We have studied the transcriptional regulatory mechanism of the human histo-blood group ABO genes, and identified DNA cis-elements and trans-activating protein that control the expression of these genes which are important in blood transfusion and organ transplantation. We introduced the 5 -upstream sequence of ABO genes into the promoterless reporter vector and characterized the promoter activity of deletion constructs using transient transfection assays with gastric cancer cell line KATO III cells. The sequence just upstream of the transcription start site (cap site), and an enhancer element, which is located further upstream (between ؊3899 and ؊3618 base pairs ( Histo-blood group ABH(O) antigens, the major alloantigens in humans (1), have been characterized as defined trisaccharide determinants GalNAc␣133(Fuc␣132)Gal13 R, Gal␣133(Fuc␣132)Gal13 R, and disaccharide determinant Fuc␣132Gal13 R for A, B, and H, respectively (2, 3). These structures represent the secondary gene products which are synthesized from the precursor H substrate by ␣133GalNAc (A transferase) and ␣133Gal transferase (B transferase), the primary gene products coded by the functional alleles at the ABO locus (4, 5). Molecular genetic studies of the ABO genotypes have identified two critical single-base substitutions between A and B genes, the resultant 2-amino acid substitutions being responsible for the different donor nucleotide-sugar substrate specificity between A and B transferases. A single base deletion, which shifts the codon reading frame and abolishes the function of A transferase, has been identified in O allelic cDNAs (6, 7).ABH antigens are known to undergo drastic changes during development, differentiation, and maturation. Studies of these antigens in stratified squamous epithelia provided one of the clearest examples of differential expression during cell maturation (8). In non-keratinized stratified squamous epithelia, the immature cells in the basal layers are characterized by the expression of sialylated or unsubstituted precursor peripheral cores, while differentiated and mature cells in the upper layers sequentially express ␣132-fucosylated H structures, and A and B antigens depending on the ABO genotype of the individual. This sequential expression of carbohydrate antigens is associated with the differentiation pattern of the epithelium. An interesting question is how these changes are controlled during cell differentiation. Since keratinocytes are known to greatly change their gene expression during terminal cell differentiation (9), the switch-on of the ABO genes during the maturation may be governed by the same factor(s). To fill in the gap between the expression of the ABO genes and the appearance of the ABO phenotypes in the terminal differentiation of epithelial cells, it is essential to understand the transcriptional regulatory mechanism of the ABO genes. In addition to the normal cell differentiation process, the changes of ABH antigen expression have also been documented in abnormal processes such as tumorig...