Glycoprotein hormones (GPHs) are the main regulators of the pituitary-thyroid and pituitary-gonadal axes. Selective interaction between GPHs and their cognate G protein-coupled receptors ensure specificity in GPH signaling. The mechanisms of how these hormones activate glycoprotein hormone receptors (GPHRs) or how mutations and autoantibodies can alter receptor function were unclear. Based on the hypothesis that GPHRs contain an internal agonist, we systematically screened peptide libraries derived from the ectodomain for agonistic activity on the receptors. We show that a peptide (p10) derived from a conserved sequence in the C-terminal part of the extracellular N terminus can activate all GPHRs in vitro and in GPHR-expressing tissues. Inactivating mutations in this conserved region or in p10 can inhibit activation of the thyroid-stimulating hormone receptor by autoantibodies. Our data suggest an activation mechanism where, upon extracellular ligand binding, this intramolecular agonist isomerizes and induces structural changes in the 7-transmembrane helix domain, triggering G protein activation. This mechanism can explain the pathophysiology of activating autoantibodies and several mutations causing endocrine dysfunctions such as Graves disease and hypo-and hyperthyroidism. Our findings highlight an evolutionarily conserved activation mechanism of GPHRs and will further promote the development of specific ligands useful to treat Graves disease and other dysfunctions of GPHRs.
Glycoprotein hormone receptors (GPHRs)2 were cloned about 25 years ago (1-3) and, since then, the glycoprotein hormones (GPHs) TSH, LH/hCG, and FSH are considered as the agonists for their respective receptors. In contrast to other rhodopsin-like G protein-coupled receptors (GPCRs), they possess a large extracellular leucine-rich repeat (LRR) hormone-binding domain, which is linked via a hinge region (HR) to the 7-transmembrane helix domain (7TM) (see Fig. 1A). Based on the crystal structure of human FSH bound to the receptor's extracellular domain (ECD), it has been suggested that the FSHR grabs the FSH in a "hand-clasp" mode, orienting the hormone to interact with the extracellular loops and juxtamembrane regions of the 7TM to induce signaling (4). However, to date, all attempts to identify agonistic parts of GPHs have failed, and even extreme high concentrations of hCG did not activate the 7TM of LHR lacking the ECD (5).In addition to TSH and thyrostimulin (6), the TSHR can be activated by mutations in the ECD and by ECD-directed autoantibodies, which cause hyperthyroidism and Graves disease, respectively (7). The detailed mechanism of how the ECD integrates the activating actions of TSH, thyrostimulin, mutations, and autoantibodies to trigger GPHR signal transduction is unsolved, although there are numerous mutagenesis studies (5,8) and crystallographic data of the liganded GPHR ECD (4, 9 -11).Based on findings that proteolytic cleavage of the ECD by trypsin, or artificially generated ECD deletions and truncations, can increase TSHR ac...