34The adenosine A 2A receptor (A 2A R) is a prototypical G protein-coupled receptor (GPCR) that 35 couples to the heterotrimeric G protein G S . Here we determine the structure by electron cryo-36 microscopy (cryo-EM) of A 2A R at pH 7.5 bound to the small molecule agonist NECA and 37 coupled to an engineered heterotrimeric G protein, which contains mini-G S , the βγ subunits 38 and nanobody Nb35. Most regions of the complex have a resolution of ~3.8 Å or better. 39 Comparison with the 3.4 Å resolution crystal structure shows that the receptor and mini-G S 40 are virtually identical and that the density of the side chains and ligand are of comparable 41 quality. However, the cryo-EM density map also indicates regions that are flexible in 42 comparison to the crystal structures, which unexpectedly includes regions in the ligand 43 binding pocket. In addition, an interaction between intracellular loop 1 of the receptor and the 44 β subunit of the G protein was observed. 45 46 47 48
49The adenosine A 2A receptor (A 2A R) is an archetypical Class A G protein-coupled 50 receptor (GPCR) 1 . A 2A R is activated by the endogenous agonist adenosine and plays a 51 prominent role in cardiac function, the immune system and central nervous system, including 52 the release of the major excitatory neurotransmitter glutamate 2,3 . Given the widespread tissue 53 distribution and physiological relevance of A 2A R, it is a validated drug target for many 54 disorders 4 , including Parkinson's disease 5 and cancer 6 . A 2A R is one of the most stable GPCRs 55 and structures have been determined of A 2A R in an inactive state bound to inverse agonists 7-56 13 , an active intermediate state bound to agonists 14-16 and the fully active state bound to an 57 agonist and coupled to an engineered G protein, mini-G S 17 . In addition, structure-based drug 58 design has been applied to inactive state structures of A 2A R to develop potent and subtype 59 specific inverse agonists with novel scaffolds 9 and these are currently in clinical trials. 60Comparison of the structures has led to an understanding of the molecular determinants for 61 an inverse agonist compared to an agonist 15 , the conformational changes induced by agonist 62 binding to convert the inactive state to the active intermediate state 18 , and the role of the G 63 protein in stabilising the fully active state 17 . The active state was determined by crystallizing 64 the receptor coupled solely to mini-G S , an engineered G protein with eight point mutations 65 and three deletions, including the whole of the α-helical domain 19 . Although 66 pharmacologically mini-G S recapitulates the ability of a heterotrimeric G protein to increase 67 the affinity of agonist binding to the receptor 17 , the roles for the βγ subunits could not be 68 described. In terms of the interactions between a heterotrimeric G protein and a Class A 69 GPCR, the vast majority of interactions are made by the α subunit, in particular the C-70 terminal α5 helix 20 . However, there was an interaction be...