The study deals with the area of the allosteric modulation of the muscarinic M2 receptors. The allosteric modulators have an influence on binding of orthosteric ligands (agonists and antagonists) to the classical orthosteric binding site of the muscarinic M2-receptors. The modulators are able to enhance (positive cooperativity) or decrease (negative cooperativity)the affinity of ligands to the orthosteric binding site. The allosteric binding site is located at the entrance of the receptor binding pocket. It is less conserved than the orthosteric binding site which is located in a narrow cavity created by the seven transmembrane domains. Consequently, development of subtype selective allosteric ligands is easier than subtypeselective muscarinic agonists or antagonists. Furthermore, subtype selectivity can be achieved by differently cooperative interactions between the allosteric and orthosteric ligand at different receptor subtypes. For example, the allosteric modulators that are positively cooperative with ACh at M1 receptors and neutrally cooperative at the other receptor subtypes could be beneficial for treatment of the Alzheimer’s disease. Bisquaternary analogues of the Strychnos alkaloid caracurine V are among the most potent allosteric modulators of muscarinic M2-receptors. The very rigid ring skeleton comprises the pharmacophoric elements of two positively charged nitrogens at an approximate distance of 10 surrounded by two aromatic ring systems in a distinct spatial arrangement. Owing to the close structural relationship of caracurine V salts to the strong muscle relaxants toxiferine and alcuronium, they are likely to exhibit neuromuscular blocking activity, which would limit their usefulness as research tools and make the therapeutical use impossible. Reduction of the caracurine V ring skeletons to structural features responsible for good allosteric potency could possibly lead to compounds with negligible neuromuscular blocking activity and very high affinity to the allosteric binding site at M2 receptor. Thus, the aim of this study was to synthesize and pharmacologically evaluate analogues of a novel heterocyclic ring system, which comprises the pharmacophoric elements mentioned previously. The key step of the synthesis of the desired 6,7,14,15-tetrahydro[1,5]diazocino[1,2-a:6,5-a]-diindole ring system (6) involved the intermolecular double N-alkylation of the bromoethylindole (5), which was prepared from the known indolyl methylacetate (3) by reduction of the ester group to alcohol and subsequent substitution by bromine. 3 could be prepared in three steps involving N,N-dibenzylation of tryptamine followed by introduction of the dimethyl malonate moiety at C-2 of indole ring and a subsequent demethoxycarbonylation. The total synthesis of 6,7,14,15-tetrahydro[1,5]diazocino[1,2-a:6,5-a]diindole ring system (6) is shown in Scheme 24. In order to examine the influence of the length of the side-chain on muscarinic activity,exchange of the ethylamine moieties of 14 by the methylamino groups was planned. This should be accomplished by dimerization of the unsubstituted 2-bromoethylindole (32), and subsequent Mannich aminomethylation of the resulting unsubstituted pentacyclic ring. The total synthesis of the 6,7,14,15-tetrahydro-15aH-azocino[1,2-a:6,5-b]diindole ring system(35) is shown in Scheme 25. 32 was prepared from indole-2-carboxylic acid in six steps involving reduction of the acid to the corresponding alcohol 26, benzoylation of 26 followed by nucleophilic substitution with KCN, hydrolysis of the cyanide 28 to indolyl acetic acid 29,reduction of 29 to the corresponding alcohol 30, and finally bromination of 30 to give the bromide 32. Since dimerization attempts of 32 provided only 2-vinylindole (33), the tosylate 34 was used as starting material for the intermolecular alkylation to give exclusively an isomeric pentacyclic ring system, 7,14,15-tetrahydro-15aH-azocino[1,2-a:6,5-b]diindole (35). The formation of the novel, asymmetric ring skeleton can be explained by the ambident nucleophilic character of the indolyl anion that can be alkylated either at nitrogen or at C-3 of indole ring. 35 was subjected to a Mannich reaction to give 2,13-dimethylaminoalkylated product 37 as well as small amounts of the 13-monosubstituted compound (36). The geometry of novel ring systems 6 was elucidated by means of NMR spectroscopy and semiempirical calculations. The diazocinodiindole ring skeleton of 6 exists in chloroform solution at room temperature in a twisted-boat conformation, as indicated by 600 MHz ROESY experiment, vicinal coupling constants within the eight-membered ring, and AM1 calculations. In order to obtain potent allosteric ligands, the new heterocycles 6 and 37 were quarternized with methyliodide to the corresponding ammonium salts 14 and 38, respectively. Additionally, the N,N -diallylsalts of 37 (compound 39) was prepared. The allosteric effect of 14, 38, and 39 on the dissociation of the orthosteric radioligand [3H]Nmethylscopolamine([3H]NMS) and their effects on [3H]NMS equilibrium binding were studied in homogenates of porcine heart ventricles. The concentration of an allosteric agent for a half-maximum effect on orthosteric ligand dissociation (EC50,diss) corresponds to a 50 % occupancy of the liganded receptors by the respective allosteric test compounds. Due to the presence of two benzyl groups on each nitrogen in the side chains of 14, its binding affinity can be best compared with that of N,N -dibenzylcaracurinium V dibromide (EC50,diss = 69 nM). Compound 14 exhibited the comparable affinity to N,N -dibenzylcaracurinium V dibromide with EC50,diss = 54 nM. This result suggested that replacement of the bulky benzyl groups of 14 by smaller substitutents will probably increase the allosteric potency, since dimethyl- and diallylcaracurinium salts showed a 5-fold increase of binding affinity relative to the dibenzyl analogue. Even though the new azocinodiindole ring system of 38 and 39, is not included in the caracurine V ring skeleton, it comprises the essentially pharmacophoric elements of allosteric potency. Due to the different spatial arrangements of the aromatic rings, as well as to different internitrogen distances in both ring systems, compound 38 and 39 exhibited 4-fold lower M2 binding affinity (EC50,diss = 35 and 48 nM, respectively) than the corresponding caracurine V analogues. This study deals with the synthesis of the first representative (Compound 6) of a novel pentacyclic ring system derived from caracurine V. The high allosteric potency of its dimethyl analogue reveals the [1,5]diazocino[1,2-a:6,5-a]-diindole ring system as a new promising lead structure for allosteric modulators of muscarinic M2 receptors. Future research will be focused on structural modifications of the new ring system in order to increase the affinity to the muscarinic receptors. Furthermore, the binding affinities of the new synthesized compounds to the muscle type of nicotinic ACh-receptor should reveal structural features responsible for the muscarinic/nicotinic selectivity.