The elastase I gene enhancer that specifies high levels of pancreatic transcription comprises three functional elements (A, B, and C). When assayed individually in transgenic mice, homomultimers of A are acinar cell specific, those of B are islet specific, and those of C are inactive. To determine how the elements interact in the elastase I enhancer and to investigate further the role of the C element, we have examined the activity of the three possible combinations of synthetic double elements in transgenic animals. Combining the A and B elements reconstitutes the exocrine plus endocrine specificity of the intact enhancer with an increased activity in acinar cells compared with that in the A homomultimer. The B element therefore plays a dual role: in islet cells it is capable of activating transcription, whereas in acinar cells it is inactive alone but greatly augments the activity specified by the A element. The C element augments the activity of either the A or B element without affecting their pancreatic cell type specificity. The roles of each element were verified by examining the effects of mutational inactivation of each element within the context of the elastase I enhancer. These results demonstrated that when tested in animals, the individual enhancer elements can perform discrete, separable functions that combine additively for cell type specificity and cooperatively for the overall strength of a multielement stage-and site-specific transcriptional enhancer.The elastase I (EI) gene is one of the pancreatic digestive enzyme genes which are activated in a stage-and site-specific manner during development of the mammalian gut. EI mRNA is present at very high levels in pancreatic acinar cells, equivalent to approximately 1% of the mRNA population, and at 100-to 1,000-fold-lower levels in other parts of the gastrointestinal tract including the stomach, duodenum, and colon (16,26). EI mRNA first becomes detectable in the pancreas at about embryonic day 14 in rats (9), about 4 days after the appearance of the pancreatic bud on the developing gut. The transcriptional regulatory regions that confer this organ-and stage-specific expression lie immediately upstream of the EI structural gene (14,22). This region includes a 134-bp enhancer (Ϫ72 to Ϫ205) that is both necessary and sufficient for the spectrum of gastrointestinal transcription (8, 26) and a TATA box-containing promoter (ϩ8 to Ϫ71) that does not contribute to organ specificity (21, 26). Although organ specific, the isolated enhancer directs expression inappropriately to islet cells as well as acinar cells (14). The acinar cell specificity notable for the endogenous gene is enforced by a negative regulatory region immediately upstream of the enhancer (Ϫ206 to Ϫ501) that selectively suppresses islet cell expression.The EI transcriptional enhancer contains three functional elements (A, B, and C) of 12 to 25 bp each (26, 35). When multimerized, the A and B elements can direct the activation of a naive reporter gene in the pancreas of transgenic mice (14, ...