ABSTRACT. Ion transport by the epithelium lining the airways of patients with cystic fibrosis (CF) is characterized by a raised transepithelial PD and an increased amiloride sensitivity (I). These properties could arise from normal sodium transport across an epithelium with decreased cell chloride permeability and limited chloride secretion. Alternatively, a higher than normal rate of sodium absorption could contribute to these abnormalities. We investigated the latter possibility by measuring oxygen consumption and specific ouabain binding of CF and atopic polyp epithelia and normal turbinate epithelium. Tissue from CF patients consumed oxygen at a rate that was two to three times that of non-CF tissues and had 60% more ouabain binding sites than non-CF epithelium. These results are not consistent with an isolated defect in chloride permeability but support recent findings that the sodium conductance of the apical cell membrane and net sodium absorption by CF nasal epithelium are greater than those of non-CF nasal epithelium. In CF, ion transport by airway epithelium is markedly abnormal (1, 2). The lumen negative PD generated in vivo by the nasal or tracheobronchial epithelium of CF patients is 2-to 3-fold greater than that of normal or disease control individuals (1) and hyperpolarizes less in response to superfusion with a chloridefree solution (3). Parallel findings in studies of sweat gland ductal epithelium have been interpreted as evidence for reduced membrane chloride permeability that traps salt in the duct lumen (4, 5). The more complete inhibition of airway PD by superfused amiloride, in vivo, is also consistent with the absence of a functioning chloride secretory path in CF airways (1, 2). Others have speculated, based on this reasoning, that the functional defect in CF airway epithelia is deficient chloride conductance (4). Alternatively, the greater amiloride eficacy and raised PD in CF airway epithelia could reflect both a decreased chloride permeability and an increased sodium absorptive rate.In epithelia that are dependent on operation of the Na+-K+-ATPase for ion transport, variations in transport rate can be paralleled by changes in indices of Na+-K+-ATPase activity. For example, increased ATP hydrolysis and numbers of sodium pumps have been found to accompany increases in sodium absorption by renal tubules (6) and chloride secretory capacity was paralleled by pump activity in shark rectal gland (7). In dog trachea, a predominantly chloride secreting airway epithelium, inhibition of chloride secretion caused a decrease in ouabainsensitive oxygen consumption (8). We reasoned that if the defect in cell chloride permeability in CF airways caused decreased chloride secretion, then hydrolysis of ATP by the Na+-K+-ATPase in CF cells would be normal or even reduced. On the other hand, if sodium absorption is increased in CF airway epithelium, then the synthesis and hydrolysis of ATP devoted to sodium pump activity should be greater than normal because of faster pump turnover and/or increased pump de...