Structural and Functional Diversity of Snake Sarafotoxins Yazine Mahjoub, Stéphanie Malaquin, and Frédéric Ducancel Contents Introduction....................................................................................... 2 Sources,Structure,andToxicity.................................................................. 3 ShortSarafotoxinsfromA.engaddensis..................................................... 3 LongSarafotoxinsfromA.microlepidotamicrolepidota.................................... 4 LongSarafotoxinsfromA.irregularis....................................................... 6 Toxicity........................................................................................ 7 PharmacologicalPropertiesofSRTXs........................................................... 7 EndothelinReceptors......................................................................... 7 AffinityandAgonistPropertyofShortandLongSRTXs................................... 8 MechanismofAction............................................................................. 8 EffectofBindingtoET-A.................................................................... 8 EffectofBindingtoET-B.................................................................... 9 BiologicalActivity:DifferencesBetweenShortandLongSarafotoxins....................... 9 ConclusionandFutureDirections................................................................ 10 References........................................................................................ 11 Abstract Sarafotoxins(SRTXs)areextractedsolelyfromthevenomofsnakesbelongingto theAtractaspisgenus,aburrowingaspfromAfricaandMiddleEast.Theysharea high-sequencehomology with endothelins,potent vasoconstrictorsproducedby Y.Mahjoub(*) Pôled’Anesthésie-Réanimation,CHUAmiens,Unitéderéanimationchirurgicale,Amiens,France UnitéINSERMU1088,Amiens,France e-mail:[email protected] S.Malaquin Pôled’Anesthésie-Réanimation,CHUAmiens,Unitéderéanimationchirurgicale,Amiens,France F.Ducancel CEA,iMETI,JointUnitIMVA,CEAFontenay-aux-Roses,Fontenay-aux-Roses,France #SpringerScience+BusinessMediaDordrecht2016 1 P.Gopalakrishnakoneetal.(eds.),SnakeVenoms,Toxinology, DOI10.1007/978-94-007-6648-8_1-1 2 Y.Mahjoubetal. mammalianendothelialcellsandimplicatedinvascular toneregulationandcell growth.SRTXsandendothelinshaveacommoncoreof21aminoacidsandtwo conserveddisulfidebridgesbetweencysteines+1/+15and+3/+11whichconsti- tuteauniqueandtypical“signature”amongnaturalbioactivepeptides:Cys -X- 1 Cys ...Cys -X-X-X-Cys .SRTXsbindtoendothelinreceptorsET-AandET-B 3 11 15 situated on the membrane of numerous cells especially endothelial cells and smooth muscle cells. Recently long SRTXs have been discovered in the venom of A. microlepidota microlepidota and A. irregularis. These long SRTXs have three orfour additional amino acids on their C-terminal domain. The affinity of longSRTXsforendothelinreceptorsisdramaticallydecreasedcomparedtoshort SRTXs.Nevertheless,theystillhaveahightoxicityastestedonmice.Combining invasiveandechocardiographicprocedures,recentexperimentsshowedthatshort andlongSRTXshaveverydifferentinvivohemodynamiceffects.ShortSRTXs impair leftventricular functionwhilelong SRTXs impairrightventricular func- tion and increase airway pressures with no effect on left ventricular function. Furtherexperimentsareneededtoexplainthisdiscrepancy.Thehypothesesofa new type ofendothelin receptors (non-A non-B) cannot be discarded. Thus,the C-terminusextensionseemstoplayamajorroleindefiningtheinvivoeffectof thesepeptides. Keywords Atractaspis (cid:129) Sarafotoxin (cid:129) Endothelin (cid:129) C-terminal domain (cid:129) Vasoconstriction activity(cid:129)Rightventricle Introduction Snake venom sarafotoxins (SRTXs) and mammalian endothelins (ETs) form a structurally and functionally related family of potent vasoconstrictor peptides. Endothelins are synthetized by mammalian endothelial cells and are released in verysmallamounts(plasmaconcentrationinpicomolarrange). SRTXs have been discovered in the early 1980s in the venom of Atractaspis engaddensis, a snake belonging to the Atractaspidae family (Kochva et al. 1982). The name “Sarafotoxin” comes from the Hebrew name of the snake: Saraf Ein Geddi. Saraf means dragon and “Ein Geddi” is the name of the oasis where A. engadensis has been first described. Atractaspididae are a single genus family of oviparous burrowing asps from Africa and Middle East. They are of medium length between 70 and 120 cm. These snakes have lateral small fangs that can be seenevenwhentheirmouthisclosed(Fig.1).Hence,tothecontrarytootherasps theydonotbitebuttheycanstabtheirpreymouthclosed,thustheyaresometimes knownasside-stabbers.Theyfeedessentiallyfromsmallreptiles,amphibians,and rodents. “Bites” from Atractaspis snakes are responsible of pain, local edema and ischemiaornecrosis,generalweakness,nauseaandvomiting,bradycardia,T-wave StructuralandFunctionalDiversityofSnakeSarafotoxins 3 Fig.1 HeadofAtractaspisengaddensiswithavisiblefangprotrudingfromclosedmouth inversion,atrioventricularblock,andmayleadtocardiacarrest(Kurniketal.1999; Wollebergetal.1988;Leeetal.1986). Recently, sarafotoxins extracted from other snakes belonging to the atractaspididae family have been described (Hayashi et al. 2004; Quinton et al. 2005). These sarafotoxins have a longer C-terminus extension but have the same 3-D structure as SRTXs from A. engaddensis and endothelins (Mourier et al. 2012). After presenting the structural diversity of SRTXs, and the effect of agonist propriety of SRTXs on endothelin receptors, this review will explain the functionaldiversityrelatedtothestructuraldiversityofSRTXs(shortvs.long)based onrecentexperimentalinvivostudies. Sources, Structure, and Toxicity Short Sarafotoxins from A. engaddensis In 1988, the primary sequences of three peptides extracted from the venom of A. engaddensis and named SRTX-a, SRTX-b, and SRTX-c have been described (Takasaki et al. 1988). The same year, Yanagisawa et al. discovered a potent vasoconstrictor peptide synthetized by mammalian endothelial cells: endothelin-1 (ET-1)(Yanagisawaetal.1988).Later,twootherisoformsofendothelinshavebeen discovered(ET-2,ET-3andVIC)(Inoueetal.1989;Saidaetal.1989)whileanother SRTX called bibrotoxin (Btx) was identified in the venom of Atractaspis bibroni (Beckeretal.1993). Endothelins and SRTXs share a high sequence homology (about 60 %). They haveacommoncoreof21aminoacidsandtwoconserveddisulfidebridgesbetween cysteines +1/+15 and +3/+11 which constitute a unique and typical “signature” among natural bioactive peptides: Cys -X-Cys ...Cys -X-X-X-Cys . Sequence 1 3 11 15 homologybetweenSRTXsfromA.engaddensisandET-1ismorethan60 %,while 4 Y.Mahjoubetal. SRTX-b and BBTX differ only from one amino acid in position +4. Three- dimensionalstructuresanalysesofthesepeptidesareconsistentwithasimilaroverall structure: SRTXs and endothelins adopt a cysteine-stabilized alpha-helical motif characterizedbyanextendedstructureofthefirstthreeorfourresidues,abeta-turn structurebetweenposition+5and+8,analpha-helicalconformationofthesegment Lys -Cys , and the absence of conformation of the C-terminal domain (Mourier 9 15 et al. 2012). Complementary DNA (cDNA) encoding SRTXs in A. engaddensis comprise1948basepairs(bp)includingoneopenreadingframeof1629pbcoding for a long pre-pro-polypeptide of 543 amino acids which starts with a methionine that initiates translation followed by a hydrophobic peptide characteristic of signal sequence (Ducancel et al. 1993). This long open reading frame deduced for this precursorhasanoriginalrepetitivestructurecomprisingonesequenceof39amino acids followed by 11 sequences of 40 residues. Each of these contains a SRTX sequenceprecededbyaninvariantspacerpeptideof19aminoacids.Thelastcopyof SRTX is followed by a peptide that differs the previous one both in terms of its sequence and length (13 amino acids). In all, five different isoforms of SRTXs are encoded by this single precursor: SRTX-a, SRTX-a1, SRTX-b, SRTX-c, and SRTX-e. A sixth isoform called SRTX-b1, differing from SRTX-b by one amino acid at position +7, was also identified during sequencing of an incomplete cDNA (Ducanceletal.1993).So,sixisoformspresentinthevenomofA.engaddensisare produced from 2 precursors. This so-called rosary-type organization is unique in terms of its regularity in precursors of snake toxins with disulfide bridges (Fig. 2). Thus “three-fingered” toxins, such as neuromuscular toxins, muscarinic toxins, fasciculins and type A2 phospholipases for which numerous isoforms have been identified, are all produced from mono-cistronic precursors (Ducancel et al. 1991). This peculiar organization seems to constitute a simple, economical, and effective way of amplifying the production of SRTXs in the venom of A. engaddensis (Ducancel2005). Long Sarafotoxins from A. microlepidota microlepidota ThroughexhaustivestudyofthevenomofA.mmicrolepidota,anotherspeciesofthe genus Atractaspis, a second poly-cistronic precursor encoding SRTXs have been describedbyHayashietal.(Hayashietal.2004).Usingmassspectrometryanalysis ofthevenomcompositionandmolecularcloningoftheprecursorsencodingSRTXs, these authors identified a new family of longer SRTXs, since displaying three additional residues at their C-terminus extremities. A cDNA fragment containing seven 144-nucleotide repeats, each coding for a peptide link followed by a SRTX sequence, hasbeen identified. ThiscDNAfragment displays a poly-cistronic orga- nization as in the case of precursor encoding SRTXs from A. engaddensis. Five differentisoformsnamedSRTX-m,SRTX-m1,SRTX-m2,SRTX-m,andSRTX-m4 are encoded by this precursor. These isoforms (except SRTX-m4) successively present downstream of the invariant tryptophan at position +21, an aspartate, glutamate,andaproline.Comparisonoftheprimarystructuresofthefiveisoforms StructuralandFunctionalDiversityofSnakeSarafotoxins 5 Fig. 2 Complete “rosary-type” structure of the precursor of sarafotoxins from A. engaddensis (DDBJ/EMBL/GenBankAccessionNumberAAA48515).The5’and3’noncodingendsareshown initalics.Thededucedaminoacidsequence,whichconstitutestheopenreadingframe,isnumbered totherightofthefigure.Theaminoacidsequencecorrespondingtoeachsarafotoxinishighlighted inred.Thenameofeachsarafotoxiniswritteninredtotheleftofthefigure 6 Y.Mahjoubetal. revealsbetween54 %and96 %homology:SRTX-m1and-m2differfromSRTX-m only by one substitution, when SRTX-m4 is the most distant isoform with eight substitutions in the +1/+21 sequence, as well as a different C-terminal extension (Fig.3).NMRstudiesshowedthatdespiteitslongerC-terminalextension,SRTX-m displaysatypicalSRTX/ETthree-dimensionalstructure.Nevertheless,unlikeshort- SRTXs and ETs, the conformation of the long C-terminus tail is restricted. NOE connectivitiesareobservedbetweentheendofthealpha-helixandthebeginningof theC-terminustail.Asaresult,theresiduesH16toV19arelooselyloopedbackonto hydrophobicpatch,restrictinglargeamplitudemotion(Mourieretal.2012). Long Sarafotoxins from A. irregularis InadditiontothepreviousworkdoneonA.m.m.,amolecularstudyonaspecimenof A. irregularis, another species of the genus Atractaspis, has been carried out (Quintonetal.2005).Directanalysisbynanospray-Fourier-Transformioncyclotron resonance of the crude venom of this snake revealed about 60 distinct molecular mass in the range 0.6–15.0 kDa, half of which is between 2.0 and 3.5 kDa, which correspondstopeptides between20and 30amino acids, acharacteristic lengthfor SRTXs. Inparallel,theprecursorsofA.irregularis SRTXswereclonedbyhomol- ogy,anddenovosequencingbymassspectrometryofthereducedcrudevenomwas carriedout.ThepresenceofaSRTXsequenceattheC-terminusofthe118-amino- SRTX-b C S C K D M T D K E C L Y F C H Q D V I W SRTX-c C T C N D M T D E E C L N F C H Q D V I W Btx C S C A D M T D K E C L Y F C H Q D V I W SRTX-m C S C N D I N D K E C M Y F C H Q D V I W D E P SRTX-i3 C S C T D M S D L E C M N F C H K D V I W V N R N ET-1 C S C S S L M D K E C V Y F C H L D I I W ET-2 C S C S S W L D K E C V Y F C H L D I I W ET-3 C T C F T Y K D K E C V Y Y C H L D I I W VIC C S C N S W L D K E C V Y F C H L D I I W D K M C S C T SRTX-b D K D C L Y F C H Q D V I W Fig.3 Aminoacidsequencesofendothelins(ET1,2,3andVIC),short-sarafotoxins(SRTX-b,-c andBtx)andlong-SRTXs(SRTX-mand-i3).Cysteinesresponsibleforinvariantdisulfidebridges areinyellow.Allpeptidespossesstwodisulfidebonds:betweenC1andC15andbetweenC3and C11(asshownforSRTX-b).Conservedaminoacidsareingray.Btxbibrotoxin StructuralandFunctionalDiversityofSnakeSarafotoxins 7 acid residue precursor protein clearly establishes that it corresponds to an A. irregularis SRTX precursor. However, in the case of A. irregularis, only one copyofmatureSRTXemergesfromeachprecursorwhenseveraltandemcopiesof mature SRTXs are encoded per molecule of the rosary-type precursors in the two previously studied Atractaspididae snakes. In total, three isoforms of SRTX emerged from this analysis: SRTX-i1, SRTX-i2, and SRTX-i3. These SRTXs are 25aminoacidlongpeptides(Fig.3)withfouradditionalresiduesattheirC-terminus domain. SRTX-i1 and SRTX-i3 (the most abundant isoform) differ only by one amino acid: a valine for SRTX-i3 and an isoleucine for SRTX-i1 at position +22 followingtheconservedtryptophaneatposition+21(Quintonetal.2005). NMR structure characterization showed that SRTX-i3 have the typical three- dimensional structure of SRTXs and endothelins. Unlike SRTX-m, the longer C-terminus extension of SRTX-i3 is found flexible and disordered without any interaction with the folded N-terminus CSH motif. This is due to the absence of NOE connectivities between these two regions and in agreement with the small dispersion of amide proton chemical shifts for residues H16 to N25 (Mourier etal.2012). Toxicity SRTX-b from A. engaddensis is among the most lethal toxins ever described. It causes death in mice within minutes. The mean lethal 50 (LD ) doses of SRTX-b 50 aresimilartothatofET-1andareabout15ug/kg(Kochvaetal.1993).SRTX-cis about30timeslesstoxicwithaLD of300ug/g.ToxicityofSRTX-miscloseto 50 thatofSRTX-bwithanLD of32ug/gwhileSRTX-i3isslightlylesswithaLD 50 50 of115ug/g(Hayashietal.2004;Mourieretal.2012). Pharmacological Properties of SRTXs Endothelin Receptors Several data confirmed that SRTXs and ETs acts the same receptors called the endothelin receptors. Two main subtypes have been described: ET-A and ET-B (Ducancel2002).Theyaremembersofthehepta-helicalG-proteincoupledreceptor superfamily and range from 45 to 50 kDa in size. Human ET-A is formed by 426 amino acids and is encoded by a gene located on chromosome four. Human ET-Bisformedby442aminoacids andisencoded bya genesituated onchromo- some 13.Theyshare about 60 %homology andarehighlypreservedacross mam- malian species. Each subtype receptor consists of a long extracellular amino- terminal domain,sevenloops ofmembrane-spanningdomains,andanintracellular C-terminal domain. The C-terminal tail and the third cytoplasmic loop contain several putative phosphorylation sites. The Asp-Arg-Tyr motif in the second cyto- plasmic loop is highly conserved and is possibly involved in coupling G-proteins. 8 Y.Mahjoubetal. Moreover, the tyrosine on position +129 situated on the second transmembrane domain seems to play a major role in receptor selectivity (Krystek et al. 1994). ET-A has a high affinity for ET-1 and ET-2 and a 100 times less affinity for ET-3. ET-Bhasthesameaffinityforall3ETisoforms(BartonandYanagisawa2008). Affinity and Agonist Property of Short and Long SRTXs TheaffinityofSRTXsfortheendothelinissignificantlydifferentbetweenshortand long SRTXs. On one hand, endothelins and short SRTXs have high affinities for ET-B with affinity constants in the picomolar range, and on the other hand, long SRTXs have low affinities for ET-B receptors with constant affinity in the micro- molarrange.Hence,thetruncatedformsoflongSRTXShavesimilaraffinitythatof shortSRTXs.Moreover,theadditionofanextendedtailofalongSRTXtoashort SRTX is responsible of a drop in affinity. These results are confirmed to a lesser extentforET-Areceptors(Mourieretal.2012). Mourier et al. have investigated the agonist property of SRTXs on ET-B recep- tors. They used ET-B receptors stably expressed at the surface of CHO cells and measuredthefluorescenceofacalciumdyethatvariesaccordingtotheintracellular calciumconcentration.TheystudiedSRTX-b,ET-1,andSRTX-cbutalsotruncated forms of long SRTXs (SRTX-m and SRTX-i3 without their extended C-terminus tail)andchimericlongSRTXs(SRTX-bwiththeextendedtailofSRTX-morSRTX- i3). They measured the dose–response curves and highlighted the full agonist property of all SRTXs but also the high potency of short SRTXs (EC in the 50 10nanomolarrange)andthelowpotencyoflongSRTXs(EC inthemicromolar 50 range)(Mourieretal.2012). Mechanism of Action Effect of Binding to ET-A ET-A subtype receptor is present on the surface of smooth muscle cells but not on endothelialcells.ET-AbindingstimulatesaphospholipaseClinkedtoaG-protein. Phospholipase C hydrolyzes phosphatidyl inositol 4,5 biphosphate to form the water-soluble inositol triphosphate (IP3) and the neutral diacylglycerol (DAG). IP3 and DAG are second messengers. IP3 induces calcium mobilization from the sarcoplasmicreticulumleadingtoanincreaseofintracellularcalciumconcentration that provokes the opening of store-dependent calcium channels (SOC) that further increase cytosolic calcium. DAG opens receptor-dependent calcium channels (Horinouchi et al. 2013). The intracellular calcium elevation activates various ions channels resulting in calcium entry across the plasma membrane and the sustained increase of intracellular calcium concentration. Intracellular calcium concentration leadstosmoothmusclecellcontractionandcontributestogrowth-promotingeffects throughinductionofproto-oncogeneslikec-fos,c-jun,andc-myc. StructuralandFunctionalDiversityofSnakeSarafotoxins 9 Effect of Binding to ET-B ET-B subtype receptors are present on the surface of endothelial cells and on the surface of smooth muscle cells. ET-B binding on smooth muscle cells has similar effecttoET-AbindingwhileET-Bbindingonendothelialcellshasdifferenteffects. Onendothelialcells,ET-Bbindingactivatesthephosphoinositide3kinase(PI3/Akt) that stimulates phosphorylation of eNOS with subsequent NO production (Liu etal.2005).ET-Bbindingalsoactivatescyclooxygenase2thatinducesthesynthesis of prostacyclin, resulting in the activation of adenylate cyclase that leads to a decrease in calcium concentration. This phenomenon is responsible for smooth muscle cells relaxation. Moreover, after binding on ET-B, ET-1 is rapidly internal- ized and degraded by endosomes. This is the main way of endothelin clearance especiallyinlungsandkidneys(MazzzucaandKhalil2012). Biological Activity: Differences Between Short and Long Sarafotoxins In mammals, endothelins are the most potent endogenous vasoconstrictors to date (Yanagisawaetal.1988),whenSRTXsdisplayvariousvasoconstriction potencies. Thus,SRTX-bhasthesamepotentvasoconstrictionactivitythanETs,whileSRTX-c is a very weak constrictor and showsat high doses a vasodilatory effect(Wollberg etal.1989).Hanetal.haveshownonisolatedperfusedheartthatSRTX-bandET-1 had potent positive inotropic and negative chronotropic effects (Han et al. 1990). Animal studies have shown that intravenous injection of ET-1 is responsible of an increaseofbloodpressureduetoaperipheralvasoconstrictionwhile intracoronary injection provokes a coronary vasoconstriction (Konrad et al. 2005). Recently, an invivostudyonanesthetizedratsundermechanicalventilation,combininginvasive catheterizationoftheleftventricleandDopplerechocardiography,hasinvestigated the precise cardiovascular effect of short and long SRTXs (Mahjoub et al. 2015). TheseauthorsshowedthatintravenousinfusionofSRTX-bdecreasescardiacoutput andimpairsleftventricularsystolicanddiastolicfunction(negativelusitropiceffect) whileincreasingtotalperipheral resistance.Hence,SRTX-b(themostpotentvaso- constrictoramongSRTXs)impairsleftventricularfunctioninvivobyincreasingleft ventricularafterload.ConcerninglongSRTXs,theauthorshaveshownthatSRTX-m hasnoeffectonleftventricularafterloadorcontractilefunction.Interestingly,these authors have shown that SRTX-m induces an acute right ventricular dysfunction while SRTX-b has no effect on the right ventricle. SRTX-m seems to have also a significant effect on bronchial smooth muscle cell as intravenous injection of SRTX-m significantly increases airway pressure. Moreover, a truncated form of SRTX-m (SRTX-m without its longer C-terminus extension) has exactly the same effectsasSRTX-b(Mahjoubetal.2015). Together, these results pave the way for several hypotheses. First, an in vivo maturation of thelong SRTXs by an endogenous enzyme may liberate a short-like SRTX.ThepreviousresultsdonotsupportthishypothesisasSRTX-mandSRTX-b 10 Y.Mahjoubetal. havedifferentinvivoeffects.Second,onemayconsidertheinvolvementofanother subtype of receptors (non-A, non-B endothelin receptors). Some authors have postulated this hypothesis: Zeng et al. have cloned and characterized a human genethatencodesaputative“humanET-Blikeprotein”fromahumanhippocampus tissue cDNA library. The deduced amino acid sequence of this protein is 52 % similar and 26.7 % identical to human ET-B, but ligands and physiological signif- icance of this protein remains unknown (Zeng et al. 1997). Moreover, Bdolah et al. have found that to thecontrary to ET-1, SRTX-b failed to induce contraction ofEgyptianmongoose(Herpestesichneumon)aortalpreparation.Theseauthorsalso foundET-1andSRTXspecificbindingsitesinthemongoosebrain.Thus,theymade thehypothesisthatsomestructuralfeaturesofET/SRTXreceptorsinthemongoose enablethemtodifferentiatebetweenthetwopeptides(Bdolahetal.1997).Further studiesremainnecessarytoconfirmthishypothesisespeciallyforothermammalian species.Finally,a hetero-oligomerization process may modulate thepharmacology ofinteractingligands.Fukurodaetal.providedevidencethatthecombinedtreatment with ET-A and ET-B antagonists antagonized the contraction of human isolated bronchiinducedbyET-1butnosignificantinhibitionwasobservedwiththeuseof the respective antagonist alone suggesting collaboration in the recognition of ET-1 betweenET-AandET-Breceptors(Fukurodaetal.1996).Haradaetal.havestudied bindingpropertiesofET-AandET-Breceptorsofratpituitaryglands.Theyconclude thatalthoughthereareET-AandET-Breceptorswithafunctionalbindingcapability for ET-receptor–ligands, the ET-B receptor does not independently recognize ET-1 withouttheaidoftheET-Areceptor.TheymadethehypothesisthatET-1canbridge between the two receptors to form an ET-A-ET-B receptor heterodimer (Harada etal.2002).Thephenomenonofhetero-oligomerizationofG-protein-couplerecep- tors has been described for functional opioid receptors (k and δ) (Jordan and Devi 1999).Furtherstudiesremainmandatorytoinvestigatethesehypotheses. Nevertheless,theseresultsemphasizethemajorandelaboratedrole“played”by theC-terminusextensionindefiningtheinvivoeffectsofSRTXs. Conclusion and Future Directions SRTXsextractedfromthevenomofatractaspididaesnakesbelongtotheendothelin- like peptide family. They are potent vasoconstrictors. Short SRTXs have high affinity for endothelin receptors especially for ET-B and high toxicity. Long SRTXs have an extended C-terminal domain with to three or four additional amino acids. This extended C-terminal domain is responsible for a dramatic decay in agonist affinity but did not impair significantly the toxicity of these peptides. In vivo experiments have shown that the cardiovascular effects of short and long SRTXs are completely different. Long SRTXs impair right ventricular function andprovokebronchoconstrictionwhileshortSRTXsimpairleftventricularfunction withnoeffectontherightventricle.Someauthorshavemadethehypothesisfornew subtypereceptorsorhetero-olgomerizationprocess.Furtherexperimentsareneces- sarytocharacterizetheroleoftheC-terminusextensionindefiningtheinvivotoxic