Li MS, Holstead RG, Wang W, Linsdell P. Regulation of CFTR chloride channel macroscopic conductance by extracellular bicarbonate. Am J Physiol Cell Physiol 300: C65-C74, 2011. First published October 6, 2010 doi:10.1152/ajpcell.00290.2010.-The CFTR contributes to Cl Ϫ and HCO 3 Ϫ transport across epithelial cell apical membranes. The extracellular face of CFTR is exposed to varying concentrations of Cl Ϫ and HCO 3 Ϫ in epithelial tissues, and there is evidence that CFTR is sensitive to changes in extracellular anion concentrations. Here we present functional evidence that extracellular Cl Ϫ and HCO 3 Ϫ regulate anion conduction in open CFTR channels. Using cell-attached and inside-out patch-clamp recordings from constitutively active mutant E1371Q-CFTR channels, we show that voltage-dependent inhibition of CFTR currents in intact cells is significantly stronger when the extracellular solution contains HCO 3 Ϫ than when it contains Cl Ϫ . This difference appears to reflect differences in the ability of extracellular HCO 3 Ϫ and Cl Ϫ to interact with and repel intracellular blocking anions from the pore. Strong block by endogenous cytosolic anions leading to reduced CFTR channel currents in intact cells occurs at physiologically relevant HCO 3 Ϫ concentrations and membrane potentials and can result in up to ϳ50% inhibition of current amplitude. We propose that channel block by cytosolic anions is a previously unrecognized, physiologically relevant mechanism of channel regulation that confers on CFTR channels sensitivity to different anions in the extracellular fluid. We further suggest that this anion sensitivity represents a feedback mechanism by which CFTR-dependent anion secretion could be regulated by the composition of the secretions themselves. Implications for the mechanism and regulation of CFTR-dependent secretion in epithelial tissues are discussed. anion secretion; cystic fibrosis transmembrane conductance regulator; open channel block CYSTIC FIBROSIS (CF), a disease of deficient epithelial cell anion transport, is caused by genetic mutations that result in loss of function of the CFTR anion channel (15). CFTR is expressed in many different epithelial tissues, and, as a result, CF is associated with lung, pancreatic, gastrointestinal, and reproductive disease (45,46 (10,19,27). Again, the relative importance of direct HCO 3 Ϫ transport by CFTR vs.indirect, CFTR-regulated HCO 3 Ϫ transport by SLC26 proteins to overall epithelial cell HCO 3 Ϫ transport and their relevance to CF disease are the subject of current debate (24,29,51,55).Since CFTR is expressed in the apical membrane of epithelial cells, its extracellular face is exposed to epithelial secretions in the luminal fluid; the composition of this fluid may change dramatically under different conditions. The most striking example is the pancreatic duct, which in humans can secrete a fluid containing up to 140 mM HCO 3,5,7,13,25), and there is evidence that some epithelia may "switch" between Cl Ϫ and HCO 3 Ϫ secretion, depending on the stimulus (8,...