Structural Mechanisms of SAMD9 Autoinhibition and Pathogenic Dysregulation

SAMD9 and SAMD9L (SAMD9/9L) are large cytosolic proteins essential for hematopoietic homeostasis and antiviral defense1-3. Germline gain-of-function (GoF) mutations in SAMD9/9L cause severe multisystem disorders and predisposition to leukemia, yet the mechanisms that regulate SAMD9/9L activity and how pathogenic mutations disrupt these processes, remain poorly understood. Here, we determine cryo-electron microscopy structures of human SAMD9 in multiple conformational and oligomeric states. We show that SAMD9 predominantly adopts a closed, autoinhibited conformation stabilized by a central ATP-bound nucleotide-binding oligomerization domain (NOD) and an extensive network of intramolecular interactions. Recurrent patient-derived GoF mutations localize to and destabilize these intramolecular interfaces, and restoring the disrupted interactions through compensatory mutations reinstates autoinhibition. We further identify low-abundance asymmetric SAMD9 dimers in which one protomer undergoes large conformational changes and establishes intermolecular interactions that are essential for SAMD9 activation. Together, these findings define the structural basis of SAMD9 autoinhibition and explain how human GoF mutations subvert this regulatory mechanism to drive disease.