Human P-glycoprotein (P-gp, ABCB1), which conveys multidrug resistance, is a drug efflux pump that transports a wide variety of structurally unrelated compounds out of cells [1][2][3][4]. The transport by P-gp is driven by energy from ATP hydrolysis, and P-gp is classified as a member of the ATP-binding cassette (ABC) transporter family [5,6].The transport of substrate by P-gp is thought to be coupled with ATP hydrolysis [7]. Without a transport substrate, P-gp has low basal ATP hydrolase (ATPase) activity, whereas with substrates P-gp exhibits high ATPase activity, which is known as substrate-stimulated ATPase activity [8][9][10][11]. Thus, the substrate-stimulated ATPase activity can be a measure of the recognition of substrate by P-gp. When titrating P-gp substrates, the activity increases up to a maximum but then decreases at high substrate concentrations. This characteristic bell-shaped activity profile has been Human P-glycoprotein (P-gp), which conveys multidrug resistance, is an ATP-dependent drug efflux pump that transports a wide variety of structurally unrelated compounds out of cells. P-gp possesses a 'linker region' of $ 75 amino acids that connects two homologous halves, each of which contain a transmembrane domain followed by a nucleotide-binding domain. To investigate the role of the linker region, purified human P-gp was cleaved by proteases at the linker region and then compared with native P-gp. Based on a verapamil-stimulated ATP hydrolase assay, sizeexclusion chromatography analysis and a thermo-stability assay, cleavage of the P-gp linker did not directly affect the preservation of the overall structure or the catalytic process in ATP hydrolysis. However, linker cleavage increased the k cat values both with substrate (k sub ) and without substrate (k basal ), but decreased the k sub ⁄ k basal values of all 10 tested substrates. The former result indicates that cleaving the linker activates P-gp, while the latter result suggests that the linker region maintains the tightness of coupling between the ATP hydrolase reaction and substrate recognition. Inspection of structures of the P-gp homolog, MsbA, suggests that linker-cleaved P-gp has increased ATP hydrolase activity because the linker interferes with a conformational change that accompanies the ATP hydrolase reaction. Moreover, linker cleavage affected the specificity constants [k sub ⁄ K m(D) ] for some substrates (i.e. linker cleavage probably shifts the substrate specificity profile of P-gp). Thus, this result also suggests that the linker region regulates the inherent substrate specificity of P-gp.Abbreviations