Structural insights into single-pass transmembrane receptor GC-A activation by distinct antihypertensive antibodies.

TitleStructural insights into single-pass transmembrane receptor GC-A activation by distinct antihypertensive antibodies.
Publication TypeJournal Article
Year of Publication2026
AuthorsLiu S, Manzo O, Wang J, Zhu L, Xiao F, Su Y-C, Kurre D, Liu W, Miao Y, Di Lorenzo A, Huang X-Y
JournalNat Commun
Date Published2026 Apr 06
ISSN2041-1723
Abstract

The single-pass transmembrane receptor guanylyl cyclase A (GC-A), also known as natriuretic peptide receptor A (NPR-A) or NPR1, regulates blood pressure through vasodilation and natriuresis, making it a promising therapeutic target for hypertension and heart failure. We describe two monoclonal antibodies, XX16 and REGN5308, that differentially activate GC-A. Using cryo-electron microscopy and molecular dynamics simulations, we reveal that XX16 stabilizes GC-A in an active conformation even without its ligand ANP, whereas REGN5308 requires ANP to fully promote receptor activation. Both antibodies increase ANP binding affinity to GC-A and enhance GC-A-mediated cGMP signaling, although XX16 exerts a stronger stabilizing influence on ATP and GTP binding. In a mouse model of obesity-induced hypertension, XX16 treatment significantly reduces blood pressure, underscoring its therapeutic potential. These findings outline the structural and functional basis of GC-A activation by antibody positive allosteric modulators, offering strategies for durable antihypertensive therapies and improved management of cardiovascular diseases.

DOI10.1038/s41467-026-71594-7
Alternate JournalNat Commun
PubMed ID41942428
Grant ListHL177433 / / U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute (NHLBI) /