We show here that the cell-permeant cAMP analog CPT-cAMP, infused in vivo, results in an almost twofold increase in apical V-ATPase accumulation in AE1-positive A-IC within 15 min and that these cells develop an extensive array of apical microvilli compared with controls. In contrast, no significant change in VATPase distribution could be detected by immunocytochemistry in B-intercalated cells at the acute time point examined. To show a direct effect of cAMP on A-IC, we prepared cell suspensions from the medulla of transgenic mice expressing EGFP in IC (driven by the B1-subunit promoter of the V-ATPase) and exposed them to cAMP analogs in vitro. Three-dimensional reconstructions of confocal images revealed that cAMP induced a time-dependent growth of apical microvilli, starting within minutes after addition. This effect was blocked by the PKA inhibitor myristoylated PKI. These morphological changes were paralleled by increased cAMP-mediated proton extrusion (pHi recovery) by A-IC in outer medullary collecting ducts measured using the ratiometric probe BCECF. These results, and our prior data showing that the bicarbonate-stimulated soluble adenylyl cyclase (sAC) is highly expressed in kidney intercalated cells, support the idea that cAMP generated either by sAC, or by activation of other signaling pathways, is part of the signal transduction mechanism involved in acid-base sensing and V-ATPase membrane trafficking in kidney intercalated cells. proton pump; H ϩ -ATPase; immunocytochemistry; membrane trafficking; acid-base sensing; phosphorylation PROTON SECRETION BY THE RENAL proximal tubule and collecting duct is induced by a variety of factors, including systemic acidemia and basolateral CO 2 elevation. This increased acid secretion occurs at least in part by inducing the apical accumulation of the vacuolar proton pumping ATPase (V-ATPase) in A-type intercalated cells (A-IC) in both the cortical and medullary collecting ducts of the kidney. Simultaneously, bicarbonate-secreting B-type IC (B-IC) are "inactivated" by acidosis, a process that involves the endocytotic removal of basolateral plasma membrane V-ATPases that are characteristic of this cell type (6, 53). The sensing mechanism in IC that detects changes in acid-base status and regulates plasma membrane V-ATPase expression remains largely unknown.Based on our work on proton-secreting cells in the epididymis, we proposed that luminal bicarbonate may play a central role in this process via its stimulatory effect on the soluble adenylyl cyclase (sAC), an atypical cyclase distinct from canonical transmembrane adenylyl cyclases, which generates intracellular cAMP in response to increased intracellular HCO 3 Ϫ concentration (42). We have previously shown that sAC is expressed in many segments of the kidney tubule, but its expression is especially elevated in IC, where it is colocalized in a protein complex with the V-ATPase. Furthermore, sAC and V-ATPase are concentrated together in the apical domain of IC of rats treated with the carbonic anhydrase inhibitor ac...