The past 2 decades have seen a remarkable explosion of information about the structural basis of ligand interactions with nuclear hormone receptors. Hormones, however, do not simply interact with an isolated receptor but, rather, engage in transient interactions with many different proteins that comprise a system-wide hormone signaling pathway (1, 2). Thyroid hormones (THs), for example, bind to serum transport proteins that help to ensure even delivery of hormone to all tissues, cell type-specific membrane transporters, cytoplasmic interacting proteins, enzymes that variously activate prohormones or inactivate active hormones, and the TH receptors (TRs) themselves (3, 4). Presently, our understanding of chemical features of THs that are important for interactions with different binding proteins is incomplete. TH interacting proteins regulate important steps that dictate the availability of hormone for the intracellular receptor, so it is very important to understand structure activity relationships of TH in the context of both the receptor and the proteins that comprise the entire signaling system. Papers by Braun et al and Groeneweg et al in this issue of Endocrinology (23, 24) shed light on the molecular basis of cross-membrane TH transport by monocarboxylate transporter (MCT)8 (solute carrier family 16, member 2, SLC16A2). THs are zwitterionic amino acid derivatives. They have both positive and negative electrical charges and, therefore, require specific transporters in order to travel along concentration gradients across the hydrophobic plasma membrane (5, 6). It has traditionally been very difficult to directly investigate the organization of membrane proteins using classical structural biology approaches, and consequently, very little is known about the organization of TH transporters and the molecular basis of TH transport. Consideration of transporter function suggests that there must be overlaps and differences in ligand binding interactions relative to TRs. Both types of protein must display significant specificity for hormone (7, 8). The transporters, however,must transientlybindand then rapidly release hormone in a vectorial manner that stands in contrast to the requirement for a relatively stable hormone-receptor complex throughout the transcription cycle (9). Among known TH transporters, MCT8 is expressed in brain and liver and is highly selective for THs vs other molecules (10, 11). MCT8 is crucially important for uptake and efflux of THs across the blood-brain barrier and neurons and is the target for mutations that cause an inherited human disease called Allan-Herndon-Dudley syndrome (AHDS) (12). AHDS was one of the first reported X-linked mental retardation syndromes (13), and as yet, there is no treatment. ADHS males present with mental retardation, congenital hypotonia, and generalized muscle weakness. Additionally, there are characteristic alterations in TH homeostasis. Affected individuals exhibit high serum-free T3, low normal levels of free T4, and normal levels of TSH (14). Pathogenic MCT8 mutations have been described in more than 45 families worldwide and include frame-shifts, exon deletions, and nonsense and missense mutations, which all block activity of ectopically expressed MCT8 proteins in biochemical assays (15). Although the structure of MCT8 is not known, there are important clues about its organization and mechanism of action. First, MCT8 is a member of the large major facilitator superfamily of 12 transmembrane-spanning
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