SUMMARY
The Polycystic Kidney Disease 2 (pkd2) gene is mutated
in autosomal dominant polycystic kidney disease (ADPKD), one of the most common
human monogenic disorders. Here, we present the cryo-EM structure of PKD2 in
lipid bilayers at 3.0 Å resolution, which establishes PKD2 as a
homotetrameric ion channel and provides insight into potential mechanisms for
its activation. The PKD2 voltage-sensor domain retains two of four gating
charges commonly found in those of voltage-gated ion channels. The PKD2 ion
permeation pathway is constricted at the selectivity filter and near the
cytoplasmic end of S6, suggesting that two gates regulate ion conduction. The
extracellular domain of PKD2, a hotspot for ADPKD pathogenic mutations,
contributes to channel assembly and strategically interacts with the
transmembrane core, likely serving as a physical substrate for extracellular
stimuli to allosterically gate the channel. Finally, our structure establishes
the molecular basis for the majority of pathogenic mutations in
pkd2-related ADPKD.