Monocarboxylate transporter 8
MCT8 contains a substrate-binding pocket optimized for thyroid hormones (T3, T4) characterized by aromatic residue interactions and a hydrophobic core, as revealed by cryo-EM and crystal structures (PDB: 8ZKN, 9DWY). The transporter likely employs an alternating access mechanism with distinct inward- and outward-facing conformations, providing opportunities for state-selective modulators to enhance or bypass defective transport.
Selectivity is a major challenge given MCT8's tissue-specific expression in brain and peripheral tissues; off-target transport of substrates to other SLC16 family members (MCT1, MCT4, MCT10) could cause systemic effects. Conversely, the restricted CNS penetration requirement and X-linked inheritance pattern offer a natural selectivity advantage for brain-targeted thyroid hormone analogs over systemic monocarboxylate transporters.
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