Alveolar epithelial type II cells secrete lung surfactant via exocytosis. Soluble N-ethylmaleimide-sensitive factor attachment protein receptors (SNARE) are implicated in this process. Lipid rafts, the cholesterol-and sphingolipid-rich microdomains, may offer a platform for protein organization on the cell membrane. We tested the hypothesis that lipid rafts organize exocytotic proteins in type II cells and are essential for the fusion of lamellar bodies, the secretory granules of type II cells, with the plasma membrane. The lipid rafts, isolated from type II cells using 1% Triton X-100 and a sucrose gradient centrifugation, contained the lipid raft markers, flotillin-1 and -2, whereas they excluded the nonraft marker, Na ϩ -K ϩ ATPase. SNAP-23, syntaxin 2, and VAMP-2 were enriched in lipid rafts. When type II cells were depleted of cholesterol, the association of SNAREs with the lipid rafts was disrupted and the formation of fusion pore was inhibited. Furthermore, the cholesterol-depleted plasma membrane had less ability to fuse with lamellar bodies, a process mediated by annexin A2. The secretagogue-stimulated secretion of lung surfactant from type II cells was also reduced by methyl--cyclodextrin. When the raft-associated cell surface protein, CD44, was cross-linked using anti-CD44 antibodies, the CD44 clusters were observed. Syntaxin 2, SNAP-23, and annexin A2 co-localized with the CD44 clusters, which were cholesterol dependent. Our results suggested that lipid rafts may form a functional platform for surfactant secretion in alveolar type II cells, and raft integrity was essential for the fusion between lamellar bodies with the plasma membrane.Keywords: alveolar type II cells; lipid rafts; membrane fusion; SNARE proteins; surfactant secretion Lung alveolar epithelium consists of two different types of cells, the cuboidal type II cells and squamous type I cells. Type II cells synthesize, store, and secrete a surface-active lipid-rich substance, the lung surfactant. The released surfactant lines the alveolar epithelium, lowers the surface tension, and thus prevents the collapse of alveoli at end-expiration. Lung surfactant deficiency causes respiratory distress syndrome (RDS) in infants. Type II cells are also involved in defense, injury and repair, and trans-differentiation into type I cells.Lung surfactant, stored in lamellar bodies, is released upon its fusion with the plasma membrane via exocytosis. The formation of fusion pore precedes the release of lamellar body contents. The SNARE (soluble N-ethylmaleimide-sensitive factor attachment protein receptors) hypothesis was proposed to elucidate the mechanisms of membrane fusion during exocytosis. During fusion, the proteins on the plasma membrane (target or t-SNAREs) and vesicles (vesicular or v-SNARE) form a highly stable, hetero-tetrameric SNARE complex. The two coiled-coil domains are contributed by soluble N-ethylmaleimide-sensitive factor attachment protein (SNAP)-25/23 and one each from syntaxin and VAMP (vesicle-associated membrane protein) (1). NSF ...