A single asparagine-to-tyrosine point mutation in the human M 3 muscarinic acetylcholine (mACh) receptor at residue 514 (N514Y) resulted in a marked increase (ϳ300%) in agonistindependent [3 H]inositol phosphate ([ 3 H]IP x ) accumulation compared with the response observed for the wild-type (WT) receptor. All the antagonists tested were able to inhibit both the WT-M 3 and N514Y M 3 mACh receptor-mediated basal [ 3 H]IP x accumulation in a concentration-dependent manner. However, significant differences in both potency and binding affinity were only seen for those antagonists that possess greater receptor affinity. Despite being transfected with equivalent amounts of cDNA, cells expressed the N514Y M 3 mACh receptor at levels that were only 25 to 30% of those seen for the WT receptor. Differences in the ability of chronic antagonist exposure to up-regulate N514Y M 3 mACh receptor expression levels were also seen, with 4-diphenylacetoxy-N-methylpiperidine (4-DAMP) producing only 50% of the receptor up-regulation produced by atropine or pirenzepine. Basal phosphorylation of the N514Y M 3 mACh receptor was approximately 100% greater than that seen for the WT-M 3 receptor. The ability of antagonists to decrease basal N514Y M 3 mACh receptor phosphorylation revealed differences in inverse-agonist efficacy. Atropine, 4-DAMP, and pirenzepine all reduced basal phosphorylation to similar levels, whereas methoctramine, a full inverse agonist with respect to reducing agonist-independent [ 3 H]IP x accumulation, produced no significant attenuation of basal receptor phosphorylation. This study shows that mACh receptor inverse agonists can exhibit differential signaling profiles, which are dependent on the specific pathway investigated, and therefore provides evidence that the molecular mechanism of inverse agonism is likely to be more complex than the stabilization of a single inactive receptor conformation.Substantial experimental evidence now exists to show that G protein-coupled receptors (GPCRs) can productively couple to G proteins in the absence of agonist to produce a measurable downstream response (see de Ligt et al., 2000;Parnot et al., 2002;Milligan, 2003). An early demonstration of constitutive activity was the observation of agonist-independent G protein GTPase activity mediated by ␦-opioid receptors endogenously expressed in NG108-15 neuroblastoma glioma cells (Costa and Herz, 1989). However, the majority of GPCRs exhibit low levels of agonist-independent activity even when overexpressed. Therefore, much of the pioneering work on GPCR constitutive activity has exploited either single point mutations (Kjelsberg et al., 1992) or small amino acid sequence replacements (Samama et al., 1993) to create constitutively active receptors that have been presumed to (at least partially) reflect the endogenous, agonist-stabilized activated state. These constitutively active mutants also show both increased affinity and intrinsic activity for agonists. To accommodate these empirical observations, the "extended ternary...