Diverse muscarinic allosteric ligands exhibit greatest affinity toward the M 2 receptor subtype and lowest affinity toward M 5 . In this study, we evaluated the potencies with which two groups of highly M 2 /M 5 selective allosteric agents modulate the dissociation of [3 H]N-methylscopolamine from M 2 /M 5 chimeric and point-mutated receptors. These allosteric ligands included two alkane-bisammonium compounds and a series of caracurine V derivatives, which are structurally closely related to (but stereochemically different from) the prototype allosteric ligand alcuronium. Like alcuronium, the caracurine V and alkanebisammonium compounds displayed significantly increased affinities compared with M 5 toward the chimera that included the M 2 second outer loop (o2) plus surrounding regions. Unlike alcuronium, the compounds had enhanced affinities for a chimera with M 2 sequence in transmembrane region (TM) 7; sitedirected mutagenesis in wild-type and chimeric receptors indicated that the threonine residue at M 2 423 was entirely responsible for the sensitivity toward TM7. Subsequent studies demonstrated that this TM7 epitope is likewise present in the M 4 receptor, as M 4 436 serine. The M 2 423 threonine residue is near the M 2 419 asparagine identified previously to influence gallamine binding. These studies demonstrate that a stereochemical difference can be sufficient to translate into divergent epitope sensitivities. Nonetheless, these allosteric ligands seem to derive affinity from two main regions of the receptor: o2 plus flanking regions and o3/TM7. These two epitopes are sufficient to explain the M 2 /M 5 selectivity of the presently investigated compounds; this is the first time that the subtype selectivity of muscarinic allosteric agents has been completely accounted for by distinct receptor epitopes.The five subtypes of muscarinic acetylcholine receptors are members of the superfamily of G protein-coupled receptors. The binding site for acetylcholine and conventional agonists and antagonists on muscarinic receptors seems to be located within a pocket formed by the seven ␣-helical transmembrane domains characteristic of all G protein-coupled receptors (Hulme et al., 1990;Wess, 1993). There is a high degree of conservation of amino acid sequence in the regions that are considered to bind agonists and antagonists. This may be a reason for the difficulty in developing agonists and antagonists that are highly subtype selective.Another feature of muscarinic receptors is the presence of a second, allosteric, binding site (Lee and El-Fakahany, 1991;Lazareno and Birdsall, 1995;Tucek and Proska, 1995;Ellis, 1997;Christopoulos et al., 1998;Holzgrabe and Mohr, 1998). Several observations have suggested that muscarinic allosteric ligands bind to more extracellular and presumably less conserved regions of the receptor, which may allow for greater selectivities. All five muscarinic receptor subtypes are subject to allosteric modulation (Ellis et al., 1991), and a wide array of structurally very different allost...