Nanobodies as negative allosteric modulators for human calcium sensing receptor.

Human calcium sensing receptor (CaSR) senses calcium ion concentrations in vivo and is an important class of drug targets. Mutations in the receptor can lead to disorders of calcium homeostasis, including hypercalcemia and hypocalcemia. Here, 127 CaSR-targeted nanobodies were generated from camels, and four nanobodies with inhibitory function were further identified. Among these nanobodies, NB32 can effectively inhibit the mobilization of intracellular calcium ions (Ca2+ i) and suppress the G 12/13 and ERK 1/2 signaling pathways downstream of CaSR. Moreover, it enhanced the inhibitory effect of the calcilytics as a negative allosteric modulator (NAM). We determined the structure of complex and found NB32 bound to LB2 (Ligand-binding 2) domain of CaSR to prevent the interaction of LB2 domains of two protomers to stabilize the inactive state of CaSR. • 127 CaSR-targeting nanobodies were screened from camels. • NB32 effectively inhibit the mobilization of intracellular calcium ions. • NB32 enhanced the inhibitory effect of the calcilytics as a negative allosteric modulator (NAM). • Cryo-EM revealed that NB32 binds to the LB2 domain of CaSR. [ABSTRACT FROM AUTHOR]