The AT-rich cis-motif A elements of the insulin gene promoter contribute to directing the gene's expression to pancreatic beta-cells, bound by a homeodomain-containing transcription factor, PDX-1/IPF1/STF-1/IDX-1. The islet amyloid polypeptide (IAPP; amylin) gene, which is also expressed in limited tissues such as pancreatic beta- and delta-cells, contained similar AT-rich sequences in its regulatory sequences. To understand the molecular basis of IAPP gene regulation, we evaluated the possible physiological significance of the motif in human IAPP gene regulation. All of the three typical A element-like sequences that matched the CT-box consensus (AT-1, -207/-202; AT-2, -154/-142; and AT-3, -88/-83) were shown to bind specifically to a nuclear factor in the beta-cell-derived MIN6 cells, which was subsequently identified immunologically as the insulin gene transcription factor PDX-1. When the promoter activity was examined in MIN6 cells, the disruption of AT-1 or AT-3 but not of AT-2 caused a marked reduction in the IAPP gene promoter. Thus, despite the observation that all the three A element-like regions could bind to PDX-1, the AT-2 site may not be involved in mediating the PDX-1 action in vivo. These observations suggest the involvement of PDX-1 in human IAPP gene regulation, which seems to be mediated through at least two A element-like cis-motifs in the gene promoter.