New views into class B GPCRs from the crystal structure of PTH1R

The parathyroid hormone 1 receptor (PTH1R) is a major regulator of mineral ion homeostasis and bone metabolism and is thus considered an attractive drug target for the treatment of disorders in calcium metabolism and bone‐related diseases such as osteoporosis. PTH1R is a member of the class B of GPCRs, which all share a dynamic multidomain binding mechanism to the peptide hormone. For a long time, these complexes have been recalcitrant to structural studies despite their great therapeutic relevance. Through extensive engineering of both the receptor and the peptide agonist ligand, we were able to determine the first high‐resolution structure of a PTH1R–agonist complex. Comparisons of the PTH1R crystal structure with subsequently reported cryo‐electron microscopy structures of the same receptor in complex with a G protein, as well as with other class B GPCR structures bound to antagonists, reveal new insights into the two‐step activation mechanism of class B GPCRs and extend our understanding of the precise molecular rearrangements during receptor activation.