Allosteric modulators for adenosine receptors (ARs) are of an increasing interest and may have potential therapeutic advantage over orthosteric ligands. Benzoylthiophene derivatives (including PD 81,723), 2-aminothiazolium salts, and related allosteric modulators of the A(1) AR have been studied. The benzoylthiophene derivatives were demonstrated to be selective enhancers for the A(1) AR, with little or no effect on other subtypes of ARs. Allosteric modulation of the A(2A) AR has also been reported. A(3) allosteric enhancers may be predicted to be useful against ischemic conditions. We have recently characterized two classes of A(3) AR allosteric modulators: 3-(2-pyridinyl)isoquinolines (e.g. VUF5455) and 1H-imidazo-[4,5-c]quinolin-4-amines (e.g. DU124183), which selectively decreased the agonist dissociation rate at the human A(3)AR but not at A(1) and A(2A) ARs. DU124183 left-shifted the agonist conc.-response curve for inhibition of forskolin-stimulated cAMP accumulation in intact cells expressing the human A(3)AR with up to 30% potentiation of the maximal efficacy. The increased potency of A(3) agonists was evident only in the presence of an A(3) antagonist, since VUF5455 and DU124183 also antagonized, i.e. displaced binding at the orthosteric site, with K(i) values of 1.68 and 0.82 microM, respectively. A(3)AR mutagenesis studies implicated F182(5.43) and N274(7.45) in the action of the enhancers and was interpreted using a rhodopsin-based A(3)AR molecular model, suggesting multiple binding modes. Amiloride analogues, SCH-202676 (N-(2,3-diphenyl-1,2,4-thiadiazol-5(2H)-ylidene)methanamine), and sodium ions were demonstrated to be common allosteric modulators for at least three subtypes (A(1), A(2A), and A(3)) of ARs.