The cystic fibrosis transmembrane conductance regulator (CFTR) is vital for Cl ؊ and HCO 3 ؊ transport in many epithelia. As the HCO 3 ؊ concentration in epithelial secretions varies and can reach as high as 140 mM, the lumen-facing domains of CFTR are exposed to large reciprocal variations in Cl ؊ and HCO 3 ؊ levels. We have investigated whether changes in the extracellular anionic environment affects the activity of CFTR using the patch clamp technique. In fast whole cell current recordings, the replacement of 100 mM external Cystic fibrosis transmembrane conductance regulator (CFTR) 1 is a cyclic AMP activated epithelial Cl Ϫ channel, the mutation of which causes the potentially fatal inherited disease cystic fibrosis (CF) (1). The CFTR protein is a member of the ABC transporter family and is regulated by phosphorylation (2-4) and by ATP binding and hydrolysis (5-7). Dephosphorylation of CFTR by membrane-bound protein phosphatases is also important in the physiological regulation of channel activity (2,8,9).Although CF is generally considered to result from a defect in Cl Ϫ transport, most of the affected epithelia also transport HCO 3 Ϫ ions. Indeed, recent work suggests that there is a better correlation between defects in CFTR-dependent HCO 3 Ϫ transport than defects in Cl Ϫ transport and the severity of disease (10). HCO 3 Ϫ is an important component of epithelial secretions and, via its buffering role, controls the pH at the epithelial cell surface. It has been reported that CF-affected epithelia, particularly in the gastrointestinal tract, secrete fluid with a more acidic pH than normal epithelia (11,12). Whether this is also true for airway surface liquid is still controversial (13,14), but recent measurements of the pH and HCO 3 Ϫ concentration of fluid secreted by polarized human submucosal gland cells, Calu-3, indicate that these cells are capable of secreting substantial amounts of HCO 3 Ϫ (ϳ80 mM) under appropriate stimulation, a process that would be defective in CF (15). An acidic luminal environment affects the physical properties of mucus (16,17) and promotes bacterial binding to mucins (18,19), both of which may have important implications for CF lung disease (20). As many CF-affected epithelia normally secrete substantial amounts of HCO 3 Ϫ , the luminal HCO 3 Ϫ concentration will vary under different physiological situations. This is particularly the case for the pancreas, a tissue in which CFTR is highly expressed and is severely affected in CF. Although plasma HCO 3 Ϫ is ϳ25 mM, the concentration of HCO 3 Ϫ in pancreatic juice can reach ϳ140 mM in humans, and because pancreatic juice is isotonic with plasma, these high HCO 3 Ϫ concentrations are accompanied by a reciprocal fall in juice Cl Ϫ concentration (21, 22). Thus under physiological conditions, the apical surface of pancreatic duct cells and therefore the extracellular face of CFTR will be exposed to large variations in external Cl Ϫ (Cl o Ϫ ) and HCO 3 Ϫ (HCO 3 o Ϫ ) concentrations. A similar but less extreme situation is also lik...