Prior studies have shown that acidification due to hypercarbia protects endothelial cells from serum deprivation-induced apoptosis. However, the mechanism(s) responsible for the antiapoptotic effect of acidification is still unclear. cDNA array screening was performed on human umbilical vein endothelial cells cultured in a bicarbonate medium equilibrated either with 5% CO2 (pH 7.4) or with 20% CO2 (pH 7.0). Tyrosine kinase receptor Axl expression was 3.3-fold higher after 6 hours at pH 7.0 compared with pH 7.4; this modulation was confirmed by reverse transcriptase-polymerase chain reaction (3.0+/-0.9-fold, P<0.03; n=3), Northern blot (3.6+/-0.1-fold, P<0.0003; n=3), and Western blot (10+/-1.8-fold, P<0.004; n=3). In a time-course study, both Northern and Western blot analyses showed that the most marked difference in Axl expression between pH 7.4 and pH 7.0 occurred after 24 to 48 hours. Furthermore, Axl phosphorylation was enhanced at pH 7.0. Axl ligand, the survival factor growth arrest-specific gene 6 product (Gas6), was released into the conditioned medium, and by Western blot analysis, similar amounts of protein were found at pH 7.0 and 7.4. Full-length Axl cDNA overexpression reduced serum deprivation-induced apoptosis by 64.4+/-11.9% in human umbilical vein endothelial cells cultured at pH 7.4 compared with mock-transfected cells (P<0.0004). Furthermore, overexpression of either soluble Axl or antisense Gas6 mRNA partially reverted the protective effect of acidification, increasing approximately 2.5-fold the number of apoptotic cells at pH 7.0 (control 19.3+/-2.7%, soluble Axl 48.9+/-9.7%, P<0.001; antisense Gas6 49.3+/-14.3%, P<0.03). In conclusion, Gas6/Axl signaling may play an important role in endothelial cell survival during acidification. The full text of this article is available at http://www.circresaha.org.