Using bioinformatic tools, mutagenesis, and binding studies, we have investigated the structural organization of the extracellular region of the RET receptor tyrosine kinase, a functional receptor for glial cell linederived neurotrophic factor (GDNF). Multiple sequence alignments of seven vertebrate sequences and one invertebrate RET sequence delineated four distinct N-terminal domains, each of about 110 residues, containing many of the consensus motifs of the cadherin fold. Based on these alignments and the crystal structures of epithelial and neural cadherins, we have generated molecular models of each of the four cadherin-like domains in the extracellular region of human RET. The modeled structures represent realistic models from both energetic and geometrical points of view and are consistent with previous observations gathered from biochemical analyses of the effects of Hirschsprung's disease mutations affecting the folding and stability of the RET molecule, as well as our own site-directed mutagenesis studies of RET cadherin-like domain 1. We have also investigated the role of Ca 2؉ in ligand binding by RET and found that Ca
2؉ions are required for RET binding to GDNF but not for GDNF binding to the GFR␣1 co-receptor. In agreement with these results, RET, but not GFR␣1, was found to bind Ca 2؉ directly. Our results indicate that the overall architecture of the extracellular region of RET is more closely related to cadherins than previously thought. The models of the cadherin-like domains of human RET represent valuable tools with which to guide future site-directed mutagenesis studies aimed at identifying residues involved in ligand binding and receptor activation.The RET receptor tyrosine kinase is an unusual receptor from many points of view. It cannot by itself bind its ligand, GDNF, 1 unless in a complex with another protein, the glycosyl phosphatidylinositol-anchored receptor GFR␣1 (1, 2). In contrast with other receptor tyrosine kinases, there appears to be only one RET homologue in all species investigated so far. All members of the GDNF ligand family utilize RET as a signal transducing receptor subunit, with specificity being determined by cooperation between RET and different members of the GFR␣ family of glycosyl phosphatidylinositol-anchored receptors (1, 2). Both gain-and loss-of-function mutations in the RET gene have been identified in human diseases. Mutations in RET of patients with multiple endocrine neuroplasias type 2A and 2B and familial medullary thyroid carcinoma induce constitutive activation of the RET tyrosine kinase and lead to congenital and sporadic cancers in neuroendocrine organs (3, 4). On the other hand, loss-of-function mutations in RET cause a dominant genetic disorder of neural crest development known as Hirschsprung's disease (HSCR), which results in the death of neurons in distal segments of the enteric nervous systems and colon aganglionosis (5).The extracellular region of the RET molecule is peculiar compared with that found in other receptor tyrosine kinases in that ...