TSH Receptor

Pituitary control of the thyroid funnels through a single Class A GPCR, the TSH receptor (TSHR). Like FSHR, it carries a large extracellular leucine-rich repeat domain that captures the glycoprotein hormone thyroid-stimulating hormone. In thyroid follicular cells, TSH binding activates Gs and the cAMP/PKA pathway, stimulating glandular growth, iodide uptake and synthesis of thyroxine and triiodothyronine. TSHR is famously the target of stimulating autoantibodies in Graves' disease, the commonest cause of hyperthyroidism, while gain-of-function germline mutations cause familial non-autoimmune hyperthyroidism. Recombinant human TSH is used clinically in the follow-up of differentiated thyroid cancer, and small-molecule allosteric modulators of TSHR are under active investigation.