Airway epithelial cells are exposed to environmental toxicants that result in airway injury. Naphthalene (NA) causes site-selective damage to Clara cells in mouse distal airways. Nterminally truncated recombinant human keratinocyte growth factor (DN23-KGF) protects against acute lung injury. The present study investigated whether or not DN23-KGF protects against NAinduced acute Clara cell damage by measuring airway responses specifically and in order to identify underlying molecular mechanisms.Mice were treated with DN23-KGF or PBS 33 h prior to injection of 200 mg?kg body weight -1 NA.Lung function was analysed by head-out body plethysmography. Distal airways isolated by microdissection were assessed for cell permeability using ethidium homodimer-1.Immunohistochemistry of Clara cell-specific protein in conjunction with a physical dissector was used to quantify Clara cell numbers. RNA was isolated from frozen airways in order to analyse gene expression using quantitative RT-PCR. DN23-KGF prevented NA-induced airflow limitation and Clara cell permeability, and resulted in twice as many Clara cells compared with PBS pre-treatment. DN23-KGF-pre-treated mice exhibited increased expression of proliferating cell nuclear antigen mRNA. Cytochrome P 450 isoform 2F2, which converts NA into its toxic metabolite, was reduced by ,50%.The present results demonstrate that pre-treatment with N-terminally truncated recombinant human keratinocyte growth factor protects against naphthalene-induced injury. This suggests that N-terminally truncated recombinant human keratinocyte growth factor exerts its beneficial effect through a decrease in the expression of cytochrome P 450 isoform 2F2.