Calcium-sensing receptor

Last updated
CASR
Available structures
PDB Ortholog search: PDBe RCSB
Identifiers
Aliases CASR , CAR, EIG8, FHH, FIH, GPRC2A, HHC, HHC1, HYPOC1, NSHPT, PCAR1, calcium sensing receptor, hCasR, Calcium-sensing receptor+CaSR
External IDs OMIM: 601199 MGI: 1351351 HomoloGene: 332 GeneCards: CASR
Orthologs
SpeciesHumanMouse
Entrez

846

12374

Ensembl

ENSG00000036828

ENSMUSG00000051980

UniProt

P41180

Q9QY96

RefSeq (mRNA)

NM_000388
NM_001178065

NM_013803

RefSeq (protein)

NP_000379
NP_001171536

NP_038831

Location (UCSC) Chr 3: 122.18 – 122.29 Mb Chr 16: 36.31 – 36.38 Mb
PubMed search [3] [4]
Wikidata
View/Edit Human View/Edit Mouse

The calcium-sensing receptor (CaSR) is a Class C G-protein coupled receptor which senses extracellular levels of calcium ions. It is primarily expressed in the parathyroid gland, the renal tubules of the kidney and the brain. [5] [6] In the parathyroid gland, it controls calcium homeostasis by regulating the release of parathyroid hormone (PTH). [7] In the kidney it has an inhibitory effect on the reabsorption of calcium, potassium, sodium, and water depending on which segment of the tubule is being activated. [8]

Contents

Since the initial review of CaSR, [9] there has been in-depth analysis of its role related to parathyroid disease and other roles related to tissues and organs in the body. 1993, Brown et al. [10] isolated a clone named BoPCaR (bovine parathyroid calcium receptor) which replicated the effect when introduced to polyvalent cations. Because of this, the ability to clone full-length CaSRs from mammals were performed. [11]

Structure

Each protomer of the receptor has a large, N-terminal extracellular domain that linked to create VFT (Venus flytrap) domain. The receptor has a CR (cysteine-rich) domain that links the VFT to the 7 transmembrane domains of the receptor. The 7 transmembrane domain is followed by a long cytoplasmatic tail. The tail has no structure, but still, it has an important role in trafficking and phosphorylation. [12]

The CaSR is a homodimer receptor. The signal transmission occurs only when the agonist binds to the homodimer of the CaSR. Binding of a single protomer will not lead to signal transmission. In vitro experiments showed that the receptor can form a heterodimer with mGlu1/5 or with GABAB receptor. The heterodimerization may facilitate the varied functional roles of the CaSR in different tissues, particularly in the brain.

The CryoEM structures of CasR homodimer was recentlly solved

Calcium-Sensing Receptor Extracellular Domain

The VFT extends outside the cell and is composed of two lobe subdomains. Each lobe forms part of the ligand binding cleft.

In contrast to the conservative structure of other class C GPCR receptors, the CaSR cleft is an allosteric or co-agonist binding site, with the cations (Ca2+) binding elsewhere.

The inactive state of the receptor has two extracellular domains, oriented in an open conformation with an empty intradomain part. When the receptor is activated, the two lobes interact with each other and creates a rotation of the interdomain cleft. [13]

Cation Binding Sites

The cation binding sites varied in their location and in the number of repetitive appearances. [13]

The receptor has four Calcium binding sites that have a role in the stabilization [13] of the extracellular domain (ECD) and in the activation of the receptor. The stabilization maintains the receptor in its active conformation.

Calcium cations bind to the first Calcium binding site in the inactive conformation. In the second binding site, Calcium cations are bound to both the active and inactive structures. In the third binding Site, the binding of the calcium facilitates the closure of lobe 1 and 2. This closure permits the interaction between the two lobes. The fourth binding site is located on lobe 2 in a place close to the CR domain. The agonist binding to the fourth binding site leads formation of homodimer interface bridge. This bridge between lobe 2 domain of subunit 1 and the CR domain of subunit 2, stabilize the open conformation.

The order of Calcium binding affinity to four of the bindings sites is as follows: 1 = 2 > 3 > 4. The lower affinity of Calcium to site 4 indicates that the receptor is activated only when the calcium concentration is elevated above the required concentration. That behavior makes the binding of calcium at site 4 to hold a major role in stabilization.

The CaSR also has binding sites for Magnesium and Gadolinium.

Anion Binding Sites

There are four anion binding sites in the ECD. Sites 1-3 are occupied in the inactive structure, whereas in the active structure only sites 2 and 4 are occupied.

Calcium-Sensing Receptor 7- Transmembrane Domain

Based on a similarity of CaSR to mGlu5, it is believed that in the inactivated form of the receptor, the VFT domain disrupts the interface between the 7TM domains, and the activation of the receptor force a reorientation of the 7TM domains. [14]

Signal transduction

The inactivated form of the receptor has an open conformation. upon binding of the fourth binding site, the structure of the receptor changes to a close conformation. The change in the structure conformation leads to inhibition of PTH release.

On the intracellular side, initiates the phospholipase C pathway, [15] [16] presumably through a Gqα type of G protein, which ultimately increases intracellular concentration of calcium, which inhibits vesicle fusion and exocytosis of parathyroid hormone. It also inhibits (not stimulates, as some [17] sources state) the cAMP dependent pathway. [16]

Ligands

Agonist

Positive allosteric modulators

Negative allosteric modulators

  • NPS 2143
  • Ronacaleret
  • Calhex 231

Antagonist

  • Calcilytics
  • Phosphate [20]

It is unknown whether Ca2+ alone can activate the receptor, but L-amino acids and g-Glutamyl peptides are shown to act as co-activator of the receptor. Those molecules intensify the intracellular responses evoked by Calcium cation. [21]

Pathology

Mutations that inactivate a CaSR gene cause familial hypocalciuric hypercalcemia (FHH) (also known as familial benign hypercalcemia because it is generally asymptomatic and does not require treatment), [22] when present in heterozygotes. Patients who are homozygous for CaSR inactivating mutations have more severe hypercalcemia. [23] Other mutations that activate CaSR are the cause of autosomal dominant hypocalcemia [24] or Type 5 Bartter syndrome. An alternatively spliced transcript variant encoding 1088 aa has been found for this gene, but its full-length nature has not been defined. [25]

Role in Chronic kidney disease

In CKD, the dysregulation of CaSR leads to a secondary hyperparathyroidism linked with osteoporosis, which considered as one of the main complications.

Patients suffers from secondary hyperparathyroidism require to make changes in their diet in order to balance the disease. [26] The diet recommendation includes restriction of Calcium, phosphate, and protein intake. Those nutrients are abundance in our diet and because of that, avoiding foods that contains those nutrients may limit our dietary options and can lead to other nutrients deficiencies.

Therapeutic application

The drugs cinacalcet and etelcalcetide are allosteric modifiers of the calcium-sensing receptor. [27] They are classified as a calcimimetics, binding to the calcium-sensing receptor and decreasing parathyroid hormone release.

Calcilytic drugs, which block CaSR, produce increased bone density in animal studies and have been researched for the treatment of osteoporosis. Unfortunately clinical trial results in humans have proved disappointing, with sustained changes in bone density not observed despite the drug being well tolerated. [28] [29] More recent research has shown the CaSR receptor to be involved in numerous other conditions including Alzheimer's disease, asthma and some forms of cancer, [30] [31] [32] [33] and calcilytic drugs are being researched as potential treatments for these. Recently it has been shown that biomimetic bone like apatite inhibits formation of bone through endochondral ossification pathway via hyperstimulation of extracellular calcium sensing receptor. [34]

Transactivation across the dimer can result in unique pharmacology for CaSR allosteric modulators. For example, Calhex 231, which shows a positive allosteric activity when bound to the allosteric site in just one protomer. In contrast, it shows a negative allosteric activity when occupying both the allosteric sites of the dimer. [18]

Interactions

Calcium-sensing receptor has been shown to interact with filamin. [35] [36]

Role in sensory evaluation of food

Kokumi was discovered in Japan, 1989. It is defined as a sensation that enhances existing flavors and creates feelings of roundness, complexity, and richness in the mouth. The kokumi is present in different foods such as fish sauce, soybean, garlic, beans, etc. [37] The Kokumi substances are Gamma-glutamyl peptides.

CaSR is known to be expressed in the parathyroid gland and kidneys, but recent experiments showed that the receptor is also expressed in the alimentary canal (known as the digestive tract) and the near the taste buds on the back of the tongue. [38]

Gamma-glutamyl peptides are allosteric modulators of the CaSR, and the binding of those peptides to the CaSR on the tongue is what mediates the Kokumi sensation in the mouth.

In the mouth, unlike in other tissues, the influx of the extracellular Calcium does not affect the receptor activity. Instead, the activation of the CaSR is by the binding of the Gamma glutamine peptides.

Taste signal involves a release of intracellular calcium as respond to the molecule binding to the taste receptor, leads to secretion of neurotransmitter and taste perception. The simultaneous binding of gamma glutamine peptides to the CaSR increases the level of the intracellular calcium, and that intensify the taste perception. [38] [39] [37]

Related Research Articles

<span class="mw-page-title-main">Calcium in biology</span> Use of calcium by organisms

Calcium ions (Ca2+) contribute to the physiology and biochemistry of organisms' cells. They play an important role in signal transduction pathways, where they act as a second messenger, in neurotransmitter release from neurons, in contraction of all muscle cell types, and in fertilization. Many enzymes require calcium ions as a cofactor, including several of the coagulation factors. Extracellular calcium is also important for maintaining the potential difference across excitable cell membranes, as well as proper bone formation.

<span class="mw-page-title-main">Parathyroid hormone</span> Mammalian protein found in Homo sapiens

Parathyroid hormone (PTH), also called parathormone or parathyrin, is a peptide hormone secreted by the parathyroid glands that regulates the serum calcium concentration through its effects on bone, kidney, and intestine.

<span class="mw-page-title-main">Calcitonin</span> Amino acid peptide hormone secreted by the thyroid gland

Calcitonin is a 32 amino acid peptide hormone secreted by parafollicular cells (also known as C cells) of the thyroid (or endostyle) in humans and other chordates in the ultimopharyngeal body. It acts to reduce blood calcium (Ca2+), opposing the effects of parathyroid hormone (PTH).

Hypercalcemia, also spelled hypercalcaemia, is a high calcium (Ca2+) level in the blood serum. The normal range is 2.1–2.6 mmol/L (8.8–10.7 mg/dL, 4.3–5.2 mEq/L), with levels greater than 2.6 mmol/L defined as hypercalcemia. Those with a mild increase that has developed slowly typically have no symptoms. In those with greater levels or rapid onset, symptoms may include abdominal pain, bone pain, confusion, depression, weakness, kidney stones or an abnormal heart rhythm including cardiac arrest.

Disorders of calcium metabolism occur when the body has too little or too much calcium. The serum level of calcium is closely regulated within a fairly limited range in the human body. In a healthy physiology, extracellular calcium levels are maintained within a tight range through the actions of parathyroid hormone, vitamin D and the calcium sensing receptor. Disorders in calcium metabolism can lead to hypocalcemia, decreased plasma levels of calcium or hypercalcemia, elevated plasma calcium levels.

<span class="mw-page-title-main">Parathyroid chief cell</span>

Parathyroid chief cells are one of the two cell types of the parathyroid glands, along with oxyphil cells. The chief cells are much more prevalent in the parathyroid gland than the oxyphil cells. It is perceived that oxyphil cells may be derived from chief cells at puberty, as they are not present at birth like chief cells.

<span class="mw-page-title-main">Hyperparathyroidism</span> Increase in parathyroid hormone levels in the blood

Hyperparathyroidism is an increase in parathyroid hormone (PTH) levels in the blood. This occurs from a disorder either within the parathyroid glands or as response to external stimuli. Symptoms of hyperparathyroidism are caused by inappropriately normal or elevated blood calcium excreted from the bones and flowing into the blood stream in response to increased production of parathyroid hormone. In healthy people, when blood calcium levels are high, parathyroid hormone levels should be low. With long-standing hyperparathyroidism, the most common symptom is kidney stones. Other symptoms may include bone pain, weakness, depression, confusion, and increased urination. Both primary and secondary may result in osteoporosis.

Ryanodine receptors form a class of intracellular calcium channels in various forms of excitable animal tissue like muscles and neurons. There are three major isoforms of the ryanodine receptor, which are found in different tissues and participate in different signaling pathways involving calcium release from intracellular organelles. The RYR2 ryanodine receptor isoform is the major cellular mediator of calcium-induced calcium release (CICR) in animal cells.

<span class="mw-page-title-main">Cinacalcet</span> Chemical compound

Cinacalcet, sold under the brand name Sensipar among others, is a medication used to treat tertiary hyperparathyroidism, parathyroid carcinoma, and primary hyperparathyroidism. Cinacalcet acts as a calcimimetic by allosteric activation of the calcium-sensing receptor that is expressed in various human organ tissues.

<span class="mw-page-title-main">Calcitriol</span> Active form of vitamin D

Calcitriol is the active form of vitamin D, normally made in the kidney. It is also known as 1,25-dihydroxycholecalciferol. It is a hormone which binds to and activates the vitamin D receptor in the nucleus of the cell, which then increases the expression of many genes. Calcitriol increases blood calcium (Ca2+) mainly by increasing the uptake of calcium from the intestines.

<span class="mw-page-title-main">Primary hyperparathyroidism</span> Medical condition

Primary hyperparathyroidism is a medical condition where the parathyroid gland produce excess amounts of parathyroid hormone (PTH). The symptoms of the condition relate to the resulting elevated serum calcium (hypercalcemia), which can cause digestive symptoms, kidney stones, psychiatric abnormalities, and bone disease.

<span class="mw-page-title-main">Secondary hyperparathyroidism</span> Medical condition

Secondary hyperparathyroidism is the medical condition of excessive secretion of parathyroid hormone (PTH) by the parathyroid glands in response to hypocalcemia, with resultant hyperplasia of these glands. This disorder is primarily seen in patients with chronic kidney failure. It is sometimes abbreviated "SHPT" in medical literature.

<span class="mw-page-title-main">Tertiary hyperparathyroidism</span> Medical condition

Tertiary hyperparathyroidism is a condition involving the overproduction of the hormone, parathyroid hormone, produced by the parathyroid glands. The parathyroid glands are involved in monitoring and regulating blood calcium levels and respond by either producing or ceasing to produce parathyroid hormone. Anatomically, these glands are located in the neck, para-lateral to the thyroid gland, which does not have any influence in the production of parathyroid hormone. Parathyroid hormone is released by the parathyroid glands in response to low blood calcium circulation. Persistent low levels of circulating calcium are thought to be the catalyst in the progressive development of adenoma, in the parathyroid glands resulting in primary hyperparathyroidism. While primary hyperparathyroidism is the most common form of this condition, secondary and tertiary are thought to result due to chronic kidney disease (CKD). Estimates of CKD prevalence in the global community range from 11 to 13% which translate to a large portion of the global population at risk of developing tertiary hyperparathyroidism. Tertiary hyperparathyroidism was first described in the late 1960s and had been misdiagnosed as primary prior to this. Unlike primary hyperparathyroidism, the tertiary form presents as a progressive stage of resolved secondary hyperparathyroidism with biochemical hallmarks that include elevated calcium ion levels in the blood, hypercalcemia, along with autonomous production of parathyroid hormone and adenoma in all four parathyroid glands. Upon diagnosis treatment of tertiary hyperparathyroidism usually leads to a surgical intervention.

<span class="mw-page-title-main">TRPV6</span> Protein-coding gene in the species Homo sapiens

TRPV6 is a membrane calcium (Ca2+) channel protein which is particularly involved in the first step in Ca2+absorption in the intestine.

<span class="mw-page-title-main">Parathyroid hormone 1 receptor</span> Protein-coding gene in the species Homo sapiens

Parathyroid hormone/parathyroid hormone-related peptide receptor, also known as parathyroid hormone 1 receptor (PTH1R), is a protein that in humans is encoded by the PTH1R gene. PTH1R functions as a receptor for parathyroid hormone (PTH) and for parathyroid hormone-related protein (PTHrP), also called parathyroid hormone-like hormone (PTHLH).

<span class="mw-page-title-main">Parathyroid hormone 2 receptor</span> Protein-coding gene in the species Homo sapiens

Parathyroid hormone 2 receptor is a protein that in humans is encoded by the PTH2R gene.

<span class="mw-page-title-main">Parathyroid carcinoma</span> Medical condition

Parathyroid carcinoma is a rare cancer resulting in parathyroid adenoma to carcinoma progression. It forms in tissues of one or more of the parathyroid glands.

Familial hypocalciuric hypercalcemia (FHH) is an inherited condition that can cause hypercalcemia, a serum calcium level typically above 10.2 mg/dL; although uncommon. It is also known as familial benign hypocalciuric hypercalcemia (FBHH) where there is usually a family history of hypercalcemia which is mild, a urine calcium to creatinine ratio <0.01, and urine calcium <200 mg/day.

A calcimimetic is a pharmaceutical drug that mimics the action of calcium on tissues, by allosteric activation of the calcium-sensing receptor that is expressed in various human organ tissues. Calcimimetics are used to treat secondary hyperparathyroidism (SHPT).

<span class="mw-page-title-main">Etelcalcetide</span> Chemical compound

Etelcalcetide is a calcimimetic drug for the treatment of secondary hyperparathyroidism in patients undergoing hemodialysis. It is administered intravenously at the end of each dialysis session. Etelcalcetide functions by binding to and activating the calcium-sensing receptor in the parathyroid gland. Parsabiv is currently owned by Amgen and Ono Pharmaceuticals in Japan.

References

  1. 1 2 3 GRCh38: Ensembl release 89: ENSG00000036828 - Ensembl, May 2017
  2. 1 2 3 GRCm38: Ensembl release 89: ENSMUSG00000051980 - Ensembl, May 2017
  3. ↑ "Human PubMed Reference:". National Center for Biotechnology Information, U.S. National Library of Medicine.
  4. ↑ "Mouse PubMed Reference:". National Center for Biotechnology Information, U.S. National Library of Medicine.
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  9. ↑ Brown, E. M.; Pollak, M.; Riccardi, D.; Hebert, S. C. (1994). "Cloning and characterization of an extracellular Ca(2+)-sensing receptor from parathyroid and kidney: new insights into the physiology and pathophysiology of calcium metabolism". Nephrology, Dialysis, Transplantation. 9 (12): 1703–1706. ISSN   0931-0509. PMID   7708247.
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  12. ↑ Leach, Katie; Hannan, Fadil M.; Josephs, Tracy M.; Keller, Andrew N.; Møller, Thor C.; Ward, Donald T.; Kallay, Enikö; Mason, Rebecca S.; Thakker, Rajesh V.; Riccardi, Daniela; Conigrave, Arthur D.; Bräuner-Osborne, Hans (2020-05-28). "International Union of Basic and Clinical Pharmacology. CVIII. Calcium-Sensing Receptor Nomenclature, Pharmacology, and Function". Pharmacological Reviews. 72 (3): 558–604. doi:10.1124/pr.119.018531. ISSN   0031-6997. PMC   7116503 . PMID   32467152.
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  31. ↑ Aggarwal A, Prinz-Wohlgenannt M, Tennakoon S, Höbaus J, Boudot C, Mentaverri R, Brown EM, Baumgartner-Parzer S, Kállay E (Feb 2015). "The calcium-sensing receptor: A promising target for prevention of colorectal cancer". Biochimica et Biophysica Acta (BBA) - Molecular Cell Research. 1853 (9): 2158–67. doi:10.1016/j.bbamcr.2015.02.011. PMC   4549785 . PMID   25701758.
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  34. ↑ Sarem M, Heizmann M, Barbero A, Martin I, Shastri VP (July 2018). "Hyperstimulation of CaSR in human MSCs by biomimetic apatite inhibits endochondral ossification via temporal down-regulation of PTH1R". Proceedings of the National Academy of Sciences of the United States of America. 115 (27): E6135–E6144. Bibcode:2018PNAS..115E6135S. doi: 10.1073/pnas.1805159115 . PMC   6142224 . PMID   29915064.
  35. ↑ Hjälm G, MacLeod RJ, Kifor O, Chattopadhyay N, Brown EM (Sep 2001). "Filamin-A binds to the carboxyl-terminal tail of the calcium-sensing receptor, an interaction that participates in CaR-mediated activation of mitogen-activated protein kinase". The Journal of Biological Chemistry. 276 (37): 34880–7. doi: 10.1074/jbc.M100784200 . PMID   11390380.
  36. ↑ Awata H, Huang C, Handlogten ME, Miller RT (Sep 2001). "Interaction of the calcium-sensing receptor and filamin, a potential scaffolding protein". The Journal of Biological Chemistry. 276 (37): 34871–9. doi: 10.1074/jbc.M100775200 . PMID   11390379.
  37. 1 2 Amino, Yusuke; Nakazawa, Masakazu; Kaneko, Megumi; Miyaki, Takashi; Miyamura, Naohiro; Maruyama, Yutaka; Eto, Yuzuru (2016). "Structure–CaSR–Activity Relation of Kokumi γ-Glutamyl Peptides". Chemical and Pharmaceutical Bulletin. 64 (8): 1181–1189. doi: 10.1248/cpb.c16-00293 . PMID   27477658.
  38. 1 2 Ohsu, Takeaki; Amino, Yusuke; Nagasaki, Hiroaki; Yamanaka, Tomohiko; Takeshita, Sen; Hatanaka, Toshihiro; Maruyama, Yutaka; Miyamura, Naohiro; Eto, Yuzuru (January 2010). "Involvement of the Calcium-sensing Receptor in Human Taste Perception". Journal of Biological Chemistry. 285 (2): 1016–1022. doi: 10.1074/jbc.m109.029165 . ISSN   0021-9258. PMC   2801228 . PMID   19892707.
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