The Role of Cholesterol in Driving IAPP-Membrane Interactions

Our knowledge of the molecular events underlying type 2 diabetes mellitus--a protein conformational disease characterized by the aggregation of islet amyloid polypeptide (IAPP) in pancreatic b cells--is limited. However, amyloid-mediated membrane damage is known to play a key role in IAPP cytotoxicity, and therefore the effects of lipid composition on modulating IAPP-membraneinteractions have been the focus of intense research. In particular,membrane cholesterol content varies with aging and consequently with adverse environmental factors such as diet and lifestyle, but its role in the development of the disease is controversial. In this study, we employ a combination of experimental techniques and in silico molecular simulations to shed light on the role of cholesterol in IAPP aggregation and the related membrane disruption.We show that if anionic POPC/POPS vesicles are used asmodelmembranes, cholesterol has a negligible effect on the kinetics of IAPPfibril growth on the surface of the bilayer. In addition, cholesterol inhibits membrane damage by amyloid-induced poration onmembranes, but enhances leakage through fiber growth on themembrane surface. Conversely, if 1:2 DOPC/DPPC raft-likemodel membranes are used, cholesterol accelerates fiber growth. Next, it enhances pore formation and suppresses fiber growth on themembrane surface, leading to leakage. Our results highlight a twofold effect of cholesterol on the amyloidogenicity of IAPP and help explain its debated role in type 2 diabetesmellitus.