4.1 G-Protein Coupled Receptors (GPCRs)

GPCRs are the largest family of membrane receptors and represent ~34% of all FDA-approved drug targets. These seven-transmembrane domain receptors transduce extracellular signals through G-proteins to activate intracellular signaling cascades.

Structure and Mechanism

Seven Transmembrane Domains

GPCRs span the membrane seven times forming a characteristic structure:

  • • Extracellular N-terminus (ligand binding site)
  • • Seven α-helical transmembrane segments (TM1-TM7)
  • • Three extracellular loops (ECL1-3)
  • • Three intracellular loops (ICL1-3)
  • • Intracellular C-terminus (G-protein coupling domain)

G-Protein Activation Cycle

1. Ligand binding → 2. Conformational change → 3. G-protein coupling → 4. GDP/GTP exchange → 5. G-protein dissociation (Gα-GTP + Gβγ) → 6. Effector activation → 7. GTP hydrolysis → 8. Reassociation

G-Protein Subtypes and Signaling

Gαs (Stimulatory)

Effector: Adenylyl cyclase ↑

Second messenger: cAMP ↑ → PKA activation

Examples: β-adrenergic receptors, D1 dopamine, H2 histamine, glucagon

Gαi/o (Inhibitory)

Effector: Adenylyl cyclase ↓

Second messenger: cAMP ↓

Examples: α2-adrenergic, M2/M4 muscarinic, D2 dopamine, opioid receptors (μ/δ/κ)

Gαq/11

Effector: Phospholipase C (PLC) ↑

Second messengers: IP3 (Ca²⁺ release) + DAG (PKC activation)

Examples: α1-adrenergic, M1/M3/M5 muscarinic, H1 histamine, angiotensin II

Gα12/13

Effector: Rho GEFs

Pathway: Rho/ROCK pathway

Effects: Cytoskeletal reorganization, smooth muscle contraction

Major GPCR Drug Classes

β-Adrenergic Agonists/Antagonists

Agonists: Albuterol (β2, asthma), isoproterenol (β1/β2) | Antagonists: Propranolol (β1/β2, hypertension), metoprolol (β1, heart failure)

Opioid Receptor Agonists

Morphine, fentanyl, oxycodone (μ-agonists, analgesia) | Naloxone (antagonist, overdose reversal)

Antihistamines

H1 antagonists: Diphenhydramine, loratadine (allergies) | H2 antagonists: Ranitidine (GERD)

Dopamine Modulators

D2 antagonists: Haloperidol, risperidone (antipsychotics) | D1/D2 agonists: Levodopa (Parkinson's)

Serotonin Modulators

5-HT1B/D agonists: Sumatriptan (migraines) | 5-HT2A antagonists: Atypical antipsychotics

Angiotensin Receptor Blockers (ARBs)

Losartan, valsartan (AT1 antagonists, hypertension)

GPCR Regulation

Desensitization

Rapid loss of response despite continued agonist presence. Mechanisms: 1) Receptor phosphorylation by GRKs (GPCR kinases) → 2) β-arrestin binding → 3) Receptor uncoupling from G-proteins

Internalization

Receptor endocytosis via clathrin-coated pits. β-arrestin serves as adaptor protein. Internalized receptors can be: 1) Recycled to membrane, or 2) Degraded in lysosomes

Downregulation

Chronic agonist exposure → decreased total receptor number. Mechanisms: Reduced transcription, increased degradation

Upregulation

Chronic antagonist use → increased receptor expression (supersensitivity). Clinical relevance: Rebound effects upon drug withdrawal

Clinical Significance

Why GPCRs are Druggable

  • • Large, accessible ligand-binding pocket
  • • High structural diversity → selective targeting possible
  • • Modulate critical physiological processes
  • • Both agonists and antagonists therapeutically useful
  • • Biased agonism enables selective pathway activation

Therapeutic Areas

Cardiovascular (β-blockers, ARBs), CNS (antidepressants, antipsychotics, opioids), Respiratory (β2-agonists), GI (antiemetics), Endocrine (GLP-1 agonists), Oncology (CXCR4 antagonists)