) and SFTPA2 (SP-A2), encode surfactant protein A, a molecule of innate immunity and surfactant-related functions. Several genetic variants have been identified for both genes. These include nucleotide (nt) polymorphisms, as well as alternative splicing patterns at the 5= untranslated region (5=UTR). Exon B (eB) is included in the 5=UTR of most SP-A2, but not SP-A1 splice variants. We investigated the role of eB in the regulation of gene expression and translation efficiency. A luciferase (Luc) reporter gene was cloned downstream of the entire (AeBD) or eB deletion mutants (del_mut) of the SP-A2 5=UTR, or heterologous 5=UTRs containing the eB sequence, or a random sequence of equal length. The del_mut constructs consisted in consecutive deletions of five nucleotides (n ϭ 8) within eB and the exon-exon junctions in the AeBD 5=UTR. Luc activities and mRNA levels were compared after transfection of NCI-H441 cells. We found that 1) eB increased Luc mRNA levels when placed upstream of heterologous 5=UTR sequences or the promoter region, regardless of its position and orientation; 2) translation efficiency of in vitrogenerated mRNAs containing eB was higher than that of mRNAs without eB; and 3) the integrity of eB sequence is crucial for transcription and translation of the reporter gene. Thus eB 1) is a transcription enhancer, because it increases mRNA content regardless of position and orientation, 2) enhances translation when placed in either orientation within its natural 5=UTR sequence and in heterologous 5=UTRs, and 3) contains potential regulatory elements for both transcription and translation. We conclude that eB sequence and length are determinants of transcription and translation efficiency. surfactant protein A; untranslated regions; secondary structure stability; trans-binding sites; cell-specific regulatory factors SURFACTANT PROTEIN A (SP-A) plays an important role in host defense and surfactant-related functions. Two functional genes, SFTPA1 (SP-A1), and SFTPA2 (SP-A2), encode this protein in humans. More than 30 gene variants have been described and characterized on the basis of nucleotide polymorphisms and amino acid sequences at the coding region (7,8,10). At the mRNA level, variants show differences at the untranslated regions (UTRs), resulting in sequence variants at the 3=UTR (16,23,42,49) and splice variants at the 5=UTR (20). The genomic sequence of SP-A 5=UTR contains several exons (A, B, B=, C, C=, D, D=) (Fig. 1A) that are alternatively spliced to give rise to specific SP-A1 and SP-A2 patterns. The formation of SP-A 5=UTR splice variants is not a random process since there are major, minor, and rare splice variants for SP-A1 and SP-A2 transcripts (20). A study of SP-A transcripts found that the predominant splice variant configurations and their frequencies differ between the two genes, and these likely also differ among individuals (21). The major splice variant for SP-A1 is AD= (81%), followed by ACD= and AB=D= (7%). The major SP-A2 variants are ABD= (49%), and ABD (44%) (20).In humans, se...