ABSTRACT-We investigated the effects of the novel gastroprokinetic agent Z-338 (N-(N'-N'-diisopropylaminoethyl)-[2-(2-hydroxy-4,5-dimethoxybenzoylamino)-1,3-thiazole-4-yl] carboxyamide monohydrochloride trihydrate) on L-type voltage-dependent Ca 2+ currents (ICa) in guinea pig gastric myocytes by using the whole-cell patch clamp technique. Bath-applied acetylcholine (ACh) produced biphasic effects on ICa, i.e., enhancement (1 -100 nM) and inhibition (1 -100 mM), both of which were abolished by pretreatment with atropine (10 mM) or intracellular perfusion of GDPbS (500 mM). Z-338 (³1 nM, ED50: 120 nM) mimicked the enhancing effects of ACh, but did not inhibit ICa. The effects of Z-338 and ACh were non-additive and blocked by atropine and GDPb S, but not by pertussis toxin (PTX) pretreatment (500 ng /ml). ACh (³1 m M) induced slow inward currents via activation of the muscarinic receptor /PTX-sensitive G-protein pathway, but Z-338 was devoid of these effects. Neither pirenzepine (1 m M), AF-DX116 (1 mM), nor oxybutynin (100 nM) could prevent Z-338 (1 mM) and ACh (10 nM) from enhancing I Ca , whilst 4-DAMP (100 nM) blocked the effects of Z-338 and ACh. Bath-application of protein kinase C (PKC) activator PDBu (phorbol-12,13-dibutyrate) (250 nM) enhanced I Ca , and conversely, pipette inclusion of PKC inhibitor peptide (150 mM) abolished the effects of ACh and Z-338 on I Ca . These results collectively suggest that although contribution of the M 3 receptor is not excluded, the major actions of Z-338 on gastric myocytes are potentiation of I Ca through activation of M 5 -like receptor.Keywords: Z-338, M5 muscarinic receptor, L-type calcium channel, Gastric smooth muscle Z-338, a novel carboxyamide derivative, has recently been synthesized, in the hope to obtain more potent and clinically safer gastroprokinetic agents having a different mechanism from those of existing gastroprokinetic agents such as cisapride and domperidone, which have been reported to show unfavorable adverse effects on the central nervous and cardiovascular systems (1). It has been shown that Z-338 enhances gastric motor activity in conscious dogs with chronically implanted force transducers and restores gastric emptying suppressed by clonidine treatment in both dog and rat gastroparesis models (1). The mechanisms involved in theses actions of Z-338 have been investigated in more detail by a number of different techniques. In guinea pig stomach strips preincubated with [3 H]-labelled choline, Z-338 enhances the electrically stimulated release of [ 3 H]-ACh. This is likely to occur through inhibition of M1 and M2 receptors, since Z-338 can bind to M1 and M2 (but not M3) receptors prepared from rat tissues and effectively block membrane currents associated with activation of recombinantly expressed rat M1 and M2 receptors in Xenopus oocytes (2). Furthermore, it was also found that Z-338 enhances spontaneous contractions as well as electrically evoked excitatory junction potentials and concomitant contractions in guinea pig stomach with no significan...