Multidrug resistance associated protein 2 (Mrp2) is a canalicular transporter responsible for organic anion secretion into bile. Mrp2 activity is regulated by insertion into the plasma membrane; however, the factors that control this are not understood. Calcium (Ca 21 ) signaling regulates exocytosis of vesicles in most cell types, and the type II inositol 1,4,5-triphosphate receptor (InsP 3 R2) regulates Ca 21 release in the canalicular region of hepatocytes. However, the role of InsP 3 R2 and of Ca 21 signals in canalicular insertion and function of Mrp2 is not known. The aim of this study was to determine the role of InsP 3 R2-mediated Ca 21 signals in targeting Mrp2 to the canalicular membrane. Livers, isolated hepatocytes, and hepatocytes in collagen sandwich culture from wild-type (WT) and InsP 3 R2 knockout (KO) mice were used for western blots, confocal immunofluorescence, and time-lapse imaging of Ca 21 signals and of secretion of a fluorescent organic anion. Plasma membrane insertion of green fluorescent protein (GFP)-Mrp2 expressed in HepG2 cells was monitored by total internal reflection microscopy. InsP 3 R2 was concentrated in the canalicular region of WT mice but absent in InsP 3 R2 KO livers, whereas expression and localization of InsP 3 R1 was preserved, and InsP 3 R3 was absent from both WT and KO livers. Ca 21 signals induced by either adenosine triphosphate (ATP) or vasopressin were impaired in hepatocytes lacking InsP 3 R2. Canalicular secretion of the organic anion 5-chloromethylfluorescein diacetate (CMFDA) was reduced in KO hepatocytes, as well as in WT hepatocytes treated with 1,2-bis(o-aminophenoxy)ethane-N,N,N 0 ,N 0 -tetraacetic acid (BAPTA). Moreover, the choleretic effect of tauroursodeoxycholic acid (TUDCA) was impaired in InsP 3 R2 KO mice. Finally, ATP increased GFP-Mrp2 fluorescence in the plasma membrane of HepG2 cells, and this also was reduced by BAPTA. Conclusion: InsP 3 R2-mediated Ca 21 signals enhance organic anion secretion into bile by targeting Mrp2 to the canalicular membrane. (HEPATOLOGY 2010;52:327-337)