Somatostatin inhibits adrenocorticotropin (ACTH) secretion from pituitary tumor cells. To assess the contribution of somatostatin receptor subtype 5 (SST5) to somatostatin receptor subtype 2 (SST2) action in these cells, we assessed multipathway responses to novel highly monoreceptor-selective peptide agonists and multireceptor agonists, including octreotide and somatostatin-28. Octreotide and somatostatin-28 cell membrane binding affinities correlated with their respective SST2-selective peptide ligand. Although octreotide had similar inhibiting potency (picomolar) for cAMP accumulation and ACTH secretion as an SST2-selective agonist, somatostatin-28 exhibited a higher potency (femtomolar). Baseline spontaneous calcium oscillations assessed by fluorescent confocal microscopy revealed two distinct effects: SST2 activation reduced oscillations at femtomolar concentrations reflected by high inhibiting potency of averaged normalized oscillation amplitude, whereas SST5 activation induces brief oscillation pauses and increased oscillation amplitude. Octreotide exhibits an integrated effect of both receptors; however, somatostatin-28 exhibited a complex response with two separate inhibitory potencies. SST2 internalization was visualized with SST2-selective agonist at lower concentrations than for octreotide or somatostatin-28, whereas SST5 did not internalize. Using monoreceptor-selective peptide agonists, the results indicate that, in AtT-20 cells, SST5 regulates the dominant SST2 action, attenuating SST2 effects on intracellular calcium oscillation and internalization. This may explain superior somatostatin-28 potency and provides a rationale for somatostatin ligand design to treat ACTH-secreting pituitary tumors.Somatostatin (somatotropin-release inhibiting factor, SRIF), 1 suppresses hormone release from secreting cells, including pituitary corticotrophs (1, 2). Selective SST receptor subtype ligands regulate pituitary hormones in vitro (3-5). Deletion of mouse somatostatin receptor type 2 (SST2) (6) resulted in increased pituitary ACTH release (7) underscoring the physiologic role for SRIF in regulating ACTH (8, 9). Mouse pituitary AtT-20 corticotroph cells are the only viable cell line available to study ACTH secretion in vitro. These cells express endogenous somatostatin receptors (SSTs) and respond to SRIF with a dose-dependent inhibition of ACTH secretion. AtT-20 cells express specific binding sites for SST2 and SST5, but not for SST1, -3, or -4 (10, 11). Through these receptors, SRIF inhibits pituitary cell adenylate cyclase activity and blocks inward Ca 2ϩ currents (12-14). Unfortunately, the currently available SRIF agonist, octreotide, which recognizes primarily SST2, is ineffective in treating ACTH-secreting pituitary adenomas (15). Therefore, elucidating pathways whereby SRIF activates corticotroph receptors will facilitate design of effective SRIF analog ligand-selective pharmacotherapy (1) for the inexorable ACTH hypersecretion-characterizing patients with Cushing disease.Baseline spontaneous Ca 2ϩ os...