Agonist-induced phosphorylation of the parathyroid hormone (PTH) receptor 1 (PTHR1) regulates receptor signaling in vitro, but the role of this phosphorylation in vivo is uncertain. We investigated this role by injecting "knock-in" mice expressing a phosphorylation-deficient (PD) PTHR1 with PTH ligands and assessing acute biologic responses. Following injection with PTH (1-34), or with a unique, long-acting PTH analog, PD mice, compared with WT mice, exhibited enhanced increases in cAMP levels in the blood, as well as enhanced cAMP production and gene expression responses in bone and kidney tissue. Surprisingly, however, the hallmark hypercalcemic and hypophosphatemic responses were markedly absent in the PD mice, such that paradoxical hypocalcemic and hyperphosphatemic responses were observed, quite strikingly with the long-acting PTH analog. Spot urine analyses revealed a marked defect in the capacity of the PD mice to excrete phosphate, as well as cAMP, into the urine in response to PTH injection. This defect in renal excretion was associated with a severe, PTH-induced impairment in glomerular filtration, as assessed by the rate of FITC-inulin clearance from the blood, which, in turn, was explainable by an overly exuberant systemic hypotensive response. The overall findings demonstrate the importance in vivo of PTH-induced phosphorylation of the PTHR1 in regulating acute ligand responses, and they serve to focus attention on mechanisms that underlie the acute calcemic response to PTH and factors, such as blood phosphate levels, that influence it.calcium homeostasis | family B GPCR | phosphate homeostasis | receptor phosphorylation P arathyroid hormone (PTH) plays a critical role in regulating blood concentrations of ionized calcium by acting via its receptor, the PTH receptor 1 (PTHR1), expressed by target cells of bone and kidney. In response to decreases in blood Ca 2+ levels, PTH thus acts to promote the release of calcium from bone, and the reabsorption of calcium from the glomerular filtrate. PTH also acts to lower blood inorganic phosphate (Pi) by promoting the renal excretion of Pi into the urine. PTH acts in concert with several other calcium-and phosphate-regulating factors, including 1,25(OH) 2 -vitamin-D 3 and FGF23, as part of a tightly regulated homeostatic system of mineral ion control (1). Of note, PTH peptides injected daily at low dose can stimulate new bone formation and are thus in use to treat osteoporosis (2). Because of their calcemic actions, PTH peptides also hold promise as treatments for hypoparathyroidism (3).The PTHR1 is a class B G protein-coupled receptor (GPCR) that signals via the Gαs/cAMP/PKA and Gαq/phopholipase C (PLC)/intracellular calcium (iCa)/PKC pathways (4). In cultured cells, agonist activation of the PTHR1 induces rapid receptor internalization and signal desensitization. As for most GPCRs, the PTHR1 is phosphorylated on its C-terminal tail following agonist activation, and this phosphorylation promotes the internalization and desensitization responses, in large part...