-L1) and mutated L1, we found that cysteine substitution of both residues (E33C/Y418C-L1) significantly increased L1 adhesion above levels observed for WT-L1 or the single cysteine substitutions E33C-L1 or Y418C-L1. The reducing agent -mercaptoethanol (ME) reversibly decreased the adhesion of E33C/ Y418C-L1, but had no effect on WT-L1, E33C-L1, or Y418C-L1. Thus, disulfide bond formation occurs between Cys-33 and Cys-418, confirming both the close proximity of these residues and the importance of Ig1-Ig4 interactions in L1 adhesion. Maximal ethanol inhibition of cell adhesion was significantly lower in cells expressing E33C/Y418C-L1 than in those expressing WT-L1, E33C-L1, or Y418C-L1. Moreover, the effects of ME and ethanol on E33C/Y418C-L1 adhesion were non-additive. The cutoff for alcohol inhibition of WT-L1 adhesion was between 1-butanol and 1-pentanol. Increasing the size of the alcohol binding pocket by mutating Glu-33 to Ala-33, increased the alcohol cutoff from 1-butanol to 1-decanol. These findings support the hypothesis that alcohol binding within a pocket bordered by Glu-33 and Tyr-418 inhibits L1 adhesion by disrupting the Ig1-Ig4 interaction.Alcohol exposure during pregnancy is the leading cause of preventable mental retardation in the Western world (1, 2).Depending on timing, dose, and duration of exposure, alcohol causes a range of facial and brain dysmorphology, growth retardation, and cognitive, neurological, and behavioral abnormalities, referred to as fetal alcohol spectrum disorders (FASD) 2 (3). Alcohol is a weak, pleiotropic drug that disrupts fetal development through a variety of mechanisms (4, 5). One potentially important target molecule for alcohol is the L1 neural cell adhesion molecule (CAM), a developmentally critical protein (6 -8).Children with mutations in the gene for L1 have brain lesions that resemble those of children with FASD, including hydrocephalus, agenesis, or hypoplasia of the corpus callosum, and cerebellar dysplasia (7, 9, 10). Concentrations of ethanol attained after one drink inhibit the adhesion of L1 expressed in fibroblasts, neural cell lines, and cerebellar granule neurons (CGN) (6, 7). Furthermore, ethanol inhibits L1-mediated neurite outgrowth in CGNs with similar potency to its inhibition of L1 adhesion (11, 12). Finally, drugs that block ethanol inhibition of L1 adhesion also prevent ethanol teratogenesis in mouse embryos (13)(14)(15)(16)(17)(18).L1 is an immunoglobulin transmembrane glycoprotein (8). The extracellular domain (ECD) includes six Ig domains and five fibronectin III repeats. The first four Ig domains (L1 Ig1-4 ) comprise the minimal elements required for L1 adhesion (19,20). The crystal structure of neurofascin, a member of the L1 family of CAMs, and homology modeling with related CAMs suggest that L1 Ig1-4 folds into a horseshoe structure, with Ig1 in apposition to Ig4 and Ig2 in apposition to (Fig. 6A). Electron microscopy has captured both a horseshoe and an extended conformation of L1 , and functional studies suggest that the hors...