Heterodimeric integrin adhesion receptors regulate diverse biological processes including angiogenesis, thrombosis and wound healing. The transmembrane-cytoplasmic domains (TMCDs) of integrins play a critical role in controlling activation of these receptors via an inside-out signaling mechanism, but the precise structural basis remains elusive. Here, we present the solution structure of integrin ␣IIb3 TMCD heterodimer, which reveals a righthanded coiled-coil conformation with 2 helices intertwined throughout the transmembrane region. The helices extend into the cytoplasm and form a clasp that differs significantly from a recently published ␣IIb3 TMCD structure. We show that while a point mutation in the clasp interface modestly activates ␣IIb3, additional mutations in the transmembrane interface have a synergistic effect, leading to extensive integrin activation. Detailed analyses and structural comparison with previous studies suggest that extensive integrin activation is a highly concerted conformational transition process, which involves transmembrane coiled-coil unwinding that is triggered by the membrane-mediated alteration and disengagement of the membrane-proximal clasp. Our results provide atomic insight into a type I transmembrane receptor heterocomplex and the mechanism of integrin inside-out transmembrane signaling.NMR ͉ protein structure ͉ transmembrane domain I ntegrins are a major class of cell adhesion receptors that are found in almost every living organism (1). They are obligate heterodimers (␣,) in which each subunit is composed of a large extracellular domain, a single pass transmembrane (TM) segment, and a small cytoplasmic tail (CT). Integrins interact with extracellular matrix (ECM) proteins via their extracellular domains and with intracellular proteins via their CTs. This interconnection allows integrins to regulate diverse cellular adhesive processes. A central and unresolved issue in integrin biology is the molecular basis for signal transmission across the cell membrane. A large body of genetic, cell biological, and biochemical data indicate that the conformational states of integrin ␣/ transmembrane-cytoplasmic domains (TMCDs) control the ability of integrins to bind extracellular ligands (inside-out signaling) and to cluster and form focal adhesions (outside-in signaling) (for reviews see refs. 1 and 2). Biochemical and structural evidence suggests that the ␣/ TMCDs associate via both their TMs (3-6) and their CTs (7-9) to maintain integrins in a resting state. Dissociation of the TMs or CTs triggers receptor activation and signaling (7,(10)(11)(12)(13)(14). However, many different computational models for the TM association exist (3-5, 11, 13, 15-18) and the structural analyses of the CT interaction are inconsistent (6)(7)(8)(9)19). Earlier studies failed to observe heterodimeric TMCD interaction in micelles (20), which reflects the technical difficulty in structurally characterizing this kind of transmembrane heterodimers (21). Here, we have successfully determined the NMR ...