id: MODULE:calcium_sensing_receptor_signaling
title: Calcium-sensing receptor signaling — extracellular calcium activation of CaSR, Gq/11-phospholipase C and Gi/o-adenylyl cyclase coupling, AP2-dependent endocytic signalling, PKC feedback, and GRK/beta-arrestin desensitization
description: >-
  The calcium-sensing receptor (CaSR) is a class C G protein-coupled receptor that detects
  the concentration of extracellular calcium and sets the body's calcium set point. It is
  most abundant in the parathyroid glands, where its activation suppresses parathyroid
  hormone secretion, and in the kidney, where it regulates calcium reabsorption. CaSR is an
  obligate disulfide-linked homodimer; calcium ions bind cooperatively in the Venus flytrap
  domains of its large extracellular region, closing them and driving an asymmetric
  rearrangement of the seven-transmembrane domains. The active receptor couples to
  G alpha q/11, which activates phospholipase C beta to produce inositol trisphosphate
  (release of stored calcium) and diacylglycerol (protein kinase C), and to G alpha i/o,
  which inhibits adenylyl cyclase and lowers cAMP. Loss-of-function mutations in CASR, in
  GNA11 (G alpha 11) or in AP2S1 (the sigma 2 subunit of the clathrin adaptor AP-2, which
  mediates CaSR endocytosis and sustained signalling) each cause familial hypocalciuric
  hypercalcaemia, and gain-of-function CASR and GNA11 mutations cause autosomal dominant
  hypocalcaemia. Protein kinase C phosphorylation of the receptor tail feeds back to blunt
  calcium mobilization, and G protein-coupled receptor kinases and beta-arrestins
  desensitize the receptor.
status: DRAFT
scope: CONCRETE
references:
  - id: PMID:8255296
    title: Cloning and characterization of an extracellular Ca(2+)-sensing receptor from bovine parathyroid.
    reference_review:
      relevance: HIGH
      correctness: VERIFIED
      review_notes: >-
        PubMed-verified (Brown et al., Nature 1993). Abstract only. Cloning of CaSR; the
        native sensor couples through phosphoinositide turnover and cytosolic calcium to PTH
        secretion.
  - id: PMID:27434672
    title: Structural mechanism of ligand activation in human calcium-sensing receptor.
    reference_review:
      relevance: HIGH
      correctness: VERIFIED
      review_notes: >-
        Full text cached (Geng et al., eLife 2016); source of CASR IDA rows for calcium ion
        binding and detection of calcium ion. Cited for Ca2+ as principal agonist and the
        range of G protein couplings.
  - id: PMID:38632411
    title: Promiscuous G-protein activation by the calcium-sensing receptor.
    reference_review:
      relevance: HIGH
      correctness: VERIFIED
      review_notes: >-
        Full text cached (Zuo et al., Nature 2024); CaSR-Gq and CaSR-Gi structures; source of
        CASR IDA rows for GO:0007193 and GO:0007200.
  - id: PMID:38326620
    title: Allosteric modulation and G-protein selectivity of the Ca(2+)-sensing receptor.
    reference_review:
      relevance: HIGH
      correctness: VERIFIED
      review_notes: >-
        Full text cached (He et al., Nature 2024); CaSR coupling to Gi versus Gq in nanodiscs.
  - id: PMID:23802516
    title: Mutations affecting G-protein subunit α11 in hypercalcemia and hypocalcemia.
    reference_review:
      relevance: HIGH
      correctness: VERIFIED
      review_notes: >-
        PubMed-verified (Nesbit et al., NEJM 2013); full text cached. GNA11 loss-of-function
        causes FHH2 and gain-of-function causes ADH2, by changing cell sensitivity to
        extracellular calcium.
  - id: PMID:23222959
    title: Mutations in AP2S1 cause familial hypocalciuric hypercalcemia type 3.
    reference_review:
      relevance: HIGH
      correctness: VERIFIED
      review_notes: >-
        Full text cached (Nesbit et al., Nat Genet 2013). AP2S1 Arg15 mutations reduce CaSR
        endocytosis and cell sensitivity to extracellular calcium.
  - id: PMID:9694886
    title: Protein kinase C phosphorylation of threonine at position 888 in Ca2+o-sensing receptor (CaR) inhibits coupling to Ca2+ store release.
    reference_review:
      relevance: MEDIUM
      correctness: VERIFIED
      review_notes: >-
        Abstract only (Bai et al., JBC 1998). PKC phosphorylation of CaSR Thr888 inhibits
        receptor-evoked calcium release.
  - id: PMID:15637145
    title: Beta-arrestin- and G protein receptor kinase-mediated calcium-sensing receptor desensitization.
    reference_review:
      relevance: HIGH
      correctness: VERIFIED
      review_notes: >-
        PubMed-verified (Pi et al., Mol Endocrinol 2005; RGD diagram reference RGD:7207060).
        Abstract only. GRK4 and GRK2 desensitize CaSR; beta-arrestin2 null mice show altered
        PTH responses.
evidence:
  - source_id: PW:0001141
    title: calcium signaling pathway via the calcium-sensing receptor
    statement: >-
      The module boundary follows the RGD diagram for this Pathway Ontology term: Ca2+,
      calcimimetics and calcilytics associated with Casr; Casr feeding the Galphaq, Galphai and
      Galpha12/13 family G protein pathways, giving increased DAG/IP3 via PLC activation (and
      PKC signalling) and inhibition of adenylyl cyclases/decreased cAMP; GRKs acting
      negatively on Casr, with Arrb1 and Arrb2 associated with it; RGS proteins acting
      negatively on the three G protein pathways; Flna associated with Casr; and Casr acting
      negatively on PTH secretion and the parathyroid hormone signaling pathway. Derived
      through projects/RGD_PATHWAY_ONTOLOGY (pathways/PW_0001141.yaml).
  - source_id: GO:0071277
    title: cellular response to calcium ion
    statement: >-
      The closest GO process; GO has no calcium-sensing receptor signaling pathway term, and
      this term covers every cellular response to calcium (see notes).
notes: >-
  Derived from the RGD Pathway Ontology diagram PW:0001141 (12 RGD-curated human genes)
  through the RGD_PATHWAY_ONTOLOGY project, where it sits in the no_specific_go_term tier.

  GO term search. The go-basic release used for validation (2026-07-26) was searched again
  for calcium-sensing, extracellular calcium, calcium ion sensing and calcium response terms.
  There is no CaSR signaling pathway term and no receptor-specific molecular function term
  (no "calcium-sensing receptor activity"). The live terms are GO:0071277 cellular response
  to calcium ion (module concept, as on the project page), GO:0005513 detection of calcium
  ion (synonym calcium ion sensing), which CASR carries by IDA and as a CASR review core
  process and which is used on the receptor annoton, and the generic G protein routes
  GO:0007200 and GO:0007193, also CASR IDA rows. The two "calcium-mediated signaling using
  extracellular/intracellular calcium source" terms are obsolete. A CaSR signaling pathway
  term is requested in proposed_new_terms.

  Molecular functions come from experimental GOA rows or gene review core functions: CASR
  GO:0004930 G protein-coupled receptor activity (IDA; CASR review core); GNA11 and GNAQ
  GO:0003925 G protein activity (IDA; review core); GNAI1 and GNAI2 GO:0003925 (IDA; review
  core); AP2S1 GO:0035615 clathrin-cargo adaptor activity (TAS, accepted in the AP2S1
  review, whose core functions carry no molecular function); GRK2 GO:0004703 (IDA; review
  core); ARRB1/ARRB2 GO:0030674 protein-macromolecule adaptor activity (IDA), as in the
  sibling pth_receptor_signaling module. The ligand, extracellular Ca2+, is a chemical and
  not an annoton; calcimimetics (positive allosteric modulators such as cinacalcet) and
  calcilytics are pharmacology, recorded here only.

  Shared steps by reference. The Gq/11 route reuses the phospholipase C beta step of
  modules/gpcr_plc_calcium_pkc_signaling.yaml by module_ref, as pth_receptor_signaling does,
  and the PKC step of the same module is referenced for the feedback loop. The G alpha 11/q
  annoton is kept local because GNA11 is a disease gene of this pathway (FHH2/ADH2). The
  Gi/o route has no generic module, so the G alpha i annoton is local and its target, the
  adenylyl cyclase step of modules/gpcr_camp_pka_signaling.yaml, is referenced and connected
  with NEGATIVELY_REGULATES. Downstream PKA, IP3 receptor calcium release and PTH secretion
  are outside the module.

  Added genes. GNA11, GNAQ, GNAI1, GNAI2 and AP2S1 are not on RGD's curated list for
  PW:0001141 (RGD represents the G protein steps as links to PW:0000229 and PW:0000228) but
  the coupling steps cannot be modelled without the G alpha subunits, and GNA11 and AP2S1 are
  the FHH2 and FHH3 genes that regulate CaSR signalling directly (PMID:23802516,
  PMID:23222959). AP2S1 is modelled as a regulator that sustains signalling: FHH3 mutations
  reduce CaSR endocytosis and decrease cell sensitivity to extracellular calcium, and loss of
  the CaSR dileucine motif that AP2 sigma 2 recognises also reduces intracellular signalling,
  so AP2-mediated endocytosis supports rather than ends the response here.

  Termination and feedback. GRK4 and GRK2 desensitize CaSR and beta-arrestin2 matters in vivo
  (PMID:15637145); GRK3, also on the RGD list, has no specific CaSR evidence in the cached
  literature and is mentioned only. PKC phosphorylation of Thr888 blunts receptor-evoked
  calcium release (PMID:9694886). The RGS proteins on the RGD list (RGS2, RGS4, RGS5, RGS12)
  act on the G alpha subunits generally and are not modelled as parts; the RGD record notes
  that several inhibit CaSR signalling, but no cached paper was found to ground a specific
  one. Filamin A (FLNA) and RHOA, the G12/13-Rho route, Gs coupling in breast cancer cells,
  and the ERK/MAPK outputs (RGD links PW:0000230, PW:0000105, PW:0000102) are out of scope;
  FLNA binds the receptor tail and scaffolds Rho signalling (RGD record text) and belongs with
  a Rho module.

  GO-CAM grounding. CASR is linked to its two human models: the Gq model
  gomodel:67c10cc400004380 (CASR, GNAQ, PLCB3) and the Gi model gomodel:67c10cc400004342
  (CASR, GNAI1, ADCY6). PLCB3 and ADCY6 are in the referenced generic modules. GNA11 is not in
  either CASR model, which uses GNAQ. The GRK2 and arrestin annotons are linked, as in
  pth_receptor_signaling, to the desensitization model gomodel:67f85f2b00004426 built for
  C5AR1 (the seed's best_gocam lead): gene and function match but not the receptor. No cached
  GO-CAM covers AP2S1 with CaSR. GRK4, ARRB1 and ARRB2 have no gene review yet in this
  repository's genes/human tree, which is curation follow-up for the project plan.
proposed_new_terms:
- proposed_name: calcium-sensing receptor signaling pathway
  proposed_definition: >-
    A G protein-coupled receptor signaling pathway initiated by extracellular calcium ions
    binding to the calcium-sensing receptor (CaSR) on the surface of a target cell, and ending
    with the regulation of a downstream cellular process.
  justification: >-
    GO has no CaSR signaling pathway term. The module concept uses GO:0071277 cellular response
    to calcium ion, and the receptor annoton uses the generic G protein routes GO:0007200 and
    GO:0007193.
  proposed_parent:
    id: GO:0007186
    label: G protein-coupled receptor signaling pathway
  supported_by:
  - reference_id: PMID:27434672
    supporting_text: The general consensus is that the principal agonist of CaSR is extracellular Ca2+
  - reference_id: PMID:38632411
    supporting_text: In parathyroid and kidney, CaSR signals through Gq/11 and Gi/o
module:
  id: calcium_sensing_receptor_signaling
  label: Calcium-sensing receptor signaling
  module_type: SIGNALING_PATHWAY
  concepts:
    - preferred_term: cellular response to calcium ion
      term:
        id: GO:0071277
        label: cellular response to calcium ion
      description: >-
        Broad GO process; GO has no calcium-sensing receptor signaling pathway term. The
        module is the CaSR-initiated share of the cellular response to extracellular calcium.
  context:
    taxa:
      - preferred_term: Homo sapiens
        term:
          id: NCBITaxon:9606
          label: Homo sapiens
        description: >-
          Members are grounded on the human proteins; the diagram is RGD's rat curation and the
          pathway is conserved across vertebrates.
    cellular_components:
      - preferred_term: plasma membrane
        term:
          id: GO:0005886
          label: plasma membrane
        description: CaSR, its G proteins, GRKs and arrestins act at the plasma membrane.
  parts:
    - order: 1
      role: CaSR activation by extracellular calcium and G protein coupling
      node:
        id: casr_receptor
        label: CaSR senses extracellular calcium and couples to Gq/11 and Gi/o
        module_type: REGULATORY_STEP
        description: >-
          Extracellular Ca2+ binds the Venus flytrap domains of the CaSR homodimer; the active
          receptor acts as a guanine nucleotide exchange factor for G alpha q/11 and G alpha i/o.
        annotons:
          - id: casr_gpcr
            label: CaSR G protein-coupled receptor activity
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: CASR
                term:
                  id: UniProtKB:P41180
                  label: Extracellular calcium-sensing receptor
            function:
              preferred_term: G protein-coupled receptor activity
              term:
                id: GO:0004930
                label: G protein-coupled receptor activity
            processes:
              - preferred_term: detection of calcium ion
                term:
                  id: GO:0005513
                  label: detection of calcium ion
              - preferred_term: phospholipase C-activating G protein-coupled receptor signaling pathway
                term:
                  id: GO:0007200
                  label: phospholipase C-activating G protein-coupled receptor signaling pathway
              - preferred_term: adenylate cyclase-inhibiting G protein-coupled receptor signaling pathway
                term:
                  id: GO:0007193
                  label: adenylate cyclase-inhibiting G protein-coupled receptor signaling pathway
            locations:
              - preferred_term: plasma membrane
                term:
                  id: GO:0005886
                  label: plasma membrane
            role_description: >-
              Class C dimeric GPCR whose principal agonist is extracellular Ca2+; the hub of the
              module and the target of AP2 endocytosis, PKC feedback and GRK/arrestin
              desensitization.
            evidence:
              - source_id: PMID:8255296
                statement: >-
                  The parathyroid cell-surface Ca2+ sensor couples through phosphoinositide
                  turnover and cytosolic Ca2+ to regulation of PTH secretion.
                supporting_text: >-
                  couples by changes in phosphoinositide turnover and cytosolic Ca2+ to
                  regulation of parathyroid hormone secretion
              - source_id: PMID:27434672
                statement: Extracellular Ca2+ is the principal CaSR agonist.
                supporting_text: >-
                  The general consensus is that the principal agonist of CaSR is extracellular
                  Ca2+
              - source_id: PMID:38632411
                statement: In parathyroid and kidney CaSR signals through Gq/11 and Gi/o.
                supporting_text: In parathyroid and kidney, CaSR signals through Gq/11 and Gi/o
              - source_id: PMID:38326620
                statement: The receptor couples selectively to Gi and Gq through distinct interfaces.
                supporting_text: >-
                  Selective Gi and Gq coupling by the receptor is achieved through substantial
                  rearrangements of intracellular loop 2 and the C terminus
            gocam_associations:
              - model: gomodel:67c10cc400004380
                activity: gomodel:67c10cc400004380/67c10cc400004381
                title: CASR-mediated signaling via G-alpha-q (phospholipase c-activating, IP3, DAG) following activation by extracellular calcium (Human).
                description: Same gene and molecular function (GO:0004930), upstream of GNAQ and PLCB3.
              - model: gomodel:67c10cc400004342
                activity: gomodel:67c10cc400004342/67c10cc400004343
                title: CASR-mediated signaling via G-alpha-i (inhibitory), inhibiting adenylate cyclase) following activation by extracellular calcium (Human).
                description: Same gene and molecular function (GO:0004930), upstream of GNAI1 and ADCY6.
        variant_sets:
          - id: casr_g_protein_routes
            label: CaSR G protein routes
            axis: G protein class
            selection: ONE_OR_MORE
            notes: >-
              Parathyroid and kidney cells use both routes; G12/13 and (in some cancer cells) Gs
              coupling are outside the module.
            variants:
              - id: casr_gq_route
                label: Gq/11 route (phospholipase C beta)
                module_type: REGULATORY_STEP
                description: CaSR activates G alpha 11 and G alpha q, which stimulate phospholipase C beta.
                annotons:
                  - id: casr_gna11
                    label: G alpha 11/q G protein activity
                    participant:
                      selector_type: FAMILY
                      family:
                        preferred_term: G alpha q/11 subunits (GNA11, GNAQ)
                        representative_members:
                          - preferred_term: GNA11 (G alpha 11)
                            term:
                              id: UniProtKB:P29992
                              label: Guanine nucleotide-binding protein subunit alpha-11
                          - preferred_term: GNAQ (G alpha q)
                            term:
                              id: UniProtKB:P50148
                              label: Guanine nucleotide-binding protein G(q) subunit alpha
                    function:
                      preferred_term: G protein activity
                      term:
                        id: GO:0003925
                        label: G protein activity
                    processes:
                      - preferred_term: phospholipase C-activating G protein-coupled receptor signaling pathway
                        term:
                          id: GO:0007200
                          label: phospholipase C-activating G protein-coupled receptor signaling pathway
                    locations:
                      - preferred_term: plasma membrane
                        term:
                          id: GO:0005886
                          label: plasma membrane
                    role_description: >-
                      G alpha 11 is the CaSR G protein whose loss-of-function causes FHH2 and
                      gain-of-function causes ADH2; G alpha q is its paralog and the subunit used in
                      the CASR GO-CAM.
                    evidence:
                      - source_id: PMID:23802516
                        statement: CaSR signals through G alpha 11.
                        supporting_text: >-
                          the calcium-sensing receptor, a guanine nucleotide-binding protein
                          (G-protein)-coupled receptor that signals through the G-protein subunit α11
                          (Gα11)
                      - source_id: PMID:23802516
                        statement: >-
                          FHH2 GNA11 mutations decrease, and ADH2 mutations increase, the sensitivity
                          of CaSR-expressing cells to extracellular calcium.
                        supporting_text: >-
                          familial hypocalciuric hypercalcemia type 2-associated mutations decreased
                          the sensitivity of cells expressing calcium-sensing receptors to changes in
                          extracellular calcium concentrations, whereas autosomal dominant
                          hypocalcemia type 2-associated mutations increased cell sensitivity
                    gocam_associations:
                      - model: gomodel:67c10cc400004380
                        activity: gomodel:67c10cc400004380/67c10cc400004383
                        title: CASR-mediated signaling via G-alpha-q (phospholipase c-activating, IP3, DAG) following activation by extracellular calcium (Human).
                        description: GNAQ with the same molecular function (GO:0003925) and process (GO:0007200).
              - id: casr_gi_route
                label: Gi/o route (adenylyl cyclase inhibition)
                module_type: REGULATORY_STEP
                description: CaSR activates G alpha i, which inhibits adenylyl cyclase and lowers cAMP.
                annotons:
                  - id: casr_gnai
                    label: G alpha i G protein activity
                    participant:
                      selector_type: FAMILY
                      family:
                        preferred_term: G alpha i subunits (GNAI1, GNAI2)
                        representative_members:
                          - preferred_term: GNAI1
                            term:
                              id: UniProtKB:P63096
                              label: Guanine nucleotide-binding protein G(i) subunit alpha-1
                          - preferred_term: GNAI2
                            term:
                              id: UniProtKB:P04899
                              label: Guanine nucleotide-binding protein G(i) subunit alpha-2
                    function:
                      preferred_term: G protein activity
                      term:
                        id: GO:0003925
                        label: G protein activity
                    processes:
                      - preferred_term: adenylate cyclase-inhibiting G protein-coupled receptor signaling pathway
                        term:
                          id: GO:0007193
                          label: adenylate cyclase-inhibiting G protein-coupled receptor signaling pathway
                    locations:
                      - preferred_term: plasma membrane
                        term:
                          id: GO:0005886
                          label: plasma membrane
                    role_description: >-
                      Inhibitory G alpha subunits; their GTP-bound form inhibits adenylyl cyclase.
                    evidence:
                      - source_id: PMID:38632411
                        statement: CaSR forms complexes with Gi as well as Gq.
                        supporting_text: >-
                          We determined structures of CaSR in complex with G proteins from three
                          different subfamilies: Gq, Gi and Gs.
                    gocam_associations:
                      - model: gomodel:67c10cc400004342
                        activity: gomodel:67c10cc400004342/67c10cc400004345
                        title: CASR-mediated signaling via G-alpha-i (inhibitory), inhibiting adenylate cyclase) following activation by extracellular calcium (Human).
                        description: GNAI1 with the same molecular function (GO:0003925) and process (GO:0007193), upstream of ADCY6.
    - order: 2
      role: phospholipase C beta produces IP3 and DAG
      node:
        id: casr_plc_beta
        label: Phospholipase C beta produces IP3 and DAG
        description: >-
          Included by reference to the PLC beta step of the generic Gq-PLC-calcium-PKC module
          (the CASR GO-CAM uses PLCB3).
        module_ref: gpcr_plc_calcium_pkc_signaling#plc_beta_activation
    - order: 3
      role: PKC activation and receptor feedback
      optional: true
      node:
        id: casr_pkc_feedback
        label: PKC activation feeds back on CaSR
        description: >-
          Included by reference to the PKC step of the generic module. DAG-activated PKC
          phosphorylates CaSR Thr888 and blunts receptor-evoked calcium release.
        module_ref: gpcr_plc_calcium_pkc_signaling#pkc_activation
        evidence:
          - source_id: PMID:9694886
            statement: PKC phosphorylation of CaSR Thr888 mediates the inhibition of receptor-evoked calcium mobilization.
            supporting_text: >-
              threonine at amino acid position 888 is the major PKC site that mediates the
              inhibitory effect of PKC activators on Ca2+ mobilization
    - order: 4
      role: adenylyl cyclase inhibition
      node:
        id: casr_adenylyl_cyclase
        label: Adenylyl cyclase (inhibited)
        description: >-
          Included by reference to the adenylyl cyclase step of the generic Gs-cAMP-PKA module;
          here G alpha i inhibits it, lowering cAMP (the CASR Gi GO-CAM uses ADCY6).
        module_ref: gpcr_camp_pka_signaling#adenylyl_cyclase_activation
    - order: 5
      role: AP2-mediated CaSR endocytosis sustaining signalling (regulation)
      optional: true
      node:
        id: casr_ap2_endocytosis
        label: AP2 sigma 2 recognition of CaSR for clathrin-mediated endocytosis
        module_type: REGULATORY_STEP
        description: >-
          The AP-2 adaptor, through its sigma 2 subunit, binds the CaSR carboxy-terminal
          dileucine motif and drives clathrin-mediated endocytosis, which supports sustained
          signalling and the receptor's sensitivity to extracellular calcium.
        annotons:
          - id: casr_ap2s1
            label: AP2S1 clathrin-cargo adaptor activity
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: AP2S1 (AP-2 complex subunit sigma)
                term:
                  id: UniProtKB:P53680
                  label: AP-2 complex subunit sigma
            function:
              preferred_term: clathrin-cargo adaptor activity
              term:
                id: GO:0035615
                label: clathrin-cargo adaptor activity
              targets:
                - preferred_term: CaSR carboxy-terminal dileucine motif
                  term:
                    id: UniProtKB:P41180
                    label: Extracellular calcium-sensing receptor
            processes:
              - preferred_term: clathrin-dependent endocytosis
                term:
                  id: GO:0072583
                  label: clathrin-dependent endocytosis
            locations:
              - preferred_term: plasma membrane
                term:
                  id: GO:0005886
                  label: plasma membrane
            role_description: >-
              The sigma 2 subunit of the AP-2 clathrin adaptor; FHH3 mutations at Arg15 reduce
              CaSR endocytosis and signalling. It acts as part of the AP-2 heterotetramer.
            evidence:
              - source_id: PMID:23222959
                statement: >-
                  FHH3 AP2S1 mutations decrease CaSR-expressing cells' sensitivity to
                  extracellular calcium and reduce CaSR endocytosis.
                supporting_text: >-
                  AP2S1 mutations decreased the sensitivity of CaSR-expressing cells to
                  extracellular calcium and reduced CaSR endocytosis, probably through loss of
                  interaction with a C-terminal CaSR dileucine-based motif, whose disruption also
                  decreased intracellular signaling.
    - order: 6
      role: receptor desensitization (termination)
      node:
        id: casr_termination
        label: GRK phosphorylation and beta-arrestin desensitization of CaSR
        module_type: REGULATORY_STEP
        description: >-
          GRKs phosphorylate the agonist-occupied receptor and beta-arrestins bind it,
          uncoupling it from its G proteins; GRK2 additionally disrupts Gq signalling
          independently of phosphorylation.
        annotons:
          - id: casr_grk
            label: GRK phosphorylation of CaSR
            participant:
              selector_type: FAMILY
              family:
                preferred_term: G protein-coupled receptor kinases (GRK2, GRK4)
                representative_members:
                  - preferred_term: GRK2
                    term:
                      id: UniProtKB:P25098
                      label: G protein-coupled receptor kinase 2
                  - preferred_term: GRK4
                    term:
                      id: UniProtKB:P32298
                      label: G protein-coupled receptor kinase 4
            function:
              preferred_term: G protein-coupled receptor kinase activity
              term:
                id: GO:0004703
                label: G protein-coupled receptor kinase activity
              targets:
                - preferred_term: CaSR
                  term:
                    id: UniProtKB:P41180
                    label: Extracellular calcium-sensing receptor
            processes:
              - preferred_term: desensitization of G protein-coupled receptor signaling pathway
                term:
                  id: GO:0002029
                  label: desensitization of G protein-coupled receptor signaling pathway
            locations:
              - preferred_term: plasma membrane
                term:
                  id: GO:0005886
                  label: plasma membrane
            role_description: >-
              GRK4 enhances CaSR phosphorylation and arrestin recruitment; GRK2 desensitizes
              by phosphorylation and by disrupting Gq signalling.
            evidence:
              - source_id: PMID:15637145
                statement: GRK4 inhibits CaSR signalling by enhancing receptor phosphorylation and beta-arrestin translocation.
                supporting_text: >-
                  the transfection of GRK4 inhibits CASR signaling by enhancing receptor
                  phosphorylation and beta-arrestin translocation to the CASR
              - source_id: PMID:15637145
                statement: GRK2 desensitizes CaSR by classical and phosphorylation-independent mechanisms.
                supporting_text: >-
                  overexpression of GRK2 desensitizes CASR by classical mechanisms as well as
                  through phosphorylation-independent mechanisms involving disruption of
                  Galphaq signaling
            gocam_associations:
              - model: gomodel:67f85f2b00004426
                activity: gomodel:67f85f2b00004426/67f85f2b00004469
                title: Desensitization of C5AR1-mediated signaling following phosphorylation by GRK2 or GRK3 (Human).
                description: >-
                  GRK2 with the same molecular function (GO:0004703) and process (GO:0002029),
                  modelled on C5AR1 rather than CaSR.
          - id: casr_arrestin
            label: Beta-arrestin desensitization of CaSR
            participant:
              selector_type: FAMILY
              family:
                preferred_term: beta-arrestins (ARRB1, ARRB2)
                representative_members:
                  - preferred_term: ARRB1 (beta-arrestin-1)
                    term:
                      id: UniProtKB:P49407
                      label: Beta-arrestin-1
                  - preferred_term: ARRB2 (beta-arrestin-2)
                    term:
                      id: UniProtKB:P32121
                      label: Beta-arrestin-2
            function:
              preferred_term: protein-macromolecule adaptor activity
              term:
                id: GO:0030674
                label: protein-macromolecule adaptor activity
              targets:
                - preferred_term: CaSR
                  term:
                    id: UniProtKB:P41180
                    label: Extracellular calcium-sensing receptor
            processes:
              - preferred_term: desensitization of G protein-coupled receptor signaling pathway
                term:
                  id: GO:0002029
                  label: desensitization of G protein-coupled receptor signaling pathway
            locations:
              - preferred_term: plasma membrane
                term:
                  id: GO:0005886
                  label: plasma membrane
            role_description: >-
              Bind the phosphorylated receptor and block G protein coupling; beta-arrestin2 loss
              alters the parathyroid response to hypocalcaemia in mice. RGD also links the
              arrestins to ERK activation, which is outside the module.
            evidence:
              - source_id: PMID:15637145
                statement: Beta-arrestin2-null mice show lower PTH and an attenuated PTH rise after hypocalcaemia.
                supporting_text: >-
                  we observed lower circulating PTH levels and an attenuated increase in serum
                  PTH after hypocalcemic stimulation in beta-arrestin2 null mice
            gocam_associations:
              - model: gomodel:67f85f2b00004426
                activity: gomodel:67f85f2b00004426/67f85f2b00004504
                title: Desensitization of C5AR1-mediated signaling following phosphorylation by GRK2 or GRK3 (Human).
                description: ARRB1 with the same molecular function (GO:0030674), modelled on C5AR1.
              - model: gomodel:67f85f2b00004426
                activity: gomodel:67f85f2b00004426/67f85f2b00004511
                title: Desensitization of C5AR1-mediated signaling following phosphorylation by GRK2 or GRK3 (Human).
                description: ARRB2 with the same molecular function (GO:0030674), modelled on C5AR1.
  connections:
    - source: casr_gq_route
      target: casr_plc_beta
      connection_type: POSITIVELY_REGULATES
      description: G alpha q/11-GTP activates phospholipase C beta.
    - source: casr_plc_beta
      target: casr_pkc_feedback
      connection_type: PROVIDES_INPUT_FOR
      description: Diacylglycerol (with released calcium) activates PKC.
    - source: casr_pkc_feedback
      target: casr_receptor
      connection_type: NEGATIVELY_REGULATES
      description: PKC phosphorylation of CaSR Thr888 inhibits coupling to calcium store release.
    - source: casr_gi_route
      target: casr_adenylyl_cyclase
      connection_type: NEGATIVELY_REGULATES
      description: G alpha i-GTP inhibits adenylyl cyclase, lowering cAMP.
    - source: casr_ap2_endocytosis
      target: casr_receptor
      connection_type: POSITIVELY_REGULATES
      description: >-
        AP2-dependent endocytosis sustains CaSR signalling; FHH3 mutations that reduce it lower
        the receptor's sensitivity to extracellular calcium.
    - source: casr_termination
      target: casr_receptor
      connection_type: NEGATIVELY_REGULATES
      description: GRK phosphorylation and beta-arrestin binding desensitize CaSR.
