splicing generates diverse transcripts. Am. J. Physiol. 274 (Cell Physiol. 43): C1215-C1225, 1998.-Na ϩ -myo-inositol cotransport activity generally maintains millimolar intracellular concentrations of myo-inositol and specifically promotes transepithelial myoinositol transport in kidney, intestine, retina, and choroid plexus. Glucose-induced, tissue-specific myo-inositol depletion and impaired Na ϩ -myo-inositol cotransport activity are implicated in the pathogenesis of diabetic complications, a process modeled in vitro in cultured human retinal pigment epithelium (RPE) cells. To explore this process at the molecular level, a human RPE cDNA library was screened with a canine Na ϩ -dependent myo-inositol cotransporter (SMIT) cDNA. Overlapping cDNAs spanning 3569 nt were cloned. The resulting cDNA sequence contained a 2154-nt open reading frame, 97% identical to the canine SMIT amino acid sequence. Genomic clones containing SMIT exons suggested that the cDNA is derived from at least five exons. Hypertonic stress induced a time-dependent increase, initially in a 16-kb transcript and subsequently in 11.5-, 9.8-, 8.5-, 3.8-, and ϳ1.2-kb SMIT transcripts, that was ascribed to alternate exon splicing using exon-specific probes and direct cDNA sequencing. The human SMIT gene is a complex multiexon transcriptional unit that by alternate exon splicing generates multiple SMIT transcripts that accumulate differentially in response to hypertonic stress. human retinal pigment epithelial cells; hypertonic stress; exon splicing; osmoregulation; diabetes mellitus THE WATER-SOLUBLE CYCLIC hexitol myo-inositol is a constituent of virtually every living cell and an essential nutrient for most mammalian cells in culture. Intracellular concentrations 50-to 1,000-fold greater than that of extracellular fluid are with few exceptions (25) ascribed to the action of membrane-associated, Na ϩ -dependent myo-inositol cotransporters (SMITs) (2). At the cellular level, myo-inositol is an obligate and sometimes rate-limiting (19) substrate for phosphoinositide synthesis. Along with sorbitol, taurine, and betaine, myo-inositol belongs to a family of alternative nonionic organic intracellular osmolytes whose regulated accumulation and efflux in response to hypertonic stress preserve intracellular volume and tonicity without perturbing the ionic milieu (2, 5). Organic osmolyte accumulation is coordinated by the regulated expression and/or activity of osmotically responsive, osmolytespecific genes or gene products: distinct Na ϩ -cotransporters for myo-inositol, taurine, and betaine and aldose reductase (AR) for the synthesis of sorbitol from glucose. Gradient-dependent organic osmolyte efflux is thought to be regulated primarily but not exclusively by a nonselective, ATP-dependent, volume-sensitive organic anion channel (2,14,27). Thus, at any given tonicity, the relative abundance of each osmolyte depends in part on substrate availability, the abundance and activity of their transporter or biosynthetic enzyme, and their efflux or degradation. T...