Abstract Disclosure: C.E. Citterio: None. K. Kim: None. B. Rajesh: None. K. Pena: None. O.B. Clarke: None. P. Arvan: None. Thyroglobulin (Tg), must be released into the lumen of thyroid follicles to facilitate thyroid hormone synthesis. The Tg primary sequence (∼2,760 amino acids) includes regions I, II, III, as well as ∼570 residues of cholinesterase-like (ChEL) domain (which bears 47% similarity to acetylcholinesterase), folded as a globular protein with multiple contacts between different Tg regions. The ChEL domain is reported to function as an intramolecular chaperone assisting Tg region I. This function cannot be replaced by acetylcholinesterase or neuroligins, indicating a unique function of Tg ChEL. However, the specific amino acids of ChEL neighboring upstream Tg regions have only recently been identified, and the key functional residues for Tg folding remain unknown. Here, we’ve combined structural analyses with functional characterization of recombinant Tg expressed in cell culture. We’ve identified hTg-ChEL K2223 and W2222 as amino acids that exhibit the closest physical proximity with Tg region I. By cryo-EM of Tg (both human and bovine), Tg-K2223 and Tg-W2222 reside only ∼4.5Å from Tg-W1089 and Tg-P1098, respectively, both of which are located in the Tg 1-9 repeat within region I. We’ve employed site-directed mutagenesis to determine the impact of these contacts by studying both full length Tg as well as Tg expressed in a two-component system in cultured cells. We find that secretory ChEL-K2223E and ChEL-W2222A behave much like WT secretory ChEL; both mutants are reasonably well expressed and secreted efficiently. However, when secretory ChEL was co-expressed with Tg region I-II-III lacking its own ChEL domain, region I-II-III secretion could be rescued in the presence of WT secretory ChEL, but not by co-expression of either ChEL-K2223E or ChEL-W2222A. In context of a single contiguous full length Tg, both expression and secretion of Tg-K2223E and Tg-W2222A were significantly diminished. These results highlight two residues (K2223 and W2222) that are not needed for the independent folding (or endoplasmic reticulum export) of the Tg ChEL domain, but are key residues for contacting Tg region I, thereby offering the overall Tg structure a great increase in conformational stability, which is needed to satisfy endoplasmic reticulum quality control requirements for intracellular protein trafficking. These findings point to the possibility that mutations altering regional contacts within the Tg structure could contribute to the molecular pathogenesis of congenital hypothyroidism. Presentation: Friday, June 16, 2023