ATP8A2 is a P 4 -ATPase ("flippase") located in membranes of retinal photoreceptors, brain cells, and testis, where it mediates transport of aminophospholipids toward the cytoplasmic leaflet. It has long been an enigma whether the mechanism of P 4 -ATPases resembles that of the well-characterized cation-transporting P-type ATPases, and it is unknown whether the flippases interact directly with the lipid and with counterions. Our results demonstrate that ATP8A2 forms a phosphoenzyme intermediate at the conserved aspartate (Asp 416 ) in the P-type ATPase signature sequence and exists in E 1 P and E 2 P forms similar to the archetypical P-type ATPases. Using the properties of the phosphoenzyme, the partial reaction steps of the transport cycle were examined, and the roles of conserved residues Asp 196 , Glu 198 , Lys 873 , and Asn 874 in the transport mechanism were elucidated. The former two residues in the A-domain T/D-G-E-S/T motif are involved in catalysis of E 2 P dephosphorylation, the glutamate being essential. Transported aminophospholipids activate the dephosphorylation similar to K þ activation of dephosphorylation in Na þ ,K þ -ATPase. Lys 873 mutants (particularly K873A and K873E) display a markedly reduced sensitivity to aminophospholipids. Hence, Lys 873 , located in transmembrane segment M5 at a "hot spot" for cation binding in Ca 2þ -ATPase and Na þ ,K þ -ATPase, appears to participate directly in aminophospholipid binding or to mediate a crucial interaction within the ATP8A2-CDC50 complex. By contrast, Lys 865 is unimportant for aminophospholipid sensitivity.to the E 1 form as a counterion is not required for activation of phosphorylation from ATP. Therefore, phospholipids could be the only substrate transported by ATP8A2.lipid transport mechanism | mutagenesis | phospholipid flippase | phosphatidylserine | membrane asymmetry P -type ATPases are a large family of membrane pumps believed to be transiently phosphorylated at the conserved aspartate residue of the DKTGT motif during the catalytic cycle. An important challenge is to understand how these proteins couple the utilization of ATP with transport of substances across the membrane. Among the most well-characterized P-type ATPases are the sarcoplasmic reticulum Ca 2þ -ATPase and the Na þ ,K þ -ATPase. During the reaction cycle of these ATPases, the intermediates E 1 , E 1 P, E 2 P, and E 2 (P representing phosphorylation) are formed sequentially, involving large movements of the three cytoplasmic domains, N (nucleotide binding), P (phosphorylation), and A ("actuator"), that are coupled through a linker region with the ion translocation occurring in the membrane domain M (1-3). For many other P-type ATPases, much less is known regarding the transport mechanism due to lack of structural and biochemical data, and even the existence of a phosphorylated intermediate is a conjecture based on sequence homology. P 4 -ATPases constitute a subfamily of P-type ATPases implicated in the transport of aminophospholipids (4, 5). Using ATP as an energy source, ...