Malignant hyperthermia (MH)3 is an autosomal dominant, pharmacogenetic disorder of skeletal muscle. MH is triggered by volatile anesthetics (e.g. halothane) and depolarizing muscle relaxants and is characterized by muscle rigidity and a hypermetabolic state (1-5). MH also occurs in pigs, in which it is caused by stress and known as porcine stress syndrome (6, 7). A single point mutation, R615C, in the pig skeletal muscle ryanodine receptor RyR1 is responsible for all cases of porcine MH (6, 7). On the other hand, human MH has been linked to a large number of mutations in RyR1 (4,5,8). Some human RyR1 mutations have also been linked to central core disease, which is often associated with MH. Although the genetic basis of MH has been well defined, the molecular mechanisms by which RyR1 mutations confer MH susceptibility and volatile anesthetics and stress trigger MH are not completely understood.The pig model has proven invaluable in investigating the molecular basis of MH, and these studies have consistently demonstrated that Ca 2ϩ release from MH-susceptible (MHS) pig skeletal muscle or sarcoplasmic reticulum (SR) membrane vesicles is enhanced upon exposure to various stimuli (1, 4, 9 -14). However, to date no clear mechanistic basis of this enhanced responsiveness of MHS RyR1 channels to stimuli has emerged. For example, some studies reported that this enhanced activity of MHS RyR1 channels was associated with changes in the apparent sensitivity of the channel to cytosolic Ca 2ϩ or Mg 2ϩ , whereas others found no marked difference in the apparent sensitivity to cytosolic Ca 2ϩ activation between MHS and normal RyR1 channels (1,(13)(14)(15)(16)(17)(18)(19)(20). Hence, the intrinsic properties of the RyR1 channel that are altered by the MH R615C mutation have remained undefined.Increasing evidence has highlighted the importance not only of cytosolic Ca 2ϩ , but also of luminal Ca 2ϩ , in controlling the activity of the RyR channel (21-23). However, in comparison with the extensive investigations of the sensitivity of MHS RyR1 channels to cytosolic Ca 2ϩ and Mg 2ϩ , the effects of the MH R615C mutation on the luminal Ca 2ϩ sensitivity of the channel remain largely unexplored. A notable exception is found among the earliest work investigating the effect of the MH R615C mutation on Ca 2ϩ handling by isolated SR membranes (13,24,25). Nelson and colleagues (13,24,25)