Regulatory sequences of the M isozyme of the creatine kinase (MCK) gene have been extensively mapped in skeletal muscle, but little is known about the sequences that control cardiac-specific expression. The promoter and enhancer sequences required for MCK gene expression were assayed by the direct injection of plasmid DNA constructs into adult rat cardiac and skeletal muscle. A 700-nucleotide fragment containing the enhancer and promoter of the rabbit MCK gene activated the expression of a downstream reporter gene in both muscle tissues. Deletion of the enhancer significantly decreased expression in skeletal muscle but had no detectable effect on expression in cardiac muscle. Further deletions revealed a CArG sequence motif at position -179 within the promoter that was essential for cardiac-specific expression. The CArG element of the MCK promoter bound to the recombinant serum response factor and YY1, transcription factors which control expression from structurally similar elements in the skeletal actin and c-fos promoters. MCK-CArG-binding activities that were similar or identical to serum response factor and YY1 were also detected in extracts from adult cardiac muscle. These data suggest that the MCK gene is controlled by different regulatory programs in adult cardiac and skeletal muscle.Cardiac and skeletal muscle are functionally similar, highly differentiated tissues that can be distinguished by the expression of distinct tissue-specific isoforms of contractile proteins, receptors, ion channels, and cytosolic enzymes. Numerous DNA regulatory elements, transcription factors, and determination genes required for expression in skeletal muscle have been identified (17,19,29,30,36,37,40,42,45), but far less is known about the developmental molecular biology of cardiac muscle. These studies are complicated by the lack of cardiac cell lines and by the tendency of cultured cells to express the fetal isoforms of muscle-specific genes (3,8,9). Recently, adult cardiac and skeletal muscle tissues have been shown to take up directly injected plasmid DNA and to express reporter genes from viral and muscle-specific regulatory sequences (1,2,5,21,25,33,43,44). Expression from these extrachromosomal, circular plasmids is detected in a small number of myocytes at the site of injection, and expression can persist for months. The simplicity of this technique and the stability of expression has led to the belief that the direct intramuscular injection of DNA may ultimately be used to deliver vaccines, hormones, and other polypeptides to adult organisms, thereby requiring the identification of gene regulatory sequences that control expression in terminally differentiated tissues.We chose to investigate the M isozyme of the creatine kinase (MCK) gene by the direct injection method because, unlike the case for myosin and actin, the same isoform is expressed in cardiac and skeletal muscle, and because its regulatory sequences have been extensively characterized in skeletal muscle cell culture and in transgenic mice studies (12, 16...