We present a novel hypothesis for the molecular mechanism of autosomal dominant cataract linked to two mutations in the ␣A-crystallin gene of the ocular lens. ␣A-crystallin is a molecular chaperone that plays a critical role in the suppression of protein aggregation and hence in the long term maintenance of lens optical properties. Using a steady state binding assay in which the chaperone-substrate complex is directly detected, we demonstrate that the mutations result in a substantial increase in the level of binding to non-native states of the model substrate T4 lysozyme. The structural basis of the enhanced binding is investigated through equivalent substitutions in the homologous heat shock protein 27. The mutations shift the oligomeric equilibrium toward a dissociated multimeric form previously shown to be the binding-competent state. In the context of a recent thermodynamic model of chaperone function that proposes the coupling of small heat shock protein activation to the substrate folding equilibrium (Shashidharamurthy, R., Koteiche, H. A., Dong, J., and McHaourab, H. S. (2005) J. Biol. Chem. 280, 5281-5289), the enhanced binding by the ␣A-crystallin mutants is predicted to shift the substrate folding equilibrium toward non-native intermediates, i.e. the mutants promote substrate unfolding. Given the high concentration of ␣A-crystallin in the lens, the molecular basis of pathogenesis implied by our results is a gain of function that leads to the binding of undamaged proteins and subsequent precipitation of the saturated ␣-crystallin complexes in the developing lens of affected individuals.Lens optical properties, refractivity and transparency, are derived from a unique cellular and molecular architecture. The predominant cellular components are terminally differentiated, organelle-free fiber cells (1) that contain a highly concentrated solution of three families of water-soluble proteins, the crystallins (2). The crystallins pack in a glasslike state characterized by a short range spatial order (3). Molecular diversity, generated by multiple homologues in each crystallin family, polydisperse structures, and hetero-oligomerization, hinders long range interactions that can cause pockets of crystallization and thus fluctuations in the refractive index (4). At the origin of the time axis, proteinprotein interactions are tuned to yield a uniform protein distribution on dimensions comparable with the wavelength of visible light.In the process of aging, post-translational modifications and protein damage (5-11) result in changes in the intrinsic free energies of protein folding, protein-protein interactions, and the solubility of the various molecular species. Consequently, the balance of intermolecular forces is disturbed, and protein aggregation and precipitation can occur. Because fiber cells do not have machineries to degrade and synthesize proteins, these events are detrimental to lens optical properties. Age-related cataract, a leading cause of blindness, is a protein unfolding and condensation disease tha...