The assembly of cytosolic subunits p47 phox , p67 phox , and p40 phox with flavocytochrome b 558 at the membrane is required for activating the neutrophil NADPH oxidase that generates superoxide for microbial killing. The p47 phox subunit plays a critical role in oxidase assembly. Recent studies showed that the p47 phox Phox homology (PX) domain mediates phosphoinositide binding in vitro and regulates phorbol ester-induced NADPH oxidase activity in a K562 myeloid cell model. Because the importance of the p47 phox PX domain in neutrophils is unclear, we investigated its role using p47 phox knock-out (KO) mouse neutrophils to express human p47 phox and derivatives harboring R90A mutations in the PX domain that result in loss of phosphoinositide binding. Human p47 phox proteins were expressed at levels similar to endogenous murine p47 phox , with the exception of a chronic granulomatous disease-associated R42Q mutant that was poorly expressed, and wild type human p47 phox rescued p47 phox KO mouse neutrophil NADPH oxidase activity. Plasma membrane NAPDH oxidase activity was reduced in neutrophils expressing p47 phox with Arg 90 substitutions, with substantial effects on responses to either phorbol ester or formyl-Met-Leu-Phe and more modest effects to particulate stimuli. In contrast, p47phox Arg 90 mutants supported normal levels of intracellular NADPH oxidase activity during phagocytosis of a variety of particles and were recruited to phagosome membranes. This study defines a differential and agonist-dependent role of the p47 phox PX domain for neutrophil NADPH oxidase activation.The reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase of phagocytic leukocytes plays a key role in innate host defense against bacterial and fungal infections (1-3). The phagocyte NADPH oxidase is composed of membrane-integrated flavocytochrome b 558 (a heterodimer composed of gp91 phox (NOX2) and p22 phox ) and four cytosolic components: p47 phox , p67 phox , p40 phox , and Rac2 (2-4). Upon activation by either soluble or particulate stimuli, the cytosolic subunits translocate to flavocytochrome b 558 to form the activated NADPH oxidase complex, resulting in electron transfer from cytosolic NADPH through FAD and heme groups to extracellular or phagosome-located oxygen, from which superoxide is generated (2-4). Genetic defects in any of the five phox subunits of the NADPH oxidase complex result in chronic granulomatous disease (CGD), 2 which is characterized by absent or deficient NADPH oxidase activity, recurrent pyogenic infections, and granulomatous inflammation (1, 5, 6).The assembly of the NADPH oxidase complex is essential for activation of superoxide production, and p47 phox plays a central role in this assembly (2-4, 7-12). From the N terminus to the C terminus, p47 phox contains a Phox homology (PX) domain, two tandemly arranged Src homology 3 (SH3) domains, an autoinhibitory region (AIR), and a proline-rich region (PRR; Fig. 1A). In the resting state, p47 phox is autoinhibited via intramolecular interactions o...