The P2X7 receptor (P2X7R) belongs to the P2X family of ATP-gated cation channels. P2X7Rs are expressed in epithelial cells, leukocytes, and microglia, and they play important roles in immunological and inflammatory processes. P2X7Rs are obligate homotrimers, with each subunit having two transmembrane helices, TM1 and TM2. Structural and functional data regarding the P2X2 and P2X4 receptors indicate that the central trihelical TM2 bundle forms the intrinsic transmembrane channel of P2X receptors. Here, we studied the accessibility of single cysteines substituted along the pre-TM2 and TM2 helix (residues 327-357) of the P2X7R using as readouts (i) the covalent maleimide fluorescence accessibility of the surface-bound P2X7R and (ii) covalent modulation of macroscopic and single-channel currents using extracellularly and intracellularly applied methanethiosulfonate (MTS) reagents. We found that the channel opening extends from the pre-TM2 region through the outer half of the trihelical TM2 channel. ytolytic pore formation by extracellular adenosine triphosphate (ATP) was first described in mast cells and was outright suggested to involve the activation and subsequent pore dilatation of a hypothetical ATP receptor channel (1). A similar ATP-triggered pore-forming activity was subsequently found in many immune and inflammatory cells and certain transformed cell lines. The distinctive feature that is unique to this tentatively termed P2Z receptor (2) is that brief application of ATP (in its tetraanionic form, ATP 4− ) evokes depolarizing cation fluxes, whereas prolonged application of ATP 4− causes formation of cytolytic pores with a molecular cutoff of ∼900 Da (for review, see ref.3). The cytolytic activity was eventually assigned to the P2X7 receptor (P2X7R), the seventh and final member of the P2X receptor family. In HEK293 cells, the recombinant P2X7R conferred the same responses that were attributed previously to the P2Z receptor, including the dual-mode operation as a cation channel and a cytolytic pore (4, 5). Today, it is widely believed that P2X7R can mediate apoptotic or necrotic cell death under pathophysiological conditions (4-6).The cytolytic activity of human P2X7R (hP2X7R) has been attributed to a time-dependent dilation of the integral ion channel based on macroscopic current recordings of various cell types (7-11). Particularly revealing was the observation that substituting T348 and D352 with basic residues in the channellining second transmembrane domain (TM2) of the rat P2X7R (rP2X7R) simultaneously increased the permeability of the normally cationic channel for Cl − and an acidic fluorescent dye with an effective diameter of >10 Å (12). A "channel-to-pore" dilatation that changed the permeation characteristic from small inorganic cations (e.g., Na + , K + , and Ca
2+) to large organic cations [e.g., N-methyl-D-glucamine (NMDG + )] has also been found for P2X2, P2X2/X3, and P2X4 receptors (13, 14) and certain transient receptor potential (TRP) channels (15, 16). In contrast, in extended single-chann...