—figure supplement 2</xref>). In these initial experiments, we found mutations of the N-pocket as well as Asp 504 and Arg 466 to drastically reduce the affinity to TMR-hepcidin, which is expected in light of their contribution to hepcidin binding (<xref ref-type="fig" rid="fig4s2">Figure 4—figure supplement 2B, D</xref>). Specifically, TMR-hepcidin interacts with mutants Y501S and D504A with μM affinity, with curves overlapping with a WT titration performed in presence of a high excess of vamifeport to block specific TMR-hepcidin binding, suggesting that TMR-hepcidin binding to these mutants is non-specific (<xref ref-type="fig" rid="fig5s2">Figure 5—figure supplement 2A</xref>). V68S bound TMR-hepcidin with considerably lower affinity (K<sub>D</sub> of 1044 nM vs 100 nM for WT) and for R466A, we determined a K<sub>D</sub> value of 501 nM (<xref ref-type="fig" rid="fig5s2">Figure 5—figure supplement 2A</xref>). In contrast, mutants of the C-pocket bound TMR-hepcidin with similar affinity as WT (i.e. L469A 57 nM; L469S 94 nM; W470S 227 nM; <xref ref-type="fig" rid="fig5s2">Figure 5—figure supplement 2B</xref>, <xref ref-type="table" rid="table2">Table 2</xref>). Subsequent experiments performed for mutants of the C-pocket and R466A showed displacement of TMR-hepcidin by hepcidin-25, underlining the specificity of its binding (<xref ref-type="fig" rid="fig5">Figure 5B</xref>, <xref ref-type="table" rid="table2">Table 2</xref>). As expected, in these competition assays, R466A displayed an elevated K<sub>D</sub> (713 nM vs 130 nM for WT), while the values for L469S and W470S were in the same range as for WT (108 nM for L469A, 180 nM for L469S, and 222 nM for W470S; <xref ref-type="fig" rid="fig5">Figure 5C–F</xref>, <xref ref-type="table" rid="table2">Table 2</xref>). Similarly, in all mutants, vamifeport did still compete with TMR-hepcidin, however, with considerably lower affinity than WT (25 nM; <xref ref-type="fig" rid="fig5">Figure 5B</xref>, <xref ref-type="table" rid="table2">Table 2</xref>). Specifically, the fit for R466A resulted in a K<sub>D</sub> of 83 nM, and truncation of the side chains comprising the hydrophobic C-pocket resulted in K<sub>D</sub> values of 37 nM (L469A), 60 nM (L469S), and 82 nM (W470S), implying that these residues indeed contribute to the binding of vamifeport (<xref ref-type="fig" rid="fig5">Figure 5C–F</xref>, <xref ref-type="table" rid="table2">Table 2</xref>), thus further supporting our structural results defining the vamifeport binding site.</p><table-wrap id="table2" position="float"><label>Table 2.</label><caption><title>Hepcidin and vamifeport binding.</title></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="bottom">hsFPN construct</th><th align="left" valign="bottom">K<sub>D</sub> TMR-hepcidin (nM)</th><th align="left" valign="bottom">K<sub>D</sub> hepcidin-25 (nM)</th><th align="left" valign="bottom">K<sub>D</sub> vamifeport (nM)</th></tr></thead><tbody><tr><td align="left" valign="bottom">WT</td><td align="left" valign="bottom">100±4</td><td align="left" valign="bottom">131±12</td><td align="left" valign="bottom">24±3</td></tr><tr><td align="left" valign="bottom">R466A</td><td align="left" valign="bottom">501±22</td><td align="left" valign="bottom">713±117</td><td align="left" valign="bottom">83±16</td></tr><tr><td align="left" valign="bottom">L469A</td><td align="left" valign="bottom">57±2</td><td align="left" valign="bottom">108±10</td><td align="left" valign="bottom">37±4</td></tr><tr><td align="left" valign="bottom">L469S</td><td align="left" valign="bottom">94±3</td><td align="left" valign="bottom">180±17</td><td align="left" valign="bottom">60±7</td></tr><tr><td align="left" valign="bottom">W470S</td><td align="left" valign="bottom">227±8</td><td align="left" valign="bottom">222±19</td><td align="left" valign="bottom">82±11</td></tr><tr><td align="left" valign="bottom">V68S</td><td align="left" valign="bottom">1044±60</td><td align="left" valign="bottom">n.d.</td><td align="left" valign="bottom">n.d.</td></tr><tr><td align="left" valign="bottom">Y501S</td><td align="left" valign="bottom">&gt;&gt;1000</td><td align="left" valign="bottom">n.d.</td><td align="left" valign="bottom">n.d.</td></tr><tr><td align="left" valign="bottom">D504A</td><td align="left" valign="bottom">&gt;&gt;1000</td><td align="left" valign="bottom">n.d.</td><td align="left" valign="bottom">n.d.</td></tr></tbody></table><table-wrap-foot><fn><p>n.d., not determined.</p></fn></table-wrap-foot></table-wrap><fig-group><fig id="fig5" position="float"><label>Figure 5.</label><caption><title>Properties of binding site mutants.</title><p>(<bold>A</bold>) Close-up of vamifeport/FPN interactions with mutated residues. Residues of the C-pocket whose mutations were characterized in detail are labeled in red. Displacement of TMR-hepcidin with unlabeled hepcidin-25 or vamifeport measured by changes in the fluorescence polarization of labeled hepcidin. Investigated constructs show: (<bold>B</bold>) hsFPN WT and the point mutants, (<bold>C</bold>) R466A, (<bold>D</bold>) L469A, (<bold>E</bold>) L469S, and (<bold>F</bold>) W470S. The K<sub>D</sub> values for the interaction between FPN/hepcidin-25 and FPN/vamifeport are displayed. Values were obtained from a fit to a competition binding model (lines) described in the methods. (<bold>B–F</bold>) Data show mean of three independent measurements; errors are SEM. Similar results were obtained in independent experiments using different preparations and concentrations of hsFPN.</p><p><supplementary-material id="fig5sdata1"><label>Figure 5—source data 1.</label><caption><title>TMR-hepcidin fluorescence polarization displacement data of hsFPN WT and point mutants.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-83053-fig5-data1-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig5-v1.tif"/></fig><fig id="fig5s1" position="float" specific-use="child-fig"><label>Figure 5—figure supplement 1.</label><caption><title>Expression of hsFPN mutants.</title><p>Fluorescence detection size-exclusion chromatography profiles of detergent solubilized extracts of hsFPN wild type (WT) and point mutants harboring the C-terminal GFP-tag. The first panel (top left) shows a comparison of traces of WT (gray) and non-transfected cells (blue, neg.) as negative control, demonstrating that the peak eluting at low volume is not related to FPN. The height of the second peak (●) indicates the monomeric transporters from mutant preparations (red) compared to WT (gray).</p><p><supplementary-material id="fig5s1sdata1"><label>Figure 5—figure supplement 1—source data 1.</label><caption><title>Fluorescence detection size-exclusion chromatography data of detergent solubilized extracts of hsFPN WT and point mutants harboring a C-terminal GFP-tag.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-83053-fig5-figsupp1-data1-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig5-figsupp1-v1.tif"/></fig><fig id="fig5s2" position="float" specific-use="child-fig"><label>Figure 5—figure supplement 2.</label><caption><title>Hepcidin binding to hsFPN mutants.</title><p>Binding of fluorescently labeled hepcidin-25 (TMR-hepcidin) to increasing concentrations of hsFPN mutants determined by the change in the fluorescence polarization of the peptide. Point mutants with (<bold>A</bold>) decreased and (<bold>B</bold>) similar potency compared to wild type (WT) hsFPN (dashed black line). The gray curve in <bold>A</bold> shows an experiment with WT hsFPN in the presence of a large excess (i.e. 30 μM) of vamifeport to determine unspecific binding. Data show mean of three independent measurements, and errors are SEM. The fit yielded K<sub>D</sub> values of 100±4 nM for WT, 57±2 nM for L469A, 94±3 nM for L469S, 227±8 nM for W470S, 501±22 nM for R466A, 1044±60 nM for V68S, and about 4.5 μM and 6 μM for Y501S and D504A, respectively.</p><p><supplementary-material id="fig5s2sdata1"><label>Figure 5—figure supplement 2—source data 1.</label><caption><title>TMR-hepcidin fluorescence polarization direct binding data of hsFPN WT and point mutants.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-83053-fig5-figsupp2-data1-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig5-figsupp2-v1.tif"/></fig></fig-group></sec></sec><sec id="s3" sec-type="discussion"><title>Discussion</title><p>Here, we have investigated the interaction between human FPN (hsFPN) and its inhibitor vamifeport, which was shown to ameliorate anemia and iron homeostasis in a mouse model of β-thalassemia and is now in clinical development for this disorder and sickle cell disease (<xref ref-type="bibr" rid="bib32">Manolova et al., 2019</xref>; <xref ref-type="bibr" rid="bib39">Nyffenegger et al., 2022</xref>). Our study has provided two major novel results, it has revealed the structure of an occluded state of hsFPN, where the access to the substrate binding sites is blocked from both sides of the membrane (<xref ref-type="fig" rid="fig3">Figure 3</xref>), and it has defined the interactions with vamifeport in the same occluded conformation (<xref ref-type="fig" rid="fig4">Figure 4</xref>).</p><p>The structures determined in the course of our investigations were obtained using two sybodies binding to different epitopes of hsFPN, which both stabilize distinct conformations of the transporter (<xref ref-type="fig" rid="fig2">Figure 2</xref>). Whereas, the hsFPN/Sy12/vamifeport complex shows an outward-facing conformation in the absence of bound metal ions that closely resembles equivalent states determined in previous studies (<xref ref-type="bibr" rid="bib6">Billesbølle et al., 2020</xref>; <xref ref-type="bibr" rid="bib40">Pan et al., 2020</xref>), two hsFPN/Sy3 structures obtained in the absence and presence of vamifeport display a previously unknown conformation of FPN, where the access to substrate binding sites from the outside has closed, while the intracellular part of the transporter has remained unchanged (<xref ref-type="fig" rid="fig3">Figure 3</xref>). In both structures in complex with Sy3, helix α7b, located at the extracellular part of the C-domain, has moved toward the N-domain while unwinding its N-terminal turn. The resulting extended loop connecting α7a with α7b bridges toward α-helices 1 and 2 to seal off the outward-facing cavity leading to the substrate binding sites (<xref ref-type="fig" rid="fig3">Figure 3C–E</xref>). Since this conformation with occluded substrate binding pocket is stabilized by the binding of Sy3 from the extracellular side to a cleft between both sub-domains involving α-helices 1, 5, 7, and 8 (<xref ref-type="fig" rid="fig2">Figure 2D</xref>), it is currently not known to which degree it represents an intermediate in the transport cycle. Notwithstanding the ambiguity concerning its functional relevance, several lines of evidence suggest that this conformation would be assumed in solution and at least be close to conformations on the transition toward the inward-facing state. In the sybody selection process, binders frequently target pre-existing conformations or ones that are energetically close. Consequently, we find it unlikely that this conformation would be solely induced by sybody binding, particularly since it is also targeted by vamifeport, which was not present during the selection process. Moreover, the observed occluded conformation bears features that directly relate to the differences between distinct states of known FPN structures. The mobility of α7b and α2 is evident in the comparison between outward-facing structures of FPN obtained in the absence and presence of hepcidin, where binding of the latter causes a further opening of the aqueous cleft to accommodate the bound peptide hormone (<xref ref-type="bibr" rid="bib6">Billesbølle et al., 2020</xref>; <xref ref-type="fig" rid="fig6">Figure 6A</xref>). Conversely, the same structural elements of the occluded conformation are positioned between the outward- and inward-facing structures of the close bacterial homolog bbFPN (<xref ref-type="bibr" rid="bib52">Taniguchi et al., 2015</xref>; <xref ref-type="fig" rid="fig6">Figure 6B</xref>). Finally, the closure of the extracellular entrance by the movement of α7b toward the N-terminal domain is also found in other members of the MFS that transport sugars and peptides (<xref ref-type="bibr" rid="bib12">Dang et al., 2010</xref>; <xref ref-type="bibr" rid="bib27">Huang et al., 2003</xref>; <xref ref-type="bibr" rid="bib38">Newstead et al., 2011</xref>). This is best illustrated in transporters of the GLUT family on their transition between outward and occluded states, where this helix was assigned as extracellular gating element (<xref ref-type="bibr" rid="bib13">Deng et al., 2015</xref>; <xref ref-type="bibr" rid="bib16">Drew and Boudker, 2016</xref>; <xref ref-type="bibr" rid="bib17">Drew et al., 2021</xref>; <xref ref-type="bibr" rid="bib45">Quistgaard et al., 2016</xref>; <xref ref-type="fig" rid="fig6s1">Figure 6—figure supplement 1A, B</xref>). Compared to other transporters sharing the MFS fold, however, the unwound part of α7 in the occluded conformation of FPN is unusually long. While somewhat flexible in the same conformation obtained in the absence of vamifeport, it rigidifies in its presence as a consequence of inhibitor interactions, which presumably further stabilize this state (<xref ref-type="fig" rid="fig4s1">Figure 4—figure supplement 1A–D</xref>). Hence, although weak cryo-EM density indicates binding of the inhibitor to a similar position also in the outward-facing conformation of the hsFPN/Sy12/vamifeport complex, the much better defined density implies stronger interactions in the occluded conformation, suggesting that the latter would be preferentially adopted in complex with the compound in a cellular environment (<xref ref-type="fig" rid="fig4">Figure 4A</xref>, <xref ref-type="fig" rid="fig4s1">Figure 4—figure supplement 1A, E</xref>).</p><fig-group><fig id="fig6" position="float"><label>Figure 6.</label><caption><title>Hypothetical mechanism of FPN regulation by vamifeport.</title><p>Conformational plasticity of the extracellular region surrounding helix α7b as illustrated by a superposition of the occluded conformation of hsFPN with (<bold>A</bold>) hsFPN in outward-facing apo (PDBID 6W4S) and hepcidin-bound states (PDBID 6WBV) and (<bold>B</bold>) the prokaryotic bbFPN in outward- and inward-facing states (PDBID 5AYN and 5AYO). (<bold>C</bold>) Location of vamifeport at the extracellular rim of the occluded cavity leaves sufficient space for larger inhibitors. (<bold>D</bold>) Comparison of the metal ion binding site S2 in the outward-facing conformation of hsFPN (PDBID 6VYH) and its occluded conformation indicates competition of vamifeport with the ion binding to S2. (<bold>E</bold>) Hypothetical relationship between vamifeport-bound FPN conformations and the ability of the protein to get ubiquitinated. The possible binding of Fe<sup>2+</sup> to the S1 site, which is not overlapping with the vamifeport binding site, is indicated. The stabilization of the occluded conformation might potentially facilitate the recruitment of the ubiquitination machinery on the intracellular side.</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig6-v1.tif"/></fig><fig id="fig6s1" position="float" specific-use="child-fig"><label>Figure 6—figure supplement 1.</label><caption><title>Conformational changes and substrate binding in different transporters.</title><p>Comparison of the transition of the outward-facing to the occluded conformations in (<bold>A</bold>) GLUT3 (PDBIDs 4ZWC and 4ZW9) and (<bold>B</bold>) hsFPN (PDBID 6VYH). Shown is the movement of α7 toward α1. Outward-facing structures are colored in gray, and the location of bound glucose and vamifeport is displayed. (<bold>C</bold>) Location of the presumed ion binding sites to the occluded conformation of hsFPN. The ion positions were obtained from the metal-bound outward-facing structure (PDB 6VYH). (<bold>D</bold>) View of the entire structure, and (<bold>E</bold>) close-up of the outward-facing cavity with insets showing closeup of the individual binding sites. The molecular surface is shown in magenta, bound metal ions as yellow spheres, and interacting protein residues as sticks. The proximity of the bound ions to the large cavity indicates their interaction with trapped water molecules. (<bold>F</bold>) Ribbon representation of the occluded conformation of the prokaryotic SLC11 transporter DraNRAMP (PDBID 8E60) with domains of the protein shown in unique colors. Inset (right) shows a zoom into the substrate binding site with residues coordinating the bound metal ion (yellow) displayed as sticks. The white pocket shows the only space in vicinity of the binding site that is not occupied by either the protein or the metal ion, interactions are indicated as dashed lined, and a water molecule involved in ion interactions is displayed.</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-83053-fig6-figsupp1-v1.tif"/></fig></fig-group><p>The spacious protein-enclosed aqueous region that is formed in the occluded conformation of hsFPN encompasses a volume of 906 Å<sup>3</sup>, which is about three times larger than the volume of vamifeport (<xref ref-type="fig" rid="fig6">Figure 6C</xref>). By binding at its extracellular rim, vamifeport forms extended tight interactions with the protein at one of its faces, whereas the opposite face of the inhibitor is exposed to the trapped aqueous environment of the cavern, which might accommodate even considerably larger molecules. In this location, the terminal benzimidazole and fluoro-pyridine groups are embedded in hydrophobic pockets, with the N-pocket being constituted by residues on α2 and α11 and the C-pocket by residues on α7a and α10, whereas the linker containing an oxazole ring and connecting both aromatic groups is contacted by residues on α10, 11, and the α7a–7b loop (<xref ref-type="fig" rid="fig4">Figure 4E–G</xref>). These residues are highly conserved throughout FPN orthologs, and they are identical in all mammalian family members (<xref ref-type="fig" rid="fig2s5">Figure 2—figure supplement 5B</xref>), explaining the inhibitory action of vamifeport in mice (<xref ref-type="bibr" rid="bib32">Manolova et al., 2019</xref>). The involvement of the N-pocket and the region contacting the vamifeport linker in the binding of hepcidin underlies the competitive relationship between both ligands despite their stabilization of distinct protein conformations (<xref ref-type="fig" rid="fig4s2">Figure 4—figure supplement 2B, C</xref>). In contrast, the observed interactions in the C-pocket are unique to vamifeport, with mutations in this site lowering its affinity to hsFPN, consistent with our structural data (<xref ref-type="fig" rid="fig5">Figure 5C–F</xref>).</p><p>Notwithstanding the unknown functional correspondence of the described occluded conformation, we expect a spacious aqueous cavity to be retained during transport by FPN, which is uncommon for selective metal ion transporters, where bound substrates are usually tightly surrounded by protein residues (<xref ref-type="fig" rid="fig6s1">Figure 6—figure supplement 1C–F</xref>). In contrast, the two substrates binding sites (S1 and S2) identified in the outward-facing state of FPN are located at two disconnected locations toward the extracellular border of the cavern (<xref ref-type="bibr" rid="bib6">Billesbølle et al., 2020</xref>; <xref ref-type="bibr" rid="bib40">Pan et al., 2020</xref>; <xref ref-type="fig" rid="fig6s1">Figure 6—figure supplement 1C, D</xref>). Both sites offer only few protein interactions, with surrounding water molecules likely completing the preferred octahedral metal ion coordination geometry (<xref ref-type="fig" rid="fig6s1">Figure 6—figure supplement 1E</xref>). The organization of these sites is in striking contrast to unrelated transition metal ion transporters of the SLC11 family, which tightly coordinate their substrate by protein residues in narrow pockets that exclude most of the solvent (<xref ref-type="bibr" rid="bib8">Bozzi et al., 2019</xref>; <xref ref-type="bibr" rid="bib19">Ehrnstorfer et al., 2014</xref>; <xref ref-type="bibr" rid="bib46">Ray et al., 2022</xref>; <xref ref-type="fig" rid="fig6s1">Figure 6—figure supplement 1F</xref>), thus emphasizing the distinct transport mechanism of FPN that is still not fully understood.</p><p>In the inhibition of transport, a presumable interference between vamifeport and transported metal ion binding appears plausible. The overlap of the bound inhibitor with the S2 site suggests a competition with metal ion binding at this location, whereas the S1 site would not be affected, although experimental evidence for such competition still needs to be provided (<xref ref-type="fig" rid="fig6">Figure 6D</xref>, <xref ref-type="fig" rid="fig4s5">Figure 4—figure supplement 5</xref>). Similarly, the primary mechanism of how vamifeport reduces iron transport has remained ambiguous as it is not clear whether this would be accomplished by a slowdown or block of transport by locking the transporter in a single conformation or by its displacement from the plasma membrane. As previously shown, vamifeport and hepcidin affect hsFPN in a similar way, both leading to ubiquitination, internalization, and degradation of the transporter (<xref ref-type="bibr" rid="bib32">Manolova et al., 2019</xref>). However, compared to hepcidin, the effect of vamifeport is less pronounced, resulting in a mere slow-down of the process. Thus, the question remains how these extracellular signals are relayed to the intracellular side to promote ubiquitination. Binding of hepcidin locks the transporter in an outward-facing state with the peptide hormone impeding structural transitions (<xref ref-type="bibr" rid="bib6">Billesbølle et al., 2020</xref>; <xref ref-type="bibr" rid="bib40">Pan et al., 2020</xref>; <xref ref-type="fig" rid="fig4s2">Figure 4—figure supplement 2A</xref>). This locked state might facilitate the binding of ubiquitin ligases on the intracellular side. In contrast, our data suggest that the binding of the smaller ligand vamifeport would stabilize an occluded state, which shares its intracellular conformation with the outward-facing state (<xref ref-type="fig" rid="fig3">Figures 3C</xref> and <xref ref-type="fig" rid="fig6">6E</xref>) and might thus exert a comparable effect. The transition from an outward facing to an occluded state raises the question of whether the transporter could further transit into an inward-facing state even in the presence of vamifeport, which appears possible considering the spacious cavity found in the inward-facing state of a bacterial FPN homolog, which could accommodate a molecule with the size of vamifeport (<xref ref-type="bibr" rid="bib52">Taniguchi et al., 2015</xref>). It is thus conceivable that, while stabilizing an intermediate state, the binding of vamifeport does not completely prohibit the transition of FPN into an inward-facing conformation (<xref ref-type="fig" rid="fig6">Figure 6E</xref>). The resulting less stringent impediment of movement compared to hepcidin might explain the altered phenotype of vamifeport with respect to ubiquitination, internalization, and degradation of FPN, although the detailed mechanism of inhibition still needs to be elucidated (<xref ref-type="bibr" rid="bib32">Manolova et al., 2019</xref>). In combination, our work has provided novel insight into the conformational properties of a central regulator of iron homeostasis in humans and defined its interaction with a compound of high therapeutic relevance. It does thus provide the basis for the development of novel classes of molecules with improved pharmacological properties.</p></sec><sec id="s4" sec-type="materials|methods"><title>Materials and methods</title><sec id="s4-1"><title>Construct preparation</title><p>The human FPN (hsFPN, UniProt identifier Q9NP59) gene was codon optimized for expression in a mammalian expression system (<xref ref-type="table" rid="table3">Table 3</xref>), synthesized by GeneScript and cloned by FX-cloning (<xref ref-type="bibr" rid="bib25">Geertsma and Dutzler, 2011</xref>) into the expression vector pcDX3cGMS, which adds an HRV 3C protease cleavage site, GFP, a myc-tag and streptactin-binding peptide to the C-terminus of the protein. Sybody sequences (<xref ref-type="table" rid="table3">Table 3</xref>) were cloned into the pBSinit vector (<xref ref-type="bibr" rid="bib58">Zimmermann et al., 2020</xref>), an FX-compatible, chloramphenicol resistant, arabinose-inducible vector containing an N-terminal pelB leader sequence and a C-terminal His<sub>6</sub> tag. Point mutations were introduced by site-directed mutagenesis (<xref ref-type="table" rid="table4">Table 4</xref>; <xref ref-type="bibr" rid="bib31">Li et al., 2008</xref>).</p><table-wrap id="table3" position="float"><label>Table 3.</label><caption><title>DNA sequences.</title></caption><table frame="hsides" rules="groups"><tbody><tr><td align="left" valign="bottom"><bold>Codon optimized sequence of hsFPN</bold><break/><named-content content-type="sequence">GTACCAGAGCCGGAGATCACAACCGGCAGAGAGGCTGCTGCGGCAGCCTGGCAGATTACCTGACCTCTGCCAAATTCCTGCTGTACCTGGGCCATTCTCTGAGCACATGGGGCGACAGAATGTGGCACTTCGCCGTGTCCGTCTTTCTCGTGGAACTGTATGGAAACAGCCTGCTGCTGACTGCTGTTTACGGCCTGGTGGTGGCCGGCAGCGTGCTGGTGCTGGGAGCCATTATAGGCGATTGGGTCGACAAGAACGCCCGGCTGAAAGTGGCCCAAACAAGCCTGGTGGTGCAGAACGTGAGCGTGATCCTCTGTGGCATCATCCTGATGATGGTGTTCCTGCATAAGCACGAACTGCTGACAATGTACCACGGCTGGGTGCTGACCTCTTGCTACATCCTGATCATCACAATTGCCAATATCGCCAATCTGGCCAGCACCGCTACCGCCATCACCATTCAAAGAGATTGGATCGTGGTTGTGGCCGGCGAGGACCGGAGCAAGCTGGCTAACATGAACGCCACCATCCGGAGAATCGACCAGTTAACCAACATCCTGGCTCCTATGGCCGTGGGCCAGATCATGACATTTGGCAGCCCCGTGATCGGCTGTGGCTTCATCAGCGGCTGGAACCTCGTGTCCATGTGCGTGGAATACGTGCTGCTGTGGAAGGTGTACCAGAAAACCCCTGCCCTGGCCGTGAAGGCCGGCCTGAAGGAGGAAGAGACGGAGCTGAAGCAGCTGAACCTGCACAAGGACACCGAGCCTAAGCCTCTGGAGGGCACACACCTGATGGGAGTGAAAGACAGCAATATCCACGAACTGGAACACGAGCAGGAGCCCACCTGCGCCTCTCAGATGGCCGAGCCTTTTCGAACCTTCCGGGACGGCTGGGTGTCCTACTACAACCAGCCTGTGTTCCTGGCCGGCATGGGCCTGGCCTTCCTGTACATGACCGTGCTGGGATTCGATTGTATCACCACCGGCTACGCCTACACCCAGGGCCTGAGCGGCAGCATTCTGTCTATCCTGATGGGCGCCAGCGCCATCACCGGCATTATGGGTACAGTGGCTTTCACCTGGCTGAGAAGGAAGTGCGGACTTGTTAGAACCGGCCTGATCAGCGGCCTGGCCCAACTGTCTTGTCTGATCCTGTGCGTGATCAGCGTCTTTATGCCTGGCAGCCCTCTGGACCTGTCTGTGTCCCCATTCGAGGACATCAGATCAAGATTCATCCAGGGCGAGAGCATCACACCTACCAAGATCCCCGAGATTACCACCGAAATCTACATGAGCAACGGCTCCAACAGCGCTAACATCGTGCCCGAGACAAGCCCTGAATCTGTGCCCATCATCTCGGTGAGCCTCCTGTTCGCTGGAGTGATCGCCGCCAGAATCGGCCTGTGGTCCTTTGACCTGACAGTGACCCAGCTGCTGCAGGAGAACGTGATCGAGAGCGAGAGAGGAATCATCAACGGCGTGCAGAACAGCATGAACTACCTGCTGGATCTGCTGCACTTCATCATGGTCATCCTAGCTCCAAACCCCGAGGCCTTCGGCCTGCTGGTCCTGATCAGCGTGAGCTTCGTGGCCATGGGCCACATCATGTATTTCAGATTCGCCCAGAATACACTGGGCAACAAGCTGTTCGCATGCGGACCTGACGCCAAGGAAGTGCGGAAGGAAAATCAGGCCAATACCAGCGTGGTG</named-content></td></tr><tr><td align="left" valign="bottom"><bold>Sequence of Sybody 1</bold><break/><named-content content-type="sequence">GTTCAGCTGGTTGAGAGCGGTGGTGGCCTGGTCCAAGCTGGCGGTTCGCTGCGTCTGAGCTGCGCCGCAAGCGGTTTCCCGGTGGAACAGGGTTGGATGGCTTGGTATCGTCAGGCACCGGGCAAAGAACGTGAGTGGGTCGCGGCGATTTCTAGCTCTGGTTGGCATACGTGGTACGCAGATTCTGTTAAGGGCCGCTTTACCATCAGCCGCGACAACGCGAAGAATACGGTCTATTTGCAGATGAATAGCCTGAAACCGGAAGATACCGCGGTTTACTACTGTAACGTGAAAGACAACGGTTGGTACTCTGCTCAGTACGACTATTGGGGCCAAGGTACCCAAGTGACTGTGAGCGCAGGAAGAGCTGGCGAACAAAAACTCATCTCAGAAGAGGATCTGAATAGCGCCGTCGAC</named-content></td></tr><tr><td align="left" valign="bottom"><bold>Sequence of Sybody 3</bold><break/><named-content content-type="sequence">GTTCAGCTGGTTGAGAGCGGTGGTGGCCTGGTCCAAGCTGGCGGTTCGCTGCGTCTGAGCTGCGCCGCAAGCGGTTTCCCGGTGGCTTGGAACGAAATGCGTTGGTATCGTCAGGCACCGGGCAAAGAACGTGAGTGGGTCGCGGCGATTGCTAGCATCGGTGTTACTACGTACTACGCAGATTCTGTTAAGGGCCGCTTTACCATCAGCCGCGACAACGCGAAGAATACGGTCTATTTGCAGATGAATAGCCTGAAACCGGAAGATACCGCGGTTTACTACTGTAACGTGAAAGACTACGGTATGGCTTTCTGGTACTACGACTATTGGGGCCAAGGTACCCAAGTGACTGTGAGCGCAGGAAGAGCTGGCGAACAAAAACTCATCTCAGAAGAGGATCTGAATAGCGCCGTCGAC</named-content></td></tr><tr><td align="left" valign="bottom"><bold>Sequence of Sybody 8</bold><break/><named-content content-type="sequence">GTTCAGCTGGTTGAGAGCGGTGGTGGCCTGGTCCAAGCTGGCGGTTCGCTGCGTCTGAGCTGCGCCGCAAGCGGTTTCCCGGTGTACGCTTACAACATGGAATGGTATCGTCAGGCACCGGGCAAAGAACGTGAGTGGGTCGCGGCGATTGCTAGCTACGGTCATACTACGGAATACGCAGATTCTGTTAAGGGCCGCTTTACCATCAGCCGCGACAACGCGAAGAATACGGTCTATTTGCAGATGAATAGCCTGAAACCGGAAGATACCGCGGTTTACTACTGTAACGTGAAAGACTACGGTTACCTGTGGTACCATTACGACTATTGGGGCCAAGGTACCCAAGTGACTGTGAGCGCAGGAAGAGCTGGCGAACAAAAACTCATCTCAGAAGAGGATCTGAATAGCGCCGTCGAC</named-content></td></tr><tr><td align="left" valign="bottom"><bold>Sequence of Sybody 11</bold><break/><named-content content-type="sequence">GTTCAGCTGGTTGAGAGCGGTGGTGGCCTGGTCCAAGCTGGCGGTTCGCTGCGTCTGAGCTGCGCCGCAAGCGGTTTCCCGGTGTACTCTCGTGGTATGTACTGGTATCGTCAGGCACCGGGCAAAGAACGTGAGTGGGTCGCGGCGATTCATAGCTACGGTACTCAGACGGAATACGCAGATTCTGTTAAGGGCCGCTTTACCATCAGCCGCGACAACGCGAAGAATACGGTCTATTTGCAGATGAATAGCCTGAAACCGGAAGATACCGCGGTTTACTACTGTAACGTGAAAGACATGGGTTACCTGTGGTACCAGTACGACTATTGGGGCCAAGGTACCCAAGTGACTGTGAGCGCAGGAAGAGCTGGCGAACAAAAACTCATCTCAGAAGAGGATCTGAATAGCGCCGTCGAC</named-content></td></tr><tr><td align="left" valign="bottom"><bold>Sequence of Sybody 12</bold><break/><named-content content-type="sequence">GTTCAGCTGGTTGAGAGCGGTGGTGGCCTGGTCCAAGCTGGCGGTTCGCTGCGTCTGAGCTGCGCCGCAAGCGGTTTCCCGGTGTGGAACTCTCGTATGTTCTGGTATCGTCAGGCACCGGGCAAAGAACGTGAGTGGGTCGCGGCGATTGCTAGCAAAGGTTACTCTACGCATTACGCAGATTCTGTTAAGGGCCGCTTTACCATCAGCCGCGACAACGCGAAGAATACGGTCTATTTGCAGATGAATAGCCTGAAACCGGAAGATACCGCGGTTTACTACTGTAACGTGAAAGACGACGGTTGGTGGTGGCAGACTTACGACTATTGGGGCCAAGGTACCCAAGTGACTGTGAGCGCAGGAAGAGCTGGCGAACAAAAACTCATCTCAGAAGAGGATCTGAATAGCGCCGTCGAC</named-content></td></tr></tbody></table></table-wrap><table-wrap id="table4" position="float"><label>Table 4.</label><caption><title>Primers for mutagenesis.</title></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="bottom">Mutation</th><th align="left" valign="bottom">Primer sequences</th></tr></thead><tbody><tr><td align="left" valign="bottom">Y64A</td><td align="left" valign="bottom">for: GCTGACTGCTGTTGCCGGCCTGGTGGTGGCCGGCAGC<break/>rev: AACAGCAGTCAGCAGCAGGCTGTTTCCATACAGTTCCACG</td></tr><tr><td align="left" valign="bottom">Y64S</td><td align="left" valign="bottom">for: GCTGACTGCTGTTTCCGGCCTGGTGGTGGCCGGCAGC<break/>rev: AACAGCAGTCAGCAGCAGGCTGTTTCCATACAGTTCCACG</td></tr><tr><td align="left" valign="bottom">V68A</td><td align="left" valign="bottom">for: GCTGACTGCTGTTTACGGCCTGGTGGCGGCCGGCAGC<break/>rev: AACAGCAGTCAGCAGCAGGCTGTTTCCATACAGTTCCACG</td></tr><tr><td align="left" valign="bottom">Y68S</td><td align="left" valign="bottom">for: GCTGACTGCTGTTTACGGCCTGGTGTCGGCCGGCAGC<break/>rev: AACAGCAGTCAGCAGCAGGCTGTTTCCATACAGTTCCACG</td></tr><tr><td align="left" valign="bottom">L314A</td><td align="left" valign="bottom">for: TGACCGTGCTGGGATTCGATTGTATCACCACCGGCTACG<break/>rev: CCCAGCACGGTCATGTACAGGAAGGCCGCGCCCATGC</td></tr><tr><td align="left" valign="bottom">L314S</td><td align="left" valign="bottom">for: TGACCGTGCTGGGATTCGATTGTATCACCACCGGCTACG<break/>rev: CCCAGCACGGTCATGTACAGGAAGGCCGAGCCCATGC</td></tr><tr><td align="left" valign="bottom">L317A</td><td align="left" valign="bottom">for: TGACCGTGCTGGGATTCGATTGTATCACCACCGGCTACG<break/>rev: CCCAGCACGGTCATGTACGCGAAGGCCAGGCCCATGC</td></tr><tr><td align="left" valign="bottom">L317S</td><td align="left" valign="bottom">for: TGACCGTGCTGGGATTCGATTGTATCACCACCGGCTACG<break/>rev: CCCAGCACGGTCATGTACGAGAAGGCCAGGCCCATGC</td></tr><tr><td align="left" valign="bottom">Y318A</td><td align="left" valign="bottom">for: TGACCGTGCTGGGATTCGATTGTATCACCACCGGCTACG<break/>rev: CCCAGCACGGTCATGGCCAGGAAGGCCAGGCCCATGC</td></tr><tr><td align="left" valign="bottom">Y318S</td><td align="left" valign="bottom">for: TGACCGTGCTGGGATTCGATTGTATCACCACCGGCTACG<break/>rev: CCCAGCACGGTCATGGACAGGAAGGCCAGGCCCATGC</td></tr><tr><td align="left" valign="bottom">R466A</td><td align="left" valign="bottom">for: GAGTGATCGCCGCCGCAATCGGCCTGTGGTCCTTTGACCTGACAG<break/>rev: GCGGCGATCACTCCAGCGAACAGGAGGCTCACCGAGATGATGG</td></tr><tr><td align="left" valign="bottom">L469A</td><td align="left" valign="bottom">for: GAGTGATCGCCGCCAGAATCGGCGCGTGGTCCTTTGACCTGACAG<break/>rev: GCGGCGATCACTCCAGCGAACAGGAGGCTCACCGAGATGATGG</td></tr><tr><td align="left" valign="bottom">L469S</td><td align="left" valign="bottom">for: GAGTGATCGCCGCCAGAATCGGCTCGTGGTCCTTTGACCTGACAG<break/>rev: GCGGCGATCACTCCAGCGAACAGGAGGCTCACCGAGATGATGG</td></tr><tr><td align="left" valign="bottom">W470A</td><td align="left" valign="bottom">for: GAGTGATCGCCGCCAGAATCGGCCTGGCGTCCTTTGACCTGACAG<break/>rev: GCGGCGATCACTCCAGCGAACAGGAGGCTCACCGAGATGATGG</td></tr><tr><td align="left" valign="bottom">W470S</td><td align="left" valign="bottom">for: GAGTGATCGCCGCCAGAATCGGCCTGTCGTCCTTTGACCTGACAG<break/>rev: GCGGCGATCACTCCAGCGAACAGGAGGCTCACCGAGATGATGG</td></tr><tr><td align="left" valign="bottom">D473A</td><td align="left" valign="bottom">for: GAGTGATCGCCGCCAGAATCGGCCTGTGGTCCTTTGCCCTGACAG<break/>rev: GCGGCGATCACTCCAGCGAACAGGAGGCTCACCGAGATGATGG</td></tr><tr><td align="left" valign="bottom">Y501A</td><td align="left" valign="bottom">for: GAACAGCATGAACGCCCTGCTGGATCTGCTGCACTTCATCATGG<break/>rev: GTTCATGCTGTTCTGCACGCCGTTGATGATTCCTCTCTCG</td></tr><tr><td align="left" valign="bottom">Y501S</td><td align="left" valign="bottom">for: GAACAGCATGAACTCCCTGCTGGATCTGCTGCACTTCATCATGG<break/>rev: GTTCATGCTGTTCTGCACGCCGTTGATGATTCCTCTCTCG</td></tr><tr><td align="left" valign="bottom">F508A</td><td align="left" valign="bottom">for: GAACAGCATGAACTACCTGCTGGATCTGCTGCACGCCATCATGG<break/>rev: GTTCATGCTGTTCTGCACGCCGTTGATGATTCCTCTCTCG</td></tr><tr><td align="left" valign="bottom">F508S</td><td align="left" valign="bottom">for: GAACAGCATGAACTACCTGCTGGATCTGCTGCACTCCATCATGG<break/>rev: GTTCATGCTGTTCTGCACGCCGTTGATGATTCCTCTCTCG</td></tr></tbody></table></table-wrap></sec><sec id="s4-2"><title>Expression and purification of hsFPN</title><p>Suspension-adapted HEK293S GlnTI<sup>−</sup> cells were grown in HyClone Trans FX-H media supplemented with 2% fetal bovine serum, 2 mM L-glutamine, 100 U/ml penicillin/streptomycin, 1 mM pyruvate, and 1.5 g/l kolliphor-P188 in a humified incubator at 37°C and 5% CO<sub>2</sub>. Cells were checked for mycoplasma contamination. Plasmid DNA for transfection was amplified in <italic>Escherichia coli</italic> MC1061 and purified using a NucleoBond GigaPrep Kit. The day prior to transfection, 300 ml of suspension-adapted HEK293 GlnTI<sup>−</sup> cells were seeded to 0.5 Mio/ml cell density. As transfection mixture, purified plasmid DNA was mixed with PEI MAX (PolySciences Inc) in a 1:2.5 (w/w) ratio and subsequently diluted with DMEM media (High-Glucose DMEM, Gibco, MERCK) to a final DNA concentration of 0.01 mg/ml. The mixture was incubated at room temperature for 20 min prior to transfection, and each bioreactor vessel was supplemented with 50 ml transfection mixture and valproic acid to a final concentration of 4 mM. Expression was performed by incubation in a humidified incubator at 37°C, 5% CO<sub>2</sub> for 48 hr. Afterwards, the cells were harvested by centrifugation at 500 g, for 15 min at 4°C. The cell pellets were washed twice with PBS, flash-frozen in liquid nitrogen, and stored at –20°C until further use.</p><p>For purification, the cell pellet was thawed on ice and resuspended with ice-cold lysis buffer (20 mM Hepes pH 7.5, 200 mM NaCl, 2% [w/v] DDM, 10% w/v glycerol, 20 μg/ml DNase I, cOmplete protease inhibitor mix [Roche], 20 μl/ml Biotin blocking solution [IBA]). The suspension was sonified on ice in three cycles of 30 s using a VT70 titanium probe on a UW3200 sonicator. All further purification steps were performed at 4°C. Membrane proteins were extracted for 1 hr, while gently mixing. Cell debris and insoluble fractions were separated by centrifugation at 15,000 g for 25 min. The supernatant was loaded by gravity flow onto Strep-tactin Superflow resin (1.5–3 ml resin per liter of suspension culture) equilibrated with SEC buffer (20 mM Hepes pH 7.5, 200 mM NaCl, and 0.04% [w/v] DDM). The resin was washed with 20 column volumes (CV) SEC buffer, and bound proteins were eluted with five CV elution buffer (20 mM Hepes pH 7.5, 200 mM NaCl, 0.04% [w/v] DDM, and 5 mM Desthiobiotin). To cleave fusion tags, protein-containing fractions were supplemented with HRV-3C protease at a molar ratio of 5 (hsFPN) to 1 (3C protease) and incubated for 1 hr. The cleaved protein fraction was concentrated to approx. 500 μl using a 50 kDa cut-off centrifugal concentrator, filtered through a 0.22 μm filter, and finally injected into a SEC system connected to a Superdex S200 10/300 GL column, which was equilibrated with SEC buffer (20 mM Hepes pH 7.5, 200 mM NaCl, and 0.04% [w/v] DDM). For FP experiments, the DDM concentration in the SEC buffer was lowered to 0.02% (w/v) DDM. Peak fractions corresponding to monomeric FPN were pooled and concentrated to the desired concentration as described before.</p></sec><sec id="s4-3"><title>Expression and analysis of FPN mutants by fluorescence SEC</title><p>Adherent HEK293T cells were cultured in DMEM media supplemented with 10% fetal bovine serum and 100 U/ml penicillin/streptomycin in 100 mm TC dishes (Sarstedt AG) in an incubator at 37°C and 5% CO<sub>2</sub>. Cells were checked for mycoplasma contamination and split the day prior to transfection to 30–40% confluence. The transfection mixes containing 10 µg plasmid and 40 µg polyethylenimine (PEI) in 1 ml of non-supplemented DMEM media were added to the adherent cells after 15 min of incubation at room temperature, together with 5 mM valproic acid. The cells were harvested after 2 days of expression, washed with 1 ml ice cold sterile PBS, and collected by centrifugation. Membrane proteins were extracted with 500 µl lysis buffer (20 mM Hepes pH 7.5, 200 mM NaCl, 2% [w/v] DDM, 10% w/v glycerol, 20 μg/ml DNase I, and protease inhibitor mix) for 1 hr under gentle mixing on a rotating wheel at 4°C. Insoluble fractions were separated by centrifugation at 15,000 g for 20 min at 4°C, and the supernatants were filtered through 0.22 µm sized pores. From the cleared flowthroughs, 50 µl were injected onto a Superdex S200 5/150 GL column equilibrated with gel-filtration buffer (20 mM Hepes pH 7.5, 200 mM NaCl, and 0.04% [w/v] DDM) connected to an HPLC system. EGFP fluorescence was excited at 488 nm, and the emission was recorded at 507 nm.</p></sec><sec id="s4-4"><title>Protein biotinylation</title><p>Purified protein at a concentration of 1 mg/ml was chemically biotinylated using EZ link NHS-PEG4-Biotin (Thermo Scientific, A39259) at a 10–30 times molar excess. The samples were incubated on ice for 1 hr, and the reaction was terminated by adding Tris-HCl pH 7.5 to a final concentration of 5 mM. Excess PEG-biotin was removed by SEC using a Superdex S200 10/300 GL column equilibrated with SEC buffer (20 mM Hepes pH 7.5, 200 mM NaCl, and 0.04% [w/v] DDM). The biotinylation level of hsFPN was estimated using mass spectroscopy and by incubation with an excess of Streptavidin followed by analysis of the resulting complexes by SDS-PAGE and SEC.</p><p>For SPR, purified FPN containing a C-terminal Avi-tag (30 µM) was enzymatically biotinylated in reaction buffer (20 mM HEPES pH 7.5, 200 mM NaCl, 0.04% DDM, 5 mM ATP, 10 mM magnesium acetate, 60 µM biotin, and 40 μg bifunctional ligase/repressor enzyme BirA). The sample was incubated overnight on ice and purified by SEC using a Superdex S200 10/300 GL column equilibrated with SEC buffer (20 mM Hepes pH 7.5, 200 mM NaCl, and 0.04% [w/v] DDM). The biotinylation efficiency was estimated as described above.</p></sec><sec id="s4-5"><title>Selection of synthetic nanobodies against hsFPN</title><p>Selection of synthetic nanobodies against hsFPN was performed as described previously (<xref ref-type="bibr" rid="bib58">Zimmermann et al., 2020</xref>) with the detergent DDM added to a final concentration of 0.04% (w/v) to buffers used for membrane protein preparations. The selection was performed with mRNA libraries and vectors generously provided by Prof. Dr. Markus Seeger (Institute of Medical Microbiology, UZH). As a first step, one round of ribosome display was performed with the concave, loop, and convex mRNA libraries that each encode for around 10<sup>12</sup> different binders with an hsFPN sample that was biotinylated to about 30%. After ribosome display, the eluted mRNA pool was cloned into a phagemid vector, and the resulting library was subsequently used in two rounds of phage display with a hsFPN sample that was 100% biotinylated at a molar ratio of PEG-biotin to hsFPN of two. During the second round of phage display, binders with high off rates were removed by incubation with non-biotinylated hsFPN at a concentration of 5 μM for 3 min. The concentrations of eluted phages were subsequently determined by quantitative PCR, and the specific enrichment was calculated by dividing the number of phages eluted in the hsFPN sample with the number of phages eluted in the negative control (biotinylated TM287/288; <xref ref-type="bibr" rid="bib28">Hutter et al., 2019</xref>). Whereas, no enrichment could be detected for the concave and convex libraries (enrichment factors of 1.01 and 0.82, respectively), and the loop library resulted in an enrichment of 3.89. Thus, the DNA resulting from the loop library was further processed by cloning into the pSBinit vector and expression of the resulting sybodies in 96 well plates. Periplasmatic extractions were used for an ELISA assay in 384 well format, using either 50 μl of biotinylated hsFPN or biotinylated EcoDMT (<xref ref-type="bibr" rid="bib20">Ehrnstorfer et al., 2017</xref>) as a control (at a concentration of 50 nM/well). In total, 42 ELISA hits were detected comprising 19 unique sybody sequences. All 19 binder candidates were further tested for expression and biochemical behavior. Subsequently, five sybodies (Sy1, Sy3, Sy8, Sy11, and Sy12) were further tested for binding to hsFPN by SEC and SPR.</p></sec><sec id="s4-6"><title>Expression and purification of sybodies</title><p>Plasmids encoding sybodies were transformed into <italic>E. coli</italic> MC1061, and single colonies were used for sybody expression in Terrific Broth media supplemented with 30 μg/ml chloramphenicol. For expression, media was inoculated with the preculture at a ratio of 1:100 (v/v). The culture was incubated at 37°C for 2 hr, and the temperature was subsequently lowered to 22°C. At an OD<sub>600</sub> 0.8–0.9, the culture was supplemented with L-arabinose at a final concentration of 0.02% (w/v) to induce sybody overexpression for 16–18 hr. The overnight culture was harvested at 4000 g for 20 min at 4°C. Pellets were flash frozen and stored at –20°C until further use.</p><p>For sybody purification, pellets from a 100 ml culture were resuspended in 10 ml periplasmatic extraction buffer (50 mM Tris-HCl pH 7.4, 20% [w/v] sucrose, 0.5 mM EDTA pH 8, 0.5 μg/ml lysozyme, and 20 μg/ml DNaseI) and incubated on ice for 30–60 min. The incubated mixture was diluted with 40 ml Tris-buffered saline (TBS) supplemented with 1 mM MgCl<sub>2</sub> and subsequently centrifuged at 4000 g for 20 min at 4°C to remove cell debris. The supernatant was supplemented with Ni-NTA resin (1 ml resin per 100 ml culture) and imidazole to a final concentration of 15 mM. The mixture was incubated for 1 hr under gentle agitation. After incubation, the resin was retained in a column and washed with 20 CV sybody wash buffer (TBS supplemented with 30 mM imidazole). The protein was eluted with five CV of sybody elution buffer (TBS supplemented with 300 mM imidazole). Protein containing fractions were pooled and concentrated to 500 μl using a 10 kDa cut-off concentrator. Concentrated protein was filtered through a 0.22 μm filter and injected into an Azura Knauer UVD 2.1 HPLC system connected to Sepax SRT 10 C-SEC100 column, which was equilibrated in sybody SEC buffer (20 mM Hepes pH 7.5 and 150 mM NaCl). Monomeric peak fractions were pooled and concentrated to 3–18 mg/ml as described before, flash frozen in liquid nitrogen, and stored at –80°C until further use.</p></sec><sec id="s4-7"><title>SPR binding assays</title><p>SPR experiments were performed using a BiaCore T200, with hsFPN immobilized on an SAD200M sensor chip for XanTec. For immobilization, hsFPN was expressed and purified with a C-terminal Avi-tag for enzymatic biotinylation. FPN at a concentration of 3 µg/ml was immobilized at a density of 675 RU. Flow cell 1 was left blank to serve as a reference cell for the measurements. Prior to measurements, the system was equilibrated for 2 hr with running buffer (20 mM HEPES pH 7.4, 200 mM NaCl, 0.04% DDM, and 0.1% BSA). All analytes were injected at 20°C at a flow rate of 30 µl/min except for sybody 12, which was measured at a flow rate of 100 µl/min to exclude interference form mass transport effects. For the quantification, sybodies were injected at appropriate concentrations related to their binding affinities (sybody 1: 35.2, 70.5, 141, 282, 565, 1130, and 2260 nM; sybody 3: 3.4, 13.5, 54.5, 109, 217.5, 435, and 870 nM; sybody 8: 26, 52.5, 105, 210, 420, 840, and 1680 nM; sybody 11: 8.6, 34.5, 69, 137.5, 275, 550, and 1100 nM; sybody 12: 8, 32, 64, 128, 256, 512, and 1024 nM). Data was analyzed with the BIAevaluation software (GE Healthcare) and fitted to a single-site binding model. Data points influenced by machine noise were omitted from the analysis, and missing data are displayed as gaps. Very similar results were obtained for at least two independent protein preparations.</p></sec><sec id="s4-8"><title>SEC binding assays</title><p>For the binding assays, 30 μg hsFPN was incubated with vamifeport (Vifor Pharma) at a final concentration of 1 mM and incubated on ice for 5 min. In case of control experiments without vamifeport, this initial incubation step was left out. Incubated hsFPN was subsequently mixed with purified sybody in a 5× molar excess and incubated on ice for 30 min, filtered through 0.22 μm filters, and injected into HPLC system connected to a Superdex S200 5/150 GL column. Peak fractions of suspected monomeric hsFPN peaks were collected and concentrated to 40 μl (molecular weight cut-off 3 kDa). Evaluation of the binding assay was performed by SDS-PAGE analysis and comparison of peak height and retention volume of the suspected monomeric hsFPN peaks.</p></sec><sec id="s4-9"><title>Thermal stability assay using fluorescence-detection SEC</title><p>The assay was essentially performed as described (<xref ref-type="bibr" rid="bib26">Hattori et al., 2012</xref>). Specifically, hsFPN aliquots of 30 μl at 0.5 μM, containing a 200-fold molar excess of vamifeport in indicated samples, were incubated at temperatures up to 75°C for 12 min. Aggregated protein was removed by centrifugal filtration (0.22 μm), and the resulting sample was subsequently subjected onto a Superose S6 column (GE Healthcare) equilibrated in SEC buffer. Proteins were detected using tryptophan fluorescence (λex = 280 nm; λem = 315 nm) using a fluorescence detector (Agilent technologies 1200 series, G1321A). The peak heights of the monomeric hsFPN peaks were used to assess the stability by normalizing heights to the corresponding value from samples incubated at 4°C (100% stability). Melting temperatures (T<sub>m</sub>) were determined by fitting the curves to a sigmoidal dose-response equation.</p></sec><sec id="s4-10"><title>Reconstitution of hsFPN into proteoliposomes</title><p>Purified hsFPN was reconstituted into detergent-destabilized liposomes according to the described protocol (<xref ref-type="bibr" rid="bib24">Geertsma et al., 2008</xref>). Before reconstitution, soybean polar extract lipids (Avanti Polar lipids) were dried, washed with diethylether, and dried under nitrogen stream followed by exsiccation overnight. The dried lipids were then resuspended in liposome buffer (20 mM Hepes pH 7.5 and 150 mM KCl) in sonication cycles and flash frozen in liquid nitrogen three times before storing them at –80°C until further use.</p><p>For reconstitution, the thawed lipid stocks were extruded through a 400 nm filter (Liposo Fast-Basic, Avestin), and the extruded lipids were diluted to 4 mg/ml with liposome buffer. The diluted lipids were destabilized with Triton-X100 while monitoring light scattering at 540 nm. For reconstitutions, protein to lipid ratio of either 1:70 (w/w) or 1:50 (w/w) was used. After addition of the protein to the lipids, the mixture was incubated for 15 min at room temperature while gently mixing. Subsequently, detergent was removed by excessive addition of BioBeads SM-2 (BioRad) over the course of 3 days.</p><p>After removal of detergent, the proteoliposomes were harvested by centrifugation at 236,400 g for 40 min at 16°C. After centrifugation, the proteoliposomes were resuspended in liposome buffer to a final concentration of 20 mg/ml, flash frozen in liquid nitrogen, and stored at –80°C until further use.</p></sec><sec id="s4-11"><title>Fluorescence-based substrate transport assays</title><p>To measure the Co<sup>2+</sup> transport into liposomes mediated by hsFPN, 1 mg of thawed proteoliposomes were mixed with 400 μl buffer IN (20 mM Hepes pH 7.5, 100 mM KCl, and 250 μM calcein). After five freeze-thaw cycles in liquid nitrogen, the liposomes were extruded through a 400 nm filter, harvested by centrifugation at 170,000 g for 25 min at 22°C, and subsequently washed twice with buffer WASH (20 mM Hepes pH 7.5 and 100 mM KCl). The washed liposomes were resuspended with buffer WASH to a final lipid concentration of 25 mg/ml. The assay was started by diluting the liposome stock into buffer OUT (20 mM Hepes pH 7.5 and 100 mM NaCl) to a final concentration of 0.25 mg/ml and distributing aliquots of 100 μl in a black 96-well plate (Thermo Fischer Scientific). The calcein fluorescence was measured in 4 s intervals on Tecan Infinite M1000 fluorimeter with the excitation wavelength λex = 492 nm, and the emission wavelength λem = 518 nm until a stable signal was obtained. The addition of valinomycin (Invitrogen) to a final concentration of 100 nM established a negative membrane potential of –118 mV as consequence of 100-fold outwardly directed K<sup>+</sup> gradient. During transport experiments, the established membrane potential did not affect transport rates as expected for an electroneutral process. To start transport, CoCl<sub>2</sub> was added in different concentrations to the liposome suspension. As final step, liposomes were supplemented with calcimycin (Invitrogen) to a final concentration of 100 nM to equilibrate Co<sup>2+</sup> concentrations. Transport data were analyzed in GraphPad Prism 8.4.3. (GraphPad Software, LLC).</p></sec><sec id="s4-12"><title>FP assays</title><p>The FP assays were performed in a similar way as described (<xref ref-type="bibr" rid="bib32">Manolova et al., 2019</xref>). In these assays, a derivative of the peptide hormone hepcidin was used that was labeled with TMR at position 21, where the Met was replaced with a Lys. To determine direct binding of TMR-hepcidin to hsFPN, purified WT or mutant proteins serially diluted in FP assay buffer containing 20 mM Hepes pH 7.4, 200 mM NaCl, 0.02% DDM, and 0.1 mg/ml BSA were plated into a 384-well black low-volume round bottom plate (Corning) at 16 μl per well. The final FPN concentrations ranged from 13 nM to 6 µM. TMR-hepcidin was added at a volume of 8 μl to reach a final concentration of 10 nM. To determine unspecific binding, 30 μM vamifeport was added to the reaction mixture. For displacement assays, a mixture of purified WT hsFPN or its point mutants and 15 nM TMR-hepcidin in FP assay buffer was plated into a 384-well black low-volume round bottom plate (Corning) at 16 μl per well. Competitors (vamifeport, hepcidin-25 [Bachem] or hepcidin-20 [Bachem]) were added at a volume of 8 μl per well from serial dilutions to reach a final TMR-hepcidin concentration of 10 nM. Final hsFPN concentrations varied depending on the measured affinity for TMR-hepcidin to the corresponding protein constructs. Specifically, for the results displayed in <xref ref-type="fig" rid="fig5">Figure 5</xref>, the final hsFPN concentrations were 400 nM for WT, L469A, L469S, and W470S and 800 nM for R466A. For both types of experiments, direct binding and displacement assays, the plates were incubated at room temperature for 90 min, and subsequently, the parallel (F<sub>para</sub>) and perpendicular (P<sub>perp</sub>) fluorescence were measured in a Synergy H1 fluorescence reader (BioTek). The following formula was used to calculate the FP in mP:<disp-formula id="equ1"><mml:math id="m1"><mml:semantics><mml:mrow><mml:mi>F</mml:mi><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mtext>​</mml:mtext><mml:mfrac><mml:mrow><mml:mi>F</mml:mi><mml:mi>p</mml:mi><mml:mi>a</mml:mi><mml:mi>r</mml:mi><mml:mi>a</mml:mi><mml:mo>−</mml:mo><mml:mi>F</mml:mi><mml:mi>p</mml:mi><mml:mi>e</mml:mi><mml:mi>r</mml:mi><mml:mi>p</mml:mi></mml:mrow><mml:mrow><mml:mi>F</mml:mi><mml:mi>p</mml:mi><mml:mi>a</mml:mi><mml:mi>r</mml:mi><mml:mi>a</mml:mi><mml:mo>+</mml:mo><mml:mi>F</mml:mi><mml:mi>p</mml:mi><mml:mi>e</mml:mi><mml:mi>r</mml:mi><mml:mi>p</mml:mi></mml:mrow></mml:mfrac><mml:mo>⋅</mml:mo><mml:mn>1000</mml:mn></mml:mrow></mml:semantics></mml:math></disp-formula></p><p>To calculate K<sub>D</sub> values of hsFPN to TMR-hepcidin, FP data was fitted to the following equation:<disp-formula id="equ2"><mml:math id="m2"><mml:semantics><mml:mrow><mml:mi>Y</mml:mi><mml:mo>=</mml:mo><mml:mtext>​</mml:mtext><mml:msub><mml:mi>B</mml:mi><mml:mrow><mml:mi>max</mml:mi></mml:mrow></mml:msub><mml:mfrac><mml:mi>x</mml:mi><mml:mrow><mml:mi>x</mml:mi><mml:mo>+</mml:mo><mml:msub><mml:mi>K</mml:mi><mml:mi>D</mml:mi></mml:msub></mml:mrow></mml:mfrac><mml:mo>+</mml:mo><mml:mi>N</mml:mi><mml:mi>S</mml:mi><mml:mo>⋅</mml:mo><mml:mi>x</mml:mi><mml:mo>+</mml:mo><mml:mi>b</mml:mi><mml:mi>a</mml:mi><mml:mi>c</mml:mi><mml:mi>k</mml:mi><mml:mi>g</mml:mi><mml:mi>r</mml:mi><mml:mi>o</mml:mi><mml:mi>u</mml:mi><mml:mi>n</mml:mi><mml:mi>d</mml:mi></mml:mrow></mml:semantics></mml:math></disp-formula></p><p>With Y being the FP value, x the variable hsFPN concentration, K<sub>D</sub> the dissociation constant, NS the slope of the non-specific binding signal, and B<sub>max</sub> the maximal specific binding signal. B<sub>max</sub> and the background signal were constrained to the same values for WT and mutants. The fitting yielded K<sub>D</sub> values of 100±4 nM for WT, 57±2 nM for L469A, 94±3 nM for L469S, 227±8 nM for W470S, 501±22 nM for R466A, 1044±60 nM for V68S, and about 4.5 μM and 6 μM for Y501S and D504A, respectively.</p><p>To obtain IC<sub>50</sub> values from displacement data, FP data was fitted to a four parameter Hill equation.<disp-formula id="equ3"><mml:math id="m3"><mml:semantics><mml:mrow><mml:mi>Y</mml:mi><mml:mo>=</mml:mo><mml:mtext>​</mml:mtext><mml:mi>B</mml:mi><mml:mi>o</mml:mi><mml:mi>t</mml:mi><mml:mi>t</mml:mi><mml:mi>o</mml:mi><mml:mi>m</mml:mi><mml:mo>+</mml:mo><mml:mfrac><mml:mrow><mml:mi>T</mml:mi><mml:mi>o</mml:mi><mml:mi>p</mml:mi><mml:mo>−</mml:mo><mml:mi>B</mml:mi><mml:mi>o</mml:mi><mml:mi>t</mml:mi><mml:mi>t</mml:mi><mml:mi>o</mml:mi><mml:mi>m</mml:mi></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>+</mml:mo><mml:msup><mml:mrow><mml:mn>10</mml:mn></mml:mrow><mml:mrow><mml:mo>(</mml:mo><mml:mi>log</mml:mi><mml:mi>I</mml:mi><mml:msub><mml:mi>C</mml:mi><mml:mrow><mml:mn>50</mml:mn></mml:mrow></mml:msub><mml:mo>−</mml:mo><mml:mi>x</mml:mi><mml:mo>)</mml:mo><mml:mo>⋅</mml:mo><mml:mi>n</mml:mi></mml:mrow></mml:msup></mml:mrow></mml:mfrac></mml:mrow></mml:semantics></mml:math></disp-formula></p><p>With Y being the FP value, x the variable competitor concentration, and n the Hill coefficient. Bottom and Top FP values were constrained to the same values for hepcidin-25 and vamifeport (225 mP and 307 mP, respectively).</p><p>To convert obtained IC<sub>50</sub> values to K<sub>D</sub>s, the displacement data were fitted to a competition binding model:<disp-formula id="equ4"><mml:math id="m4"><mml:semantics><mml:mrow><mml:mi>Y</mml:mi><mml:mo>=</mml:mo><mml:mtext>​</mml:mtext><mml:mfrac><mml:mrow><mml:msub><mml:mi>L</mml:mi><mml:mrow><mml:mi>d</mml:mi><mml:mi>i</mml:mi><mml:mi>s</mml:mi></mml:mrow></mml:msub></mml:mrow><mml:mrow><mml:msub><mml:mi>L</mml:mi><mml:mrow><mml:mi>d</mml:mi><mml:mi>i</mml:mi><mml:mi>s</mml:mi></mml:mrow></mml:msub><mml:mo>+</mml:mo><mml:msub><mml:mi>K</mml:mi><mml:mrow><mml:mi>D</mml:mi><mml:mo>(</mml:mo><mml:mi>d</mml:mi><mml:mi>i</mml:mi><mml:mi>s</mml:mi><mml:mo>)</mml:mo></mml:mrow></mml:msub><mml:mo>⋅</mml:mo><mml:mo>(</mml:mo><mml:mn>1</mml:mn><mml:mo>+</mml:mo><mml:mfrac><mml:mi>x</mml:mi><mml:mrow><mml:msub><mml:mi>K</mml:mi><mml:mi>D</mml:mi></mml:msub><mml:msub><mml:mrow/><mml:mrow><mml:mo>(</mml:mo><mml:mi>x</mml:mi><mml:mo>)</mml:mo></mml:mrow></mml:msub></mml:mrow></mml:mfrac><mml:mo>)</mml:mo></mml:mrow></mml:mfrac></mml:mrow></mml:semantics></mml:math></disp-formula></p><p>With Y being the fractional saturation of TMR-hepcidin binding to hsFPN, which was calculated using the affinity of TMR-hepcidin to hsFPN measured before. L<sub>dis</sub> corresponds to the concentration of the displaced ligand (400 nM FPN for WT, L469A, L469S, and W470S and 800 nM for the R466A mutant), K<sub>D(dis)</sub> is the dissociation constant for the FPN/TMR-hepcidin interaction measured before, x is the variable competitor concentration, and K<sub>D(x)</sub> is the fitted dissociated constant for the FPN/competitor interaction. For K<sub>D(hep-25)</sub> values of 131±12 nM for WT, 108±17 nM for L469A, 180±17 nM for L469S, 222±19 nM for W470S, and 713±117 nM for R466A were obtained. For K<sub>D(vamifeport)</sub> values of 24±3 nM for WT, 37±4 nM for L469A, 60±7 nM for L469S, 82±11 nM for W470S, and 83±16 nM for R466A were obtained.</p><p>All fits were performed in GraphPad Prism 8.4.3. (GraphPad Software, LLC). For all FP experiments, very similar results were obtained for at least two different protein preparations and at different concentrations of hsFPN.</p></sec><sec id="s4-13"><title>Preparation of the hsFPN complexes for cryo-EM and data collection</title><p>Samples of freshly purified hsFPN at a concentration of 3–4 mg/ml were incubated with vamifeport at a final concentration of 1 mM on ice for 5 min prior to further supplementing it with a 1.5× molar excess of sybody 3 or 12. For sample without vamifeport, hsFPN was only supplemented with sybody 3. For all conditions, the hsFPN concentration in the final sample was between 2.5 and 3 mg/ml, a final detergent concentration of 0.04% (w/v) DDM was maintained, and all complexes were incubated for at least 30 min on ice prior to grid freezing.</p><p>After incubation on ice, 2.5 μl of complex mixture was applied on glow-discharged holey carbon grids (Quantifoil R1.2/1.3, Au 200 mesh), and excess of liquid was removed by blotting for 2–4 s in controlled environment (4 °C, 100% humidity) using a Vitrobot Mark IV. Samples were plunge-frozen in a propane-ethane freezing mixture and stored in liquid nitrogen until data acquisition.</p><p>All datasets were collected on a 300 kV Titan Krios G3i (ThermoFischer Scientific) with a 100 μm objective aperture and using a post-column BioQuantum energy filter (Gatan) with a 20 eV slit and a K3 direct electron detector (Gatan) operating in a super-resolution mode. Micrographs were recorded in an automated manner using EPU2.9 with a defocus range from –1 to –2.4 μm at a magnification 130,000× corresponding to a pixel size of 0.651 Å per pixel (0.3255 Å in super resolution mode) and an exposure of 1.01 s (36 frames) and a dose of approximately 1.8 e<sup>–</sup>/Å<sup>2</sup>/frame. The total electron dose on the specimen level for all datasets was between 61 e<sup>–</sup>/Å<sup>2</sup> and 71 e<sup>–</sup>/Å<sup>2</sup>.</p></sec><sec id="s4-14"><title>Cryo-EM image processing</title><p>All datasets were pre-processed in the same manner (<xref ref-type="fig" rid="fig2s1">Figure 2—figure supplements 1</xref>–<xref ref-type="fig" rid="fig2s3">3</xref>) using cryoSPARC v.3.0.1, v3.2.0, and v4.0.3 (<xref ref-type="bibr" rid="bib43">Punjani et al., 2017</xref>). Micrographs were subjected to patch motion correction with a fourier crop factor of 2 (pixel size of 0.651 Å /pix) followed by patch CTF estimation. Based on CTF estimations, low-quality micrographs showing a significant drift, ice contamination, or poor CTF estimates were discarded resulting in datasets of 4384 images of hsFPN/Sy3 complex (dataset 1), 8752 images of hsFPN/Sy3 complex with vamifeport (dataset 2), and 13,730 images of hsFPN/Sy12 complex with vamifeport (dataset 3), which were subjected to further data processing. Particles were initially picked using a blob picker with a minimum particle diameter of 120 Å and a minimum inter-particle distance of 60 Å. Selected particles were extracted with a box size of 360 pixels (down-sampled to 180 pixels at a size of 1.302 Å/pixel) and subjected to 2D classification. 2D class averages showing protein features were subsequently used as templates for more accurate template-based particle picking as well as inputs for generating two 3D ab initio models. Subsequently, the promising 2D classes were subjected to several rounds of heterogenous refinements using one of the ab initio models as a ‘reference’ and an obviously bad model as a decoy model. After several rounds of heterogenous refinement, the selected particles and models were subjected to non-uniform refinement (input model lowpass-filtered to 15 Å). The hsFPN/Sy3 complex with vamifeport was additionally subjected to CTF-refinement followed by a second round of non-uniform refinement. The quality of the map was validated using 3DFSC (<xref ref-type="bibr" rid="bib51">Tan et al., 2017</xref>) for FSC validation and local resolution estimation. For Bayesian polishing, the particles of the respective best maps of all three datasets were exported from cryoSPARC and converted into a RELION 4.0 readable star file using the cspar2star script of pyem (<xref ref-type="bibr" rid="bib3">Asarnow et al., 2019</xref>). The raw micrographs were down-sampled twice, and the beam-induced motion in the movies was corrected in all frames using RELION’s implementation of MotionCor2 (<xref ref-type="bibr" rid="bib57">Zheng et al., 2017</xref>). The contrast transfer function parameters were estimated using CTFFIND4 (<xref ref-type="bibr" rid="bib47">Rohou and Grigorieff, 2015</xref>). The particles were imported to RELION and re-extracted from the two-fold binned motion corrected micrographs (pixel size of 0.651 Å /pix) using a box size of 360 pixels. The extracted particles were imported back to cryoSPARC and associated with the RELION 4.0 motion corrected micrographs with estimated CTF parameters and were subjected to a non-uniform refinement. The resulting maps and masks were used for a round of 3D refinement and postprocessing in RELION (<xref ref-type="bibr" rid="bib30">Kimanius et al., 2016</xref>; <xref ref-type="bibr" rid="bib49">Scheres, 2012</xref>). The particles were polished (<xref ref-type="bibr" rid="bib59">Zivanov et al., 2019</xref>) using an expected 0.2 Å/dose movement, 5000 Å spatial correlation length, and an average particle acceleration of 2 Å/dose. The polished particles were imported back to cryoSPARC and associated with the RELION motion corrected micrographs and subjected to a final non-uniform refinement. This procedure resulted in an improvement of the resolution of the hsFPN/Sy3/vamifeport dataset from 3.37 to 3.24 Å (<xref ref-type="fig" rid="fig2s2">Figure 2—figure supplement 2</xref>) but not of the hsFPN/Sy12/vamifeport and the hsFPN/Sy3 datasets.</p></sec><sec id="s4-15"><title>Model building and refinement</title><p>The models of the hsFPN/Sy3 complex with and without vamifeport and the hsFPN/Sy12 complex with vamifeport were built in Coot (<xref ref-type="bibr" rid="bib21">Emsley and Cowtan, 2004</xref>), using the published human FPN structures as references (<xref ref-type="bibr" rid="bib6">Billesbølle et al., 2020</xref>; <xref ref-type="bibr" rid="bib40">Pan et al., 2020</xref>). Vamifeport was generated using the ligand tool implemented in Coot, and constraints for the refinement were generated using the CCP4 program PRODRG (<xref ref-type="bibr" rid="bib50">Schüttelkopf and van Aalten, 2004</xref>). The model was improved iteratively by cycles of real-space refinement in PHENIX (<xref ref-type="bibr" rid="bib2">Adams et al., 2002</xref>) with secondary structure constraints applied followed by manual corrections in Coot. Validation of the model was performed in PHENIX. Surfaces were calculated with MSMS (<xref ref-type="bibr" rid="bib48">Sanner et al., 1996</xref>). Figures containing molecular structures and densities were prepared with DINO (<ext-link ext-link-type="uri" xlink:href="http://www.dino3d.org">http://www.dino3d.org</ext-link>), Chimera (<xref ref-type="bibr" rid="bib41">Pettersen et al., 2004</xref>), and ChimeraX (<xref ref-type="bibr" rid="bib42">Pettersen et al., 2021</xref>).</p></sec><sec id="s4-16"><title>Docking</title><p>The interaction energy between hsFPN and vamifeport in the two possible binding orientations (original and alternative, <xref ref-type="fig" rid="fig4s3">Figure 4—figure supplement 3</xref>) was estimated with a docking protocol for predicting binding affinities based on the ABSINTH implicit solvation model (<xref ref-type="bibr" rid="bib33">Marchand et al., 2020</xref>; <xref ref-type="bibr" rid="bib55">Vitalis and Pappu, 2009</xref>) and implemented in the CAMPARI v4 software package (<ext-link ext-link-type="uri" xlink:href="https://campari.sourceforge.net/V4/">https://campari.sourceforge.net/V4/</ext-link>). Each run consisted of 25,000 steps of hybrid Monte Carlo (MC) and Molecular Dynamics (MD; 4000 steps of MC, followed by alternating cycles of 200 steps of MD and 50 steps of MC) in hybrid rigid body and torsional space (<xref ref-type="bibr" rid="bib56">Vitalis and Pappu, 2014</xref>). The simulations were carried out in the NVT ensemble at 250 K, with velocity-rescaling thermostat (0.1 ps coupling time; <xref ref-type="bibr" rid="bib9">Bussi et al., 2007</xref>).</p><p>In order to preserve the pose of vamifeport, the non hydrogen atoms of the ligand were harmonically restrained to their initial positions (with a force constant of 0.1 kcal/mol/Å<sup>2</sup>), and its internal degrees of freedom were frozen, only allowing rigid body rotations and translations. For hsFPN, atoms within a maximum distance of 15 Å from vamifeport were allowed to move to permit local adaptations to both investigated binding orientations of the inhibitor. As exception, the coordinates of Asp 259 were fixed to prevent its reorientation to optimize its interactions with the protonated amine of the linker in the alternative orientation of vamifeport. This reorientation does not match the experimental cryo-EM density and thus presents additional evidence that the alternative pose is less compatible with the observed protein conformation. In our case, this meant that 16 side chain dihedral angle degrees of freedom in 8 distinct binding site residues were allowed to move, where those involving only hydrogen atoms (like R-C-O-H) are also included in the count. The system was parameterized with ABSINTH 4.2 together with CHARMM 36 force field (<xref ref-type="bibr" rid="bib5">Best et al., 2012</xref>), and the atomic charges of vamifeport were generated with CGenFF v2.5.1 (<xref ref-type="bibr" rid="bib53">Vanommeslaeghe and MacKerell, 2012a</xref>; <xref ref-type="bibr" rid="bib54">Vanommeslaeghe et al., 2012b</xref>). For each of the two alternative vamifeport orientations, 20 simulations were run, and the pose with the minimum single-point energy was selected (<xref ref-type="fig" rid="fig4s4">Figure 4—figure supplement 4</xref>). In the ABSINTH model, the total internal energy is the sum of bonded terms, a van der Waals term, and a solvation term encompassing both the direct mean field interaction (DMFI) between solute and solvent and screened polar interactions. The DMFI is based on experimental-free energies of solvation and thus accounts for entropic, polar, and non-polar terms. We report both the total energy (after subtraction of the energetic penalty due to restraints) and the solvation and van der Waals (vdW) terms separately. The mean energy penalty for restraining the ligand was 1.12 kcal/mol for poses in the original orientation and 3.62 kcal/mol for poses in the alternative orientation of vamifeport (<xref ref-type="fig" rid="fig4s4">Figure 4—figure supplement 4A, B</xref>), which further demonstrates that the original binding position fits the protein conformation better, as unrestrained runs would deviate much more from the density in the alternative case. Deviating from the published scoring protocol (<xref ref-type="bibr" rid="bib33">Marchand et al., 2020</xref>), we were only interested in the difference in binding affinity between the two orientations of vamifeport. Hence, we directly compared the total energies of the complex. In the docking runs, the original conformation described in this study consistently had a lower energy by about 12–20 kcal/mol compared to the best poses for the alternative conformation, where the difference in energy is dominated by solvation and polar terms (<xref ref-type="fig" rid="fig4s4">Figure 4—figure supplement 4C, D</xref>).</p></sec></sec></body><back><sec sec-type="additional-information" id="s5"><title>Additional information</title><fn-group content-type="competing-interest"><title>Competing interests</title><fn fn-type="COI-statement" id="conf1"><p>No competing interests declared</p></fn><fn fn-type="COI-statement" id="conf2"><p>P.A. is employee of CSL Vifor and is inventor in patents related to the publication (WO2021013771A1)</p></fn><fn fn-type="COI-statement" id="conf3"><p>No competing interests declared</p></fn><fn fn-type="COI-statement" id="conf4"><p>V.M. is employee of CSL Vifor and is inventor in patents related to the publication (WO2017068089A9, WO2017068090, WO2021013771A1, WO2021013772A1, WO2021078889A1, WO2022157185A1)</p></fn><fn fn-type="COI-statement" id="conf5"><p>H.S. is employee of CSL Vifor</p></fn><fn fn-type="COI-statement" id="conf6"><p>F.D. is employee of CSL Vifor and is inventor in patents related to the publication (WO2017068089A9, WO2017068090, WO2021013771A1, WO2021013772A1, WO2021078889A1, WO2022157185A1)</p></fn></fn-group><fn-group content-type="author-contribution"><title>Author contributions</title><fn fn-type="con" id="con1"><p>Formal analysis, Validation, Investigation, Methodology, Writing – review and editing, cloned; expressed and purified proteins; prepared samples for cryo-em; processed cryo-em data; built models and performed proteoliposome-based transport assays</p></fn><fn fn-type="con" id="con2"><p>Formal analysis, Validation, Investigation, Methodology, Writing – review and editing, Cloned, expressed and purified proteins, prepared samples for cryo-EM, processed cryo-EM data, built models and performed SPR experiments</p></fn><fn fn-type="con" id="con3"><p>Data curation, Formal analysis, Validation, Investigation, Methodology, Writing – review and editing, Collected cryo-EM data</p></fn><fn fn-type="con" id="con4"><p>Conceptualization, Formal analysis, Investigation, Methodology, Writing – review and editing, Performed FP experiments</p></fn><fn fn-type="con" id="con5"><p>Conceptualization, Software, Supervision, Investigation, Methodology, Project administration, Writing – review and editing, Performed docking calculations</p></fn><fn fn-type="con" id="con6"><p>Conceptualization, Formal analysis, Supervision, Investigation, Methodology, Project administration, Writing – review and editing</p></fn><fn fn-type="con" id="con7"><p>Conceptualization, Formal analysis, Supervision, Investigation, Methodology, Project administration, Writing – review and editing, Performed FP experiments</p></fn><fn fn-type="con" id="con8"><p>Conceptualization, Supervision, Funding acquisition, Validation, Visualization, Writing – original draft, Project administration, Writing – review and editing</p></fn><fn fn-type="con" id="con9"><p>Conceptualization, Data curation, Formal analysis, Supervision, Funding acquisition, Validation, Investigation, Visualization, Methodology, Writing – original draft, Project administration, Writing – review and editing</p></fn><fn fn-type="con" id="con10"><p>Conceptualization, Data curation, Formal analysis, Supervision, Validation, Investigation, Visualization, Methodology, Writing – original draft, Project administration, Writing – review and editing, cloned; expressed and purified proteins; prepared samples for cryo-em; processed cryo-em data; built models and performed proteoliposome-based transport assays</p></fn></fn-group></sec><sec sec-type="supplementary-material" id="s6"><title>Additional files</title><supplementary-material id="mdar"><label>MDAR checklist</label><media xlink:href="elife-83053-mdarchecklist1-v1.docx" mimetype="application" mime-subtype="docx"/></supplementary-material></sec><sec sec-type="data-availability" id="s7"><title>Data availability</title><p>The cryo-EM density maps of the hsFPN/Sy3 complexes in absence and presence of vamifeport and of hsFPN/Sy12 in presence of vamifeport have been deposited in the Electron Microscopy Data Bank under ID codes EMD-16353 and EMD-16345 and EMD-16354, respectively. The coordinates for the atomic models of hsFPN/Sy3 in absence of vamifeport refined against the 4.09 Å cryo-EM density, hsFPN/Sy3 in presence of vamifeport refined against the 3.37 Å cryo-EM density and hsFPN/Sy12 in presence of vamifeport refined against the 3.89 Å cryo-EM density have been deposited in the Protein Data Bank under ID codes 8C02 and 8BZY and 8C03, respectively. Source data files have been provided for Figure 1, Figure1-figure supplement 1, Figure1-figure supplement 2, Figure 1-figure supplement 3, Figure 4-figure supplement 4, Figure 5, Figure 5-figure supplement 1, Figure 5-figure supplement 2.</p><p>The following datasets were generated:</p><p><element-citation publication-type="data" specific-use="isSupplementedBy" id="dataset1"><person-group person-group-type="author"><name><surname>Lehmann</surname><given-names>EF</given-names></name><name><surname>Liziczai</surname><given-names>M</given-names></name><name><surname>Drozdzyk</surname><given-names>K</given-names></name><name><surname>Dutzler</surname><given-names>R</given-names></name><name><surname>Manatschal</surname><given-names>C</given-names></name></person-group><year iso-8601-date="2023">2023</year><data-title>Structure of SLC40/ferroportin in complex with synthetic nanobody Sy3 in occluded conformation.</data-title><source>Electron Microscopy Data Bank</source><pub-id pub-id-type="accession" xlink:href="https://www.ebi.ac.uk/emdb/EMD-16353">EMD-16353</pub-id></element-citation></p><p><element-citation publication-type="data" specific-use="isSupplementedBy" id="dataset2"><person-group person-group-type="author"><name><surname>Lehmann</surname><given-names>EF</given-names></name><name><surname>Liziczai</surname><given-names>M</given-names></name><name><surname>Drozdzyk</surname><given-names>K</given-names></name><name><surname>Dutzler</surname><given-names>R</given-names></name><name><surname>Manatschal</surname><given-names>C</given-names></name></person-group><year iso-8601-date="2023">2023</year><data-title>Structure of SLC40/ferroportin in complex with vamifeport and synthetic nanobody Sy3 in occluded conformation</data-title><source>Electron Microscopy Data Bank</source><pub-id pub-id-type="accession" xlink:href="https://www.ebi.ac.uk/emdb/EMD-16345">EMD-16345</pub-id></element-citation></p><p><element-citation publication-type="data" specific-use="isSupplementedBy" id="dataset3"><person-group person-group-type="author"><name><surname>Lehmann</surname><given-names>EF</given-names></name><name><surname>Liziczai</surname><given-names>M</given-names></name><name><surname>Drozdzyk</surname><given-names>K</given-names></name><name><surname>Dutzler</surname><given-names>R</given-names></name><name><surname>Manatschal</surname><given-names>C</given-names></name></person-group><year iso-8601-date="2023">2023</year><data-title>Structure of SLC40/ferroportin in complex with vamifeport and synthetic nanobody Sy12 in outward-facing conformation.</data-title><source>Electron Microscopy Data Bank</source><pub-id pub-id-type="accession" xlink:href="https://www.ebi.ac.uk/emdb/EMD-16354">EMD-16354</pub-id></element-citation></p><p><element-citation publication-type="data" specific-use="isSupplementedBy" id="dataset4"><person-group person-group-type="author"><name><surname>Lehmann</surname><given-names>EF</given-names></name><name><surname>Liziczai</surname><given-names>M</given-names></name><name><surname>Drozdzyk</surname><given-names>K</given-names></name><name><surname>Dutzler</surname><given-names>R</given-names></name><name><surname>Manatschal</surname><given-names>C</given-names></name></person-group><year iso-8601-date="2023">2023</year><data-title>Structure of SLC40/ferroportin in complex with synthetic nanobody Sy3 in occluded conformation.</data-title><source>RCSB Protein Data Bank</source><pub-id pub-id-type="accession" xlink:href="https://www.rcsb.org/structure/8C02">8C02</pub-id></element-citation></p><p><element-citation publication-type="data" specific-use="isSupplementedBy" id="dataset5"><person-group person-group-type="author"><name><surname>Lehmann</surname><given-names>EF</given-names></name><name><surname>Liziczai</surname><given-names>M</given-names></name><name><surname>Drozdzyk</surname><given-names>K</given-names></name><name><surname>Dutzler</surname><given-names>R</given-names></name><name><surname>Manatschal</surname><given-names>C</given-names></name></person-group><source>RCSB Protein Data Bank</source><year iso-8601-date="2023">2023</year><data-title>Structure of SLC40/ferroportin in complex with vamifeport and synthetic nanobody Sy3 in occluded conformation.</data-title><pub-id pub-id-type="accession" xlink:href="https://www.rcsb.org/structure/8BZY">8BZY</pub-id></element-citation></p><p><element-citation publication-type="data" specific-use="isSupplementedBy" id="dataset6"><person-group person-group-type="author"><name><surname>Lehmann</surname><given-names>EF</given-names></name><name><surname>Liziczai</surname><given-names>M</given-names></name><name><surname>Drozdzyk</surname><given-names>K</given-names></name><name><surname>Dutzlar</surname><given-names>R</given-names></name><name><surname>Manatschal</surname><given-names>C</given-names></name></person-group><year iso-8601-date="2023">2023</year><data-title>Structure of SLC40/ferroportin in complex with vamifeport and synthetic nanobody Sy12 in outward-facing conformation.</data-title><source>RCSB Protein Data Bank</source><pub-id pub-id-type="accession" xlink:href="https://www.rcsb.org/structure/8C03">8C03</pub-id></element-citation></p></sec><ack id="ack"><title>Acknowledgements</title><p>This research was supported by the Swiss National Science Foundation (SNF) through the National Center of Competence in Research TransCure. We thank Dr. Marta Sawicka for input in cryo-EM and help during initial sample characterization and Dr. Andreas Vitalis for help with docking calculations. The cryo-electron microscope and K3-camera were acquired with support of the Baugarten and Schwyzer-Winiker foundations and a Requip grant of the Swiss National Science Foundation. We thank Prof. Markus Seeger for access to the sybody libraries, Dr. Jens Sobek from the Functional Genomics Center Zurich for input and assistance for SPR measurements, the center for Microscopy and Image Analysis (ZMB) of the University of Zurich for their support and access to the electron microscope, and Rachelle Gaudet for providing the coordinates of the occluded conformation of DraNRAMP prior to their release. 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contrib-type="author"><name><surname>Maduke</surname><given-names>Merritt</given-names></name><role specific-use="editor">Reviewing Editor</role><aff><institution-wrap><institution-id institution-id-type="ror">https://ror.org/00f54p054</institution-id><institution>Stanford University School of Medicine</institution></institution-wrap><country>United States</country></aff></contrib></contrib-group><related-object id="sa0ro1" object-id-type="id" object-id="10.1101/2022.08.29.505642" link-type="continued-by" xlink:href="https://sciety.org/articles/activity/10.1101/2022.08.29.505642"/></front-stub><body><p>This important study reports cryo-EM structures of human ferroportin (FPN), a protein essential for iron transport in humans, and will be of interest to researchers studying membrane transport mechanisms as well as to those interested in drug design. Structures detail interactions between FPN and the small-molecule inhibitor vamifeport, which is currently in clinical trials for sickle cell disease. In addition, they identify a new (occluded) protein conformation, stabilized by a small-protein binder, that may be relevant to the transport mechanism. Evidence for the mechanism of inhibition by vamifeport is convincing.</p></body></sub-article><sub-article article-type="decision-letter" id="sa1"><front-stub><article-id pub-id-type="doi">10.7554/eLife.83053.sa1</article-id><title-group><article-title>Decision letter</article-title></title-group><contrib-group content-type="section"><contrib contrib-type="editor"><name><surname>Maduke</surname><given-names>Merritt</given-names></name><role>Reviewing Editor</role><aff><institution-wrap><institution-id institution-id-type="ror">https://ror.org/00f54p054</institution-id><institution>Stanford University School of Medicine</institution></institution-wrap><country>United States</country></aff></contrib></contrib-group><contrib-group><contrib contrib-type="reviewer"><name><surname>Gaudet</surname><given-names>Rachelle</given-names></name><role>Reviewer</role><aff><institution-wrap><institution-id institution-id-type="ror">https://ror.org/03vek6s52</institution-id><institution>Harvard University</institution></institution-wrap><country>United States</country></aff></contrib></contrib-group></front-stub><body><boxed-text id="sa2-box1"><p>Our editorial process produces two outputs: (i) <ext-link ext-link-type="uri" xlink:href="https://sciety.org/articles/activity/10.1101/2022.08.29.505642">public reviews</ext-link> designed to be posted alongside <ext-link ext-link-type="uri" xlink:href="https://www.biorxiv.org/content/10.1101/2022.08.29.505642v1">the preprint</ext-link> for the benefit of readers; (ii) feedback on the manuscript for the authors, including requests for revisions, shown below. We also include an acceptance summary that explains what the editors found interesting or important about the work.</p></boxed-text><p><bold>Decision letter after peer review:</bold></p><p>Thank you for submitting your article &quot;Structures of ferroportin in complex with its specific inhibitor vamifeport&quot; for consideration by <italic>eLife</italic>. Your article has been reviewed by 3 peer reviewers, and the evaluation has been overseen by a Reviewing Editor and Richard Aldrich as the Senior Editor. The following individual involved in the review of your submission has agreed to reveal their identity: Rachelle Gaudet (Reviewer #3).</p><p>The reviewers have discussed their reviews with one another, and the Reviewing Editor has drafted this letter to help you prepare a revised submission. Overall, the reviewers appreciate the quality of your data but have concerns about presentation and interpretation. The recommendations below are mostly focused on improving the clarity of presentation and appropriateness of conclusions.</p><p>Essential revisions:</p><p>1) The formation of the occluded state may just be a consequence of Sy3 binding. Directly testing whether this state exists during the transport cycle when the protein is unconstrained could be extremely difficult but is essential for concluding whether the state is mechanistically relevant. At a minimum, the authors should discuss this point.</p><p>2) The authors state that several of the mutations negatively impact the expression levels of ferroportin. They should show some data to support this statement (at a minimum, a Western blot).</p><p>3) A major concern is the disconnect between the Results section of the paper and the Discussion. The current version appears more focused on fleshing out the transport mechanism of FPN rather than the mechanism of vamifeport inhibition. One way to address this issue would be to rewrite the paper to focus on either the vamfeport mechanism or the transport mechanism. Given the concern raised in point 1, if the transport mechanism remains prominent, it would be essential to add more experimental results to support this aspect of the Discussion section. Regardless, we would like to see more focus on the mechanism of inhibition in the Discussion section and more on the implications of the mutational data presented in Figure 5.</p><p>4) Also concerning the discussion: There is a lot of detail concerning the S1 and S2 sites, which are not well introduced in the Results section, and what relevance do these sites, or this Discussion, have with the mechanism of vamifeport inhibition? Similarly. Line 354 discusses the metal ion binding site, which seems out of place, given this appears to have nothing to do with vamifeport binding. This section appears disjointed.</p><p>5) It would enhance the discussion of the vamifeport binding site to provide information about whether the residues are conserved in ferroportin homologs. For example, vamifeport is effective in mouse models: are the binding residues conserved between human and mouse (especially the ones that may make specific polar interactions)? Also, is there a correlation between the level of conservation and the residues that reduce protein expression?</p><p>6) The figures comparing the two possible inhibitor orientations are a bit difficult to interpret to independently assess the orientation chosen by the authors. Could the authors also provide some more quantitative assessment, for example, by comparing the docking energy of different alternative poses?</p><p>7) It would be useful to list the measured Kd values of the various ferroportin mutants for hepcidin and Vamifeport in a table, for ease of reference and comparison.</p><p>8) The authors may want to update the comparison with the occluded structure of DrNramp with this recent BioRxiv preprint: doi: https://doi.org/10.1101/2022.09.08.507188.</p><p>9) Are the interactions between vamifeport and FPN similar to that observed for Hepcidin? Do the interactions explain the increased affinity observed for vamifeport over Hepcidin?</p><p>10) Figure 4 supplement 3B should include the interactions, possibly as a schematic.</p><p>11) Lines 268-271 refer to the analysis of the metal binding site and speculation that the conformation stabilized by the Sy3 binder precludes the simultaneous binding of both vamifeport and metal ion. However, physiologically, can the authors demonstrate whether vamifeport prevents Fe binding?</p><p>12) Lines 315-316 refer to the two major advances reported in this study: the structures of FPN in the occluded state and the subsequent complex and functional characterization of vamifeport binding. However, it is unclear to what extent the structures are related to physiological relevant states, given that the sybodies appear to stabilize the metal ion binding site in a conformation that cannot now bind metal ions. This section needs more explanation.</p><p>13) Lines 329 – 331, we think the first study to reference the role of helix 7 in the MFS as the 'gating helix' was the 2003 GlpT paper (10.1126/science.1087619), followed by the FucP (10.1038/nature09406) and POT (doi.org/10.1038/emboj.2010.309) studies.</p><p>14) Lines 332-334 – these lines describe what appears to be a significant mechanistic feature, that vamifeport binding causes TM7 to rigidify, which might also be a component of the inhibition mechanism. Why is this not clearly described in the Results section?</p><p>15) Lines 339 – the authors appear to focus a great deal of comparative analysis between FPN and the GLUT sugar transporters. Why? It would seem to me a more similar system would be by the multidrug exporters or peptide transporters, which also contain multiple binding sites. The link between FPN and GLUTs is not well described to make this comparison obvious.</p></body></sub-article><sub-article article-type="reply" id="sa2"><front-stub><article-id pub-id-type="doi">10.7554/eLife.83053.sa2</article-id><title-group><article-title>Author response</article-title></title-group></front-stub><body><disp-quote content-type="editor-comment"><p>Essential revisions:</p><p>1) The formation of the occluded state may just be a consequence of Sy3 binding. Directly testing whether this state exists during the transport cycle when the protein is unconstrained could be extremely difficult but is essential for concluding whether the state is mechanistically relevant. At a minimum, the authors should discuss this point.</p><p>2) The authors state that several of the mutations negatively impact the expression levels of ferroportin. They should show some data to support this statement (at a minimum, a Western blot).</p></disp-quote><p>We have discussed the ambiguity concerning the functional correspondence of the observed occluded state and removed claims that classified it as transport intermediate throughout the manuscript. However, we also mentioned that this conformation is likely populated in solution since sybodies frequently target preexisting conformations and since selections were performed in absence of vamifeport.</p><p>Line 343-353:</p><p>Since this conformation with occluded substrate binding pocket is stabilized by the binding of Sy3 from the extracellular side to a cleft between both sub-domains involving α-helices 1, 5, 7 and 8 (Figure 2D), it is currently not known to which degree it represents an intermediate in the transport cycle. Notwithstanding the ambiguity concerning its functional relevance, several lines of evidence suggest that this conformation would be assumed in solution and at least be close to conformations on the transition towards the inward-facing state. In the sybody selection process, binders frequently target pre-existing conformations or ones that are energetically close. Consequently, we find it unlikely that this conformation would be solely induced by sybody binding, particularly since it is also targeted by vamifeport, which was not present during the selection process.</p><p>We have presented the relative expression of mutants as a new Figure (Figure 5—figure supplement 1).</p><disp-quote content-type="editor-comment"><p>3) A major concern is the disconnect between the Results section of the paper and the Discussion. The current version appears more focused on fleshing out the transport mechanism of FPN rather than the mechanism of vamifeport inhibition. One way to address this issue would be to rewrite the paper to focus on either the vamfeport mechanism or the transport mechanism. Given the concern raised in point 1, if the transport mechanism remains prominent, it would be essential to add more experimental results to support this aspect of the Discussion section. Regardless, we would like to see more focus on the mechanism of inhibition in the Discussion section and more on the implications of the mutational data presented in Figure 5.</p></disp-quote><p>We have restructured the discussion to put the main focus on the interaction with vamifeport. We have also emphasized that the mechanism of how vamifeport inhibits iron transport is still poorly understood and that this could either be accomplished by the lock of FPN in the observed occluded conformation to directly block transport or, alternatively, by the promotion of its internalization. With respect to vamifeport binding, we have better documented the overlap with the hepcidin site. However, this comparison is limited by the different protein conformations stabilized by both molecules. While the mutation of residues in the part of the binding site that is not overlapping with the hepcidin site confirm our described binding mode, there is little mechanistic insight beyond that.</p><p>While we have strongly reduced the discussion related to the transport mechanism, we regard the unusual features concerning the spacious occluded pocket and the two disconnected metal ionbinding sites as important characteristic features of FPN that deserve to be addressed. Although we do not claim that the described occluded conformation would be a true intermediate on the transport cycle, the comparison of inward and outward-facing conformations of a bacterial FPN homologue independently suggest the formation of a spacious aqueous pocket during transport. With respect to vamifeport binding, this is noteworthy since the compound only occupies a third of the binding pocket, which implies that there would be still ample of space for potential modifications.</p><disp-quote content-type="editor-comment"><p>4) Also concerning the discussion: There is a lot of detail concerning the S1 and S2 sites, which are not well introduced in the Results section, and what relevance do these sites, or this Discussion, have with the mechanism of vamifeport inhibition? Similarly. Line 354 discusses the metal ion binding site, which seems out of place, given this appears to have nothing to do with vamifeport binding. This section appears disjointed.</p></disp-quote><p>We have removed the sentence in line 345, introduced the S1 and S2 binding sites in the introduction in more detail and described conformational differences of these sites in our current structures in the results. Although the detailed transport mechanism of FPN has remained to some degree elusive, the way how the protein captures its substrate strongly differs from other well characterized transition metal ion transporters. We believe that these features deserve to be mentioned, in light of the spacious substrate binding pocket found in the occluded conformation. The importance of the metal ion binding sites for vamifeport interactions is evident since the compound occupies one of these sites (S2) but does not interfere with the other (S1). This property is described in the results and illustrated in Figure 4—figure supplement 4.</p><p>Line 85-91:</p><p>Together, these studies suggest that, distinct from other MFS-transporters, FPN likely contains two conserved substrate binding sites. The first site resides within the N-domain (S1) and comprises an aspartate and a histidine on α1 (<italic>i. e.</italic> Asp39 and His 43) in both hsFPN and tsFPN. A metal ion was also found to bind to a close by location between α1 and α6 in the prokaryotic bbFPN. A second site that is confined to the mammalian transporters is contained within the C-domain (S2) and briges a conserved cysteine (Cys 326) on α7 with a histidine on α11 (<italic>i.e.</italic> His 507 in hsFPN and His 508 in tsFPN).</p><p>Line 263-272:</p><p>Besides overlapping with the hepcidin binding site, vamifeport is located in close proximity to the S2 metal binding site with His 507 on α11 and Cys 326 on the α7a-α7b loop acting as coordinating residues (Figure 4F, Figure 4—figure supplement 5A). In all present mammalian FPN structures, the position of His 507 displays only small variations, whereas the position of Cys 326 on the flexible loop shows large differences (Figure 4—figure supplement 5A, B). In presence of bound metal ions, His 507 and Cys 326 are in about 3.5 Å distance to each other, while in the same outward-facing conformation in absence of substrates, the distance to His 507 increases to 6 Å. In case of both hsFPN/Sy3 structures Cys 326 moves even further towards the N-terminal domain and enlarges the distance to His 507 to 7.5 Å, which likely prohibits the concomitant binding of vamifeport and a divalent metal ion at the S2 site (Figure 4—figure supplement 5A, B).</p><disp-quote content-type="editor-comment"><p>5) It would enhance the discussion of the vamifeport binding site to provide information about whether the residues are conserved in ferroportin homologs. For example, vamifeport is effective in mouse models: are the binding residues conserved between human and mouse (especially the ones that may make specific polar interactions)? Also, is there a correlation between the level of conservation and the residues that reduce protein expression?</p></disp-quote><p>The residues in contact with vamifeport are strongly conserved within the SLC40 family and identical between mammalian members. We have shown an alignment of the sequences surrounding the binding region in Figure 2—figure supplement 5B and added the following sentence.</p><p>Line 372-374:</p><p>These residues are highly conserved throughout FPN orthologs and they are identical in all mammalian family members (Figure 2—figure supplement 5B), explaining the inhibitory action of vamifeport in mice.</p><disp-quote content-type="editor-comment"><p>6) The figures comparing the two possible inhibitor orientations are a bit difficult to interpret to independently assess the orientation chosen by the authors. Could the authors also provide some more quantitative assessment, for example, by comparing the docking energy of different alternative poses?</p></disp-quote><p>In our revision, we have estimated the interaction of the inhibitor with FPN in both orientations by computational docking and find a more favorable interaction energy in the proposed ‘original orientation’. We have mentioned this in the text, added a chapter in the method section and provided a novel Figure supplement (Figure 4—figure supplement 4).</p><p>Line 270-272:</p><p>The preferred interactions in the initially described orientation of vamifeport are also reflected in the 12-20 kcal/mol lower docking energy of the compound, which is dominated by the more favorable polar interactions established with the protein (Figure 4—figure supplement 4).</p><p>The docking protocol is described in detail in the methods Line 770-813</p><disp-quote content-type="editor-comment"><p>7) It would be useful to list the measured Kd values of the various ferroportin mutants for hepcidin and Vamifeport in a table, for ease of reference and comparison.</p></disp-quote><p>We have listed the values in the new Table 2.</p><disp-quote content-type="editor-comment"><p>8) The authors may want to update the comparison with the occluded structure of DrNramp with this recent BioRxiv preprint: doi: https://doi.org/10.1101/2022.09.08.507188.</p></disp-quote><p>We have referred to this preprint and provide an updated panel in Figure 6—figure supplement 1F.</p><disp-quote content-type="editor-comment"><p>9) Are the interactions between vamifeport and FPN similar to that observed for Hepcidin? Do the interactions explain the increased affinity observed for vamifeport over Hepcidin?</p></disp-quote><p>We have extended the comparison of the interactions of FPN with either hepcidin or vamifeport, labeled the residues interacting in hepcidin in Figure 2—figure supplement 5 and introduced the novel panel Figure 4—figure supplement 2D to illustrate common interactions in both molecules. As described in the results, the interactions in the N-pocket strongly overlap whereas there is less overlap with interactions in the C-pocket. The fact that both molecules bind distinct protein conformations complicates a detailed comparison particularly with respect to the energetics of binding.</p><disp-quote content-type="editor-comment"><p>10) Figure 4 supplement 3B should include the interactions, possibly as a schematic.</p></disp-quote><p>We have added both corresponding schemes as panels to Figure 4—figure supplement 3D and F.</p><disp-quote content-type="editor-comment"><p>11) Lines 268-271 refer to the analysis of the metal binding site and speculation that the conformation stabilized by the Sy3 binder precludes the simultaneous binding of both vamifeport and metal ion. However, physiologically, can the authors demonstrate whether vamifeport prevents Fe binding?</p></disp-quote><p>We currently do not have definitive experimental evidence on the question concerning a competition of vamifeport and metal ions. The (partial) inhibition of Fe<sup>2+</sup> transport in the presence of vamifeport was demonstrated previously (Manolova et al., 2019). However, whether this inhibition is predominantly an effect of stalling the transporter in one conformation thus preventing transport by an alternate exchange mechanism or its removal from the plasma membrane is currently unclear. Experiments addressing a potential competition between metal ions and vamifeport carried out in the context of this study were inconclusive and were thus not described in the manuscript. Moreover, even in case vamifeport prevents binding to S2, as suggested by our data, S1 would still be accessible.</p><disp-quote content-type="editor-comment"><p>12) Lines 315-316 refer to the two major advances reported in this study: the structures of FPN in the occluded state and the subsequent complex and functional characterization of vamifeport binding. However, it is unclear to what extent the structures are related to physiological relevant states, given that the sybodies appear to stabilize the metal ion binding site in a conformation that cannot now bind metal ions. This section needs more explanation.</p></disp-quote><p>We have now removed any claim that the occluded conformation would be on the pathway of conformational changes between inward and outward-facing states. We have discussed this explicitly in a paragraph in the discussion, see response to point 1.</p><disp-quote content-type="editor-comment"><p>13) Lines 329 – 331, we think the first study to reference the role of helix 7 in the MFS as the 'gating helix' was the 2003 GlpT paper (10.1126/science.1087619), followed by the FucP (10.1038/nature09406) and POT (doi.org/10.1038/emboj.2010.309) studies.</p></disp-quote><p>We have included these references.</p><disp-quote content-type="editor-comment"><p>14) Lines 332-334 – these lines describe what appears to be a significant mechanistic feature, that vamifeport binding causes TM7 to rigidify, which might also be a component of the inhibition mechanism. Why is this not clearly described in the Results section?</p></disp-quote><p>While we clearly observe an improvement in the density in the loop preceding helix α7b, this loop is already predominantly structured in absence of the inhibitor (likely as a consequence of its interaction with Sy3, see Figure 4—figure supplement 1C, D). We have explicitly mentioned that the binding of vamifeport further stabilizes this loop region, thus likely also the observed occluded conformation and also referred to a plausible contribution to the mechanism of inhibition. However, we also emphasize that the nature of this inhibition and whether it primarily affects a slowdown of transport or an internalization of the transporter has not yet been clarified.</p><disp-quote content-type="editor-comment"><p>15) Lines 339 – the authors appear to focus a great deal of comparative analysis between FPN and the GLUT sugar transporters. Why? It would seem to me a more similar system would be by the multidrug exporters or peptide transporters, which also contain multiple binding sites. The link between FPN and GLUTs is not well described to make this comparison obvious.</p></disp-quote><p>The comparison with GLUTs is motivated by the fact that for this transporter outward-facing and occluded states are available where the protein appears to undergo a generally similar conformational change as observed in FPN. In our revision, we have removed the paragraph comparing the substrate binding features of GLUTs and FPN and the corresponding panels in Figure 6—figure supplement 1, but we have kept the comparison related to the movement of α7b in the transition towards an occluded conformation.</p></body></sub-article></article>