Corticosteroid-binding globulin (CBG) is a serine proteinase inhibitor (serpin) family member that transports glucocorticoids in blood and regulates their access to target cells. The 1.9 Å crystal structure of rat CBG shows that its steroid-binding site resembles the thyroxin-binding site in the related serpin, thyroxin-binding globulin, and mutagenesis studies have confirmed the contributions of key residues that constitute the steroid-binding pocket. Unlike thyroxin-bound thyroxin-binding globulin, the cortisol-bound CBG displays an "active" serpin conformation with the proteinase-sensitive, reactive center loop (RCL) fully expelled from the regulatory -sheet A. Moreover, the CBG structure allows us to predict that complete insertion of the proteolytically cleaved RCL into the serpin fold occurs in concert with a displacement and unwinding of helix D that would disrupt the steroid-binding site. This allosteric coupling between RCL positioning and occupancy of the CBG steroidbinding site, which resembles the ligand (glycosamino-glycan)-dependent activation of the thrombin inhibitory serpins heparin cofactor II and anti-thrombin RCLs, ensures both optimal recognition of CBG by target proteinases and efficient release of steroid to sites of action.Glucocorticoid hormones (cortisol and corticosterone) and progesterone are transported in the blood by a glycoprotein known as corticosteroid-binding globulin (CBG) 3 or transcortin (1). Plasma CBG also binds several synthetic glucocorticoids, such as prednisolone (2), and influences the half-life, distribution, and efficacy of these drugs in the same way as for natural steroids (3). The steroid binding characteristics of CBG from many species have been documented (1), and a benchmark set of CBG steroid binding characteristics has be used to develop three-dimensional quantitative structure activity relationship (3D-QSAR) computational methods (4, 5) aimed at predicting the binding affinities of ligands to target proteins. Although residues within CBG sequences critical for steroid binding have been identified through studies of naturally occurring variants (6 -10), photo-affinity labeling (11), and mutagenesis (12), a precise picture of its structure and steroidbinding site has been lacking.The primary structure of CBG defines it as a clade A member of the serine proteinase inhibitor (serpin) superfamily, together with the related transport protein for thyroxin, thyroxin-binding globulin (TBG), and the prototypical serpin members ␣1-antitrypsin (AAT) and ␣1-antichymotrypsin (ACT), among others (13,14). A hallmark of serpin structures is that they undergo conformational rearrangements as part of their biological function. The conformations they adopt are highly dependent on whether a surface-exposed loop, known as the reactive center loop (RCL) or "proteinase bait" domain, is intact. Cleavage of the RCL segment by proteinases usually causes a typical stressed to relaxed (S 3 R) transition in structure (15). This involves insertion of the entire N-terminal segment of t...