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Glial cell line-derived neurotrophic factor family receptor alpha-1 (GFRA1) is a glycosylphosphatidylinositol (GPI)-anchored cell surface receptor that serves as the primary co-receptor for Glial cell line-derived neurotrophic factor (GDNF) [1, 2]. Upon binding its ligand, GFRA1 facilitates the recruitment and activation of the RET receptor tyrosine kinase, which triggers essential downstream signaling pathways such as MAPK/ERK and PI3K/Akt [7, 17]. These pathways are critical for the survival and maintenance of various neuronal populations, most notably dopaminergic and motor neurons, making GFRA1 a key focus in neurodegenerative research like Parkinson's disease [11, 13]. Beyond the nervous system, GFRA1 is essential for kidney morphogenesis and the maintenance of spermatogonial stem cells [1, 7]. In oncology, GFRA1 is frequently overexpressed in several cancer types, including luminal A breast cancer, osteosarcoma, and pancreatic cancer [3, 6]. In these contexts, it can promote tumor progression, metastasis, and chemoresistance, sometimes through RET-independent mechanisms such as the induction of autophagy [3, 5]. Due to its limited expression in normal adult tissues and high prevalence in specific tumors, GFRA1 is being actively investigated as a target for antibody-drug conjugates (ADCs) and other targeted therapies [4, 6]. Therapeutic strategies currently involve using recombinant GDNF for neuroprotection or developing monoclonal antibodies and ADCs to selectively eliminate GFRA1-positive cancer cells [4, 17].
Ligand binding to GFRA1 induces the formation of a ternary complex with the RET tyrosine kinase, leading to RET autophosphorylation and the activation of intracellular signaling cascades (MAPK, PI3K/Akt) that promote cell survival and growth.
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