Recently, a naturally occurring variant of the human thyrotropin receptor with a Pro52Thr substitution in the N-terminal extracellular domain of the receptor has been identified. To determine the functional significance of this substitution, cDNAs of wild-type and variant thyrotropin receptors were stably expressed in Chinese hamster ovary cells. The Pro52Thr substitution did not affect synthesis and membrane localization of the receptor, as evidenced by '251-thyrotropin binding analysis to intact cells. The variant receptor and the wild-type receptor were expressed in equivalent numbers and displayed identical binding affinity for thyrotropin. Strikingly, thyrotropin increased cAMP accumulation to a much greater extent in cells expressing the variant receptor as compared to the wild-type receptor-expressing cells. Basal and cholera toxin-stimulated or forskolin-stimulated cAMP levels were not different. It is concluded that the Pro52Thr substitution in the N-terminal region of the human thyrotropin receptor produces a receptor protein with enhanced coupling to cAMP production. This naturally occurring hyperactive thyrotropin receptor may participate in hyperthyroidism of patients with Graves' disease.Keywords: thyrotropin receptor variant; CAMP; Chinese hamster ovary cells ; Graves' disease.Thyrotropin exerts its effects on the thyroid cell by binding to specific receptors on the cell surface. The thyrotropin receptor belongs to the superfamily of seven-transmembrane receptors that activate signal-transduction pathways through their interaction with guanine-nucleotide-binding regulatory proteins (G proteins) [I -41. The receptor represents one member of a subfamily of glycoprotein hormone receptors that also includes the follitropin receptor and the lutropin receptor [5-lo], and members of this subfamily are characterized by a large N-terminal extracellular domain. As demonstrated for the thyrotropin receptor, this extracellular domain is essential for ligand binding and has also been implicated in signal transduction [I1 -1 31. In contrast to the glycoprotein hormone receptors, the majority of G-protein-coupled receptors, such as rhodopsin, adrenergic, and muscarinic receptors, have a short N-terminal region that does not play a major role in ligand binding and signal transduction [14, 151. In both subgroups, however, the cytoplasmic regions play a pivotal role in G protein coupling and subsequent effector activation [14-181. The mechanism by which binding of thyrotropin to the extracellular region of the receptor is transduced via the membrane-spanning regions to the cytoplasmic segments of the receptor that interact with the G proteins is unknown. In human thyroid cells, signal transduction by the thyrotropin receptor is predominantly mediated by the stimulatory G, protein resulting in enhanced cAMP synthesis by adenylyl cyclase, hormone secretion, and proliferation [ 191.The thyrotropin receptor plays a pivotal role in function and growth of thyroid cells [19]. The receptor is also thought to be the central...