The neurohormone melatonin, primarily synthesized by the pineal gland, exerts its physiological functions by two high-affinity G protein-coupled receptors: MT1 and MT2. Both are widely expressed in the brain, retina and several other peripheral tissues to regulate a wide variety of physiological function such as circadian and seasonal rhythms, retinal physiology, glucose homeostasis and neuronal and immune functions. Melatonin receptors modulate several intracellular signal transduction pathways and inhibit cAMP and cGMP production and activate extracellular signal-regulated kinases 1/2 (ERK1/2) and ion channels. This work focuses on the central role of ERK1/2 signaling in melatonin receptor function by defining the molecular pathway(s) involved and by studying modifications of this pathway under disease conditions. In article 1, we decipher the molecular pathways involved in the activation of the ERK1/2 signaling cascade by human MT1 and MT2 receptors in HEK293 cells, a relevant cellular model system. We show that β-arrestins do not participate in ERK1/2 activation by both receptors. Whereas ERK1/2 activation by MT1 is exclusively mediated though Gi/o proteins by liberating Gβγ subunits, MT2 is strictly dependent on the cooperative activation of Gi/o and Gq/11 proteins. Both receptors activate further downstream the PI3K/PKCζ/c-Raf/MEK/ERK cascade, with which they are forming preformed mega-signaling complexes. G protein cooperativity was also observed further downstream on the ERK1/2 target gene level but not for the Gi/cAMP pathway. This work provides the first full description of the ERK signaling pathway activated by MT1 and MT2, highlights differences between the two receptors and describes a new cooperativity model between Gi/o and G/11 proteins.Naturally occurring receptor variants might have modified signal transduction properties and modified physiological functions. The functional assessment of disease-associated variants is therefore extremely important to establish a link between modified function and disease to eventually design new therapeutic strategies. In article 2, we established the ERK1/2 signaling profile of 40 natural MT2 variants associated with type 2 diabetes (T2D) by measuring ERK phosphorylation directly in cell lysates with the alpha-screen technology. Collectively, article 2 confirmed the general association between loss-of-function of MT2 and increased T2D risk and showed that the ERK1/2 pathway is not among those pathways primarily associated to T2D risk.Generation and aggregation of the amyloid-beta peptides (Aβ) is the main molecular hallmark of Alzheimer’s disease (AD). In AD patients both components of the melatoninergic system, i.e. melatonin production and melatonin receptor function, are markedly reduced. However, the mechanistic basis for that is still poorly understood. In article 3, we demonstrate that Aβ abolishes melatonin synthesis and diminishes MT1- and MT2 functions such as the activation of the ERK1/2 pathway by melatonin. This work provides a mechanistic basis for the diminished responsiveness of the melatoninergic system in AD patients.Collectively, this thesis provides new insights on how human melatonin receptors promote ERK1/2 activation and how this activation is modified by Aβ in the context of AD and by MT2 variants associated with T2D.