Abstract
Outer hair cell electromotility, driven by prestin, is essential for mammalian cochlear amplification. Here, we report the cryo-EM structures of thermostabilized human prestin (hPresTS), complexed with chloride, sulfate, or salicylate at 3.52–3.61 Å resolutions, revealing a crossed dimeric arrangement. The central positively-charged cavity allows flexible binding of various anion species, resulting in distinct modulations of nonlinear capacitance (NLC), playing an important role in electromotility. Comparisons of these hPresTS structures suggest rigid-body movement between the core and gate domains, and provide mechanistic insight into prestin inhibition by salicylate. Mutations at the dimeric interface severely diminished NLC, suggesting that stabilization of the gate domain facilitates core domain movement, thereby contributing to the expression of NLC. These findings advance our understanding of the molecular mechanism underlying mammalian cochlear amplification.