The structurally divergent agents gallamine and hexamethylene-bis-[dimethyl-(3-phthalimidopropyl)ammonium]dibromide (W84) are known to interact competitively at a common allosteric site on muscarinic receptors. Previous studies reported that the M 2 selectivity of gallamine depended largely on the EDGE (172-175) sequence in the second outer loop (o2) and on 419 Asn near the junction of o3 and the seventh transmembrane domain (TM7), whereas the selectivity of W84 depended on nearby residues 177 Tyr and 423 Thr. However, it has so far proven difficult to confer the high sensitivity for allosteric modulation of the M 2 subtype onto the weakly sensitive M 5 subtype by substituting these key residues. We now have found that M 2 423 Thr, not 419 Asn, is the dominant residue in the o3/TM7 region for gallamine's high potency, although 419 Asn can substitute for 423 Thr in some contexts; in contrast, the presence of 419 Asn reduces the potency of W84 in every context we have studied. In addition, the orientation of 177 Tyr is crucial to high sensitivity toward W84, and it seems that the proline residue at position 179 in M 5 (corresponding to M 2 172 Glu) may interfere with that orientation. Consistent with these observations, a mutant M 5 receptor with these three key mutations, M 5 P179E, Q184Y, and H478T, showed dramatically increased sensitivity for W84 (Ͼ100-fold), compared with the wild-type M 5 receptor. This same mutant receptor approached M 2 sensitivity toward gallamine. Thus, gallamine and W84 derive high potency from the same receptor domains (epitopes in o2 and near the junction between o3 and TM7), even though these allosteric agents have quite different structures.Muscarinic acetylcholine receptors (mAChRs) belong to the super family of G protein-coupled receptors and possess a highly conserved binding site (orthosteric site) for the endogenous agonist acetylcholine and for other traditional agonists or competitive antagonists (orthosteric ligands); this site is formed by the transmembrane domains (TM). The mAChRs are among the best known of a growing number of G proteincoupled receptors that possess another site (allosteric site) at which a second small ligand can bind, allowing ligand-ligand allosteric interactions at the external surface of the receptor (Christopoulos and Kenakin, 2002;Ellis, 2002). For ligands with significant selectivity, the M 2 subtype is the most sensitive of the five subtypes of mAChRs to allosteric modulation (Ellis et al., 1991;Lee and el-Fakahany, 1991;Trankle et al., 1998;Ellis and Seidenberg, 2000). Although there is evidence for the existence of multiple muscarinic allosteric sites (Ellis and Seidenberg, 1989;Potter et al., 1989;Trankle and Mohr, 1997;Birdsall et al., 2001, Lazareno et al., 2002, many muscarinic allosteric modulators seem to act at a "common allosteric site" (Ellis and Seidenberg, 1992;Trankle and Mohr, 1997).A number of investigations have attempted to identify the residues that comprise this common allosteric site. Initial