Multidrug resistance protein 1 (MRP1/ABCC1) is an ATP-binding cassette transporter that confers resistance to drugs and mediates the transport of organic anions. MRP1 has a core structure of two membrane spanning domains (MSDs) each followed by a nucleotide binding domain. This core structure is preceded by a third MSD with five transmembrane (TM) helices, whereas MSD2 and MSD3 each contain six TM helices. We investigated the consequences of Ala substitution of 18 Pro residues in both the non-membrane and TM regions of MSD2 and MSD3 on MRP1 expression and organic anion transport function. All MRP1-Pro mutants except P1113A were expressed in human embryonic kidney cells at levels comparable with wild-type MRP1. In addition, five mutants containing substitutions of Pro residues in or proximal to the TM helices of MSD2 (TM6-Pro 343 , TM8-Pro 448 , TM10-Pro 557 , and TM11-Pro 595 ) and MSD3 (TM14-Pro 1088 ) exhibited significantly reduced transport of five organic anion substrates. In contrast, mutation of Pro 1150 in the cytoplasmic loop (CL7) linking TM15 to TM16 caused a substantial increase in 17-estradiol-17--(D-glucuronide) and methotrexate transport, whereas transport of other organic anions was reduced or unchanged. Significant substrate-specific changes in the ATP dependence of transport and binding by the P1150A mutant were also observed. Our findings demonstrate the importance of TM6, TM8, TM10, TM11, and TM14 in MRP1 transport function and suggest that CL7 may play a differential role in coupling the activity of the nucleotide binding domains to the translocation of different substrates across the membrane.The human MRP1 1 (gene symbol ABCC1) that was originally cloned from a multidrug-resistant small cell lung cancer cell line is an integral membrane protein that belongs to subfamily C of the ABC superfamily of transporter proteins (1-3). The human ABCC subfamily contains nine MRP-related proteins (MRP1-6/ABCC1-6 and MRP7-9/ABCC10 -12), the cystic fibrosis transmembrane conductance regulator (CFTR/ABCC7), and the sulfonylurea receptors SUR1 (ABCC8) and SUR2 (ABCC9) (4, 5). All 12 ABCC members have a core four domain structure consisting of two MSDs (each containing 6 TM helices) and two NBDs configured MSD-NBD1-MSD-NBD2. The core structures of MRP1-3, -6, and -7, as well as SUR1 and SUR2 are connected by a cytoplasmic loop, CL3 (or L o ) to a fifth domain, an NH 2 -terminal MSD consisting of 5 TM helices. This third MSD is the major structural feature that distinguishes these five domain, 17-TM helix proteins from CFTR, MRP4,3,4,6). The precise physiological functions of all ABCC proteins are not yet fully understood, although several are known to be important in certain genetic disorders. For example, mutations in MRP2 (ABCC2) are responsible for Dubin-Johnson syndrome, a form of congenital conjugated hyperbilirubinemia (7), and mutations in CFTR (ABCC7) cause cystic fibrosis (8).Increased expression of MRP1 has been detected in drugresistant tumor cell lines and tumor tissues, and MRP1 has been demo...