The glucagon-like peptide 1 receptor (GLP-1R) is a class B1 (secretin-like) G protein-coupled receptor (GPCR) and a key regulator of postprandial blood glucose (1). Because of its critical role in insulin secretion, GLP-1R has been a major drug target for the treatment of type 2 diabetes mellitus (T2DM), a metabolic disease that is driven by both reduced presence of blood insulin, and the development of tolerance to the glucose-lowering effect of the hormone (2). Several exogenous GLP-1R agonist peptides have become important drugs for the treatment of T2DM.
Polymorphisms of the GLP-1R have been observed and may be clinically relevant (3,4). A large exome chip study revealed that the A316T single nucleotide polymorphism (SNP) of GLP-1R is present in the population with a minor allele frequency of 1.4% (5). Individuals with this SNP had significantly reduced prevalence of T2DM and lower fasting glucose, suggesting a protective effect. However, it was also found that the A316T subgroup had reduced early insulin secretion, and higher glucose 2 hours after oral challenge. While affinity for the endogenous GLP-1 hormone is not significantly improved, a recent pre-print study found that the A316T mutation improved coupling to Gs in a reductionist assay (6,7).
To enhance understanding of the molecular mechanism of this clinically-relevant mutation, we obtained a 3.3 Å cryo-EM structure of GLP-1R (A316T) in complex with G proteins and GLP-1, the major endogenous ligand. 3D variance analysis revealed increased dynamics in the extracellular loops, which are known to be important for peptide affinity and Gs-coupled modes of signalling (8). This enhanced movement may underlie pharmacological and physiological differences observed for the A316T SNP.