SR calcium depletion following reversal of the Na+/Ca2+-exchanger in rat ventricular myocytes

We previously reported that cytosolic calcium transiently increases after reversal of the sarcolemmal Na+/Ca2+-exchanger. Calcium released from sarcoplasmic reticulum (SR) constituted the major part of this cytosolic transient. The aim of this study was to test whether reversal of the Na+/Ca2+-exchanger affects SR calcium content, and whether altered SR calcium content is associated with direct triggering of SR calcium release or calcium release secondary to SR calcium overload. To this purpose we studied the change of SR calcium content after reversal of the Na+/Ca2+-exchanger and the dependence on the magnitude of change of its free energy (delta Gexch) in isolated rat ventricular myocytes. The Na+/Ca2+-exchanger was reversed by abrupt reduction of extracellular sodium ([Na+]o). The magnitude of change of deltaGexch was varied with [Na+]o. Cytosolic free calcium ([Ca2+]i) was measured with indo-1 and SR calcium content was estimated from the increase of [Ca2+]i after rapid cooling (RC). SR function was manipulated either by blockade of the SR Ca2+-ATPase with thapsigargin or by blockade of SR calcium release channels with tetracaine. Reversal of the Na+/Ca2+-exchanger caused a transient increase of [Ca2+]i of about 180 s duration with a time to peak of about 30 s. During the first 30 s rapid small amplitude cytosolic calcium fluctuations were superimposed on this transient. The magnitude of the response of [Ca2+]i to RC, during the course of the cytosolic [Ca2+]i transient, also transiently increased from 174 in control myocytes to 480 nmol/l at the time of the peak value. After correction of [Ca2+]i data for the fraction of mitochondrially compartmentalized indo-1 and mitochondrial calcium, total calcium released from SR after RC was calculated with the use of literature data on cytosolic calcium buffer capacity. Contrary to the measured RC-dependent increase of measured [Ca2+]i, after reversal of the Na+/Ca2+-exchanger, calculated total calcium released from SR transiently decreased. The extent of SR calcium depletion after reversal of the Na+/Ca2+-exchanger increased with the magnitude of change of deltaGexch. Restitution of [Na+]o 30 s after reversal of the Na+/Ca2+-exchanger, greatly accelerated both recovery of [Ca2+]i and SR calcium content. Pretreatment of myocytes with thapsigargin caused almost entire depletion of SR and substantial reduction of the cytosolic transient of [Ca2+]i following reversal of the Na+/Ca2+-exchanger. Application of tetracaine hardly affected SR calcium content, but caused an increase of the SR calcium content following reversal of the Na+/Ca2+-exchanger, while the cytosolic transient increase of [Ca2+]i was substantially reduced. We conclude that reversal of the Na+/Ca2+-exchanger directly triggers SR calcium release and decreases SR calcium content in a deltaGexch dependent manner.     

The sarcoplasmic reticulum and the Na+/Ca2+ exchanger both contribute to the Ca2+ transient of failing human ventricular myocytes

Our objective was to determine the respective roles of the sarcoplasmic reticulum (SR) and the Na+/Ca2+ exchanger in the small, slowly decaying Ca2+ transients of failing human ventricular myocytes. Left ventricular myocytes were isolated from explanted hearts of patients with severe heart failure (n=18). Cytosolic Ca2+, contraction, and action potentials were measured by using indo-1, edge detection, and patch pipettes, respectively. Selective inhibitors of SR Ca2+ transport (thapsigargin) and reverse-mode Na+/Ca2+ exchange activity (No. 7943, Kanebo Ltd) were used to define the respective contribution of these processes to the Ca2+ transient. Ca2+ transients and contractions induced by action potentials (AP transients) at 0.5 Hz exhibited phasic and tonic components. The duration of the tonic component was determined by the action potential duration. Ca2+ transients induced by caffeine (Caf transients) exhibited only a phasic component with a rapid rate of decay that was dependent on extracellular Na+. The SR Ca2+-ATPase inhibitor thapsigargin abolished the phasic component of the AP Ca2+ transient and of the Caf transient but had no significant effect on the tonic component of the AP transient. The Na+/Ca2+ exchange inhibitor No. 7943 eliminated the tonic component of the AP transient and reduced the magnitude of the phasic component. In failing human myocytes, Ca2+ transients and contractions exhibit an SR-related, phasic component and a slow, reverse-mode Na+/Ca2+ exchange-related tonic component. These findings suggest that Ca2+ influx via reverse-mode Na+/Ca2+ exchange during the action potential may contribute to the slow decay of the Ca2+ transient in failing human myocytes.     

The functional effect of adenoviral Na+/Ca2+ exchanger overexpression in rabbit myocytes depends on the activity of the Na+/K+-ATPase

OBJECTIVES: The functional consequences of Na+/Ca2+ exchanger (NCX) overexpression in heart failure have been controversially discussed. NCX function strongly depends on intracellular sodium which has been shown to be increased in heart failure. METHODS AND RESULTS: We investigated the Na+/K+-ATPase (NKA) inhibitor ouabain (0.5-16 micromol/l) in electrically stimulated, isotonically contracting adult rabbit cardiocytes overexpressing NCX after adenoviral gene transfer (Ad-NCX-GFP, 48 h culture time). Myocytes transfected with adenovirus encoding for green fluorescent protein (Ad-GFP) served as a control. Contractions were analyzed by video-edge detection. In the Ad-NCX-GFP group, the maximum inotropic response was significantly reduced by 50.7% (P<0.05). This was a result of an enhanced susceptibility to contracture after exposure to the drug (median concentration (25-75%): 4 (4-8) vs. 8 (6-16) micromol/l, P<0.05). When analyzing relaxation before contracture, the maximum relaxation velocity was reduced (0.15+/-0.04 vs. 0.27+/-0.04 microm/s, P<0.05) and the time from peak shortening to 90% of relaxation was increased (298+/-39 vs. 185+/-15 ms, P<0.05). No differences in systolic and diastolic parameters were observed with the Na+ channel modulator BDF9198 (1 micromol/l). CONCLUSIONS: Inhibition of NKA by ouabain induces a combined diastolic and systolic dysfunction in NCX overexpressing rabbit myocytes. This may be the consequence of cytoplasmic Ca2+ overload due to inhibition of forward mode or induction of reverse mode Na+/Ca2+ exchange. In end-stage failing human myocardium and during digitalis treatment this mechanism may be of major importance.     

代谢抑制处理后大鼠心室肌细胞反向Na+/Ca2+交换体转运功能的变化

目的:利用荧光标记法观察代谢抑制处理后,大鼠心肌细胞反向Na+/Ca2+交换体（NCX）转运功能的变化。方法:酶解法分离制备钙耐受心肌细胞用Fura-2/AM负载,采用双激发荧光光电倍增系统（IonOptix Photom etry Sys-tem）检测钙信号。结果:细胞置于无Na+液后,可见[Ca2+]i逐渐升高,L-型Ca2+通道阻断剂n ifed ip ine在浓度为1μmol/L时,不影响此现象;而NCX的抑制剂N i2+,在浓度为1 mmol/L时,则完全阻断[Ca2+]i的升高。采用20mmol/L乳酸加10 mmol/L脱氧葡萄糖作为代谢抑制物处理心肌细胞不同时间,正常Tyrode液灌流10 m in,之后检测无Na+液引发[Ca2+]i升高效应的变化,发现5 m in处理与对照组无显著性差异,10和30 m in处理后此效应逐渐减弱。结论:首次发现,代谢抑制处理后心肌NCX的反向转运功能被抑制,阐明其调节机制,将为心肌缺血/再灌注损伤的治疗提供新思路。     

Analysis of Na+/Ca2+ exchanger knockout mice

The Na(+)/Ca(2+) exchanger (NCX) on the plasma membrane is thought to be the main calcium extrusion system from the cytosol to the extracellular space in many mammalian excitable cells including cardiac myocytes. However, the precise roles of NCX are still unclear because of lack of its specific inhibitors. We generated NCX1-deficient mice by gene targeting to determine the in vivo function of the exchanger. Homozygous mutant died at 9.5 days post coitum. Embryonic hearts did not beat and cardiac myocytes showed apoptosis. These results suggest that NCX1 is required for heart beats and survival of cardiac myocytes in embryos. Heterozygous mutant mice were viable and indistinguishable from wild type mice. mRNA and protein levels in the heart of heterozygous mutant were half as much as wild type mice. In response to pressure overload, mutant mice showed better systolic and diastolic relaxation functions than wild type mice. Intracellular Ca(2+) measurement revealed an increase in calcium content of cytoplasm and sarcoplasmic reticulum (SR) and RNA analysis revealed preserved SR Ca(2+) ATPase expression in the ventricle of mutant mice. These results suggest that NCX plays an important role in cardiac performance in these pathological situations.     

Calcium and osmotic regulation of the Na+/H+ exchanger in neonatal ventricular myocytes

Intracellular pH regulation in primary cultures of neonatal cardiac myocytes has been characterized. Myocytes were exposed to hyperosmolar solutions to examine the effects on pH regulation by the Na+/H+ exchanger. Exposure to 100 mM NaCl, sorbitol, N-methyl-D-glucamine, or choline chloride all caused significant increases in steady state pHi in myocytes. Omission of extracellular calcium or administration of calmodulin antagonists reduced the osmotic activation of the exchanger. The myosin light-chain inhibitor ML-7 completely blocked osmotic activation of the exchanger suggesting that myosin light-chain kinase is involved in osmotic activation of the exchanger in the myocardium. The calmodulin-dependent protein kinase II inhibitor KN-93 inhibited the rate of recovery from an acute acid load as did trifluoperazine (TFP) and the calmodulin blocker W7, [N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide]. Addition of the calcium ionophore ionomycin caused a large increase in resting pHi in isolated myocytes. However, this effect was largely resistant to HMA (5-(N,N-hexamethylene)-amiloride) indicating that an alternative mechanism of pHi regulation is responsible. The results demonstrate that the Na+/H+ exchanger of the neonatal myocardium is responsive to calcium and osmotically responsive pathways and that myosin light-chain kinase is a key protein involved in mediating the osmotic response.     

Quantitation of Na/Ca exchanger function in single ventricular myocytes.

A Na/Ca exchange current can be elicited in voltage clamped single ventricular myocytes by the abrupt removal of extracellular Na+ by means of a rapid switcher device. We measured this reverse Na/Ca exchange current in isolated mouse ventricular myocytes from wild-type mice, and from transgenic mice with hearts overexpressing the Na/Ca exchanger. In mouse ventricular myocytes, the current was sensitive to nickel, and was eliminated by removal of intracellular Na+. It was not influenced by 3 m m ouabain, and thus not contaminated by Na pump currents. The magnitude of the current reached a plateau within 10-15 min after obtaining a whole cell patch with the pipettes containing EGTA, to buffer [Ca2+]i and in zero extracellular K+ concentration to completely inhibit the Na pump, and allow equilibration of pipette Na+ with subsarcolemmal [Na+]. The magnitude of the current increased with increases in pipette [Na+]. Comparison of the current magnitudes in wild-type and transgenic myocytes showed a 2.5 and 2.7 fold increase in the current in transgenic myocytes at pipette [Na+] of 10 and 20 m m. The magnitude of this increase in Na/Ca exchanger currents in single transgenic myocytes compares well with the reported 2.5 fold increase in Na+-dependent 45Ca2+ uptake measured in ventricular sarcolemmal vesicles obtained from transgenic animals. With this approach, we found variation in exchanger current densities in different species, with values for mouse>rat>rabbit>dog>human. This technique should also be useful in quantifying changes in Na/Ca exchanger current density as a consequence of pathologic processes, and exposure to drugs.     

The Na+/Ca2+ exchange blocker SEA0400 fails to enhance cytosolic Ca2+ transient and contractility in canine ventricular cardiomyocytes

AIMS: This study was designed to evaluate the effects of the Na(+)/Ca(2+) exchange (NCX) inhibitor SEA0400 on Ca(2+) handling in isolated canine ventricular myocytes. METHODS AND RESULTS: Intracellular Ca(2+) ([Ca(2+)](i)) transients, induced by either field stimulation or caffeine flush, were monitored using Ca(2+) indicator dyes. [Ca(2+)](i)-dependent modulation of the inhibitory effect of SEA0400 on NCX was characterized by the changes in Ni(2+)-sensitive current in voltage-clamped myocytes. Sarcoplasmic reticulum (SR) Ca(2+) release and uptake were studied in SR membrane vesicles. Gating properties of single-ryanodine receptors were analysed in lipid bilayers. Ca(2+) sensitivity of the contractile machinery was evaluated in chemically skinned myocytes. In myocytes paced at 1 Hz, neither diastolic [Ca(2+)](i) nor the amplitude of [Ca(2+)](i) transients was significantly altered by SEA0400 up to the concentration of 1 microM, which was shown to inhibit the exchange current. The blocking effect of SEA0400 on NCX decreased with increasing [Ca(2+)](i), and it was more pronounced in reverse than in forward mode operation at every [Ca(2+)](i) examined. The rate of decay of the caffeine-induced [Ca(2+)](i) transients was decreased significantly by 1 microM SEA0400; however, this effect was only a fraction of that observed with 10 mM NiCl(2). Neither SR Ca(2+) release and uptake nor cell shortening and Ca(2+) sensitivity of the contractile proteins were influenced by SEA0400. CONCLUSION: The lack of any major SEA0400-induced shift in Ca(2+) transients or contractility of myocytes can well be explained by its limited inhibitory effect on NCX (further attenuated by elevated [Ca(2+)](i) levels) and a concomitant reduction in Ca(2+) influx due to the predominantly reverse mode blockade of NCX and suppression of L-type Ca(2+) current.     

Ca2+ regulation in the Na+/Ca2+ exchanger features a dual electrostatic switch mechanism

Regulation of ion-transport in the Na⁺/Ca²⁺ exchanger (NCX) occurs via its cytoplasmic Ca²⁺-binding domains, CBD1 and CBD2. Here, we present a mechanism for NCX activation and inactivation based on data obtained using NMR, isothermal titration calorimetry (ITC) and small-angle X-ray scattering (SAXS). We initially determined the structure of the Ca²⁺-free form of CBD2-AD and the structure of CBD2-BD that represent the two major splice variant classes in NCX1. Although the apo-form of CBD2-AD displays partially disordered Ca²⁺-binding sites, those of CBD2-BD are entirely unstructured even in an excess of Ca²⁺. Striking differences in the electrostatic potential between the Ca²⁺-bound and -free forms strongly suggest that Ca²⁺-binding sites in CBD1 and CBD2 form electrostatic switches analogous to C₂-domains. SAXS analysis of a construct containing CBD1 and CBD2 reveals a conformational change mediated by Ca²⁺-binding to CBD1. We propose that the electrostatic switch in CBD1 and the associated conformational change are necessary for exchanger activation. The response of the CBD1 switch to intracellular Ca²⁺ is influenced by the closely located cassette exons. We further propose that Ca²⁺-binding to CBD2 induces a second electrostatic switch, required to alleviate Na⁺-dependent inactivation of Na⁺/Ca²⁺ exchange. In contrast to CBD1, the electrostatic switch in CBD2 is isoform- and splice variant-specific and allows for tailored exchange activities.     

Age and hypertrophy alter the contribution of sarcoplasmic reticulum and Na+/Ca2+ exchange to Ca2+ removal in rat left ventricular myocytes

Age and hypertension contribute significantly to cardiac morbidity and mortality, however the importance of each during the progression of hypertrophy is unclear. This investigation examined the effect of age and hypertension on Ca(2+) handling in rat ventricular myocytes by comparing a genetic model of hypertension and cardiac hypertrophy (spontaneously hypertensive rat, SHR) with its normotensive control (Wistar-Kyoto rat, WKY) at 5 and 8 months of age. Experiments were performed on single left ventricular myocytes isolated from SHR or WKY hearts. Intracellular Ca(2+) was measured optically using fura-2 or fluo-3. SHR myocytes had a significantly larger cell width and volume and a significantly decreased cell length/width ratio at 5 and 8 months compared to normotensive controls. Age had no effect on cell length, width, volume or the length/width ratio. Ca(2+) transient amplitude, sarcoplasmic reticulum (SR) Ca(2+) content and contraction amplitude were unaffected by age or hypertrophy. However at 8 months the contribution of the SR to Ca(2+) uptake during relaxation decreased, with a concomitant increase in the contribution of Na(+)/Ca(2+) exchanger (NCX) function to relaxation, in SHR and WKY myocytes. The incidence of non-synchronous SR Ca(2+) release decreased with age but not hypertrophy in SHR and WKY myocytes. These results show that the changes in Ca(2+) handling observed during progression of mild hypertrophy in SHR are the same as those that occur during ageing in normotensive control animals and can, therefore, be ascribed to maturation rather than hypertrophy.     

The Na+/K+-ATPase alpha2-isoform regulates cardiac contractility in rat cardiomyocytes

OBJECTIVE: The presence of both alpha1- and alpha2-isoforms of the Na+/K+-ATPase (NKA) in cardiomyocytes indicates different functions. We hypothesized that preferential localization of the alpha2-isoform to the t-tubules, locally controlling the Na+/Ca2+-exchanger (NCX), underlies a specific role in Ca2+ handling. METHODS: We studied NKA isoform distribution in isolated cardiomyocytes from Wistar rats using immunocytochemistry. NKA pump and NCX currents (I(pump) and I(NCX)) were measured in control and detubulated cardiomyocytes. Intracellular Na+ concentration [Na+]i was assessed with the fluorescent dye SBFI. RESULTS: The alpha2-isoform abundance was higher in the t-tubules than in the surface sarcolemma. We established that 0.3 microM ouabain specifically blocked the alpha2-isoform in isolated rat cardiomyocytes. This low concentration blocked 10.7+/-0.6% of I(pump) in control, but only 6.0+/-0.5% in detubulated cardiomyocytes. Moreover, measured and calculated alpha1-specific and alpha2-specific I(pump) in control (547+/-29 pA and 66 pA, respectively) and in detubulated cells (495+/-30 pA and 31 pA, respectively) showed that 53% of the alpha2-isoform, but only 9.5% of the alpha1-isoform, were localized to the t-tubules. Despite the small abundance of the alpha2-isoform (approximately 11% of total NKA), selective inhibition of this isoform induced a 40% increase in contractility in field stimulated cardiomyocytes, but no increase in global [Na+]i. However, inhibition of the alpha2-isoform increased I(NCX) indicating local subsarcolemmal accumulation of Na+ near NCX. CONCLUSIONS: The alpha2-isoform of the NKA is functionally coupled to the NCX and can regulate Ca2+ handling without changing global [Na+]i.     

Sodium recognition by the Na+/Ca2+ exchanger in the outward-facing conformation

Na⁺/Ca²⁺ exchangers (NCXs) are ubiquitous membrane transporters with a key role in Ca²⁺ homeostasis and signaling. NCXs mediate the bidirectional translocation of either Na⁺ or Ca²⁺, and thus can catalyze uphill Ca²⁺ transport driven by a Na⁺ gradient, or vice versa. In a major breakthrough, a prokaryotic NCX homolog (NCX_Mj) was recently isolated and its crystal structure determined at atomic resolution. The structure revealed an intriguing architecture consisting of two inverted-topology repeats, each comprising five transmembrane helices. These repeats adopt asymmetric conformations, yielding an outward-facing occluded state. The crystal structure also revealed four putative ion-binding sites, but the occupancy and specificity thereof could not be conclusively established. Here, we use molecular-dynamics simulations and free-energy calculations to identify the ion configuration that best corresponds to the crystallographic data and that is also thermodynamically optimal. In this most probable configuration, three Na⁺ ions occupy the so-called S_ext, S_Ca, and S_int sites, whereas the S_mid site is occupied by one water molecule and one H⁺, which protonates an adjacent aspartate side chain (D240). Experimental measurements of Na⁺/Ca²⁺ and Ca²⁺/Ca²⁺ exchange by wild-type and mutagenized NCX_Mj confirm that transport of both Na⁺ and Ca²⁺ requires protonation of D240, and that this side chain does not coordinate either ion at S_mid. These results imply that the ion exchange stoichiometry of NCX_Mj is 3:1 and that translocation of Na⁺ across the membrane is electrogenic, whereas transport of Ca²⁺ is not. Altogether, these findings provide the basis for further experimental and computational studies of the conformational mechanism of this exchanger.Ca²⁺ signals control a variety of cellular processes essential for the basic function of multiple organs. In cardiac cells, for example, Ca²⁺ release from the sarcoplasmic reticulum is a necessary step for heart contraction, whereas Ca²⁺ extrusion from the cell is required for cardiac relaxation. These fluctuations in the cytosolic Ca²⁺ concentration underlie the initiation of the heartbeat (1, 2). Na⁺/Ca²⁺ exchangers (NCXs) play a central role in the homeostasis of cellular Ca²⁺ (3–5). These integral membrane proteins are ubiquitous in many types of tissues including the heart, brain, and kidney (4), and consequently their dysfunction is associated with numerous human pathologies such as cardiac arrhythmia, hypertension, skeletal muscle dystrophy, and postischemic brain damage (5). NCXs facilitate the translocation of either Ca²⁺ or Na⁺ across the membrane; thus, they can harness a transmembrane sodium motive force to energize Ca²⁺ transport against a concentration gradient. For example, the cardiac exchanger NCX1 mediates the extrusion of intracellular Ca²⁺ driven by a Na⁺ transmembrane gradient maintained by the Na⁺/K⁺ ATPase (3, 6).Numerous electrophysiological studies over the past three decades have analyzed the functional and regulatory properties of these important exchangers. It is well established that NCXs are reversible and electrogenic, but it has been debated whether the Na⁺/Ca²⁺ exchange stoichiometry is 3:1 or 4:1 (3, 5, 7–12). In any case, NCXs can also facilitate Na⁺/Na⁺ and Ca²⁺/Ca²⁺ exchange, implying that the translocation of Na⁺ and Ca²⁺ are two distinct reactions (3, 5, 6, 13). NCXs are regulated by several factors, such as cytosolic Na⁺ and Ca²⁺ concentrations, pH, ATP, and PIP₂ (5, 6). Ca²⁺ regulation in particular involves accessory cytoplasmic domains not directly implicated in the ion-exchange function of the transmembrane domain (5, 14, 15). It is in highly conserved regions within the latter domain, known as α1 and α2 (in transmembrane helices TM2/TM3 and TM7/TM8, respectively), where specific polar and carboxylic amino acids have been identified to be crucial for ion binding and transport (6, 16–18). Similar sequence motifs are found in related antiporters that exchange Na⁺ for K⁺ and Ca²⁺ (NCKX), and Ca²⁺ for H⁺ (CAX) (19–21).In a recent breakthrough, the NCX exchanger from the archaeobacterium Methanocaldococcus jannaschii was isolated and functionally reconstituted, and its crystal structure determined at 1.9-Å resolution (22). The structure of NCX_Mj revealed an intriguing architecture consisting of two inverted topological repeats of five transmembrane helices each (Fig. 1A), which adopt similar but not identical conformations (Fig. S1). This structural asymmetry is likely to underlie the ability of the exchanger to adopt outward- and inward-open conformations alternately, as is mandatory in secondary-transport processes (23, 24). Importantly, the electron density map for NCX_Mj also revealed clear peaks for four putative ion-binding sites in the α1 and α2 regions, involving several of the residues previously identified as essential (Fig. 1B). One of these sites, referred to as S_Ca, also produced an anomalous scattering signal, somewhat weak but indicative of the presence of a bound Ca²⁺. The sites referred to as S_ext and S_int appeared to be Na⁺ sites, based on chemical and geometric considerations. The fourth site, S_mid, was tentatively interpreted also as a Na⁺ site, although in this case the ion-coordination number and coordination geometry would be atypical (22).Open in a separate windowFig. 1.Structure of the Na⁺/Ca²⁺ exchanger from M. jannaschii in an outward-facing conformation. (A) The architecture of NCX_Mj (PDB entry 3V5U) consists of two repeats of five transmembrane helices each (orange, marine cartoons), which adopt opposite orientations in the membrane (the cytoplasmic side is below). Four putative ion-binding sites (indicated by gray spheres) are found halfway across the transmembrane region, flanked by helices TM2–TM3 and TM7–TM8. The structures of the five-helix repeats are highly similar but not identical (Fig. S1). The major differences are the orientation of TM1/TM6 relative to the rest of the repeat, and a bend in the periplasmic half of TM7, not observed in the equivalent region of TM2. These structural asymmetries likely underlie the ability of the exchanger to alternatively adopt outward- and inward-facing conformations (24). (B) Close-up of the four putative ion-binding sites. The side-chain and backbone groups lining these sites are highlighted; the hypothetical ion coordination contacts are indicated in each case. (C) All-atom simulation model of NCX_Mj embedded in a phospholipid membrane. The membrane consists of 208 POPC molecules, and protein and membrane are hydrated by ∼14,900 water molecules. Chloride ions (omitted for clarity) were also included to counter the net charge of the ion–protein complex. The overall system size is ∼77,300 atoms. (D) Ion configuration that is most likely to correspond to the crystal structure of NCX_Mj, according to the structural and thermodynamic analyses described in Figs. 2 and ​and3.3. A water molecule (W) occupies the S_mid site, while Na⁺ ions occupy S_ext, S_Ca, and S_int. Note that D240 is protonated, and that the side-chain carboxamide group of N81 is inverted relative to the original assignment. The figure shows the conformation that is most frequently observed in a 200-ns MD simulation, according to an RMSD-based clustering analysis comprising the residues highlighted in B.If one assumes that the exchange of Na⁺ and Ca²⁺ mediated by NCX_Mj proceeds according to a “ping-pong” mechanism, in analogy with other NCXs (13), binding of Na⁺ and Ca²⁺ ought to be mutually exclusive (22), even if the exchange stoichiometry is 3:1 rather than 4:1. Thus, the detection of concurrent electron density signals for three Na⁺ and one Ca²⁺ must reflect the coexistence of protein molecules with either of these two ion configurations in the crystal lattice. On the other hand, configurations in which Na⁺ and Ca²⁺ are simultaneously bound cannot be entirely ruled out; indeed, a minor transport mode has been reportedly observed for cardiac NCX1 whereby one Na⁺ and one Ca²⁺ are cotranslocated (9). Either way, it is puzzling that the local structure of the binding sites revealed by the electron density is uniquely defined, as it seems unlikely that this structure is identical irrespective of which ion type is bound. This lack of disorder could be explained if only one of the ion configurations that hypothetically coexist in the protein crystal was significantly populated, but it is not immediately apparent which of these configurations is represented by the data. Thus, notwithstanding the groundbreaking insights provided by the NCX_Mj structure, the interpretation of the electron density in regard to the ion configuration is, in our view, not straightforward: could the proposed Na⁺ occupancy of the suboptimal S_mid site result from the concurrent binding of Ca²⁺, explaining the minor transport mode observed for NCX1? If so, would S_mid remain occupied by Na⁺ in the absence of Ca²⁺? Or is the S_Ca site alternatively occupied by Na⁺ and Ca²⁺? If so, does the electron density signal detected in S_mid reflect a fourth Na⁺ ion? Or could it be a water molecule, or another cation, such as K⁺? It is worth noting that the amino acid composition of the binding sites in NCX_Mj is more akin to that of NCKX exchangers, which cotransport K⁺ along with Ca²⁺, than to NCX homologs (Fig. S2), including those of Escherichia coli and Methanosarcina acetivorans (25). The functional reconstitution of NCX_Mj showed that Na⁺/Ca²⁺ exchange in NCX_Mj is not influenced by a K⁺ gradient (22), but it is conceivable that K⁺ is constitutively bound throughout the transport cycle.Here, we use all-atom molecular-dynamics (MD) simulations and free-energy calculations of NCX_Mj to systematically assess a series of possible ion configurations, both in terms of their consistency with the protein conformation observed in the experimental crystal structure, and from a thermodynamic standpoint. This computational analysis yields a clear-cut testable hypothesis, which we examine experimentally via Na⁺/Ca²⁺ and Ca²⁺/Ca²⁺ exchange assays for wild-type and mutagenized NCX_Mj.     

多巴酚丁胺对大鼠心室肌细胞Na+/Ca2+交换的影响及其受体机制

目的：观察多巴酚丁胺对大鼠心室肌细胞Na^ /Ca^2 交换电流的作用及其肾上腺素能受体机制。方法：用胶原酶消化的成年大鼠心室肌单个细胞及全细胞片钳技术，记录Na^ / Ca^2 交换电流并观察药物对它作用。结果：多巴酚丁胺呈剂量领带性地增加大鼠心室肌细胞N ^ /C^2 交换电流，该作用可分别被β和β1受体阻断剂普萘洛尔和美托洛尔阻断。结论：多巴酚丁胺通过β1－受体途径增加大鼠心室肌细胞Na^ /Ca^2 交换电流，这可能是多巴酚丁胺正性变力作用的一个新的机制。     

Functional expression of the Na+/Ca2+ exchanger in the embryonic mouse heart

The Na(+)/Ca(2+) exchanger (NCX) is one of the earliest functional genes and is currently assumed to compensate at least in part for the rudimentary sarcoplasmic reticulum in the developing mouse heart. However, to date little is known about the functional expression of NCX during development. This prompted us to investigate the NCX current (I(NCX)) in very early (embryonic day E8.5-E9.5 post coitum), early (E10.5-E11.5), middle (E13.5) and late (E16.5) stage mouse embryonic cardiomyocytes. For standard I(NCX) measurements, [Ca(2+)](i) was buffered to 150 nmol/l and voltage ramps were applied from +60 mV to -120 mV. At very early stages of development, we observed a prominent role of the I(NCX) Ca(2+) inward mode in elevating the cytosolic Ca(2+) concentration ([Ca(2+)](i)). Accordingly, a high I(NCX) density was observed (+60 mV: 4.6+/-0.7 pA/pF, n=14). Likewise, we found a strong Ca(2+) outward mode of I(NCX) (-120 mV: -3.9+/-0.7 pA/pF, n=14). At later stages, however, I(NCX) Ca(2+) inward mode was reduced by 54+/-6% (n=15, p<0.0001) in ventricular and 68+/-10% (n=9, p<0.0006) in atrial cells. For the outward mode, a reduction by 43+/-10% (n=15, p<0.01) in ventricular and 62+/-11% (n=9, p<0.004) in atrial cardiomyocytes was observed. By contrast, NCX isoform expression and the reversal potential did not significantly change during development. Thus, NCX displays a prominent Ca(2+) inward and outward mode during early embryonic heart development pointing to its important contribution to maintain [Ca(2+)](i) homeostasis. The functional and protein expression of NCX declines during further development.     

Salt-sensitive hypertension, Na+/Ca2+ exchanger, and vascular smooth muscle

Hypertension is the most common chronic disease and is the leading risk factor for death caused by stroke, myocardial infarction, and end-stage renal failure. The critical importance of excess salt intake in the pathogenesis of hypertension is widely recognized. However, the molecular mechanisms underlying salt-sensitive hypertension remain obscure. Recent studies using selective Na(+)/Ca(2+) exchanger (NCX) inhibitors and genetically engineered mice provide compelling evidence that salt-sensitive hypertension is triggered by Ca(2+) entry through NCX type 1 (NCX1) in arterial smooth muscle. Cardiotonic steroids, such as endogenous ouabain, which may contribute to the pathogenesis of salt-sensitive hypertension, seem to be necessary for NCX1-mediated hypertension. These findings have enabled us to explain how high salt intake leads to hypertension and further to describe the potential of vascular NCX1 as a new therapeutic or diagnostic target for salt-sensitive hypertension.     

Na+/Ca++ exchanger and myocardial ischemia/reperfusion

Myocardial hypoxia and ischemia are characterized by the depletion of ATP and the development of intracellular acidosis, which alter cellular ionic homeostasis. Specifically, elevated cytosolic free Ca++ concentrations cause cellular injury during hypoxia/ischemia and lead to irreversible myocardial damage during reoxygenation/reperfusion. An increase in the intracellular Na+ concentration has been shown to correlate with Ca++ overload. Although inhibition of Na+/K+ exchange because of decreased ATP production may be involved, it is more likely that intracellular acidosis drives Na+ into the cells via Na+/H+ exchange. Experimental evidence supports the notion that Na+/H+ exchange is primarily responsible for Na+ influx during hypoxia/ischemia. The accumulation of intracellular Na+ may then activate the Na+/Ca++ exchanger causing Ca++ overload. Therefore, the Na+/Ca++ exchanger plays a crucial role in cellular injury during hypoxia/ischemia and in cell death during reoxygenation/reperfusion. In the past few years, the Na+/Ca++ exchanger has been cloned and the structure/function relationship studied intensively. Agents which inhibit the Na+/Ca++ exchanger may have therapeutic potential for the treatment of ischemic heart disease. These advances will greatly accelerate the understanding of the cellular and molecular mechanisms underlying the role of the Na+/Ca++ exchanger in the development of myocardial damage during hypoxia/ischemia and reoxygenation/reperfusion.     

Molecular cloning and characterization of the human cardiac Na+/Ca2+ exchanger cDNA.

The Na+/Ca2+ exchanger plays important roles in Ca2+ handling in many excitable cells. In particular, the Na+/Ca2+ exchanger is expressed at high levels in the cardiac sarcolemma and is the dominant mechanism of Ca2+ extrusion from the cells. In addition, the exchanger has been suggested to play key roles in digitalis action and in postischemic reperfusion injury of cardiac myocytes. We report here the isolation and characterization of the cDNA encoding the human cardiac Na+/Ca2+ exchanger. Twelve overlapping clones corresponding to 5.6 kilobases of the exchanger cDNA sequence were isolated from 5 x 10(5) phage plaques screened. The sequence predicted a 973-amino acid polypeptide with a putative leader peptide, 11 potential membrane-spanning regions, and one large putative cytoplasmic loop between the fifth and sixth transmembrane helices. When RNA was synthesized in vitro from the cloned cDNA and injected into Xenopus oocytes, it induced expression of Na+/Ca2+ exchange activity at high levels, confirming that this clone encodes the functional Na+/Ca2+ exchanger. Southern blot analysis indicated that the cardiac exchanger gene exists as a single copy in the human genome, although existence of other related genes cannot be ruled out. Northern blot and S1 mapping analyses revealed that the cardiac type exchanger mRNA is expressed most abundantly in the heart and next in the brain. The cardiac-type exchanger mRNA was also expressed in the retina and in skeletal and smooth muscles at very low levels. The levels of mRNA encoding the exchanger were significantly lower in fetal hearts than in adult hearts but were unchanged in the myocardium from patients with end-stage heart failure.