The insulin receptor (IR) and the type-1 insulin-like growth factor receptor (IGF1R) are homologous multidomain proteins that bind insulin and IGF with differing specificity. Here we report the crystal structure of the first three domains (L1-CR-L2) of human IR at 2.3 Å resolution and compare it with the previously determined structure of the corresponding fragment of IGF1R. The most important differences seen between the two receptors are in the two regions governing ligand specificity. The first is at the corner of the ligand-binding surface of the L1 domain, where the side chain of F39 in IR forms part of the ligand binding surface involving the second (central) -sheet. This is very different to the location of its counterpart in IGF1R, S35, which is not involved in ligand binding. The second major difference is in the sixth module of the CR domain, where IR contains a larger loop that protrudes further into the ligand-binding pocket. This module, which governs IGF1-binding specificity, shows negligible sequence identity, significantly more ␣-helix, an additional disulfide bond, and opposite electrostatic potential compared to that of the IGF1R.crystal structure ͉ ectodomain ͉ insulin-binding site T he insulin receptor (IR), like the type-1 insulin-like growth factor receptor (IGF1R), is a member of the receptor tyrosine kinase family, and is a large, transmembrane, glycoprotein dimer consisting of several structural domains (1, 2). The N-terminal half of the ectodomain contains two leucine-rich repeat domains (L1 and L2) separated by a cys-rich region (CR) (1, 3). The C-terminal half of the IR ectodomain consists of three fibronectin type III domains, the second of which contains an insert region of Ϸ120 residues (1, 2).Although there is no high-resolution structural information available for the IR ectodomain, the three-dimensional structure is known for the first three domains (L1-CR-L2) of the closely related IGF1R (4). This structure has provided a framework to interpret previous studies on receptor chimeras, site-specific mutants, and mutants from patients with defective receptors (see refs. 1 and 2) and has guided subsequent studies on the insulin-binding site using mutational analysis (5, 6). Three regions of the ectodomain are known to be involved in low-affinity binding by the soluble IR ectodomain. These are the L1 domain, the CR region and the last 16 residues of the ␣-chain (see refs. 1 and 7). Of these, only the first two (L1 and the CR) are important determinants of ligand specificity, because IR͞IGF1R chimeras of whole receptors (8) or minireceptors (9) are little affected by swapping the regions that contained the last 16 residues of the ␣-chain.The major determinants in L1 for insulin binding specificity lie in the first 68 residues of this domain (10, 11), based on the analysis of receptor chimeras. Twelve residues in this N-terminal segment have been further confirmed as part of the ligand-binding region by site-specific mutagenesis (see Table 1). Surprisingly, nine of these 12 residues a...