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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xml:lang="en" article-type="review-article">
  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">molecules</journal-id>
      <journal-title>Molecules</journal-title>
      <abbrev-journal-title abbrev-type="publisher">Molecules</abbrev-journal-title>
      <abbrev-journal-title abbrev-type="pubmed">Molecules</abbrev-journal-title>
      <issn pub-type="epub">1420-3049</issn>
      <publisher>
        <publisher-name>MDPI</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.3390/molecules171112533</article-id>
      <article-id pub-id-type="publisher-id">molecules-17-12533</article-id>
      <article-categories>
        <subj-group>
          <subject>Review</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Chemical Synthesis, Backbone Cyclization and Oxidative Folding of Cystine-knot Peptides — Promising Scaffolds for Applications in Drug Design</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Reinwarth</surname>
            <given-names>Michael</given-names>
          </name>
          <xref rid="fn1-molecules-17-12533" ref-type="fn">†</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Nasu</surname>
            <given-names>Daichi</given-names>
          </name>
          <xref rid="fn1-molecules-17-12533" ref-type="fn">†</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Kolmar</surname>
            <given-names>Harald</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Avrutina</surname>
            <given-names>Olga</given-names>
          </name>
          <xref rid="c1-molecules-17-12533" ref-type="corresp">*</xref>
        </contrib>
      </contrib-group>
      <aff id="af1-molecules-17-12533">Institute for Organic Chemistry and Biochemistry, Technische Universität Darmstadt, Petersenstraße 22, D-64287 Darmstadt, Germany</aff>
      <author-notes>
        <fn id="fn1-molecules-17-12533">
          <label>† </label>
          <p>These authors contributed equally to this work.</p>
        </fn>
        <corresp id="c1-molecules-17-12533"><label>*</label> Author  to whom correspondence should be addressed; Email: <email>Avrutina@Biochemie-TUD.de</email>; Tel.: +49-6151-164758; Fax: +49-6151-165399. </corresp>
      </author-notes>
      <pub-date pub-type="epub">
        <day>24</day>
        <month>10</month>
        <year>2012</year>
      </pub-date>
      <pub-date pub-type="collection"><month>11</month>
        <year>2012</year>
      </pub-date>
      <volume>17</volume>
      <issue>11</issue>
      <fpage>12533</fpage>
      <lpage>12552</lpage>
      <history>
        <date date-type="received">
          <day>15</day>
          <month>08</month>
          <year>2012</year>
        </date>
        <date date-type="rev-recd">
          <day>19</day>
          <month>09</month>
          <year>2012</year>
        </date>
        <date date-type="accepted">
          <day>22</day>
          <month>10</month>
          <year>2012</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>© 2012 by the authors; licensee MDPI, Basel, Switzerland.</copyright-statement>
        <copyright-year>2012</copyright-year>
        <license xmlns:xlink="http://www.w3.org/1999/xlink" license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/3.0/">
          <p>This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).</p>
        </license>
      </permissions>
      <abstract>
        <p> Cystine-knot peptides display exceptional structural, thermal, and biological stability. Their eponymous motif consists of six cysteine residues that form three disulfide bonds, resulting in a notably rigid structural core. Since they highly tolerate either rational or combinatorial changes in their primary structure, cystine knots are considered to be promising frameworks for the development of peptide-based pharmaceuticals. Despite their relatively small size (two to three dozens amino acid residues), the chemical synthesis route is challenging since it involves critical steps such as head-to-tail cyclization and oxidative folding towards the respective bioactive isomer. Herein we describe the topology of cystine-knot peptides, their synthetic availability and briefly discuss potential applications of engineered variants in diagnostics and therapy.</p>
      </abstract>
      <kwd-group>
        <kwd>CCK</kwd>
        <kwd>cyclotide</kwd>
        <kwd>cystine knot</kwd>
        <kwd>ICK</kwd>
        <kwd>inhibitor</kwd>
        <kwd>knottin</kwd>
        <kwd>miniprotein</kwd>
        <kwd>native chemical ligation</kwd>
        <kwd>oxidative folding</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec sec-type="intro">
      <title>1. Introduction</title>
      <p>Cystine-knot peptides, also termed knottins, are promising scaffolds for the design of peptide-based pharmaceuticals as they combine potent bioactivities with remarkable thermal and proteolytic stabilities [<xref ref-type="bibr" rid="B1-molecules-17-12533">1</xref>,<xref ref-type="bibr" rid="B2-molecules-17-12533">2</xref>,<xref ref-type="bibr" rid="B3-molecules-17-12533">3</xref>]. Their amide backbone of approximately 30 amino acid residues is compacted by three disulfide bonds forming a characteristic ‘pseudo-knotted’ structure [<xref ref-type="bibr" rid="B4-molecules-17-12533">4</xref>]. Cystine-knot peptides can be divided into three major subclasses: inhibitor cystine knots (ICK), cyclic cystine knots (CCK) and growth factor cystine knots (GFCK). While the majority of cystine-knot protease inhibitors comprises a linear backbone and displays inhibition constants in the low nanomolar to picomolar range, CCK peptides are defined by a head-to-tail backbone cyclization motif [<xref ref-type="bibr" rid="B5-molecules-17-12533">5</xref>]. Compared to ICK and CCK, GFCK peptides are larger, less stable and commonly produced recombinantly. Hence, they will not be considered here.</p>
      <p>The systematic research in the field of cystine-knot peptides arose in the early 1970s when a cyclotide kalata B1 was identified in Congo, where women brew tea from the leaves of the plant <italic>Oldenlandia affinis</italic> to accelerate childbirth [<xref ref-type="bibr" rid="B6-molecules-17-12533">6</xref>]. Nevertheless, it took until the 1990s to finally solve the structural properties of CCK and a short period later also of ICK peptides [<xref ref-type="bibr" rid="B7-molecules-17-12533">7</xref>,<xref ref-type="bibr" rid="B8-molecules-17-12533">8</xref>].</p>
      <p>To date, cystine-knot peptides have been found in diverse organisms: arthropoda, fungi, mollusca, plantae, porifera, and vertebrata [<xref ref-type="bibr" rid="B9-molecules-17-12533">9</xref>,<xref ref-type="bibr" rid="B10-molecules-17-12533">10</xref>]. Due to their wide-spread occurrence in combination with a structurally conserved core and an astonishing diversity with respect to amino acid sequence and function, they can be considered as one of Nature’s combinatorial libraries [<xref ref-type="bibr" rid="B11-molecules-17-12533">11</xref>].</p>
    </sec>
    <sec>
      <title>2. Structure</title>
      <sec>
        <title>2.1. The Cystine-Knot Motif</title>
        <p>Cystine knots share common structural motifs that are defined by three antiparallel <italic>β</italic>-strands which are connected through short loops along with a considerable network of hydrogen bonds, and the eponymous knotted disulfide connections [<xref ref-type="bibr" rid="B12-molecules-17-12533">12</xref>]. The constrained conformation mainly results from the disulfide bond between CysIII and CysVI (cysteines within the sequence are numbered according to their appearance from the amino- to the carboxy-terminus) which is threaded through the embedded ring formed upon the disulfide linkage of CysI and CysIV as well as CysII and CysV (<xref ref-type="fig" rid="molecules-17-12533-f001">Figure 1</xref>) [<xref ref-type="bibr" rid="B13-molecules-17-12533">13</xref>].</p>
        <fig id="molecules-17-12533-f001" position="float">
          <label>Figure 1</label>
          <caption>
            <p>Cartoon diagrams of prototypical cystine knots. Loops are depicted in light blue and numbered according to their appearance in the sequence, α-helices in dark blue, β-sheets in red, and cysteines in yellow with Roman numerals according to their appearance in the sequence. (<bold>a</bold>) Möbius cyclotide kalata B1. (PDB-ID: 1NB1) (<bold>b</bold>) Bracelet cyclotide cycloviolacin O2. (PDB-ID: 2KNM) (<bold>c</bold>) Acyclic inhibitor cystine knot ocMCoTI-II (PDB-ID: 2IT8). Structures modeled with Yasara Ver. 12.4.1.</p>
          </caption>
          <graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="molecules-17-12533-g001.tif"/>
        </fig>
        <p>Despite sequential and numerical differences within the variable loops of the different families, they all share the knotted core merging them into the cystine-knot family. These cystine motifs, in fact, are more important for peptide stability and rigidity than an eventual backbone cyclization [<xref ref-type="bibr" rid="B14-molecules-17-12533">14</xref>]. Additionally, an extensive network of hydrogen bonds, especially <italic>via</italic> the β-sheets contributes an essential energetic value to the thermodynamic stability of cystine knots [<xref ref-type="bibr" rid="B11-molecules-17-12533">11</xref>,<xref ref-type="bibr" rid="B12-molecules-17-12533">12</xref>].</p>
        <p>These structural constraints leave the loops (<xref ref-type="fig" rid="molecules-17-12533-f002">Figure 2</xref>) in a surface-exposed state regardless of the hydrophobicity of the assembled amino acid residues. Therefore, also highly hydrophobic residues can be presented on the outer shell of the miniprotein targeting hydrophobic binding pockets or disrupting cell membranes [<xref ref-type="bibr" rid="B5-molecules-17-12533">5</xref>,<xref ref-type="bibr" rid="B12-molecules-17-12533">12</xref>].</p>
        <fig id="molecules-17-12533-f002" position="float">
          <label>Figure 2</label>
          <caption>
            <p>Sequence alignment of certain cystine knots. Cystine connections as well as head-to-tail macrocyclization motif are indicated.</p>
          </caption>
          <graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="molecules-17-12533-g002.tif"/>
        </fig>
      </sec>
      <sec>
        <title>2.2. Cyclic Cystine Knots</title>
        <p>Cyclic cystine-knot peptides combine a macrolactam backbone with the knotted disulfide pattern [<xref ref-type="bibr" rid="B11-molecules-17-12533">11</xref>]. They are supposed to play an important role in plant defense, as most of them have insecticidal activity due to their ability to disrupt cell membranes [<xref ref-type="bibr" rid="B15-molecules-17-12533">15</xref>]. Interestingly, recent studies report antimicrobial, anti-HIV, and cytotoxic activities as well [<xref ref-type="bibr" rid="B16-molecules-17-12533">16</xref>,<xref ref-type="bibr" rid="B17-molecules-17-12533">17</xref>,<xref ref-type="bibr" rid="B18-molecules-17-12533">18</xref>,<xref ref-type="bibr" rid="B19-molecules-17-12533">19</xref>,<xref ref-type="bibr" rid="B20-molecules-17-12533">20</xref>].</p>
        <p>Structurally, cyclotides are divided into Möbius, bracelet, and trypsin inhibitor subclasses. In comparison to other cyclotide families cyclic trypsin inhibitors MCoTI-I and –II extracted from the seeds of <italic>Momordica cochinchinensis</italic> display considerable structural differences in their loop regions, obviously demonstrating similarities with knottins from the squash inhibitor family (<xref ref-type="fig" rid="molecules-17-12533-f002">Figure 2</xref>) [<xref ref-type="bibr" rid="B21-molecules-17-12533">21</xref>,<xref ref-type="bibr" rid="B22-molecules-17-12533">22</xref>,<xref ref-type="bibr" rid="B23-molecules-17-12533">23</xref>]. Therefore, we share the opinion to categorize them into the ICK family [<xref ref-type="bibr" rid="B11-molecules-17-12533">11</xref>,<xref ref-type="bibr" rid="B21-molecules-17-12533">21</xref>].</p>
        <p>The cyclotide kalata B1 is the prototypic cyclotide of a Möbius type, while cycloviolacin O2 is a common example for a bracelet cyclotide (<xref ref-type="fig" rid="molecules-17-12533-f001">Figure 1</xref> and <xref ref-type="fig" rid="molecules-17-12533-f002">Figure 2</xref>) [<xref ref-type="bibr" rid="B11-molecules-17-12533">11</xref>]. Conformational differences between Möbius and bracelet cyclotides are caused by the presence or absence of a <italic>cis</italic>-proline in loop 5. This moiety induces a twist in the orientation of the central <italic>β</italic>-sheet of Möbius CCK peptides, thus causing their oblate shape compared to bracelet cyclotides which lack this conformationally determinative unit [<xref ref-type="bibr" rid="B5-molecules-17-12533">5</xref>].</p>
      </sec>
      <sec>
        <title>2.3. Inhibitor Cystine Knots</title>
        <p>ICK peptides, also referred to as knottins, are found in the seeds of various plants, among them bitter gourd <italic>Momordica cochinchinensis</italic> (MCoTI I-III), squirting cucumber <italic>Ecballium elaterium</italic> (EETI I-III), and spinach <italic>Spinacia oleracea</italic> (SOTI I-III) (<xref ref-type="fig" rid="molecules-17-12533-f001">Figure 1</xref> and <xref ref-type="fig" rid="molecules-17-12533-f002">Figure 2</xref>). Their potent inhibitory effect against one of the major digestive proteases, trypsin, indicates their role in zoochory. While MCoTI and EETI are members of the squash inhibitor family with the inhibitory loop located between CysI and CysII, SOTI miniproteins display similarity to a class of antimicrobial peptides from the seeds of <italic>M. jalapa</italic> with CysV and CysVI flanking the inhibitory loop [<xref ref-type="bibr" rid="B8-molecules-17-12533">8</xref>,<xref ref-type="bibr" rid="B21-molecules-17-12533">21</xref>,<xref ref-type="bibr" rid="B24-molecules-17-12533">24</xref>,<xref ref-type="bibr" rid="B25-molecules-17-12533">25</xref>,<xref ref-type="bibr" rid="B26-molecules-17-12533">26</xref>].</p>
        <p>ICK peptides do not necessarily possess a cyclic backbone (indeed, only MCoTI-I and MCoTI-II are macrocyclic) but are defined according to their inhibitory effect against their respective target proteases. Cyclic trypsin inhibitors have been reported to be more potent than their open-chain counterparts. Nevertheless, inhibition constants of open-chain variants are still in a low nanomolar range [<xref ref-type="bibr" rid="B23-molecules-17-12533">23</xref>]. Surprisingly, backbone cyclization only has minor effects on thermal and proteolytic stability providing evidence that the cystine knot motif is mainly responsible for the remarkable robustness of this scaffold [<xref ref-type="bibr" rid="B27-molecules-17-12533">27</xref>].</p>
      </sec>
    </sec>
    <sec>
      <title>3. Synthesis of Cystine-Knot Peptides</title>
      <p>In this section we will critically discuss recombinant and chemical synthesis of cystine-knot peptides. Although the permanently increasing arsenal of reagents, methodologies, and instruments for solid phase peptide synthesis (SPPS) has largely eliminated synthetic problems during chain assembly, backbone cyclization and oxidative folding towards the regioselective formation of multiple disulfide bonds are still the crucial steps during total chemical synthesis of cystine knots and will therefore be considered in further detail [<xref ref-type="bibr" rid="B28-molecules-17-12533">28</xref>,<xref ref-type="bibr" rid="B29-molecules-17-12533">29</xref>,<xref ref-type="bibr" rid="B30-molecules-17-12533">30</xref>,<xref ref-type="bibr" rid="B31-molecules-17-12533">31</xref>,<xref ref-type="bibr" rid="B32-molecules-17-12533">32</xref>,<xref ref-type="bibr" rid="B33-molecules-17-12533">33</xref>].</p>
      <sec>
        <title>3.1. Recombinant Production</title>
        <p>In Nature, biosynthesis of cystine-knot peptides has been evolutionary optimized towards high yields of the bioactive forms [<xref ref-type="bibr" rid="B34-molecules-17-12533">34</xref>]. Therefore, extraction of cystine-knot peptides from the corresponding plant sources is a common way to isolate the wild type sequences [<xref ref-type="bibr" rid="B31-molecules-17-12533">31</xref>,<xref ref-type="bibr" rid="B35-molecules-17-12533">35</xref>,<xref ref-type="bibr" rid="B36-molecules-17-12533">36</xref>,<xref ref-type="bibr" rid="B37-molecules-17-12533">37</xref>].</p>
        <p>In contrast to chemical synthesis, backbone cyclization (rather than oxidative folding) is the crucial step during recombinant production of cyclic cystine-knot peptides as only a few enzymes are known to catalyze the desired amide bond formation [<xref ref-type="bibr" rid="B38-molecules-17-12533">38</xref>]. For cyclotides, intein-based cyclization methods have been recently reported [<xref ref-type="bibr" rid="B39-molecules-17-12533">39</xref>,<xref ref-type="bibr" rid="B40-molecules-17-12533">40</xref>,<xref ref-type="bibr" rid="B41-molecules-17-12533">41</xref>]. Through several enzyme-catalyzed steps that include an S-N acyl shift, intein fragments are finally cleaved off and the peptide termini become condensed <italic>via</italic> a native amide bond (<xref ref-type="fig" rid="molecules-17-12533-f003">Figure 3</xref>) [<xref ref-type="bibr" rid="B39-molecules-17-12533">39</xref>,<xref ref-type="bibr" rid="B40-molecules-17-12533">40</xref>,<xref ref-type="bibr" rid="B41-molecules-17-12533">41</xref>]. However, intein-mediated cyclization often lacks satisfactory yields and it remains a challenge to obtain multimilligram amounts of the respective cyclic peptide (<xref ref-type="table" rid="molecules-17-12533-t001">Table 1</xref>). The recently reported production of cyclic MCoTI-I in a BL21 strain of <italic>E. coli</italic> indicates that high-yield synthesis is possible under fine-tuned conditions. [<xref ref-type="bibr" rid="B39-molecules-17-12533">39</xref>,<xref ref-type="bibr" rid="B40-molecules-17-12533">40</xref>,<xref ref-type="bibr" rid="B41-molecules-17-12533">41</xref>,<xref ref-type="bibr" rid="B42-molecules-17-12533">42</xref>].</p>
        <fig id="molecules-17-12533-f003" position="float">
          <label>Figure 3</label>
          <caption>
            <p>Common strategies for backbone cyclization. Biosynthetic methods are depicted in green, chemical methods in blue, hybrid strategies are shown in turquoise. References: Intein cyclization: [<xref ref-type="bibr" rid="B39-molecules-17-12533">39</xref>,<xref ref-type="bibr" rid="B40-molecules-17-12533">40</xref>,<xref ref-type="bibr" rid="B41-molecules-17-12533">41</xref>]; hydrazone cyclization: [<xref ref-type="bibr" rid="B43-molecules-17-12533">43</xref>]; proteolytic cyclization: [<xref ref-type="bibr" rid="B44-molecules-17-12533">44</xref>,<xref ref-type="bibr" rid="B45-molecules-17-12533">45</xref>]; thia-zip cyclization: [<xref ref-type="bibr" rid="B46-molecules-17-12533">46</xref>,<xref ref-type="bibr" rid="B47-molecules-17-12533">47</xref>].</p>
          </caption>
          <graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="molecules-17-12533-g003.tif"/>
        </fig>
        <table-wrap id="molecules-17-12533-t001" position="float">
          <object-id pub-id-type="pii">molecules-17-12533-t001_Table 1</object-id>
          <label>Table 1</label>
          <caption>
            <p>Selected folding mixtures for a number of cystine-knot peptides from various families.</p>
          </caption>
          <table>
            <thead>
              <tr><th align="center" valign="middle">Peptide</th><th align="center" valign="middle">Type</th><th align="center" valign="middle">Folding conditions</th><th align="center" valign="middle">Yield/Conversion</th><th align="center" valign="middle">Reference</th>
              </tr>
            </thead>
            <tbody>
              <tr style="border-top:solid thin"><td rowspan="2" align="center" valign="middle">ocMCoTI</td><td rowspan="2" align="center" valign="middle">ICK</td><td rowspan="2" align="center" valign="middle">0.5 mM HCl, 200 mM NaHCO<sub>3</sub>, pH = 9.1, 1–1.5 mg/L peptide.</td><td align="center" valign="middle">16% <sup>a</sup></td><td rowspan="2" align="center" valign="middle">[<xref ref-type="bibr" rid="B48-molecules-17-12533">48</xref>]</td>
              </tr>
              <tr><td align="center" valign="middle">29% <sup>b</sup></td>
              </tr>
              <tr><td align="center" valign="middle">cMCoTI</td><td align="center" valign="middle">ICK</td><td align="center" valign="middle">100 mM NH<sub>4</sub>OAc, pH = 8.5, GSH (1‑5 mM), 0.1 mg/L peptide </td><td align="center" valign="middle">90% <sup>c</sup></td><td align="center" valign="middle">[<xref ref-type="bibr" rid="B49-molecules-17-12533">49</xref>]</td>
              </tr>
              <tr><td rowspan="2" align="center" valign="middle">Variants of ocMCoTI</td><td rowspan="2" align="center" valign="middle">ICK</td><td rowspan="2" align="center" valign="middle">50% MeCN in 100 mM (NH<sub>4</sub>)<sub>2</sub>CO<sub>3</sub>, GSH (4 eq.)</td><td align="center" valign="middle">1.8–7.7% <sup>a</sup></td><td rowspan="2" align="center" valign="middle">[<xref ref-type="bibr" rid="B45-molecules-17-12533">45</xref>]</td>
              </tr>
              <tr><td align="center" valign="middle">36–72% <sup>b</sup></td>
              </tr>
              <tr><td align="center" valign="middle">ICK toxins</td><td align="center" valign="middle">ICK</td><td align="center" valign="middle">GSSG/GSH (0.3 mM/0.15 mM) in 2 M urea, 100 mM Tris-HCl</td><td align="center" valign="middle">3–6% <sup>a</sup></td><td align="center" valign="middle">[<xref ref-type="bibr" rid="B50-molecules-17-12533">50</xref>]</td>
              </tr>
              <tr><td align="center" valign="middle">EETI-II</td><td align="center" valign="middle">ICK</td><td align="center" valign="middle">100 mM NH<sub>4</sub>OAc, pH = 9.1</td><td align="center" valign="middle">&gt;80% <sup>c</sup></td><td align="center" valign="middle">[<xref ref-type="bibr" rid="B51-molecules-17-12533">51</xref>]</td>
              </tr>
              <tr><td rowspan="2" align="center" valign="middle">Gurmarin</td><td rowspan="2" align="center" valign="middle">ICK</td><td rowspan="2" align="center" valign="middle">1. Orthogonal cysteine protecting groups 2. GSH/cystamine in 100 mM Tris-HCl, pH = 7.8</td><td align="center" valign="middle">1.: 0.55% <sup>a</sup></td><td rowspan="2" align="center" valign="middle">[<xref ref-type="bibr" rid="B52-molecules-17-12533">52</xref>]</td>
              </tr>
              <tr><td align="center" valign="middle">2.: 14.1% <sup>a</sup></td>
              </tr>
              <tr><td align="center" valign="middle">GVIA and analogues</td><td align="center" valign="middle">Cono-toxin</td><td align="center" valign="middle">Cysteine-selenocysteine exchange, GSSG/GSH (1 mM/2 mM)</td><td align="center" valign="middle">60–78% <sup>c</sup></td><td align="center" valign="middle">[<xref ref-type="bibr" rid="B53-molecules-17-12533">53</xref>]</td>
              </tr>
              <tr><td align="center" valign="middle">Cycloviolacin O2</td><td align="center" valign="middle">CCK</td><td align="center" valign="middle">35% DMSO, 6% Brij 35 (an oil dispersant), addition of GSH/cystamine after 24 h (2 mM/2 mM) in 100 mM Tris‑HCl, pH = 8.5</td><td align="center" valign="middle">52% <sup>c</sup></td><td align="center" valign="middle">[<xref ref-type="bibr" rid="B54-molecules-17-12533">54</xref>]</td>
              </tr>
              <tr><td align="center" valign="middle">Kalata B1</td><td align="center" valign="middle">CCK</td><td align="center" valign="middle">35% DMSO, 6%, Brij 35 (an oil dispersant), GSH/cystamine (2 mM/2 mM) in 100 mM NH<sub>4</sub>HCO<sub>3</sub>, pH = 8.5</td><td align="center" valign="middle">&gt;95% <sup>c</sup></td><td align="center" valign="middle">[<xref ref-type="bibr" rid="B31-molecules-17-12533">31</xref>]</td>
              </tr>
              <tr><td align="center" valign="middle">Kalata B2</td><td align="center" valign="middle">CCK</td><td align="center" valign="middle">50% <italic>i</italic>-PrOH, GSSG/GSH (2 mM/2 mM) in 100 mM NH<sub>4</sub>HCO<sub>3</sub>, pH = 8.5</td><td align="center" valign="middle">&gt;95% <sup>c</sup></td><td align="center" valign="middle">[<xref ref-type="bibr" rid="B31-molecules-17-12533">31</xref>]</td>
              </tr>
              <tr><td align="center" valign="middle">Kalata B8</td><td align="center" valign="middle">CCK</td><td align="center" valign="middle">50% <italic>i</italic>-PrOH, GSSG/GSH (2 mM/2 mM) in 100 mM NH<sub>4</sub>HCO<sub>3</sub>, pH = 8.5</td><td align="center" valign="middle">&gt;80% <sup>c</sup></td><td align="center" valign="middle">[<xref ref-type="bibr" rid="B31-molecules-17-12533">31</xref>]</td>
              </tr>
              <tr><td align="center" valign="middle">Cyclic hedyotide B1</td><td align="center" valign="middle">CCK</td><td align="center" valign="middle">70–80% <italic>i</italic>-PrOH, pH = 8.5 0.033 mg/L peptide</td><td align="center" valign="middle">48% <sup>c</sup></td><td align="center" valign="middle">[<xref ref-type="bibr" rid="B55-molecules-17-12533">55</xref>]</td>
              </tr>
              <tr><td align="center" valign="middle">ASIP</td><td align="center" valign="middle">GFCK</td><td align="center" valign="middle">100 mM Tris-buffer, pH = 7.7–7.9, 1 mM EDTA, 1 M GuHCl, GSSG/GSH (1:10)</td><td align="center" valign="middle">10% <sup>b</sup></td><td align="center" valign="middle">[<xref ref-type="bibr" rid="B56-molecules-17-12533">56</xref>]</td>
              </tr>
            </tbody>
          </table>
        <table-wrap-foot><fn><p><sup>a</sup>: yield according to resin loading; <sup>b</sup>: yield according to purified linear precursor; <sup>c</sup>: HPLC conversion.</p></fn></table-wrap-foot>
        </table-wrap>
        <p>As ICK peptides do not require any backbone cyclization, they can be recombinantly produced in lower organisms like bacteria or yeast [<xref ref-type="bibr" rid="B57-molecules-17-12533">57</xref>,<xref ref-type="bibr" rid="B58-molecules-17-12533">58</xref>,<xref ref-type="bibr" rid="B59-molecules-17-12533">59</xref>]. It is important to mention that recombinantly produced cystine-knot peptides can be further chemically modified to yield precursors that contain a non-natural cyclization motif [<xref ref-type="bibr" rid="B43-molecules-17-12533">43</xref>]. This issue will be detailed in the following section.</p>
      </sec>
      <sec>
        <title>3.2. Chemical Synthesis</title>
        <p>SPPS of cysteine-rich peptides has become a routine procedure and peptides comprising more than 30 amino acid residues can be obtained in good yields and enantiomeric purity. From a synthetic point of view, the most challenging issues in SPPS of cyclotides are associated with backbone cyclization (<xref ref-type="fig" rid="molecules-17-12533-f003">Figure 3</xref>). They will be discussed in <xref ref-type="sec" rid="sec3dot2dot3-molecules-17-12533">Section 3.2.3</xref>. Nevertheless, chemical synthesis has an obvious advantage over the recombinant route as it allows one to easily incorporate non-natural elements at any desired position in the sequence. Thus, a number of non-canonic building blocks were installed in functional loops of knottins, among them a guaninyl nucleoamino acid as a conformationally restricted and less basic arginine isoster, or homoarginine and amino isobutyric acid that are known to enhance helicity of a peptide chain [<xref ref-type="bibr" rid="B48-molecules-17-12533">48</xref>,<xref ref-type="bibr" rid="B60-molecules-17-12533">60</xref>]. Furthermore, non-natural elements were inserted in conserved regions of knotted peptides as well. Thus, selenocysteines were installed upon SPPS replacing cysteines at crucial positions of a bracelet cyclotide which resulted in a significant improvement of folding yields [<xref ref-type="bibr" rid="B53-molecules-17-12533">53</xref>]. Obviously, installation of non-natural functionalities not only provides an additional option for structural diversity, but also allows for the implementation of coupling sites for backbone cyclization or oligomerization [<xref ref-type="bibr" rid="B43-molecules-17-12533">43</xref>,<xref ref-type="bibr" rid="B61-molecules-17-12533">61</xref>].</p>
        <sec>
          <title>3.2.1. Chain Assembly</title>
          <p>SPPS can be conducted by following two different general strategies. In the <italic>tert</italic>-butyloxycarbonyl (Boc) strategy, <italic>α</italic>-amino groups are protected with acid-labile Boc groups (removed <italic>via</italic> addition of 25% TFA), while deprotection of side chains requires stronger acidic conditions (e.g., HF, methane-sulfonic acid, <italic>etc.</italic>), thus ensuring “pseudo-orthogonality” of the method [<xref ref-type="bibr" rid="B62-molecules-17-12533">62</xref>,<xref ref-type="bibr" rid="B63-molecules-17-12533">63</xref>]. In the second orthogonal strategy the base-labile fluorenylmethyloxycarbonyl (Fmoc) moiety blocks the <italic>α</italic>‑amino group, whereas side chains can be deprotected with acids (e.g., TFA) [<xref ref-type="bibr" rid="B63-molecules-17-12533">63</xref>,<xref ref-type="bibr" rid="B64-molecules-17-12533">64</xref>]. To date, Fmoc-SPPS is often the method of choice as less corrosive and aggressive reagents are used and the elongation of the peptide chain during synthesis can be easily monitored at the Fmoc deprotection step [<xref ref-type="bibr" rid="B63-molecules-17-12533">63</xref>]. However, the Boc strategy is still applied to SPPS of cystine-knot peptides, as it provides some obvious advantages over the Fmoc strategy [<xref ref-type="bibr" rid="B54-molecules-17-12533">54</xref>,<xref ref-type="bibr" rid="B55-molecules-17-12533">55</xref>,<xref ref-type="bibr" rid="B63-molecules-17-12533">63</xref>]. Besides the incompatibility of Fmoc deprotection with the synthesis of C-terminal thioesters (Section 2.3.2), Boc chemistry often provides higher yields per coupling step [<xref ref-type="bibr" rid="B54-molecules-17-12533">54</xref>,<xref ref-type="bibr" rid="B55-molecules-17-12533">55</xref>,<xref ref-type="bibr" rid="B63-molecules-17-12533">63</xref>]. Furthermore, the prices of Boc-protected amino acids in some cases are still lower in comparison to their Fmoc-protected pendants, although prices for Fmoc-protected amino acids have been decreasing continuously since the introduction of the large-scale industrial synthesis of the HIV fusion inhibitor enfuvirtide (<italic>Fuzeon<sup>®</sup></italic>, Roche) [<xref ref-type="bibr" rid="B63-molecules-17-12533">63</xref>,<xref ref-type="bibr" rid="B65-molecules-17-12533">65</xref>]. The aggregation of growing peptide chains during SPPS dramatically lowers reaction yields [<xref ref-type="bibr" rid="B63-molecules-17-12533">63</xref>]. The decreased aggregation tendency of the resin-bound peptide chain that is due to the protonated aminoterminus and backbone resulting from TFA cleavage of aminoterminal Boc groups is one major advantage of Boc- over Fmoc-SPPS [<xref ref-type="bibr" rid="B63-molecules-17-12533">63</xref>]. Nevertheless, intermolecular aggregation, the formation of undesired secondary structures and steric hindrance can also be overcome through the usage of microwave irradiation, not only for the raise of the reaction temperature, but also for the polar peptide backbone alignment with the electromagnetic irradiation [<xref ref-type="bibr" rid="B63-molecules-17-12533">63</xref>,<xref ref-type="bibr" rid="B66-molecules-17-12533">66</xref>]. These effects also lead to increased reaction rates, thereby reducing formation of side-products. Moreover, prolonged reaction times in Fmoc-SPPS are outweighed through the advantage of fully automated synthesizers that can be utilized more regularly due to the usage of less aggressive reagents (although peptide synthesizers compatible with Boc-SPPS are also commercially available). In both methodologies racemization of the amino acid through deprotonating the α-hydrogen with the activator base can be easily overcome by the usage of 2,4,6-tri-methylpyridine or racemization-resistant cysteine protection as e.g., the recently reported 4-methoxy-benzyloxymethyl group [<xref ref-type="bibr" rid="B50-molecules-17-12533">50</xref>,<xref ref-type="bibr" rid="B67-molecules-17-12533">67</xref>]. In summary, despite Fmoc-SPPS being to date the method of choice, Boc-SPPS is a valuable back-up tool for aggregation-prone peptides or peptides with base-labile moieties which are not compatible with Fmoc-chemistry [<xref ref-type="bibr" rid="B54-molecules-17-12533">54</xref>,<xref ref-type="bibr" rid="B55-molecules-17-12533">55</xref>,<xref ref-type="bibr" rid="B63-molecules-17-12533">63</xref>].</p>
        </sec>
        <sec>
          <title>3.2.2. Oxidative Folding</title>
          <p>Oxidative folding of linear or head-to-tail cyclized precursors towards the bioactive isomer is the most important and also most critical step during synthesis of cystine-knot peptides. Significant efforts have been made to determine folding pathways and optimize oxidative folding conditions [<xref ref-type="bibr" rid="B30-molecules-17-12533">30</xref>,<xref ref-type="bibr" rid="B31-molecules-17-12533">31</xref>,<xref ref-type="bibr" rid="B36-molecules-17-12533">36</xref>,<xref ref-type="bibr" rid="B49-molecules-17-12533">49</xref>,<xref ref-type="bibr" rid="B68-molecules-17-12533">68</xref>,<xref ref-type="bibr" rid="B69-molecules-17-12533">69</xref>,<xref ref-type="bibr" rid="B70-molecules-17-12533">70</xref>,<xref ref-type="bibr" rid="B71-molecules-17-12533">71</xref>,<xref ref-type="bibr" rid="B72-molecules-17-12533">72</xref>,<xref ref-type="bibr" rid="B73-molecules-17-12533">73</xref>]. </p>
          <p>Particularly the optimization of folding conditions of cyclotides is challenging since they contain patches of hydrophobic residues on their surface, which substantially contribute to their membrane-disrupting activity [<xref ref-type="bibr" rid="B11-molecules-17-12533">11</xref>]. These highly aggregation-prone residues tend to stick together in a non-native conformation, making therefore preorganization <italic>via</italic> backbone cyclization essential to obtain acceptable yields in the folding process [<xref ref-type="bibr" rid="B16-molecules-17-12533">16</xref>,<xref ref-type="bibr" rid="B74-molecules-17-12533">74</xref>]. CCK peptides belonging to the Möbius or bracelet family, respectively, follow different folding pathways. Möbius cystine-knot peptides rapidly form and accumulate an energetically trapped two-cystine intermediate which lacks the penetrating III,VI-disulfide, and finally fold in the native conformation either directly or <italic>via</italic> another, non-native three-cystine intermediate (<xref ref-type="fig" rid="molecules-17-12533-f004">Figure 4</xref>) [<xref ref-type="bibr" rid="B31-molecules-17-12533">31</xref>,<xref ref-type="bibr" rid="B36-molecules-17-12533">36</xref>]. </p>
          <p>The folding pathway varies with the addition of redox assistants or organic solvents [<xref ref-type="bibr" rid="B31-molecules-17-12533">31</xref>]. However, in contrast to the members of the bracelet family, Möbius CCK peptides fold into the bioactive conformation spontaneously in good to moderate yields [<xref ref-type="bibr" rid="B31-molecules-17-12533">31</xref>,<xref ref-type="bibr" rid="B36-molecules-17-12533">36</xref>,<xref ref-type="bibr" rid="B38-molecules-17-12533">38</xref>]. The <italic>in vitro</italic> folding of bracelet cyclotides is more challenging as their kinetic trap is not a two-cystine, but the non-native CysI-CysII, CysIII-CysIV, CysV-CysVI “ladder-like” isomer (<xref ref-type="fig" rid="molecules-17-12533-f004">Figure 4</xref>) [<xref ref-type="bibr" rid="B31-molecules-17-12533">31</xref>,<xref ref-type="bibr" rid="B54-molecules-17-12533">54</xref>]. Thus, the addition of accessory redox agents is essential. However, no recipe has been reported to date, allowing for the formation of the native form as major product [<xref ref-type="bibr" rid="B31-molecules-17-12533">31</xref>]. To overcome these problems, cyclotides, particularly those that cannot be obtained in reasonable yields <italic>via</italic> random cysteine oxidation, were subjected to a stepwise folding procedure with consecutive cleavage of orthogonally protected cysteine side chains or <italic>via</italic> the incorporation of selenocysteines as diselenides possess a higher reduction potential [<xref ref-type="bibr" rid="B53-molecules-17-12533">53</xref>,<xref ref-type="bibr" rid="B74-molecules-17-12533">74</xref>,<xref ref-type="bibr" rid="B75-molecules-17-12533">75</xref>]. Orthogonal oxidation of multiple cysteine pairs results in selective disulfide formation, thus ensuring the desired cystine pattern. From the huge repertoire of cysteine side-chain protecting groups, trityl, acetamidomethyl, S-<italic>tert</italic>-butyl, and <italic>tert</italic>-butyl are the most often used orthogonal combinations [<xref ref-type="bibr" rid="B76-molecules-17-12533">76</xref>,<xref ref-type="bibr" rid="B77-molecules-17-12533">77</xref>,<xref ref-type="bibr" rid="B78-molecules-17-12533">78</xref>]. A number of cystine-knot peptides were synthesized following the strategy of regioselective disulfide formation, among them anti-malaria peptides from <italic>Psalmopoeus cambridgei</italic> and the ICK peptide gurmarin [<xref ref-type="bibr" rid="B52-molecules-17-12533">52</xref>,<xref ref-type="bibr" rid="B79-molecules-17-12533">79</xref>].</p>
          <p>Removal of a non-critical disulfide bridge and substitution of remaining disulfides with diselenides is another way to simplify folding of multidisulfide peptides and was successfully applied to the synthesis of some conotoxines [<xref ref-type="bibr" rid="B67-molecules-17-12533">67</xref>,<xref ref-type="bibr" rid="B80-molecules-17-12533">80</xref>]. Interestingly, for the peptides possessing a two-disulfide pattern both cystines could be replaced on-support with isosteric cystathionine motifs without loss of bioactivity [<xref ref-type="bibr" rid="B81-molecules-17-12533">81</xref>].</p>
          <p>Common to twisted cyclotides, the folding pathway of ICK peptides follows a direct route resulting in a quickly formed, kinetically trapped two-disulfide intermediate [<xref ref-type="bibr" rid="B36-molecules-17-12533">36</xref>,<xref ref-type="bibr" rid="B49-molecules-17-12533">49</xref>,<xref ref-type="bibr" rid="B82-molecules-17-12533">82</xref>]. This intermediate consists of two “low-energy” disulfides and therefore is vulnerable for misfolding. Thus, peptide chain preorganization and formation of correctly folded intermediates remarkably contribute to the yield and purity of the final bioactive isomer. In contrast to Möbius cyclotides, the formation of the third ring- penetrating cystine directly yields the native conformation (<xref ref-type="fig" rid="molecules-17-12533-f004">Figure 4</xref>) [<xref ref-type="bibr" rid="B49-molecules-17-12533">49</xref>].</p>
          <p>The increased hydrophilicity of the active loops in ICK peptides admits a higher degree of structural preorganization compared to the mainly hydrophobic CCK peptides, thus enhancing their folding yields. Hence, ICK peptides frequently are not macrocyclic. Nevertheless, for MCoTI variants the cyclic form displayed an improved folding behavior compared to the linear variant [<xref ref-type="bibr" rid="B27-molecules-17-12533">27</xref>,<xref ref-type="bibr" rid="B49-molecules-17-12533">49</xref>].</p>
          <fig id="molecules-17-12533-f004" position="float">
            <label>Figure 4</label>
            <caption>
              <p><italic>In vitro</italic> folding pathways of cystine-knot peptides from different families. Most ICK peptides are thought to proceed to the folded form <italic>via</italic> formation of two-disulfide native-like intermediate. Folding of CCK peptides may either follow a similar path or proceed <italic>via</italic> a non-native 3-cystine intermediate. Structures were modeled and energy-minimized with Yasara Ver. 12.4.1.</p>
            </caption>
            <graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="molecules-17-12533-g004.tif"/>
          </fig>
          <p>Many different folding assistants have been used in various combinations, each optimized for an individual protein or peptide. Common requirements for efficient cystine-knot peptide folding are high dilution, significant ratios of organic solvents (e.g., DMSO, <italic>i</italic>-PrOH) and presence of redox folding assistants (e.g., ox./red. glutathione) [<xref ref-type="bibr" rid="B30-molecules-17-12533">30</xref>,<xref ref-type="bibr" rid="B31-molecules-17-12533">31</xref>,<xref ref-type="bibr" rid="B36-molecules-17-12533">36</xref>,<xref ref-type="bibr" rid="B49-molecules-17-12533">49</xref>,<xref ref-type="bibr" rid="B68-molecules-17-12533">68</xref>,<xref ref-type="bibr" rid="B69-molecules-17-12533">69</xref>,<xref ref-type="bibr" rid="B70-molecules-17-12533">70</xref>,<xref ref-type="bibr" rid="B71-molecules-17-12533">71</xref>,<xref ref-type="bibr" rid="B72-molecules-17-12533">72</xref>]. Despite the importance of the oxidative folding of cystine-knot peptides, particularly of those that contain grafted sequences, yields are rarely given in the present literature [<xref ref-type="bibr" rid="B54-molecules-17-12533">54</xref>,<xref ref-type="bibr" rid="B57-molecules-17-12533">57</xref>,<xref ref-type="bibr" rid="B58-molecules-17-12533">58</xref>,<xref ref-type="bibr" rid="B59-molecules-17-12533">59</xref>,<xref ref-type="bibr" rid="B83-molecules-17-12533">83</xref>]. Moreover, missing distinctions between yield and HPLC-observed conversion rates and indications, whether they are based on resin loading or correspond to the crude or purified precursor further complicate the summarized comparison of folding yields (<xref ref-type="table" rid="molecules-17-12533-t001">Table 1</xref>).</p>
        </sec>
        <sec id="sec3dot2dot3-molecules-17-12533">
          <title>3.2.3. Backbone Macrocyclization</title>
          <p>Backbone cyclization usually is accomplished <italic>via</italic> a so-called ‘thia-zip’ mechanism using the native chemical ligation (NCL) technology (<xref ref-type="fig" rid="molecules-17-12533-f005">Figure 5</xref>) [<xref ref-type="bibr" rid="B46-molecules-17-12533">46</xref>,<xref ref-type="bibr" rid="B47-molecules-17-12533">47</xref>,<xref ref-type="bibr" rid="B69-molecules-17-12533">69</xref>,<xref ref-type="bibr" rid="B84-molecules-17-12533">84</xref>,<xref ref-type="bibr" rid="B85-molecules-17-12533">85</xref>,<xref ref-type="bibr" rid="B86-molecules-17-12533">86</xref>,<xref ref-type="bibr" rid="B87-molecules-17-12533">87</xref>]. To this end, a carboxyterminal leaving group, generally a thioester, must be installed. Introduction of this moiety can be achieved through thioesterification of the fully protected peptide in solution, either as a cleavable linker on the peptide resin or as a reagent during nucleophilic cleavage. For the incorporation of the thioester after chain assembly, the peptide has to be synthesized on an ‘ultra-acid-labile’ resin (e.g., a TGT resin) from which the peptide can be cleaved with all side-chain protecting groups intact. To that fully protected peptide the thiol is coupled forming the desired thioester [<xref ref-type="bibr" rid="B88-molecules-17-12533">88</xref>]. Although this methodology is compatible with the common Fmoc-strategy of peptide synthesis, it is subjected to imponderabilities due to the unpredictable solubility of fully protected peptides, especially peptides of that size. Moreover, undesired carboxyterminal racemization may occur during synthesis [<xref ref-type="bibr" rid="B88-molecules-17-12533">88</xref>,<xref ref-type="bibr" rid="B89-molecules-17-12533">89</xref>]. This problem can be overcome very elegantly by choosing a glycine as aminoterminal and a cysteine as carboxyterminal residue as the site of macrocyclization, because glycine is the only non-chiral amino acid and glycine-cysteine combinations exist in a number of cystine-knot peptides (<xref ref-type="fig" rid="molecules-17-12533-f001">Figure 1</xref>) [<xref ref-type="bibr" rid="B88-molecules-17-12533">88</xref>]. Installation of a thioester as on-resin cleavable linker seems more elegant, as no special modification is needed [<xref ref-type="bibr" rid="B86-molecules-17-12533">86</xref>]. Unfortunately, piperidine that is a common reagent used in Fmoc-SPPS for N-terminal deprotection is not compatible with that linker as its nucleophilic attack at the thioester results in the cleavage of the peptide chain from the resin [<xref ref-type="bibr" rid="B86-molecules-17-12533">86</xref>]. A combination of non-nucleophilic 1,8-diazabicyclo[5.4.0]undec-7-ene (DBU) and 1-hydroxybenzotriazole (HOBt) helps to overcome that problem on the cost of an enhanced aspartimide formation [<xref ref-type="bibr" rid="B90-molecules-17-12533">90</xref>]. Interestingly, it has not been checked so far, whether 2-methylpiperidine could solve these problems as its utility for the synthesis of peptides with piperidine-labile tyrosine sulfate esters was demonstrated [<xref ref-type="bibr" rid="B91-molecules-17-12533">91</xref>]. The third possibility, though not yet elaborated, might be the usage of safety-catch linkers (e.g., hydrazinobenzoyl) which can be cleaved by a respective nucleophile after suitable activation [<xref ref-type="bibr" rid="B92-molecules-17-12533">92</xref>,<xref ref-type="bibr" rid="B93-molecules-17-12533">93</xref>].</p>
          <fig id="molecules-17-12533-f005" position="float">
            <label>Figure 5</label>
            <caption>
              <p>Proposed cyclization <italic>via</italic> native chemical ligation.</p>
            </caption>
            <graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="molecules-17-12533-g005.tif"/>
          </fig>
          <p>After successful incorporation of a carboxyterminal thioester, NCL frequently provides cyclic peptides in excellent conversions or yields, respectively (<xref ref-type="table" rid="molecules-17-12533-t002">Table 2</xref>) [<xref ref-type="bibr" rid="B86-molecules-17-12533">86</xref>,<xref ref-type="bibr" rid="B88-molecules-17-12533">88</xref>]. Although to date the mechanism is not fully understood and not all intermediates are precisely characterized, it is commonly accepted that intramolecular thioesterifications of the internal thiol groups and the carboxyterminus take place (<xref ref-type="fig" rid="molecules-17-12533-f005">Figure 5</xref>) [<xref ref-type="bibr" rid="B46-molecules-17-12533">46</xref>]. This “thia-zip” rearrangement gradually increases ring size and eventually brings both termini in close proximity. As a consequence, an irreversible <italic>S</italic>, <italic>N</italic>-acyl transfer is induced, finally leading to the cyclic product [<xref ref-type="bibr" rid="B46-molecules-17-12533">46</xref>,<xref ref-type="bibr" rid="B84-molecules-17-12533">84</xref>]. This model is supported by various studies, in which the aminoterminus was acetylated, a linker introduced or the ring-chain tautomeric equilibrium investigated [<xref ref-type="bibr" rid="B46-molecules-17-12533">46</xref>,<xref ref-type="bibr" rid="B84-molecules-17-12533">84</xref>,<xref ref-type="bibr" rid="B94-molecules-17-12533">94</xref>]. Nevertheless, NCL-driven macrocyclization has been reported also for peptides possessing only an aminoterminal cysteine. Due to the lack of multiple thiol groups, intramolecular thialactone exchange is not possible in such molecules and ring closure takes place without zip-like rearrangements [<xref ref-type="bibr" rid="B84-molecules-17-12533">84</xref>,<xref ref-type="bibr" rid="B85-molecules-17-12533">85</xref>,<xref ref-type="bibr" rid="B86-molecules-17-12533">86</xref>,<xref ref-type="bibr" rid="B95-molecules-17-12533">95</xref>].</p>
          <p>Despite the success of NCL as the method of choice, two alternative backbone cyclization strategies have been reported (<xref ref-type="table" rid="molecules-17-12533-t002">Table 2</xref>) [<xref ref-type="bibr" rid="B43-molecules-17-12533">43</xref>,<xref ref-type="bibr" rid="B44-molecules-17-12533">44</xref>]. One method relies on the bacterial production of the cystine-knot peptide in <italic>E. coli via</italic> fusion to a carrier protein [<xref ref-type="bibr" rid="B43-molecules-17-12533">43</xref>]. Therein, the linear precursor is fused to barnase, an RNAse from <italic>Bacillus amyloliquefaciens</italic>, which guides the fused protein complex into the periplasm of the Gram-negative <italic>E. coli</italic>, where the oxidative milieu supports folding [<xref ref-type="bibr" rid="B43-molecules-17-12533">43</xref>,<xref ref-type="bibr" rid="B96-molecules-17-12533">96</xref>]. Chemical head-to-tail cyclization of the folded ICK peptide was achieved through the formation of a stable <italic>N</italic>-C hydrazone linkage between a periodate-oxidized aminoterminal serine and a carboxyterminal hydrazide. This moiety was generated by hydrazinolysis of a homoserine lactone formed upon cyanogen bromide cleavage at a unique methionine that was present at the junction of the knottin and the carrier protein sequence (<xref ref-type="fig" rid="molecules-17-12533-f003">Figure 3</xref>) [<xref ref-type="bibr" rid="B43-molecules-17-12533">43</xref>]. Recently, protease-mediated backbone cyclization was accomplished using immobilized trypsin [<xref ref-type="bibr" rid="B44-molecules-17-12533">44</xref>,<xref ref-type="bibr" rid="B45-molecules-17-12533">45</xref>]. Therein, a solution of chemically synthesized and correctly folded MCoTI-II was added to polymer-bound trypsin and, upon covalent binding to the active site of this protease, C- and N-termini of the cystine knot were brought into close proximity and ligated between the P1 lysine and P1’ leucine within the protease inhibiting loop (<xref ref-type="fig" rid="molecules-17-12533-f003">Figure 3</xref>) [<xref ref-type="bibr" rid="B44-molecules-17-12533">44</xref>,<xref ref-type="bibr" rid="B45-molecules-17-12533">45</xref>,<xref ref-type="bibr" rid="B97-molecules-17-12533">97</xref>]. Conversion rates and yields for the various cyclization methods are summarized in <xref ref-type="table" rid="molecules-17-12533-t002">Table 2</xref>.</p>
        <table-wrap id="molecules-17-12533-t002" position="float">
            <object-id pub-id-type="pii">molecules-17-12533-t002_Table 2</object-id>
            <label>Table 2</label>
            <caption>
              <p>Selected cyclization conditions for a number of cystine-knot peptides from various families.</p>
            </caption>
            <table>
              <thead><tr>  <th align="center" valign="middle">Peptide</th>  <th align="center" valign="middle">Type</th>  <th align="center" valign="middle">Cyclization reaction; conditions</th>  <th align="center" valign="middle">Yield/Conversion</th>  <th align="center" valign="middle">Reference</th></tr>
              </thead>
              <tbody><tr style="border-top:solid thin">  <td align="center" valign="middle">Variants of cMCoTI</td>  <td align="center" valign="middle">ICK</td>  <td align="center" valign="middle">Immobilized trypsin; 100 mM phosphate buffer, pH = 7.4</td>  <td align="center" valign="middle">90–94% <sup>a</sup></td>  <td align="center" valign="middle">[<xref ref-type="bibr" rid="B44-molecules-17-12533">44</xref>,<xref ref-type="bibr" rid="B45-molecules-17-12533">45</xref>]</td></tr><tr>  <td align="center" valign="middle">Variants of cMCoTI</td>  <td align="center" valign="middle">ICK</td>  <td align="center" valign="middle">Folding and NCL as one-pot reaction; 50% GSSG (1 mM) in 100 mM carbonate buffer, 50% peptide (3 mM) in acetonitrile</td>  <td align="center" valign="middle">63–72% <sup>b</sup></td>  <td align="center" valign="middle">[<xref ref-type="bibr" rid="B45-molecules-17-12533">45</xref>]</td></tr><tr>  <td align="center" valign="middle">Variants of cMCoTI</td>  <td align="center" valign="middle">ICK</td>  <td align="center" valign="middle">Hydrazone linkage; multiple reactions from recombinantly produced barnase fusion</td>  <td align="center" valign="middle">0.5–1 mg/L <sup>c</sup></td>  <td align="center" valign="middle">[<xref ref-type="bibr" rid="B43-molecules-17-12533">43</xref>]</td></tr><tr>  <td align="center" valign="middle">Kalata B1</td>  <td align="center" valign="middle">CCK</td>  <td align="center" valign="middle">Amide bond; HBTU or BOP, respectively (1–10 eq.), DIEA in DMF</td>  <td align="center" valign="middle">~25% <sup>a</sup></td>  <td align="center" valign="middle">[<xref ref-type="bibr" rid="B69-molecules-17-12533">69</xref>]</td></tr><tr>  <td align="center" valign="middle">Kalata B1</td>  <td align="center" valign="middle">CCK</td>  <td align="center" valign="middle">NCL; 100 mM NaH<sub>2</sub>PO<sub>4</sub>, TCEP (6 eq.), pH = 7.4, 1 mg/mL peptide</td>  <td align="center" valign="middle">100% <sup>a</sup></td>  <td align="center" valign="middle">[<xref ref-type="bibr" rid="B69-molecules-17-12533">69</xref>]</td></tr><tr>  <td align="center" valign="middle">hB1</td>  <td align="center" valign="middle">CCK</td>  <td align="center" valign="middle">NCL; 100 mM NaH<sub>2</sub>PO<sub>4</sub>, 6 M GuHCl, thiophenol (100 eq.), pH = 7.5</td>  <td align="center" valign="middle">100% <sup>a</sup></td>  <td align="center" valign="middle">[<xref ref-type="bibr" rid="B55-molecules-17-12533">55</xref>]</td></tr><tr>  <td align="center" valign="middle">Cyclic MrIA</td>  <td align="center" valign="middle">Cyclic cono-toxin</td>  <td align="center" valign="middle">NCL; 100 mM Tris-HCl, pH = 7.8, 6 M GuHCl, sodium 2‑sulfonylethane sulfonate (1 mg/mL), anaerobic</td>  <td align="center" valign="middle">100% <sup>a</sup></td>  <td align="center" valign="middle">[<xref ref-type="bibr" rid="B98-molecules-17-12533">98</xref>]</td></tr>
              </tbody>
            </table>
          <table-wrap-foot><fn><p><sup>a</sup>: HPLC conversion; <sup>b</sup>: yield according to purified precursor; <sup>c</sup>: yield of purified cystine-knot peptide is given per liter cell culture.</p></fn></table-wrap-foot>
        </table-wrap>
          </sec>
        <sec>
          <title>3.2.4. Analysis of Cystine Knots</title>
          <p>RP-HPLC in combination with mass spectrometry, especially ESI-MS and MALDI-TOF, are commonly used for the routine analysis of cystine-knot peptides [<xref ref-type="bibr" rid="B23-molecules-17-12533">23</xref>,<xref ref-type="bibr" rid="B31-molecules-17-12533">31</xref>,<xref ref-type="bibr" rid="B48-molecules-17-12533">48</xref>,<xref ref-type="bibr" rid="B50-molecules-17-12533">50</xref>,<xref ref-type="bibr" rid="B55-molecules-17-12533">55</xref>]. Therein, not only the polarity, but also the molecular weight are determined giving clear evidence of the quality and nature of the product [<xref ref-type="bibr" rid="B23-molecules-17-12533">23</xref>,<xref ref-type="bibr" rid="B31-molecules-17-12533">31</xref>,<xref ref-type="bibr" rid="B48-molecules-17-12533">48</xref>,<xref ref-type="bibr" rid="B50-molecules-17-12533">50</xref>,<xref ref-type="bibr" rid="B55-molecules-17-12533">55</xref>]. For example, the progress of oxidative folding was determined through a shift in RP-HPLC retention time as well as a decreased molecular weight because of the loss of the respective number of hydrogens [<xref ref-type="bibr" rid="B23-molecules-17-12533">23</xref>,<xref ref-type="bibr" rid="B31-molecules-17-12533">31</xref>,<xref ref-type="bibr" rid="B48-molecules-17-12533">48</xref>,<xref ref-type="bibr" rid="B55-molecules-17-12533">55</xref>]. Unfortunately, this is not the final proof of correct folding as topology of the cystine connections is essential for bioactivity [<xref ref-type="bibr" rid="B51-molecules-17-12533">51</xref>]. Therefore, determination of the correct disulfide topology is necessary which is applied routinely <italic>via</italic> MS-MS analytics, Edman sequencing, and protein digestion followed by subsequent MS analysis of the reaction mixture [<xref ref-type="bibr" rid="B21-molecules-17-12533">21</xref>,<xref ref-type="bibr" rid="B24-molecules-17-12533">24</xref>,<xref ref-type="bibr" rid="B55-molecules-17-12533">55</xref>,<xref ref-type="bibr" rid="B95-molecules-17-12533">95</xref>,<xref ref-type="bibr" rid="B99-molecules-17-12533">99</xref>]. From the resulting fragments cystine connections can be deduced. Due to the small size of cystine-knot peptides, detailed structural information as the connectivity of hydrogen bonds has been collected by 2D NMR studies [<xref ref-type="bibr" rid="B25-molecules-17-12533">25</xref>,<xref ref-type="bibr" rid="B27-molecules-17-12533">27</xref>,<xref ref-type="bibr" rid="B82-molecules-17-12533">82</xref>]. Nevertheless, although to date only the crystal structure of a cyclotide and an open-chain knottin have been solved, ICK peptides can be easily co-crystallized with their target enzymes [<xref ref-type="bibr" rid="B2-molecules-17-12533">2</xref>,<xref ref-type="bibr" rid="B3-molecules-17-12533">3</xref>,<xref ref-type="bibr" rid="B12-molecules-17-12533">12</xref>,<xref ref-type="bibr" rid="B100-molecules-17-12533">100</xref>].</p>
        </sec>
      </sec>
    </sec>
    <sec>
      <title>4. Applications to Drug Design</title>
      <p>Potential applications of cystine-knot peptides to drug design have been extensively reviewed [<xref ref-type="bibr" rid="B1-molecules-17-12533">1</xref>,<xref ref-type="bibr" rid="B5-molecules-17-12533">5</xref>,<xref ref-type="bibr" rid="B10-molecules-17-12533">10</xref>,<xref ref-type="bibr" rid="B101-molecules-17-12533">101</xref>]. In this section a few examples of recently developed peptides are given that highlight the advantages of their use for <italic>in vivo</italic> and <italic>in vitro</italic> targeting of disease-related molecules.</p>
      <p>Cystine-knot peptides possess three essential characteristics which are desirable for the application as drugs: excellent stability, high affinity or inhibitory activity, and the potential for high selectivity towards the target. Additionally, these three-disulfide scaffolds provide a remarkable sequence tolerance allowing for the introduction of novel functionalities within their loop region, often without the loss of structural integrity and bioactivity [<xref ref-type="bibr" rid="B10-molecules-17-12533">10</xref>]. Moreover, at least members of the ICK family are thought to have no cytotoxic properties and demonstrate good body clearance and tissue distribution, although these characteristics require validation for each modified candidate [<xref ref-type="bibr" rid="B1-molecules-17-12533">1</xref>,<xref ref-type="bibr" rid="B10-molecules-17-12533">10</xref>,<xref ref-type="bibr" rid="B101-molecules-17-12533">101</xref>]. Interestingly, some cystine-knot peptides have been reported to be cell-penetrating [<xref ref-type="bibr" rid="B97-molecules-17-12533">97</xref>,<xref ref-type="bibr" rid="B102-molecules-17-12533">102</xref>].</p>
      <p>The choice of ICK or CCK peptides as a scaffold for drug design is mainly guided by the natural target molecule, although several instances of engineering towards completely different targets have been reported [<xref ref-type="bibr" rid="B59-molecules-17-12533">59</xref>,<xref ref-type="bibr" rid="B103-molecules-17-12533">103</xref>,<xref ref-type="bibr" rid="B104-molecules-17-12533">104</xref>]. As natural ICK peptides usually target trypsin-like proteases, they are optimal starting points for obtaining potent inhibitors against other disease-related serine proteases [<xref ref-type="bibr" rid="B9-molecules-17-12533">9</xref>,<xref ref-type="bibr" rid="B23-molecules-17-12533">23</xref>,<xref ref-type="bibr" rid="B26-molecules-17-12533">26</xref>]. Engineered “imino-cyclotides” combining the ICK backbone with a non-natural hydrazone cyclization motif have been reported to inhibit human mast cell tryptase <italic>β</italic>, a protease of interest as a therapeutic target for the treatment of inflammatory disorders and allergic asthma [<xref ref-type="bibr" rid="B43-molecules-17-12533">43</xref>]. </p>
      <p>For tumor targeting, several transmembrane serine proteases which are known to be overexpressed in cancer cells are also valuable targets [<xref ref-type="bibr" rid="B105-molecules-17-12533">105</xref>,<xref ref-type="bibr" rid="B106-molecules-17-12533">106</xref>,<xref ref-type="bibr" rid="B107-molecules-17-12533">107</xref>,<xref ref-type="bibr" rid="B108-molecules-17-12533">108</xref>]. </p>
      <p>Most interestingly, Agouti-related miniprotein (AgRP), an acyclic four-cystine knottin, has recently been modified with an RGD peptide motif towards binding of cancer-dependent integrins and the resulting constructs were used for radio imaging <italic>in vivo</italic> [<xref ref-type="bibr" rid="B59-molecules-17-12533">59</xref>,<xref ref-type="bibr" rid="B103-molecules-17-12533">103</xref>,<xref ref-type="bibr" rid="B109-molecules-17-12533">109</xref>]. A prototype for the engineering of miniproteins towards variants with antiviral activity is the HIV entry inhibitor CD4M47<sup>[Phe]</sup>. Here, the miniprotein Leiurotoxin I from the deathstalker scorpion <italic>Leiurus quinquestriatus hebraeus</italic> was used as a structural scaffold [<xref ref-type="bibr" rid="B110-molecules-17-12533">110</xref>,<xref ref-type="bibr" rid="B111-molecules-17-12533">111</xref>,<xref ref-type="bibr" rid="B112-molecules-17-12533">112</xref>,<xref ref-type="bibr" rid="B113-molecules-17-12533">113</xref>]. Several rounds of directed evolution and rational design resulted in an optimized binding towards gp120 of the viral particle of HIV, thus inhibiting cell entry [<xref ref-type="bibr" rid="B110-molecules-17-12533">110</xref>,<xref ref-type="bibr" rid="B111-molecules-17-12533">111</xref>,<xref ref-type="bibr" rid="B112-molecules-17-12533">112</xref>]. CCK peptides in most cases have shown antiviral or bactericidal activity in their wild-type form, but to date only some of them have been grafted towards new bioactivities [<xref ref-type="bibr" rid="B6-molecules-17-12533">6</xref>,<xref ref-type="bibr" rid="B20-molecules-17-12533">20</xref>,<xref ref-type="bibr" rid="B114-molecules-17-12533">114</xref>,<xref ref-type="bibr" rid="B115-molecules-17-12533">115</xref>].</p>
    </sec>
    <sec sec-type="conclusions">
      <title>5. Conclusions and Outlook</title>
      <p>Cystine-knot peptides are defined through their unique architecture which endows them with an extremely high stability and sequence tolerance resulting in promising scaffolds for drug development and chemical genetics. Current synthetic problems, oxidative folding and backbone cyclization, depend on whether cystine-knot peptides are recombinantly produced or chemically synthesized. Head-to-tail macrocyclization is problematic for recombinantly produced peptides, and formation of the three-disulfide pattern for those chemically synthesized. As for large-scale industrial processes, <italic>in vivo</italic> synthesis may become a cost-effective alternative to chemical synthesis, but microorganisms and their respective production conditions need further optimization. Novel pharmaceuticals based on cystine-knot peptides may find their way to clinical trials in the next couple of years. Continuously reported improvements in their functionalization towards modulators of disease-relevant targets in combination with the increasing number of publications for both chemical synthesis and recombinant production provide excellent future prospects.</p>
    </sec>
    </body>
  <back>
    <ack>
      <title>Acknowledgments</title>
      <p>This work was supported by the Deutsche Forschungsgemeinschaft through grant KO 1390/10-1 “Chemoselective reactions for the synthesis and application of functional proteins”.</p>
    </ack>
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