The family of G protein-coupled receptors that includes receptors for motilin, ghrelin, and growth hormone secretagogue has substantial potential importance as drug targets. Understanding of the molecular basis of hormone binding and receptor activation should provide insights that are helpful in the development of such drugs. We previously examined the unique second extracellular loop domain of the motilin receptor, identifying key epitopes in perimembranous locations at each end of this long loop (Matsuura, B., Dong, M., and Miller, L. J. (2002) J. Biol. Chem. 277, 9834 -9839). Here, we have extended that work, examining the other predicted extracellular domains of the motilin receptor by using sequential deletions of segments ranging from one to six amino acid residues and site-directed alanine replacement mutagenesis approaches. Each construct was transiently expressed in COS cells, and characterized for motilin-and erythromycin-stimulated intracellular calcium responses and motilin radioligand binding. Only those receptor segments that included key Cys residues in positions 25, 30, and 111 or perimembranous regions at the ends of the amino terminus and the first and third extracellular loops disrupted motilin biological activity. Each of these Cys deletions also disrupted action of erythromycin. Alanine replacements for each of the potentially important amino acid residues in the perimembranous segments revealed that residues Gly 36 , Pro 103 , Leu 109 , and Phe 332 were responsible for the selective negative impact on motilin biological activity, while responding normally to erythromycin. These results support the presence of functionally important disulfide bonds in the motilin receptor ectodomain and demonstrate that the structural determinants for binding and biological activity of peptide and non-peptidyl agonist ligands are distinct, with a broad extracellular perimembranous base contributing to normal motilin binding.Understanding of the molecular basis of hormone binding to and activation of receptors provides important insights into the active conformation of such receptors, providing critical insights helpful for the design and refinement of receptor-active drugs. The family of guanine nucleotide-binding protein (G protein)-coupled receptors that includes receptors for motilin, ghrelin, and growth hormone secretagogue includes potentially important drug targets (1-4). The physiological actions of these hormones make these targets compelling, with potential roles in gastrointestinal motility disorders, abnormalities of appetite and obesity, and disorders of growth and development (1-4). However, this receptor family is unique in that its natural ligands include substantial structural diversity, such as the rare, yet critical, post-translational modification representing octanoylation of ghrelin (3,5,6).As an initial effort to localize key receptor regions for motilin action, we examined the second extracellular loop domain of the motilin receptor, which is structurally divergent from the other memb...