Structural insights into the lipid and ligand regulation of serotonin receptors

Nature. 2021 Apr;592(7854):469-473. doi: 10.1038/s41586-021-03376-8. Epub 2021 Mar 24.


Serotonin, or 5-hydroxytryptamine (5-HT), is an important neurotransmitter1,2 that activates the largest subtype family of G-protein-coupled receptors3. Drugs that target 5-HT1A, 5-HT1D, 5-HT1E and other 5-HT receptors are used to treat numerous disorders4. 5-HT receptors have high levels of basal activity and are subject to regulation by lipids, but the structural basis for the lipid regulation and basal activation of these receptors and the pan-agonism of 5-HT remains unclear. Here we report five structures of 5-HT receptor-G-protein complexes: 5-HT1A in the apo state, bound to 5-HT or bound to the antipsychotic drug aripiprazole; 5-HT1D bound to 5-HT; and 5-HT1E in complex with a 5-HT1E- and 5-HT1F-selective agonist, BRL-54443. Notably, the phospholipid phosphatidylinositol 4-phosphate is present at the G-protein-5-HT1A interface, and is able to increase 5-HT1A-mediated G-protein activity. The receptor transmembrane domain is surrounded by cholesterol molecules-particularly in the case of 5-HT1A, in which cholesterol molecules are directly involved in shaping the ligand-binding pocket that determines the specificity for aripiprazol. Within the ligand-binding pocket of apo-5-HT1A are structured water molecules that mimic 5-HT to activate the receptor. Together, our results address a long-standing question of how lipids and water molecules regulate G-protein-coupled receptors, reveal how 5-HT acts as a pan-agonist, and identify the determinants of drug recognition in 5-HT receptors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Apoproteins / chemistry
  • Apoproteins / metabolism
  • Apoproteins / ultrastructure
  • Aripiprazole / metabolism
  • Aripiprazole / pharmacology
  • Binding Sites
  • Cholesterol / pharmacology
  • Cryoelectron Microscopy*
  • Heterotrimeric GTP-Binding Proteins / chemistry
  • Heterotrimeric GTP-Binding Proteins / metabolism
  • Heterotrimeric GTP-Binding Proteins / ultrastructure
  • Humans
  • Ligands*
  • Lipids*
  • Models, Molecular
  • Phosphatidylinositol Phosphates / chemistry
  • Phosphatidylinositol Phosphates / metabolism
  • Phosphatidylinositol Phosphates / pharmacology
  • Receptor, Serotonin, 5-HT1A / chemistry
  • Receptor, Serotonin, 5-HT1A / metabolism
  • Receptor, Serotonin, 5-HT1A / ultrastructure
  • Receptors, Serotonin, 5-HT1 / chemistry
  • Receptors, Serotonin, 5-HT1 / metabolism*
  • Receptors, Serotonin, 5-HT1 / ultrastructure*
  • Serotonin 5-HT1 Receptor Agonists / chemistry
  • Serotonin 5-HT1 Receptor Agonists / metabolism
  • Serotonin 5-HT1 Receptor Agonists / pharmacology
  • Water / chemistry


  • Apoproteins
  • Ligands
  • Lipids
  • Phosphatidylinositol Phosphates
  • Receptors, Serotonin, 5-HT1
  • Serotonin 5-HT1 Receptor Agonists
  • phosphatidylinositol 4-phosphate
  • Water
  • Receptor, Serotonin, 5-HT1A
  • Aripiprazole
  • Cholesterol
  • Heterotrimeric GTP-Binding Proteins