Ca/calmodulin-dependent protein kinase II contributes to intracellular pH recovery from acidosis via Na/H exchanger activation

The Na⁺/H⁺ exchanger (NHE-1) plays a key role in pH_i recovery from acidosis and is regulated by pH_i and the ERK1/2-dependent phosphorylation pathway. Since acidosis increases the activity of Ca²⁺/calmodulin-dependent protein kinase II (CaMKII) in cardiac muscle, we examined whether CaMKII activates the exchanger by using pharmacological tools and highly specific genetic approaches. Adult rat cardiomyocytes, loaded with the pH_i indicator SNARF-1/AM were subjected to different protocols of intracellular acidosis. The rate of pH_i recovery from the acid load (dpH_i/dt)—an index of NHE-1 activity in HEPES buffer or in NaHCO₃ buffer in the presence of inhibition of anion transporters—was significantly decreased by the CaMKII inhibitors KN-93 or AIP. pH_i recovery from acidosis was faster in CaMKII-overexpressing myocytes than in overexpressing β-galactosidase myocytes (dpH_i/dt: 0.195 ± 0.04 vs. 0.045 ± 0.010 min^− 1, respectively, n = 8) and slower in myocytes from transgenic mice with chronic cardiac CaMKII inhibition (AC3-I) than in controls (AC3-C). Inhibition of CaMKII and/or ERK1/2 indicated that stimulation of NHE-1 by CaMKII was independent of and additive to the ERK1/2 cascade. In vitro studies with fusion proteins containing wild-type or mutated (Ser/Ala) versions of the C-terminal domain of NHE-1 indicate that CaMKII phosphorylates NHE-1 at residues other than the canonical phosphorylation sites for the kinase (Ser648, Ser703, and Ser796). These results provide new mechanistic insights and unequivocally demonstrate a role of the already multifunctional CaMKII on the regulation of the NHE-1 activity. They also prove clinically important in multiple disorders which, like ischemia/reperfusion injury or hypertrophy, are associated with increased NHE-1 and CaMKII.