We have identified a series of 1H-imidazo- [4,5-c]quinolines as selective allosteric enhancers of human A 3 adenosine receptors. Several of these compounds potentiated both the potency and maximal efficacy of agonist-induced responses and selectively decreased the dissociation of the agonist N 6 -(4-amino-3-[125 I]iodobenzyl)-5Ј-N-methylcarboxamidoadenosine from human A 3 adenosine receptors. There was no effect on the dissociation of the antagonist observed; as for many allosteric modulators of G proteincoupled receptors, an orthosteric effect was also present. The most promising leads from the present set of analogs seem to be the 2-cyclopentyl-1H-imidazo[4,5-c]quinoline derivatives, of which the 4-phenylamino analog DU124183 had the most favorable degree of allosteric modulation versus receptor antagonism. The inhibition of forskolin-stimulated cyclic AMP accumulation in intact cells that express human A 3 receptors was employed as a functional index of A 3 receptor activation. The enhancer DU124183 caused a marked leftward shift of the concentration-response curve of the A 3 receptor agonists in the presence of antagonist and, surprisingly, a potentiation of the maximum agonist efficacy by approximately 30%. Thus, we have identified a novel structural lead for developing allosteric enhancers of A 3 adenosine receptors; such enhancers may be useful for treating brain ischemia and other hypoxic conditions.In addition to the orthosteric ligand binding site for competitive antagonists and agonists, the A 3 adenosine receptor contains an allosteric binding site (Gao et al., 2001). An allosteric ligand and a competitive ligand can bind to a given receptor simultaneously and modulate the affinity of the other. In the case of the ion channel-coupled GABA A receptor, diazepam enhances the endogenous neurotransmitter GABA via an allosteric site (Macdonald and Olsen, 1994), thus providing therapeutic efficacy, whereas the direct-acting agonists are not used clinically because of the side effects. In the ion channel-coupled nicotinic receptors, galanthamine, which is an acetylcholinesterase inhibitor as well as an allosteric modulator at nicotinic receptor sites potentiating nicotinic cholinergic neurotransmission, has recently been exGilead Sciences provided financial support for Z.-G.G.