Functional Consequences of Various Leucine Mutations in the M3/M4 Loop of the Na+,K+-ATPase α-Subunit

Red blood cell sodium transport in patients with cirrhosis

Patients with advanced cirrhosis have abnormal sodium homoeostasis. The study was undertaken to quantify the sodium transport across the plasma membrane of red blood cells (RBC) in patients with cirrhosis. RBC efflux and influx of sodium were studied in vitro with tracer (22) Na(+) according to linear kinetics in 24 patients with cirrhosis and 14 healthy controls. The sodium efflux was modified by ouabain (O), furosemide (F) and a combination of O and F (O + F). RBC sodium was significantly decreased (4·6 versus control 6·3 mmol l(-1) , P<0·001) and directly related to serum sodium (r = 0·57, P<0·05). The RBC fractional sodium efflux was higher in patients with cirrhosis (+46%, P<0·01) compared to controls. Inhibition in both high (145 mmol l(-1) )- and low (120 mmol l(-1) )-sodium buffers showed that the F-insensitive sodium efflux was twice as high in cirrhosis as in controls (P = 0·03-0·007), especially the O-sensitive, F-insensitive efflux was increased (+ 225%, P = 0·01-0·006). Fractional F-sensitive transport was normal in cirrhosis. RBC sodium influx was largely normal in cirrhosis. In conclusion, RBC sodium content is reduced in patients with cirrhosis with a direct relation to serum sodium. Increased RBC sodium efflux is especially related to ouabain-sensitive, furosemide-insensitive transport and thus most likely due to upregulated activity of the sodium-potassium pump. The study gives no evidence to an altered intracellular/extracellular sodium ratio or to a reduced fractional furosemide-sensitive sodium transport in cirrhosis.

P-type ATPases as drug targets: tools for medicine and science

P-type ATPases catalyze the selective active transport of ions like H+, Na+, K+, Ca2+, Zn2+, and Cu2+ across diverse biological membrane systems. Many members of the P-type ATPase protein family, such as the Na+,K+-, H+,K+-, Ca2+-, and H+-ATPases, are involved in the development of pathophysiological conditions or provide critical function to pathogens. Therefore, they seem to be promising targets for future drugs and novel antifungal agents and herbicides. Here, we review the current knowledge about P-type ATPase inhibitors and their present use as tools in science, medicine, and biotechnology. Recent structural information on a variety of P-type ATPase family members signifies that all P-type ATPases can be expected to share a similar basic structure and a similar basic machinery of ion transport. The ion transport pathway crossing the membrane lipid bilayer is constructed of two access channels leading from either side of the membrane to the ion binding sites at a central cavity. The selective opening and closure of the access channels allows vectorial access/release of ions from the binding sites. Recent structural information along with new homology modeling of diverse P-type ATPases in complex with known ligands demonstrate that the most proficient way for the development of efficient and selective drugs is to target their ion transport pathway.

Red blood cell Na pump: Insights from species differences

The red blood cell membrane is specialized to exchange chloride and bicarbonate; usually the pH gradient, the chloride ratio, and the membrane potential are tightly coupled. We review the evidence that led to the ability to separately vary inside and outside pH in red cells. The effect of pH on Na pump activity and on the selectivity of the inside and the outside transport sites is reviewed. In red blood cells, at high pH, the outside site is not selective. An increase in protons leads to an increase in K(+) affinity, thus making the site more selective. The pK for this site is different in rats and humans; because of the high conservation of residues in these two species, there are only a few possible residues that can account for this difference. On the inside, work from unsided preparations suggests that, at high pH, the transport site is highly selective for Na(+). Once again, an increase in protons leads to an increase in K(+) affinity, but now the result is a less selective site. During their maturation, reticulocytes lose many membrane proteins. The type and fractional loss is species dependent. For example, most reticulocytes lose most of their Na pumps, retaining about 100 pumps per cell, but animals from the order Carnivora lose all their pumps. We review some of the evidence that PKC phosphorylation of N-terminus serines is responsible for endocytosis in other cell types and species variation in this region.