New methods of elucidating the ligand-binding activity of receptors could improve our understanding of receptor function, key events they control, and their presence in normal and pathological states. We describe a method for visualizing receptor-ligand binding in cells and tissues that substitutes fluorescein for radioactive labels, and detects receptor bound, fluoresceinated ligand with an antifluorescein/horseradish peroxidase amplification system. Receptor-bound ligand is then visualized by light microscopy against a standard hemotoxylin-stained background of cell structure. Quantitative versions of the assay provide an apparent dissociation constant and number of receptors per cell at saturation in cell or tissue specimens. Receptors examined include the folate receptor, bombesin peptide-binding receptors, the epidermal growth factor receptor, the neuropeptide Y receptor, the asialoglycoprotein receptor, and RGD peptide-binding integrins. Visualizing and quantifying the binding of ligands to receptors expressed in tissues is crucial to understanding the role receptors play and the events they control in normal and pathological tissues. Though antibody based immunohistochemistry provides valuable information about the distribution of immunoreactive structures (epitopes), it does not provide information on the presence or activity of ligand binding sites (Figure 1a). In a typical assay configuration, information about receptor distribution is obtained through antibody-mediated biotinstreptavidin interaction amplified by conjugated enzymes (eg horseradish peroxidase (HRP)).1-3 Receptor autoradiography requires the use of radiolabeled ligands, with the attendant issues of frequent radiochemical synthesis and handling of radioactivity (Figure 1b). In addition, the distribution of radioactivity is obtained on a blank background and must be superimposed on a second image, to visualize ligand binding against a background of cell structure.We hypothesized that it would be possible to substitute fluoresceinated ligands for radioactive ligands, and detect bound fluorescein using the HRP amplification system to achieve a high sensitivity. We further hypothesized that fluorescein hapten detection methodologies could be configured as a cell-based method for imaging receptors (fluorescein hapten visualization (FHV)) or as a cell-based assay for bound ligand (fluorescein hapten assay (FHA)) as shown in Figure 1c. In the visualization method (FHV), a cell monolayer or tissue specimen is incubated with the receptorbinding ligand in a slide chamber and bound ligand visualized by microscopy. In the assay method (FHA), the specimen is exposed to the fluoresceinated ligand as in FHV, but rather than proceeding with microscopy the specimen is solubilized and immunoreactive fluorescein quantified by a fluorescein immunoassay. When the number of cells is measured in the sample, the bound ligand per cell can be obtained. FHV and FHA provide information about ligand-binding receptors that can be used with different types of specimens...