Diaz-Sylvester PL, Porta M, Copello JA. Halothane modulation of skeletal muscle ryanodine receptors: dependence on Ca 2ϩ , Mg 2ϩ , and ATP. Am J Physiol Cell Physiol 294: C1103-C1112, 2008. First published February 27, 2008 doi:10.1152/ajpcell.90642.2007 susceptibility is a genetic disorder of skeletal muscle associated with mutations in the ryanodine receptor isoform 1 (RyR1) of sarcoplasmic reticulum (SR). In MH-susceptible skeletal fibers, RyR1-mediated Ca 2ϩ release is highly sensitive to activation by the volatile anesthetic halothane. Indeed, studies with isolated RyR1 channels (using simple Cs ϩ solutions) found that halothane selectively affects mutated but not wild-type RyR1 function. However, studies in skeletal fibers indicate that halothane can also activate wild-type RyR1-mediated Ca 2ϩ release. We hypothesized that endogenous RyR1 agonists (ATP, lumenal Ca 2ϩ ) may increase RyR1 sensitivity to halothane. Consequently, we studied how these agonists affect halothane action on rabbit skeletal RyR1 reconstituted into planar lipid bilayers. We found that cytosolic ATP is required for halothane-induced activation of the skeletal RyR1. Unlike RyR1, cardiac RyR2 (much less sensitive to ATP) responded to halothane even in the absence of this agonist. ATP-dependent halothane activation of RyR1 was enhanced by cytosolic Ca 2ϩ (channel agonist) and counteracted by Mg 2ϩ (channel inhibitor). Dantrolene, a muscle relaxant used to treat MH episodes, did not affect RyR1 or RyR2 basal activity and did not interfere with halothane-induced activation. Studies with skeletal SR microsomes confirmed that halothane-induced RyR1-mediated SR Ca 2ϩ release is enhanced by high ATP-low Mg 2ϩ in the cytosol and by increased SR Ca 2ϩ load. Thus, physiological or pathological processes that induce changes in cellular levels of these modulators could affect RyR1 sensitivity to halothane in skeletal fibers, including the outcome of halothane-induced contracture tests used to diagnose MH susceptibility.