Alveolar type II (AT II) cells are in close contact with an air-liquid interface (IAL). This contact may be of considerable physiological relevance; however, no data exist to provide a satisfying description of this specific microenvironment. This is mainly due to the experimental difficulty to manipulate and analyze cell-air contacts in a specific way. Therefore, we designed assays to quantify cell viability, Ca 2ϩ changes, and exocytosis in the course of interface contact and miniaturized IAL devices for direct, subcellular, and real-time analyses of cell-interface interactions by fluorescence microscopy or interferometry. The studies demonstrated that the sole presence of an IAL is not sensed by the cells. However, when AT II cells are forced into closer contact with it, they respond promptly with sustained Ca 2ϩ signals and surfactant exocytosis before the occurrence of irreversible cell damage. This points to a paradoxical situation: a potential threat and potent stimulus for the cells. Furthermore, we found that the signalling mechanism underlying sensation of an I AL can be sufficiently explained by mechanical forces. These results demonstrate that the IAL itself can play a major, although so-far neglected, role in lung physiology, particularly in the regulatory mechanisms related with surfactant homeostasis. Moreover, they also support a general new concept of mechanosensation in the lung. mechanical stress; pneumocytes; strain; stretch; surfactant THE ALVEOLAR EPITHELIUM is covered by a thin and continuous layer of water (5). This aqueous layer, referred to as hypophase or alveolar lining fluid (ALF), introduces a considerable physical instability to the millions of alveolar invaginations, tending on overall to force the air out of the lungs. As a consequence, the great alveolar corner cells (or alveolar type II cells; AT II) synthesize and release surfactant into the ALF, from where it transits to the air-liquid interface (I AL ) and creates a highly surface-active coat (40). The importance of this protective coat is best demonstrated in the premature infant lung, where deficiency causes alveolar collapse with life-threatening consequences unless medicated by surfactant administration strategies (17).An important and almost unique aspect of the AT II cellspecific microenvironment is the presence of air. Not astonishingly, therefore, studies introducing such an I AL in AT II cell culture systems reported dramatic effects on cell function, morphology, protein expression, and ion channel activities (13,29). In general, the AT II cells have a higher phenotypic stability and seem to preserve characteristic cell functions for longer periods than compared with standard culture conditions. In particular, biosynthesis and secretion of surfactant is stable over several weeks. Furthermore, reculturing with exposure to air reverses the loss of differentiated AT II cell phenotype observed in submerged cultures (13). This effect of an I AL is indeed remarkable, though not readily intelligible. In particular, the phy...