The unphosphorylated regulatory (R) domain of the Cystic Fibrosis Transmembrane conductance Regulator (CFTR) is often viewed as an inhibitor that is released by phosphorylation. To test this notion, we studied domain interactions using CFTR channels assembled from three polypeptides. Nucleotides encoding the R domain (aa 635–836) were replaced with an internal ribosome entry sequence so that amino‐ and carboxyl‐terminal half‐molecules would be translated from the same mRNA transcript. Although only core glycosylation was detected on SplitΔR, biotinylation, immunostaining, and functional studies clearly demonstrated its trafficking to the plasma membrane. SplitΔR generated a constitutive halide permeability, which became responsive to cAMP when the missing R domain was coexpressed. Each half‐molecule was co‐precipitated by antibody against the other half. Contrary to expectations, GST‐R domain was pulled down only if prephosphorylated by protein kinase A, and coexpressed R domain was precipitated with SplitΔR much more efficiently when cells were stimulated with cAMP. These results indicate that phosphorylation regulates CFTR by promoting association of the R domain with other domains rather than by causing its dissociation from an inhibitory site.

Bicarbonate facilitates mucin unpacking and bacterial killing; however, its transport mechanisms in the airways are not well understood. cAMP stimulates anion efflux through the cystic fibrosis (CF) transmembrane conductance regulator (CFTR; ABCC7) anion channel, and this is defective in CF. The anion exchanger pendrin (SLC26A4) also mediates HCO3 − efflux and is upregulated by proinflammatory cytokines. Here, we examined pendrin and CFTR expression and their contributions to HCO3 − secretion by human nasal and bronchial epithelia. In native tissue, both proteins were most abundant at the apical pole of ciliated surface cells with little expression in submucosal glands. In well-differentiated primary nasal and bronchial cell cultures, IL-4 dramatically increased pendrin mRNA levels and apical immunostaining. Exposure to low-Cl− apical solution caused intracellular alkalinization (ΔpHi) that was enhanced fourfold by IL-4 pretreatment. ΔpHi was unaffected by 4,4′-diisothiocyano-2,2′-stilbenedisulfonic acid (DIDS) or CFTR inhibitor CFTRinh-172, but was reduced by adenoviral shRNA targeting pendrin. Forskolin increased ΔpHi, and this stimulation was prevented by CFTRinh-172, implicating CFTR, yet forskolin only increased ΔpHi after pendrin expression had been induced by IL-4. The dependence of ΔpHi on pendrin suggests there is minimal electrical coupling between Cl− and HCO3 − fluxes and that CFTR activation increases anion exchange–mediated HCO3 − influx. Conversely, inducing pendrin expression increased forskolin-stimulated, CFTRinh-172–sensitive current by approximately twofold in epithelial and nonepithelial cells. We conclude that pendrin mediates most HCO3 − secretion across airway surface epithelium during inflammation and enhances electrogenic Cl− secretion via CFTR, as described for other SLC26A transporters.