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Parathyroid hormone receptor 1; Parathyroid hormone receptor 2 (PTH1R; PTH2R)

Target
PTH1R; PTH2R
Molecular classification
G protein-coupled receptor (GPCR), Class B secretin family receptor, Receptor
01

Overview

Parathyroid hormone receptor 1 (PTH1R) and parathyroid hormone receptor 2 (PTH2R) are cell surface receptors that mediate the effects of parathyroid hormone (PTH) and related peptides, such as parathyroid hormone-related protein (PTHrP). These Class B G protein-coupled receptors are predominantly expressed in bone and kidney, where they regulate calcium and phosphate homeostasis, bone turnover, and skeletal development. PTH1R responds to both PTH and PTHrP, playing crucial roles in endocrine bone metabolism and paracrine regulation of fetal tissue development. PTH2R, on the other hand, is more selective for PTH and is less well characterized but is known to be expressed in other tissues, including the brain. Monogenic diseases caused by mutations in either receptor are studied for their insights into skeletal dysplasias, calcium disorders, and potential drug targeting. Drugs targeting these receptors are used therapeutically in osteoporosis and hypoparathyroidism, but safety concerns such as hypercalcemia and neoplasia require careful clinical monitoring.

Other names
Parathyroid hormone/parathyroid hormone-related peptide receptorPTH/PTHrP receptorParathyroid hormone receptor type 1Parathyroid hormone receptor type 2
02

Mechanism of action

Agonists stimulate G protein coupling, activating adenylyl cyclase and increasing cAMP for cell signaling; Some drugs act as inverse agonists or antagonists

03

Biological functions

Signal transductionRegulation of calcium ion homeostasisBone metabolism and turnoverCell proliferation and differentiation (especially in bone, cartilage, and other tissues)Endochondral bone formation
04

Disease associations

OsteoporosisHypoparathyroidismGenetic skeletal disorders (e.g., Jansen’s metaphyseal chondrodysplasia, Blomstrand chondrodysplasia, enchondromatosis, primary failure of tooth eruption)Cancer cachexia and hypercalcemia (tumor-driven)
05

Safety considerations

Hypercalcemia (overstimulation)Risk of osteosarcoma with some PTH analogsEffects on mineral homeostasis and potential ectopic calcificationOff-target effects in tissues with receptor expression (kidney, cartilage, etc.)
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Interacting drugs

Teriparatide

2 more in the full profile.

07

Biomarkers

Blood calcium and phosphate levelsPTH and PTHrP levels (as pharmacodynamic/efficacy markers)Bone turnover markers (e.g., bone-specific alkaline phosphatase)

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