id: MODULE:pth_receptor_signaling
title: Parathyroid hormone receptor signaling — PTH acting through PTH1R, dual Gs/adenylyl cyclase and Gq/PLC coupling, NHERF/ezrin scaffold control of coupling, and GRK2/beta-arrestin desensitization
description: >-
  Parathyroid hormone (PTH), secreted by the parathyroid glands when blood calcium falls,
  acts on kidney and bone through the parathyroid hormone 1 receptor (PTH1R), a class B
  G protein-coupled receptor that is also activated by PTH-related protein. A single
  PTH1R couples to two G protein routes: the stimulatory G alpha s (GNAS), which
  activates adenylyl cyclase, cAMP production and protein kinase A, and is the main
  route; and G alpha q/11, which activates phospholipase C beta, producing inositol
  trisphosphate (calcium release) and diacylglycerol (protein kinase C). The balance
  between the two is set by scaffold proteins at the receptor's carboxy-terminal tail.
  The PDZ-domain scaffolds NHERF1 and NHERF2 bind the PTH1R carboxy terminus; NHERF2
  simultaneously binds phospholipase C beta 1, biasing PTH1R toward phospholipase C
  signalling and inhibiting adenylyl cyclase through Gi/o, and NHERF1 likewise enables
  PTH-stimulated calcium signalling. Ezrin, an actin-membrane linker, binds both PTH1R
  and NHERF1 and supports apical PTH1R localization and signalling in renal proximal
  tubule cells. Signalling is terminated when GRK2 phosphorylates the agonist-occupied
  receptor and beta-arrestins (ARRB1, ARRB2) bind it, uncoupling it from G proteins and
  driving its dynamin-dependent endocytosis.
status: DRAFT
scope: CONCRETE
references:
  - id: PMID:1313566
    title: "Expression cloning of a common receptor for parathyroid hormone and parathyroid hormone-related peptide from rat osteoblast-like cells: a single receptor stimulates intracellular accumulation of both cAMP and inositol trisphosphates and increases intracellular free calcium."
    reference_review:
      relevance: HIGH
      correctness: VERIFIED
      review_notes: >-
        PubMed-verified (Abou-Samra et al., PNAS 1992); a single cloned rat/opossum PTH1R
        stimulates both adenylate cyclase and phospholipase C. Abstract only.
  - id: PMID:21777186
    title: The parathyroid hormone receptorsome and the potential for therapeutic intervention.
    reference_review:
      relevance: HIGH
      correctness: VERIFIED
      review_notes: >-
        PubMed-verified review (Mahon, Curr Drug Targets 2012; RGD diagram reference
        RGD:7207465). Used for multi-G-protein coupling (including Gs) and the
        PTH1R-ezrin-NHERF1 receptorsome. Abstract only.
  - id: PMID:12075354
    title: Na(+)/H(+ ) exchanger regulatory factor 2 directs parathyroid hormone 1 receptor signalling.
    reference_review:
      relevance: HIGH
      correctness: VERIFIED
      review_notes: >-
        PubMed-verified (Mahon et al., Nature 2002); NHERF1 and NHERF2 bind the PTH1R
        carboxy terminus, and NHERF2 tethers phospholipase C beta 1 so that PTH shifts the
        receptor toward phospholipase C and Gi/o. Abstract only.
  - id: PMID:20843475
    title: EBP50 inhibits the anti-mitogenic action of the parathyroid hormone type 1 receptor in vascular smooth muscle cells.
    reference_review:
      relevance: MEDIUM
      correctness: VERIFIED
      review_notes: >-
        PubMed-verified (Song et al., J Mol Cell Cardiol 2010); full text cached. Cited for
        NHERF1/EBP50 conferring calcium signalling on PTH1R in a vascular smooth muscle
        line, the NHERF1 counterpart of the NHERF2 result.
  - id: PMID:19608645
    title: The parathyroid hormone 1 receptor directly binds to the FERM domain of ezrin, an interaction that supports apical receptor localization and signaling in LLC-PK1 cells.
    reference_review:
      relevance: HIGH
      correctness: VERIFIED
      review_notes: >-
        PubMed-verified (Mahon, Mol Endocrinol 2009); direct PTH1R-ezrin FERM interaction
        supporting apical receptor localization and signalling. Abstract only.
  - id: PMID:9849959
    title: Identification of phosphorylation sites in the G protein-coupled receptor for parathyroid hormone. Receptor phosphorylation is not required for agonist-induced internalization.
    reference_review:
      relevance: HIGH
      correctness: VERIFIED
      review_notes: >-
        PubMed-verified (Malecz et al., Mol Endocrinol 1998); GRK2, not GRK3, enhances
        agonist-stimulated PTH1R phosphorylation, and internalization does not require it.
        Abstract only.
  - id: PMID:12920119
    title: Activation-independent parathyroid hormone receptor internalization is regulated by NHERF1 (EBP50).
    reference_review:
      relevance: HIGH
      correctness: VERIFIED
      review_notes: >-
        PubMed-verified (Sneddon et al., JBC 2003); PTH1R undergoes beta-arrestin/
        dynamin-mediated endocytosis with active PTH, while NHERF1 gates an
        arrestin-independent route. Abstract only.
evidence:
  - source_id: PW:0001135
    title: parathyroid hormone signaling pathway
    statement: >-
      The module boundary and its gene products follow the RGD diagram for this Pathway
      Ontology term: Pth associated with Pth1r; Pth1r feeding both the Galphas family and the
      Galphaq family G protein signaling pathways, giving cAMP/PKA and DAG/IP3 via PLC;
      Adrbk1 (GRK2) acting negatively on Pth1r with Arrb1 and Arrb2 associated with it; Ezr
      associated with both Pth1r and Slc9a3r1; and Slc9a3r1 (NHERF1) and Slc9a3r2 (NHERF2)
      associated with Pth1r. The record text states that the NHERF interaction biases the
      receptor between the two G protein routes, promoting Galphaq and either inhibiting or
      not affecting Galphas. Derived through projects/RGD_PATHWAY_ONTOLOGY
      (pathways/PW_0001135.yaml).
  - source_id: GO:0071374
    title: cellular response to parathyroid hormone stimulus
    statement: >-
      The module is grounded in the GO cellular-response term recorded as the curated
      skos:closeMatch for PW:0001135 in the project's PW-GO mappings; GO has no PTH receptor
      signaling pathway term. The Gs arm is the GO process adenylate cyclase-activating
      G protein-coupled receptor signaling pathway (GO:0007189), used by the human PTH1R
      GO-CAM gomodel:67c10cc400004508.
notes: >-
  Derived from the RGD Pathway Ontology diagram PW:0001135 through the RGD_PATHWAY_ONTOLOGY
  project, as one of four mutually consistent Gs-coupled hormone receptor modules
  (crh_receptor_signaling, beta_adrenergic_signaling, pth_receptor_signaling,
  glucagon_receptor_signaling) that share one structure: ligand -> receptor -> Gs ->
  adenylyl cyclase/cAMP -> PKA (the last two by reference to
  modules/gpcr_camp_pka_signaling.yaml) -> termination by GRK phosphorylation and
  beta-arrestin binding. Molecular functions were taken from each protein's experimental GO
  annotations in QuickGO (PTH GO:0005179 IDA/IMP; PTH1R GO:0004991 IDA; GNAS P63092
  GO:0003925 IDA; GRK2 GO:0004703 IDA; ARRB1/ARRB2 GO:0030674 IDA; EZR GO:0019904 IPI),
  verified against go-basic (releases/2026-07-26).
  The NHERF scaffolds are given GO:0030674 protein-macromolecule adaptor activity, the
  protein-protein counterpart of their GOA GO:0043495 protein-membrane adaptor activity
  (IBA): the activity modelled here is tethering PTH1R and phospholipase C beta 1 to each
  other. GO:0030165 PDZ domain binding, which NHERF1 carries by IPI, would say the reverse
  of what happens (NHERF's own PDZ domains bind the receptor's PDZ-binding motif). Ezrin
  keeps its GOA GO:0019904 protein domain specific binding (IPI): it too links PTH1R and
  NHERF1, but it has no adaptor-activity row in GOA, so the module keeps its experimental
  binding row rather than inferring an adaptor activity for it.

  Ligand. PTH carries hormone activity only, with no process role, following the
  substrate-versus-participant rule: the peptide is the signal and the receptor and
  downstream enzymes do the work. PTH secretion and its control by the calcium-sensing
  receptor (RGD links PW:0001141) are upstream of the module. PTHLH (PTHrP), the second
  PTH1R agonist, is not on the RGD gene list and is mentioned in prose only; the human
  GO-CAM gomodel:67c10cc400004549 models that arm.

  GNAS added. GNAS is not on RGD's curated gene list for PW:0001135 (RGD represents the Gs
  step as a link to the pathway PW:0000227) but the Gs step cannot be modelled without it,
  so it is added with the same grounding as the sibling modules: UniProtKB:P63092 with
  GO:0003925 G protein activity (IDA), and the activity
  gomodel:67c10cc400004508/67c10cc400004511 in the human PTH1R Gs GO-CAM, which places
  GNAS between PTH1R and ADCY6. The repository GNAS gene review is for the NESP55 accession
  O95467, not Gs alpha.

  Dual coupling. A single cloned PTH1R stimulates both adenylate cyclase and phospholipase C
  (PMID:1313566), and the receptor couples to several G protein classes including Gs and
  Gq/11 (PMID:21777186). The Gs arm is modelled locally through GNAS and then by reference
  to the generic cAMP/PKA module; the Gq arm is a module_ref to the PLC beta step of
  modules/gpcr_plc_calcium_pkc_signaling.yaml rather than re-modelled, since RGD represents
  it as a link to PW:0000229. The two arms are a ONE_OR_MORE variant set on the receptor
  node, because PTH1R can use either and the scaffold state decides which dominates. Gi/o
  and G12/13 coupling, which PMID:21777186 also lists, is not modelled: RGD draws neither,
  and the only Gi evidence used here is the NHERF2-dependent adenylyl cyclase inhibition
  reported in PMID:12075354, which is recorded on the scaffold regulation rather than as a
  separate G protein step.

  NHERF/ezrin scaffold as regulation. NHERF1 and NHERF2 bind the PTH1R PDZ motif; NHERF2
  additionally binds PLC beta 1 so PTH activates PLC beta and inhibits adenylyl cyclase
  through Gi/o (PMID:12075354), and NHERF1/EBP50 confers PTH-stimulated calcium signalling
  on cells that otherwise show only cAMP (PMID:20843475). Ezrin binds the PTH1R
  carboxy-terminal tail through its FERM domain and binds NHERF1, and a dominant-negative
  ezrin selectively disrupts apical PTH1R signalling (PMID:19608645; the receptorsome is
  reviewed in PMID:21777186). The three are therefore modelled as one regulatory part that
  positively regulates the Gq arm and negatively regulates the Gs arm, with
  protein-macromolecule adaptor activity (NHERF1/NHERF2) and protein domain specific
  binding (EZR) as the molecular functions rather than any catalytic or receptor activity. The downstream phosphate-transport output
  of the complex (SLC34A1/NPT2a retrieval, RGD link PW:0001183) and the bone and renal
  calcium-handling outputs are outside the module, so SLC34A1 is not a member even though
  RGD lists it.

  Termination. GRK2 (RGD Adrbk1) enhances agonist-dependent PTH1R phosphorylation whereas
  GRK3 does not (PMID:9849959), so only GRK2 is modelled, and that paper's finding that
  phosphorylation is not required for internalization is recorded as a caveat on the
  termination node: GRK phosphorylation drives the uncoupling step, not endocytosis per se.
  Active PTH drives beta-arrestin/dynamin-mediated PTH1R endocytosis (PMID:12920119), which
  also shows an arrestin-independent route gated by NHERF1 — a second, deliberate link
  between the scaffold part and termination, recorded in the connection description.

  GO-CAM grounding. PTH, PTH1R and GNAS are linked to the human PTH1R Gs model
  gomodel:67c10cc400004508; the GRK and arrestin annotons to the GRK/arrestin
  desensitization model gomodel:67f85f2b00004426 (built for C5AR1, so gene and function
  match but not the receptor). No cached GO-CAM covers the NHERF/ezrin scaffold. None of
  this module's gene products has a gene review yet (the GNAS review is a different
  accession); those are curation follow-up for the project plan.
module:
  id: pth_receptor_signaling
  label: Parathyroid hormone receptor signaling
  module_type: SIGNALING_PATHWAY
  concepts:
    - preferred_term: cellular response to parathyroid hormone stimulus
      term:
        id: GO:0071374
        label: cellular response to parathyroid hormone stimulus
      description: >-
        PTH binding to PTH1R and the resulting Gs-adenylyl cyclase-cAMP-PKA and Gq-PLC
        responses, biased by the NHERF/ezrin scaffold and terminated by GRK2/beta-arrestin.
  context:
    taxa:
      - preferred_term: Homo sapiens
        term:
          id: NCBITaxon:9606
          label: Homo sapiens
        description: >-
          Members are grounded on the human proteins; the pathway is conserved across
          mammals and the diagram is RGD's rat curation.
    cellular_components:
      - preferred_term: extracellular region
        term:
          id: GO:0005576
          label: extracellular region
        description: PTH circulates and acts on the receptor from outside the cell.
      - preferred_term: plasma membrane
        term:
          id: GO:0005886
          label: plasma membrane
        description: >-
          PTH1R, Gs and the GRK/arrestin step act at the plasma membrane; in renal proximal
          tubule the scaffolded receptor pool is apical.
  parts:
    - order: 1
      role: PTH ligand
      node:
        id: pth_ligand
        label: Parathyroid hormone
        module_type: REGULATORY_STEP
        description: >-
          Secreted parathyroid hormone, the agonist of PTH1R; its only asserted function is
          hormone activity.
        annotons:
          - id: pth_hormone
            label: PTH hormone activity
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: PTH
                term:
                  id: UniProtKB:P01270
                  label: Parathyroid hormone
            function:
              preferred_term: hormone activity
              term:
                id: GO:0005179
                label: hormone activity
              targets:
                - preferred_term: PTH1R
                  term:
                    id: UniProtKB:Q03431
                    label: Parathyroid hormone/parathyroid hormone-related peptide receptor
            locations:
              - preferred_term: extracellular region
                term:
                  id: GO:0005576
                  label: extracellular region
            role_description: >-
              Calcium-regulating peptide hormone; the signal, not a catalytic participant.
              PTHLH (PTHrP) is the second PTH1R agonist and is outside this module.
            gocam_associations:
              - model: gomodel:67c10cc400004508
                activity: gomodel:67c10cc400004508/67c10cc400004538
                title: PTH1R-mediated signaling via G-alpha-s following activation by parathyroid hormone (PTH) (Human).
                description: Same gene and molecular function (GO:0005179).
    - order: 2
      role: PTH1R activation and dual G protein coupling
      node:
        id: pth_receptor
        label: PTH1R couples to Gs and to Gq/11
        module_type: REGULATORY_STEP
        description: >-
          Agonist-occupied PTH1R acts as a guanine nucleotide exchange factor for Gs, the
          dominant route, and for Gq/11; a single receptor supports both.
        annotons:
          - id: pth1r_receptor
            label: PTH1R parathyroid hormone receptor activity
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: PTH1R
                term:
                  id: UniProtKB:Q03431
                  label: Parathyroid hormone/parathyroid hormone-related peptide receptor
            function:
              preferred_term: parathyroid hormone receptor activity
              term:
                id: GO:0004991
                label: parathyroid hormone receptor activity
            processes:
              - preferred_term: adenylate cyclase-activating G protein-coupled receptor signaling pathway
                term:
                  id: GO:0007189
                  label: adenylate cyclase-activating G protein-coupled receptor signaling pathway
              - 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: >-
              Class B receptor for PTH and PTHrP in kidney and bone; the hub of the module and
              the target of the scaffold and the GRK/arrestin step.
            evidence:
              - source_id: PMID:1313566
                statement: >-
                  A single cloned PTH/PTHrP receptor mediates stimulation of both adenylate
                  cyclase and phospholipase C.
                supporting_text: >-
                  a single cDNA clone, expressing either rat bone or opossum kidney PTH/PTHrP
                  receptor, mediates PTH and PTHrP stimulation of both adenylate cyclase and
                  phospholipase C
              - source_id: PMID:21777186
                statement: PTH1R couples to several G protein subclasses including Gs and Gq/11.
                supporting_text: >-
                  the PTH1R couples to several G protein subclasses, including Gs, Gq/11,
                  Gi/o and G12/13
            gocam_associations:
              - model: gomodel:67c10cc400004508
                activity: gomodel:67c10cc400004508/67c10cc400004509
                title: PTH1R-mediated signaling via G-alpha-s following activation by parathyroid hormone (PTH) (Human).
                description: >-
                  Same gene and the Gs process (GO:0007189); the model types the receptor with
                  the parent GO:0004930 rather than GO:0004991.
        variant_sets:
          - id: pth1r_g_protein_routes
            label: PTH1R G protein routes
            axis: G protein class
            selection: ONE_OR_MORE
            notes: >-
              The Gs route is the main one; the Gq/11 route is favoured where NHERF scaffolds
              are expressed. Either or both can carry the signal in a given cell.
            variants:
              - id: pth_gs_route
                label: Gs route (adenylyl cyclase and cAMP)
                module_type: REGULATORY_STEP
                description: PTH1R activates G alpha s, which stimulates adenylyl cyclase.
                annotons:
                  - id: pth_gnas
                    label: GNAS G protein activity
                    participant:
                      selector_type: GENE_PRODUCT
                      gene_product:
                        preferred_term: GNAS (G alpha s)
                        term:
                          id: UniProtKB:P63092
                          label: Guanine nucleotide-binding protein G(s) subunit alpha isoforms short
                    function:
                      preferred_term: G protein activity
                      term:
                        id: GO:0003925
                        label: G protein activity
                    processes:
                      - preferred_term: adenylate cyclase-activating G protein-coupled receptor signaling pathway
                        term:
                          id: GO:0007189
                          label: adenylate cyclase-activating G protein-coupled receptor signaling pathway
                    locations:
                      - preferred_term: plasma membrane
                        term:
                          id: GO:0005886
                          label: plasma membrane
                    role_description: >-
                      Stimulatory G alpha subunit; added to RGD's gene list because the Gs step
                      cannot be modelled without it.
                    gocam_associations:
                      - model: gomodel:67c10cc400004508
                        activity: gomodel:67c10cc400004508/67c10cc400004511
                        title: PTH1R-mediated signaling via G-alpha-s following activation by parathyroid hormone (PTH) (Human).
                        description: Same gene and molecular function (GO:0003925), between PTH1R and ADCY6.
              - id: pth_gq_route
                label: Gq/11 route (phospholipase C beta)
                description: >-
                  Included by reference to the PLC beta step of the generic
                  Gq-PLC-calcium-PKC module; the downstream IP3/calcium and DAG/PKC steps are
                  in that module.
                module_ref: gpcr_plc_calcium_pkc_signaling#plc_beta_activation
    - order: 3
      role: adenylyl cyclase produces cAMP
      node:
        id: pth_adenylyl_cyclase
        label: Adenylyl cyclase produces cAMP
        description: >-
          Included by reference to the adenylyl cyclase step of the generic Gs-cAMP-PKA
          module; RGD names no cyclase isoform (the PTH1R GO-CAM uses ADCY6).
        module_ref: gpcr_camp_pka_signaling#adenylyl_cyclase_activation
    - order: 4
      role: PKA activation and output
      node:
        id: pth_pka
        label: PKA activation and substrate phosphorylation
        description: >-
          Included by reference to the PKA/CREB step of the generic Gs-cAMP-PKA module. The
          renal phosphate-transport and bone outputs of PKA are outside this module.
        module_ref: gpcr_camp_pka_signaling#pka_creb_output
    - order: 5
      role: NHERF/ezrin scaffold biasing of receptor coupling (regulation)
      optional: true
      node:
        id: pth_nherf_ezrin_scaffold
        label: NHERF1/NHERF2 and ezrin scaffold at the PTH1R carboxy terminus
        module_type: REGULATORY_STEP
        description: >-
          PDZ scaffolds bound to the PTH1R carboxy-terminal motif, linked to actin through
          ezrin. The complex biases the receptor toward phospholipase C signalling and away
          from adenylyl cyclase, and in renal proximal tubule it holds the receptor apically.
        annotons:
          - id: nherf_scaffold
            label: NHERF1/NHERF2 PDZ scaffolding of PTH1R and PLC beta
            participant:
              selector_type: FAMILY
              family:
                preferred_term: NHERF PDZ scaffolds (NHERF1, NHERF2)
                representative_members:
                  - preferred_term: NHERF1 (EBP50, SLC9A3R1)
                    term:
                      id: UniProtKB:O14745
                      label: Na(+)/H(+) exchange regulatory cofactor NHE-RF1
                  - preferred_term: NHERF2 (SLC9A3R2)
                    term:
                      id: UniProtKB:Q15599
                      label: Na(+)/H(+) exchange regulatory cofactor NHE-RF2
            function:
              preferred_term: protein-macromolecule adaptor activity
              term:
                id: GO:0030674
                label: protein-macromolecule adaptor activity
              targets:
                - preferred_term: PTH1R carboxy-terminal PDZ-binding motif
                  term:
                    id: UniProtKB:Q03431
                    label: Parathyroid hormone/parathyroid hormone-related peptide receptor
            processes:
              - preferred_term: positive regulation of phospholipase C-activating G protein-coupled receptor signaling pathway
                term:
                  id: GO:1900738
                  label: positive regulation of phospholipase C-activating G protein-coupled receptor signaling pathway
              - preferred_term: negative regulation of adenylate cyclase-activating G protein-coupled receptor signaling pathway
                term:
                  id: GO:0106072
                  label: negative regulation of adenylate cyclase-activating G protein-coupled receptor signaling pathway
            locations:
              - preferred_term: apical plasma membrane
                term:
                  id: GO:0016324
                  label: apical plasma membrane
            role_description: >-
              Tether PTH1R and phospholipase C beta 1 side by side, switching the receptor's
              output from cAMP toward calcium.
            evidence:
              - source_id: PMID:12075354
                statement: >-
                  NHERF2 binds PLC beta 1 and the PTH1R carboxy-terminal PDZ motif; in cells with
                  the complex, PTH activates PLC beta and inhibits adenylyl cyclase through Gi/o.
                supporting_text: >-
                  PTH treatment of cells that express the NHERF2 PTH1R complex markedly
                  activates phospholipase C beta and inhibits adenylyl cyclase through
                  stimulation of inhibitory G proteins (G(i/o) proteins).
              - source_id: PMID:20843475
                statement: >-
                  NHERF1/EBP50 confers PTH-stimulated calcium signalling on cells that otherwise
                  respond only with cAMP.
                supporting_text: >-
                  In contrast, PTHrP(1-36) induced both cAMP and calcium signaling in A10 cells
                  over-expressing EBP50.
          - id: ezrin_anchor
            label: Ezrin FERM-domain anchoring of PTH1R and NHERF1
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: EZR (ezrin)
                term:
                  id: UniProtKB:P15311
                  label: Ezrin
            function:
              preferred_term: protein domain specific binding
              term:
                id: GO:0019904
                label: protein domain specific binding
              targets:
                - preferred_term: PTH1R carboxy-terminal tail
                  term:
                    id: UniProtKB:Q03431
                    label: Parathyroid hormone/parathyroid hormone-related peptide receptor
                - preferred_term: NHERF1
                  term:
                    id: UniProtKB:O14745
                    label: Na(+)/H(+) exchange regulatory cofactor NHE-RF1
            locations:
              - preferred_term: apical plasma membrane
                term:
                  id: GO:0016324
                  label: apical plasma membrane
            role_description: >-
              Actin-membrane linker binding the PTH1R FERM site and NHERF1; supports apical
              receptor localization and signalling. It is also an A-kinase anchoring protein
              for PKA, a role outside this module.
            evidence:
              - source_id: PMID:19608645
                statement: >-
                  Ezrin binds the PTH1R carboxy-terminal tail directly, and dominant-negative
                  ezrin selectively disrupts apical PTH1R expression and signalling.
                supporting_text: >-
                  Expression of a dominant-negative ezrin selectively disrupts apical expression
                  and signaling of the PTH1R.
    - order: 6
      role: receptor desensitization (termination)
      node:
        id: pth_termination
        label: GRK2 phosphorylation and beta-arrestin desensitization of PTH1R
        module_type: REGULATORY_STEP
        description: >-
          GRK2 phosphorylates serines in the PTH1R cytoplasmic tail of the agonist-occupied
          receptor; beta-arrestins bind it, block G protein coupling and drive
          dynamin-dependent endocytosis. Phosphorylation is required for the uncoupling step,
          not for internalization, which also has an arrestin-independent route.
        annotons:
          - id: pth_grk2
            label: GRK2 phosphorylation of PTH1R
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: GRK2
                term:
                  id: UniProtKB:P25098
                  label: G protein-coupled receptor kinase 2
            function:
              preferred_term: G protein-coupled receptor kinase activity
              term:
                id: GO:0004703
                label: G protein-coupled receptor kinase activity
              targets:
                - preferred_term: PTH1R
                  term:
                    id: UniProtKB:Q03431
                    label: Parathyroid hormone/parathyroid hormone-related peptide 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: >-
              The GRK that acts on PTH1R; GRK3 overexpression does not enhance PTH1R
              phosphorylation, so it is not modelled here.
            evidence:
              - source_id: PMID:9849959
                statement: >-
                  GRK2, but not GRK3, enhances PTH-stimulated phosphorylation of the PTH
                  receptor, on the same residues used by the endogenous kinase.
                supporting_text: >-
                  Overexpression of GRK2, but not GRK3, enhanced PTH-stimulated receptor
                  phosphorylation
            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 PTH1R.
          - id: pth_arrestin
            label: Beta-arrestin uncoupling and endocytosis of PTH1R
            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: PTH1R
                  term:
                    id: UniProtKB:Q03431
                    label: Parathyroid hormone/parathyroid hormone-related peptide receptor
            processes:
              - preferred_term: G protein-coupled receptor internalization
                term:
                  id: GO:0002031
                  label: G protein-coupled receptor internalization
            locations:
              - preferred_term: plasma membrane
                term:
                  id: GO:0005886
                  label: plasma membrane
            role_description: >-
              Bind the phosphorylated receptor, sterically block G protein coupling and route it
              into dynamin-dependent endocytosis; RGD associates both arrestins with Pth1r.
            evidence:
              - source_id: PMID:12920119
                statement: >-
                  PTH1R undergoes beta-arrestin/dynamin-mediated endocytosis in response to the
                  biologically active forms of PTH.
                supporting_text: >-
                  The PTH1R undergoes beta-arrestin/dynamin-mediated endocytosis in response to
                  the biologically active forms of PTH, PTH-(1-34), and PTH-(1-84).
            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: pth_ligand
      target: pth_receptor
      connection_type: POSITIVELY_REGULATES
      description: PTH binding activates PTH1R.
    - source: pth_gs_route
      target: pth_adenylyl_cyclase
      connection_type: POSITIVELY_REGULATES
      description: G alpha s-GTP stimulates adenylyl cyclase.
    - source: pth_adenylyl_cyclase
      target: pth_pka
      connection_type: PROVIDES_INPUT_FOR
      description: cAMP activates PKA.
    - source: pth_nherf_ezrin_scaffold
      target: pth_gq_route
      connection_type: POSITIVELY_REGULATES
      description: >-
        The NHERF/ezrin complex holds phospholipase C beta 1 at the receptor, favouring the
        Gq/PLC route.
    - source: pth_nherf_ezrin_scaffold
      target: pth_gs_route
      connection_type: NEGATIVELY_REGULATES
      description: >-
        In cells with the NHERF2-PTH1R complex, PTH inhibits adenylyl cyclase through Gi/o
        instead of stimulating it; NHERF1 either inhibits or leaves the Gs route unchanged
        (PW:0001135 record text).
    - source: pth_nherf_ezrin_scaffold
      target: pth_termination
      connection_type: NEGATIVELY_REGULATES
      description: >-
        NHERF1 also gates receptor endocytosis: it blocks the arrestin-independent
        internalization that inactive PTH fragments otherwise cause (PMID:12920119).
    - source: pth_termination
      target: pth_receptor
      connection_type: NEGATIVELY_REGULATES
      description: >-
        GRK2 phosphorylation and beta-arrestin binding uncouple PTH1R from its G proteins and
        internalize it.
