Prostaglandin E 2 (PGE 2 ) is a key mediator in inflammatory response. The main source of inducible PGE 2 , microsomal PGE 2 synthase-1 (mPGES-1), has emerged as an interesting drug target for treatment of pain. To support inhibitor design, we have determined the crystal structure of human mPGES-1 to 1.2 Å resolution. The structure reveals three well-defined active site cavities within the membrane-spanning region in each monomer interface of the trimeric structure. An important determinant of the active site cavity is a small cytosolic domain inserted between transmembrane helices I and II. This extra domain is not observed in other structures of proteins within the MAPEG (MembraneAssociated Proteins involved in Eicosanoid and Glutathione metabolism) superfamily but is likely to be present also in microsomal GST-1 based on sequence similarity. An unexpected feature of the structure is a 16-Å-deep cone-shaped cavity extending from the cytosolic side into the membrane-spanning region. We suggest a potential role for this cavity in substrate access. Based on the structure of the active site, we propose a catalytic mechanism in which serine 127 plays a key role. We have also determined the structure of mPGES-1 in complex with a glutathione-based analog, providing insight into mPGES-1 flexibility and potential for structure-based drug design.membrane protein | X-ray crystallography | enzyme mechanism P rostaglandins are potent lipid messengers and are involved in numerous homeostatic biological functions [for a review of eicosanoid biology, see review by C. D. Funk (1)]. They are enzymatically derived from the essential fatty acid arachidonic acid and the synthesis proceeds via the formation of prostaglandin H 2 (PGH 2 ), a reaction catalyzed by the constitutively active cyclooxygenase COX-1 and the inducible cyclooxygenase COX-2. PGH 2 acts as a substrate for a range of terminal prostaglandin synthases, including the PGE synthases (PGES, EC 5.3.99.3) that convert PGH 2 to PGE 2 .Microsomal prostaglandin E 2 synthase-1 (mPGES-1), colocalized and up-regulated in concert with COX-2, is the major source of inducible PGE 2 and is associated with inflammation and pain (2). Several studies support a role for mPGES-1 also in cancer cell proliferation and tumor growth (3). Because treatment with COX-2 selective inhibitors is associated with elevated cardiovascular risk, safer approaches involving, for example, PGE 2 reduction, are needed (4). Mice deficient in mPGES-1 have shown significantly reduced effect on hypertension, thrombosis, and myocardial damage compared with inhibition or disruption of COX-2, suggesting mPGES-1 to be a potential target for pharmaceutical intervention in various areas of diseases (2, 5).mPGES-1 belongs to a superfamily of Membrane-Associated Proteins involved in Eicosanoid and Glutathione metabolism, the MAPEG family (6). Members of the MAPEG family can be found in prokaryotes and eukaryotes but not in archaea (7). The most closely related MAPEG member is the microsomal glutathione transferase-1...