The 1256-base pair enhancer-promoter of the mouse muscle creatine kinase gene includes three CAnnTG Eboxes that are conserved among mammals and have flanking and middle sequences conforming to consensus muscle regulatory factor binding sites. This study seeks to determine whether these E-boxes are critical for muscle creatine kinase expression in physiologically distinct muscles. Mutations of the "right" and "left" E-boxes in the enhancer decreased expression in cultured skeletal myocytes ϳ10-and 2-fold, respectively, whereas a "promoter" E-box mutation had little effect. In neonatal myocardiocytes, the left E-box mutation decreased expression ϳ3-fold, whereas right or promoter E-box mutations had no effect. Very different effects were seen in transgenic mice, where the promoter E-box mutation decreased expression in quadriceps, extensor digitorum longus, and soleus ϳ10-fold, and ϳ100-fold in distal tongue, diaphragm, and ventricle. The right E-box mutation, tested in the presence of the other two mutations, caused a significant decrease in distal tongue, but not in quadriceps, extensor digitorum longus, soleus, or ventricle. Mutation of the left E-box actually raised expression in soleus, suggesting a possible repressor role for this control element. The discrepancies between mutation effects in differentiating skeletal muscle cultures, neonatal myocardiocytes, and adult mice suggested that the E-boxes might play different roles during muscle development and adult steady-state function. However, transgenic analysis of embryonic and early postnatal mice indicated no positive role for these three E-boxes in early development, implying that differences in E-box function between adult muscle and cultured cells are the result of physiological signals.How is the transcription of muscle-specific genes differentially regulated in different anatomical muscles? The muscle creatine kinase (MCK) 1 gene encodes the muscle-specific isoform of creatine kinase, which is transcribed at high levels in striated muscle. Fast-type muscle fibers have approximately double the enzyme expression compared with slow-type muscle fibers (1), and heart expression is approximately an order of magnitude lower than skeletal muscle (2). 2 The MCK upstream enhancer contains binding sites for MEF2, Mhox, serum response factor, Six4 3 /TrexBF, AP-2, and OctI (Refs. 3-6 and references therein) as well as the prototype E-box binding site for the myogenic regulatory factors (MRFs) MyoD, myogenin, MRF4, and Myf5 (7-11). Transgenic mouse and mouse knockout experiments, along with in situ hybridization developmental studies and transfection experiments, have shown that MyoD and Myf5 play essential roles in muscle determination and that myogenin is critical for terminal differentiation (12-14).An enhancer-promoter region of the mouse MCK gene, which extends from Ϫ1256 to ϩ7 relative to the transcription start site, exhibits tissue-specific expression similar to that of the endogenous MCK gene, as assessed by cell culture and transgenic mouse studies (6,(...