Neuropeptide S (NPS) and its receptor (NPSR) are thought to have a role in asthma pathogenesis; a number of single nucleotide polymorphisms within NPSR have been shown to be associated with an increased prevalance of asthma. One such single nucleotide polymorphism leads to the missense mutation N107I, which results in an increase in the potency of NPS for NPSR. To gain insight into structure-function relationships within NPS and NPSR, we first carried out a limited structural characterization of NPS and subjected the peptide to extensive mutagenesis studies. Our results show that the NH 2 -terminal third of NPS, in particular residues Phe-2, Arg-3, Asn-4, and Val-6, are necessary and sufficient for activation of NPSR. Furthermore, part of a nascent helix within the peptide, spanning residues 5 through 13, acts as a regulatory region that inhibits receptor activation. Notably, this inhibition is absent in the asthma-linked N107I variant of NPSR, suggesting that residue 107 interacts with the aforementioned regulatory region of NPS. Whereas this interaction may be at the root of the increase in potency associated with the N107I variant, we show here that the mutation also causes an increase in cell-surface expression of the mutant receptor, leading to a concomitant increase in the maximal efficacy (E max ) of NPS. Our results identify the key residues of NPS involved in NPSR activation and suggest a molecular basis for the functional effects of the N107I mutation and for its putative pathophysiological link with asthma.Asthma is a multifactorial disease with both genetic and environmental components that is characterized by an exaggerated immune response induced upon exposure to antigens. The disease has become a major public health concern as its incidence has increased dramatically in recent years, particularly in developed countries (for a recent review, see Ref. 1). Studies in animal models have identified several genes and proteins that contribute to the asthmatic phenotype, although a complete understanding of the interplay between these factors, and their role in human disease, remains elusive (2).A number of genetic-linkage studies have recently been carried out to identify possible therapeutic targets for asthma that are relevant in man. One approach, involving whole genome scanning followed by refined genetic mapping, has led to the recent identification of four specific candidate genes (3-6). One of these, GPR154, encoding neuropeptide S receptor (NPSR) 4 (4, 7), also known as G protein receptor for asthma susceptibility (GPRA) (4), GPR154 (8), and vasopressin receptor-related receptor 1 (VRR1) (9), has been confirmed as an asthma-linked gene in five distinct Caucasian populations (4, 10, 11). The gene for NPSR encodes at least two splice variants that differ only in their C termini (4, 12) and are referred to herein as NPSR-A and NPSR-B, corresponding to GPRA-A and GPRA-B (4), respectively. A number of single nucleotide polymorphisms in the NPSR sequence are associated with asthma, elevated serum IgE l...