Prestin is a member of the SLC26 family of anion transporters that is responsible for outer hair cell (OHC) electromotility. Measures of voltage-evoked charge density (Q sp ) of prestin indicated that the protein is highly expressed in OHCs, with single cells expressing up to 10 million molecules within the lateral membrane. In contrast, charge density measures in transfected cells indicated that they express, at best, only a fifth as many proteins on their surface. We sought to determine whether associations with other OHC-specific proteins could account for this difference. Using a yeast two-hybrid technique, we found microtubule-associated protein 1S (MAP1S) bound to prestin. The interaction was limited to the STAS domain of prestin and the region connecting the heavy and light chain of MAP1S. Using reciprocal immunoprecipitation and Forster resonance energy transfer, we confirmed these interactions. Furthermore, co-expression of prestin with MAP1S resulted in a 2.7-fold increase in Q sp in single cells that was paralleled by a 2.8-fold increase in protein surface expression, indicating that the interactions are physiological. Quantitative PCR data showed gradients in the expression of prestin and MAP1S across the tonotopic axis that may partially contribute to a previously observed 6-fold increase in Q sp in high frequency hair cells. These data highlight the importance of protein partner effects on prestin.Prestin is a member of the SLC26 family of anion transporters that is responsible for outer hair cell (OHC) 3 electromotility, the basis of mammalian cochlear amplification (1-4). Prestin is found in the lateral membrane of the OHC (5, 6) and has piezoelectric properties, deriving from reciprocal voltage and mechanical sensitivity (7-10). The voltage sensor of the protein, which is integral to electromotility, generates charge movement that can be detected as a nonlinear capacitance (NLC) (11,12). NLC parallels electromotility and has been established as an excellent surrogate marker for electromotility (11). There are three commonly described attributes of NLC as follows: V h , the voltage of peak capacitance; z, an estimate of charge carried by a single motor; and Q sp the charge moved across a unit of membrane. V h reflects the steady state energy profile of the protein, and Q sp provides an estimate of the density of the protein in the plasma membrane.Prestin in OHCs exists in very high density. It is estimated that OHCs contain up to 10 million of these molecules in the lateral membrane of a given cell (13,14). Measures of NLC in transfected cells, however, have not yielded this high density of prestin. Measures of Q sp can reach 5 fC/pF in transiently transfected CHO cells (15) but contrasts with a Q sp of 220 fC/pF in the mature OHC (16). Although differences in transcription could account for this change, we have been unable to induce OHC-like prestin expression levels in the membrane in transfected cells using the best available promoters, including cytomegalovirus and the tetracycline-inducible ...