We have studied the activity of the Na+/H+ exchanger during dimethyl sulfoxide (Me2SO)-induced maturation of the human promyelocytic leukemia cell line HL-60. 22Na uptake was measured in cells preloaded with Li+ or NH+4 in order to specifically activate the Na+/H+ exchanger. Measurement of the rate of uptake as a function of sodium concentration revealed a decrease in Km for Na+ from 38 +/- 3 to 13 +/- 1 mM after 20-24-h treatment with Me2SO. Vmax was not changed significantly. Inhibition of the exchanger by dimethylamiloride (DMA) and by acidic external pH was similar in treated and untreated cells. Thus it is unlikely that the Na+ binding site is altered. A change, however, was observed in the regulation of the exchanger by intracellular pH. In control cells maximal stimulation of the Na+ uptake was observed when the intracellular pH decreased from 7.25 to 7.00. In Me2SO-treated cells the 22Na uptake at intracellular pH 7.00 was greater than in the control and continued to increase as the intracellular pH was adjusted below 7.00, down to 6.75. This suggests that the Na+/H+ exchanger in Me2SO-treated cells is altered structurally in its allosteric H+ binding site. The appearance of this modified exchanger preceded by a period of days the appearance of a functional property characteristic of mature granulocytes, that is, the capability to produce superoxide, suggesting that the modified exchanger may be required for the expression of the mature phenotype. A second modification, a decrease in the Vmax of the 22Na uptake, occurred after 2 days treatment with Me2SO. This reduction may reflect a decrease in the number of functioning exchangers per cell.