Carbonic anhydrase (CA) is strongly expressed in the duodenum and has been implicated in a variety of physiological functions including enterocyte HCO 3 ؊ supply for secretion and the ''sensing'' of luminal acid and CO 2. Here, we report the physiological role of the intracellular CAII isoform involvement in acid-, PGE 2, and forskolin-induced murine duodenal bicarbonate secretion (DBS) in vivo. CAII-deficient and WT littermates were studied in vivo during isoflurane anesthesia. An approximate 10-mm segment of the proximal duodenum with intact blood supply was perfused under different experimental conditions and DBS was titrated by pH immediately. Two-photon confocal microscopy using the pH-sensitive dye SNARF-1F was used to assess duodenocyte pH i in vivo. After correction of systemic acidosis by infusion of isotonic Na 2CO3, basal DBS was not significantly different in CAII-deficient mice and WT littermates. The duodenal bicarbonate secretory response to acid was almost abolished in CAII-deficient mice, but normal to forskolin-or 16,16-dimethyl PGE 2 stimulation. The complete inhibition of tissue CAs by luminal methazolamide and i.v. acetazolamide completely blocked the response to acid, but did not significantly alter the response to forskolin. While duodenocytes acidified upon luminal perfusion with acid, no significant pH i change occurred in CAII-deficient duodenum in vivo. The results suggest that CA II is important for duodenocyte acidification by low luminal pH and for eliciting the acid-mediated HCO 3 ؊ secretory response, but is not important in the generation of the secreted HCO 3 ؊ ions.bicarbonate secretion ͉ duodenal mucosal protection ͉ duodenal ulcers ͉ gastrointestinal phenotype ͉ gastric acid T he proximal duodenum serves as a key segment in neutralizing the high amounts of hydrochloric acid expelled from the stomach (1). As a physiological defense to these acidic challenges, the proximal duodenum secretes HCO 3 Ϫ in higher rates than more distal parts of the small intestine in all species tested, including humans, and even a short contact with luminal acid causes a long lasting increase in duodenal bicarbonate secretion (DBS) (1). A deficiency in basal as well as acid-stimulated DBS is observed in patients with duodenal ulcer disease (2). Thus, DBS is accepted as an important duodenal mucosal defense mechanism (1, 3).CO 2 has been suggested to be a key transmitting factor in sensing the acidic luminal content (4-6), diffusing through the continuous layer of viscoelastic mucus gel on top of the epithelial surface and further through the apical cell-membrane. The generation of CO 2 from luminal acid has been suggested to depend on the action of extracellular carbonic anhydrases (5, 6). Because CA inhibitors suppressed duodenal HCO 3 Ϫ secretion, CO 2 entry and hydration in the enterocyte was thought to be a major supply pathway for basal and stimulated duodenal HCO 3 Ϫ secretion (7, 8), although this issue has remained controversial (9, 10).CAs are heavily expressed in duodenal epithelial cells...