Sodium and proton effects on inward proton transport through Na/K pumps

Structure and function of H+/K+ pump mutants reveal Na+/K+ pump mechanisms

Ion-transport mechanisms evolve by changing ion-selectivity, such as switching from Na⁺ to H⁺ selectivity in secondary-active transporters or P-type-ATPases. Here we study primary-active transport via P-type ATPases using functional and structural analyses to demonstrate that four simultaneous residue substitutions transform the non-gastric H⁺/K⁺ pump, a strict H⁺-dependent electroneutral P-type ATPase, into a bona fide Na⁺-dependent electrogenic Na⁺/K⁺ pump. Conversion of a H⁺-dependent primary-active transporter into a Na⁺-dependent one provides a prototype for similar studies of ion-transport proteins. Moreover, we solve the structures of the wild-type non-gastric H⁺/K⁺ pump, a suitable drug target to treat cystic fibrosis, and of its Na⁺/K⁺ pump-mimicking mutant in two major conformations, providing insight on how Na⁺ binding drives a concerted mechanism leading to Na⁺/K⁺ pump phosphorylation.

Structure and Function of Na,K-ATPase-The Sodium-Potassium Pump

Na,K-ATPase is an ubiquitous enzyme actively transporting Na-ions out of the cell in exchange for K-ions, thereby maintaining their concentration gradients across the cell membrane. Since its discovery more than six decades ago the Na-pump has been studied extensively and its vital physiological role in essentially every cell has been established. This article aims at providing an overview of well-established biochemical properties with a focus on Na,K-ATPase isoforms, its transport mechanism and principle conformations, inhibitors, and insights gained from crystal structures. © 2021 American Physiological Society. Compr Physiol 11:1-21, 2021.

Diseases caused by mutations in the Na+/K+ pump α1 gene ATP1A1

Human cell survival requires function of the Na⁺/K⁺ pump; the heteromeric protein that hydrolyzes ATP to extrude Na⁺ and import K⁺ across the plasmalemma, thereby building and maintaining these ions' electrochemical gradients. Numerous dominant diseases caused by mutations in genes encoding for Na⁺/K⁺ pump catalytic (α) subunit isoforms highlight the importance of this protein. Here, we review literature describing disorders caused by missense mutations in ATP1A1, the gene encoding the ubiquitously expressed α1 isoform of the Na⁺/K⁺ pump. These various maladies include primary aldosteronism with secondary hypertension, an endocrine syndrome, Charcot-Marie-Tooth disease, a peripheral neuropathy, complex spastic paraplegia, another neuromuscular disorder, as well as hypomagnesemia accompanied by seizures and cognitive delay, a condition affecting the renal and central nervous systems. This article focuses on observed commonalities among these mutations' functional effects, as well as on the special characteristics that enable each particular mutation to exclusively affect a certain system, without affecting others. In this respect, it is clear how somatic mutations localized to adrenal adenomas increase aldosterone production without compromising other systems. However, it remains largely unknown how and why some but not all de novo germline or familial mutations (where the mutant must be expressed in numerous tissues) produce a specific disease and not the other diseases. We propose hypotheses to explain this observation and the approaches that we think will drive future research on these debilitating disorders to develop novel patient-specific treatments by combining the use of heterologous protein-expression systems, patient-derived pluripotent cells, and gene-edited cell and mouse models.

Distinct effects of Q925 mutation on intracellular and extracellular Na+ and K+ binding to the Na+, K+-ATPase

Three Na⁺ sites are defined in the Na⁺-bound crystal structure of Na⁺, K⁺-ATPase. Sites I and II overlap with two K⁺ sites in the K⁺-bound structure, whereas site III is unique and Na⁺ specific. A glutamine in transmembrane helix M8 (Q925) appears from the crystal structures to coordinate Na⁺ at site III, but does not contribute to K⁺ coordination at sites I and II. Here we address the functional role of Q925 in the various conformational states of Na⁺, K⁺-ATPase by examining the mutants Q925A/G/E/N/L/I/Y. We characterized these mutants both enzymatically and electrophysiologically, thereby revealing their Na⁺ and K⁺ binding properties. Remarkably, Q925 substitutions had minor effects on Na⁺ binding from the intracellular side of the membrane - in fact, mutations Q925A and Q925G increased the apparent Na⁺ affinity - but caused dramatic reductions of the binding of K⁺ as well as Na⁺ from the extracellular side of the membrane. These results provide insight into the changes taking place in the Na⁺-binding sites, when they are transformed from intracellular- to extracellular-facing orientation in relation to the ion translocation process, and demonstrate the interaction between sites III and I and a possible gating function of Q925 in the release of Na⁺ at the extracellular side.

External Ion Access in the Na/K Pump: Kinetics of Na+, K+, and Quaternary Amine Interaction

Na/K pumps build essential ion gradients across the plasmalemma of animal cells by coupling the extrusion of three Na⁺, with the import of two K⁺ and the hydrolysis of one ATP molecule. The mechanisms of selectivity and competition between Na⁺, K⁺, and inhibitory amines remain unclear. We measured the effects of external tetrapropylammonium (TPA⁺) and ethylenediamine (EDA²⁺) on three different Na/K pump transport modes in voltage-clamped Xenopus oocytes: 1) outward pump current (I_P), 2) passive inward H⁺ current at negative voltages without Na⁺ or K⁺ (I_H), and 3) transient charge movement reporting the voltage-dependent extracellular binding/release of Na⁺ (Q_Na). Both amines competed with K⁺ to inhibit I_P. TPA⁺ inhibited I_H without competing with H⁺, whereas EDA²⁺ did not alter I_H at pH 7.6. TPA⁺ competed with Na⁺ in Q_Na measurements, reducing Na⁺-apparent affinity, evidenced by a ∼-75 mV shift in the charge-voltage curve (at 20 mM TPA⁺) without reduction of the total charge moved (Q_tot). In contrast, EDA²⁺ and K⁺ did not compete with Na⁺ to inhibit Q_Na; both reduced Q_tot without decreasing Na⁺-apparent affinity. EDA²⁺ (15 mM) right-shifted the charge-voltage curve by ∼+50 mV. Simultaneous occlusion of EDA²⁺ and Na⁺ by an E2P conformation unable to reach E1P was demonstrated by voltage-clamp fluorometry. Trypsinolysis experiments showed that EDA²⁺-bound pumps are much more proteolysis-resistant than Na⁺-, K⁺-, or TPA⁺-bound pumps, therefore uncovering unique EDA²⁺-bound conformations. K⁺ effects on Q_Na and I_H were also evaluated in pumps inhibited with beryllium fluoride, a phosphate mimic. K⁺ reduced Q_tot without shifting the charge-voltage curve, indicating noncompetitive effects, and partially inhibited I_H to the same extent as TPA⁺ in non-beryllium-fluorinated pumps. These results demonstrate that K⁺ interacts with beryllium-fluorinated pumps inducing conformational changes that alter Q_Na and I_H, suggesting that there are two external access pathways for proton transport by I_H.

A novel ATP1A2 mutation in a patient with hypokalaemic periodic paralysis and CNS symptoms

Hypokalaemic periodic paralysis is a rare genetic neuromuscular disease characterized by episodes of skeletal muscle paralysis associated with low serum potassium. Muscle fibre inexcitability during attacks of paralysis is due to an aberrant depolarizing leak current through mutant voltage sensing domains of either the sarcolemmal voltage-gated calcium or sodium channel. We report a child with hypokalaemic periodic paralysis and CNS involvement, including seizures, but without mutations in the known periodic paralysis genes. We identified a novel heterozygous de novo missense mutation in the ATP1A2 gene encoding the α2 subunit of the Na⁺/K⁺-ATPase that is abundantly expressed in skeletal muscle and in brain astrocytes. Pump activity is crucial for Na⁺ and K⁺ homeostasis following sustained muscle or neuronal activity and its dysfunction is linked to the CNS disorders hemiplegic migraine and alternating hemiplegia of childhood, but muscle dysfunction has not been reported. Electrophysiological measurements of mutant pump activity in Xenopus oocytes revealed lower turnover rates in physiological extracellular K⁺ and an anomalous inward leak current in hypokalaemic conditions, predicted to lead to muscle depolarization. Our data provide important evidence supporting a leak current as the major pathomechanism underlying hypokalaemic periodic paralysis and indicate ATP1A2 as a new hypokalaemic periodic paralysis gene.

Na/K Pump Mutations Associated with Primary Hyperaldosteronism Cause Loss of Function

Primary hyperaldosteronism (Conn's syndrome), a common cause of secondary hypertension, is frequently produced by unilateral aldosterone-producing adenomas that carry mutations in ion-transporting genes, including ATP1A1, encoding the Na/K pump's α1 subunit. Whether Na/K pump mutant-mediated inward currents are required to depolarize the cell and increase aldosterone production remains unclear, as such currents were observed in four out of five mutants described so far. Here, we use electrophysiology and uptake of the K⁺ congener ⁸⁶Rb⁺, to characterize the effects of eight additional Na/K pump mutations in transmembrane segments TM1 (delM102-L103, delL103-L104, and delM102-I106), TM4 (delI322-I325 and I327S), and TM9 (delF956-E961, delF959-E961, and delE960-L964), expressed in Xenopus oocytes. All deletion mutants induced abnormal inward currents of different amplitudes at physiological voltages, while I327S lacked such currents. A detailed functional characterization revealed that I327S significantly reduces intracellular Na⁺ affinity without altering affinity for external K⁺. ⁸⁶Rb⁺-uptake experiments show that I327S dramatically impairs function under physiological concentrations of Na⁺ and K⁺. Since Na/K pumps in the adrenal cortex may be formed by association of α1 with β3 instead of β1 subunits, we evaluated whether G99R (another mutant without inward currents when associated with β1) would show inward currents when associated with β3. We found that the kinetic characteristics of either mutant or wild-type α1β3 pumps expressed in Xenopus oocytes to be indistinguishable from those of α1β1 pumps. The observed functional consequences of each hyperaldosteronism mutant point to the loss of Na/K pump function as the common feature of all mutants, which is sufficient to induce hyperaldosteronism.

Functional consequences of the CAPOS mutation E818K of Na+,K+-ATPase

The cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss (CAPOS) syndrome is caused by the single mutation E818K of the α3-isoform of Na⁺,K⁺-ATPase. Here, using biochemical and electrophysiological approaches, we examined the functional characteristics of E818K, as well as of E818Q and E818A mutants. We found that these amino acid substitutions reduce the apparent Na⁺ affinity at the cytoplasmic-facing sites of the pump protein and that this effect is more pronounced for the lysine and glutamine substitutions (3-4-fold) than for the alanine substitution. The electrophysiological measurements indicated a more conspicuous, ∼30-fold reduction of apparent Na⁺ affinity for the extracellular-facing sites in the CAPOS mutant, which was related to an accelerated transition between the phosphoenzyme intermediates E₁P and E₂P. The apparent affinity for K⁺ activation of the ATPase activity was unaffected by these substitutions, suggesting that primarily the Na⁺-specific site III is affected. Furthermore, the apparent affinities for ATP and vanadate were WT-like in E818K, indicating a normal E₁-E₂ equilibrium of the dephosphoenzyme. Proton-leak currents were not increased in E818K. However, the CAPOS mutation caused a weaker voltage dependence of the pumping rate and a stronger inhibition by cytoplasmic K⁺ than the WT enzyme, which together with the reduced Na⁺ affinity of the cytoplasmic-facing sites precluded proper pump activation under physiological conditions. The functional deficiencies could be traced to the participation of Glu-818 in an intricate hydrogen-bonding/salt-bridge network, connecting it to key residues involved in Na⁺ interaction at site III.

On the effect of hyperaldosteronism-inducing mutations in Na/K pumps

Mutated Na/K pumps in adrenal adenomas are thought to cause hyperaldosteronism via a gain-of-function effect involving a depolarizing inward current. The findings of Meyer et al. suggest instead that the common mechanism by which Na/K pump mutants lead to hyperaldosteronism is a loss-of-function.

Primary aldosteronism, a condition in which too much aldosterone is produced and that leads to hypertension, is often initiated by an aldosterone-producing adenoma within the zona glomerulosa of the adrenal cortex. Somatic mutations of ATP1A1, encoding the Na/K pump α1 subunit, have been found in these adenomas. It has been proposed that a passive inward current transported by several of these mutant pumps is a "gain-of-function" activity that produces membrane depolarization and concomitant increases in aldosterone production. Here, we investigate whether the inward current through mutant Na/K pumps is large enough to induce depolarization of the cells that harbor them. We first investigate inward currents induced by these mutations in Xenopus Na/K pumps expressed in Xenopus oocytes and find that these inward currents are similar in amplitude to wild-type outward Na/K pump currents. Subsequently, we perform a detailed functional evaluation of the human Na/K pump mutants L104R, delF100-L104, V332G, and EETA963S expressed in Xenopus oocytes. By combining two-electrode voltage clamp with [³H]ouabain binding, we measure the turnover rate of these inward currents and compare it to the turnover rate for outward current through wild-type pumps. We find that the turnover rate of the inward current through two of these mutants (EETA963S and L104R) is too small to induce significant cell depolarization. Electrophysiological characterization of another hyperaldosteronism-inducing mutation, G99R, reveals the absence of inward currents under many different conditions, including in the presence of the regulator FXYD1 as well as with mammalian ionic concentrations and body temperatures. Instead, we observe robust outward currents, but with significantly reduced affinities for intracellular Na⁺ and extracellular K⁺. Collectively, our results point to loss-of-function as the common mechanism for the hyperaldosteronism induced by these Na/K pump mutants.

Intracellular Requirements for Passive Proton Transport through the Na+,K+-ATPase

The Na⁺,K⁺-ATPase (NKA or Na/K pump) hydrolyzes one ATP to exchange three intracellular Na+ (Na⁺_i) for two extracellular K+ (K⁺_o) across the plasma membrane by cycling through a set of reversible transitions between phosphorylated and dephosphorylated conformations, alternately opening ion-binding sites externally (E2) or internally (E1). With subsaturating [Na⁺]_o and [K⁺]_o, the phosphorylated E2P conformation passively imports protons generating an inward current (I_H), which may be exacerbated in NKA-subunit mutations associated with human disease. To elucidate the mechanisms of I_H, we studied the effects of intracellular ligands (transported ions, nucleotides, and beryllium fluoride) on I_H and, for comparison, on transient currents measured at normal Na⁺_o (Q_Na). Utilizing inside-out patches from Xenopus oocytes heterologously expressing NKA, we observed that 1) in the presence of Na⁺_i, I_H and Q_Na were both activated by ATP, but not ADP; 2) the [Na⁺]_i dependence of I_H in saturating ATP showed K_0.5,Na = 1.8 ± 0.2 mM and the [ATP] dependence at saturating [Na⁺]_i yielded K_0.5,ATP = 48 ± 11 μM (in comparison, Na⁺_i-dependent Q_Na yields K_0.5,Na = 0.8 ± 0.2 mM and K_0.5,ATP = 0.43 ± 0.03 μM; 3) ATP activated I_H in the presence of K⁺_i (∼15% of the I_H observed in Na⁺_i) only when Mg²⁺_i was also present; and 4) beryllium fluoride induced maximal I_H even in the absence of nucleotide. These data indicate that I_H occurs when NKA is in an externally open E2P state with nucleotide bound, a conformation that can be reached through forward Na/K pump phosphorylation of E1, with Na⁺_i and ATP, or by backward binding of K⁺_i to E1, which drives the pump to the occluded E2(2K), where free P_i (at the micromolar levels found in millimolar ATP solutions) promotes external release of occluded K⁺ by backdoor NKA phosphorylation. Maximal I_H through beryllium-fluorinated NKA indicates that this complex mimics ATP-bound E2P states.

Tracking protein function with sodium multi quantum spectroscopy in a 3D-tissue culture based on microcavity arrays

The aim of this study was to observe the effects of strophanthin induced inhibition of the Na-/K-ATPase in liver cells using a magnetic resonance (MR) compatible bioreactor. A microcavity array with a high density three-dimensional cell culture served as a functional magnetic resonance imaging (MRI) phantom for sodium multi quantum (MQ) spectroscopy. Direct contrast enhanced (DCE) MRI revealed the homogenous distribution of biochemical substances inside the bioreactor. NMR experiments using advanced bioreactors have advantages with respect to having full control over a variety of physiological parameters such as temperature, gas composition and fluid flow. Simultaneous detection of single quantum (SQ) and triple quantum (TQ) MR signals improves accuracy and was achieved by application of a pulse sequence with a time proportional phase increment (TQTPPI). The time course of the Na-/K-ATPase inhibition in the cell culture was demonstrated by the corresponding alterations of sodium TQ/SQ MR signals.

Why do plants lack sodium pumps and would they benefit from having one?

The purpose of this minireview is to discuss the feasibility of creating a new generation of salt-tolerant plants that express Na+/K+-ATPases from animals or green algae. Attempts to generate salt-tolerant plants have focussed on increase the expression of or introducing salt stress-related genes from plants, bryophytes and yeast. Even though these approaches have resulted in plants with increased salt tolerance, plant growth is decreased under salt stress and often also under normal growth conditions. New strategies to increase salt tolerance are therefore needed. Theoretically, plants transformed with an animal-type Na+/K+-ATPase should not only display a high degree of salt tolerance but should also reduce the stress response exhibited by the first generation of salt-tolerant plants under both normal and salt stress conditions. The biological feasibility of such a strategy of producing transgenic plants that display improved growth on saline soil but are indistinguishable from wild-type plants under normal growth conditions, is discussed.

Modulation of the Na,K-ATPase by Magnesium Ions

Since the beginning of investigations of the Na,K-ATPase, it has been well-known that Mg²⁺ is an essential cofactor for activation of enzymatic ATP hydrolysis without being transported through the cell membrane. Moreover, experimental evidence has been collected through the years that shows that Mg²⁺ ions have a regulatory effect on ion transport by interacting with the cytoplasmic side of the ion pump. Our experiments allowed us to reveal the underlying mechanism. Mg²⁺ is able to bind to a site outside the membrane domain of the protein's α subunit, close to the entrance of the access channel to the ion-binding sites, thus modifying the local concentration of the ions in the electrolyte, of which Na⁺, K⁺, and H⁺ are of physiological interest. The decrease in the concentration of these cations can be explained by electrostatic interaction and estimated by the Debye-Hückel theory. This effect provokes the observed apparent reduction of the binding affinity of the binding sites of the Na,K-ATPase in the presence of various Mg²⁺ concentrations. The presence of the bound Mg²⁺, however, does not affect the reaction kinetics of the transport function of the ion pump. Therefore, stopped-flow experiments could be performed to gain the first insight into the Na⁺ binding kinetics on the cytoplasmic side by Mg²⁺ concentration jump experiments.

Arginine substitution of a cysteine in transmembrane helix M8 converts Na+,K+-ATPase to an electroneutral pump similar to H+,K+-ATPase

Na⁺,K⁺-ATPase and H⁺,K⁺-ATPase are electrogenic and nonelectrogenic ion pumps, respectively. The underlying structural basis for this difference has not been established, and it has not been revealed how the H⁺,K⁺-ATPase avoids binding of Na⁺ at the site corresponding to the Na⁺-specific site of the Na⁺,K⁺-ATPase (site III). In this study, we addressed these questions by using site-directed mutagenesis in combination with enzymatic, transport, and electrophysiological functional measurements. Replacement of the cysteine C932 in transmembrane helix M8 of Na⁺,K⁺-ATPase with arginine, present in the H⁺,K⁺-ATPase at the corresponding position, converted the normal 3Na⁺:2K⁺:1ATP stoichiometry of the Na⁺,K⁺-ATPase to electroneutral 2Na⁺:2K⁺:1ATP stoichiometry similar to the electroneutral transport mode of the H⁺,K⁺-ATPase. The electroneutral C932R mutant of the Na⁺,K⁺-ATPase retained a wild-type-like enzyme turnover rate for ATP hydrolysis and rate of cellular K⁺ uptake. Only a relatively minor reduction of apparent Na⁺ affinity for activation of phosphorylation from ATP was observed for C932R, whereas replacement of C932 with leucine or phenylalanine, the latter of a size comparable to arginine, led to spectacular reductions of apparent Na⁺ affinity without changing the electrogenicity. From these results, in combination with structural considerations, it appears that the guanidine⁺ group of the M8 arginine replaces Na⁺ at the third site, thus preventing Na⁺ binding there, although allowing Na⁺ to bind at the two other sites and become transported. Hence, in the H⁺,K⁺-ATPase, the ability of the M8 arginine to donate an internal cation binding at the third site is decisive for the electroneutral transport mode of this pump.

Neurological disease mutations of α3 Na+,K+-ATPase: Structural and functional perspectives and rescue of compromised function

Na⁺,K⁺-ATPase creates transmembrane ion gradients crucial to the function of the central nervous system. The α-subunit of Na⁺,K⁺-ATPase exists as four isoforms (α1-α4). Several neurological phenotypes derive from α3 mutations. The effects of some of these mutations on Na⁺,K⁺-ATPase function have been studied in vitro. Here we discuss the α3 disease mutations as well as information derived from studies of corresponding mutations of α1 in the light of the high-resolution crystal structures of the Na⁺,K⁺-ATPase. A high proportion of the α3 disease mutations occur in the transmembrane sector and nearby regions essential to Na⁺ and K⁺ binding. In several cases the compromised function can be traced to disturbance of the Na⁺ specific binding site III. Recently, a secondary mutation was found to rescue the defective Na⁺ binding caused by a disease mutation. A perspective is that it may be possible to develop an efficient pharmaceutical mimicking the rescuing effect.

Importance of the Voltage Dependence of Cardiac Na/K ATPase Isozymes

Cardiac cells express more than one isoform of the Na, K-ATPase (NKA), the heteromeric enzyme that creates the Na(+) and K(+) gradients across the plasmalemma. Cardiac isozymes contain one catalytic α-subunit isoform (α1, α2, or α3) associated with an auxiliary β-subunit isoform (β1 or β2). Past studies using biochemical approaches have revealed minor kinetic differences between isozymes formed by different α-β isoform combinations; these results make it difficult to understand the physiological requirement for multiple isoforms. In intact cells, however, NKA enzymes operate in a more complex environment, which includes a substantial transmembrane potential. We evaluated the voltage dependence of human cardiac NKA isozymes expressed in Xenopus oocytes, and of native NKA isozymes in rat ventricular myocytes, using normal mammalian physiological concentrations of Na(+)o and K(+)o. We demonstrate that although α1 and α3 pumps are functional at all physiologically relevant voltages, α2β1 pumps and α2β2 pumps are inhibited by ∼75% and ∼95%, respectively, at resting membrane potentials, and only activate appreciably upon depolarization. Furthermore, phospholemman (FXYD1) inhibits pump function without significantly altering the pump's voltage dependence. Our observations provide a simple explanation for the physiological relevance of the α2 subunit (∼20% of total α subunits in rat ventricle): they act as a reserve and are recruited into action for extra pumping during the long-lasting cardiac action potential, where most of the Na(+) entry occurs. This strong voltage dependence of α2 pumps also helps explain how cardiotonic steroids, which block NKA pumps, can be a beneficial treatment for heart failure: by only inhibiting the α2 pumps, they selectively reduce NKA activity during the cardiac action potential, leading to an increase in systolic Ca(2+), due to reduced extrusion through the Na/Ca exchanger, without affecting resting Na(+) and Ca(2+) concentrations.

The selectivity of the Na(+)/K(+)-pump is controlled by binding site protonation and self-correcting occlusion

The Na⁺/K⁺-pump maintains the physiological K⁺ and Na⁺ electrochemical gradients across the cell membrane. It operates via an 'alternating-access' mechanism, making iterative transitions between inward-facing (E₁) and outward-facing (E₂) conformations. Although the general features of the transport cycle are known, the detailed physicochemical factors governing the binding site selectivity remain mysterious. Free energy molecular dynamics simulations show that the ion binding sites switch their binding specificity in E₁ and E₂. This is accompanied by small structural arrangements and changes in protonation states of the coordinating residues. Additional computations on structural models of the intermediate states along the conformational transition pathway reveal that the free energy barrier toward the occlusion step is considerably increased when the wrong type of ion is loaded into the binding pocket, prohibiting the pump cycle from proceeding forward. This self-correcting mechanism strengthens the overall transport selectivity and protects the stoichiometry of the pump cycle.

DOI:http://dx.doi.org/10.7554/eLife.16616.001

A protein called the sodium-potassium pump resides in the membrane that surrounds living cells. The role of this protein is to 'pump' sodium and potassium ions across the membrane to help restore their concentration inside and outside of the cell. About 25% of the body's energy is used to keep the pump going, rising to nearly 70% in the brain. Problems that affect the pump have been linked to several disorders, including heart, kidney and metabolic diseases, as well as severe neurological conditions.

The sodium-potassium pump must be able to effectively pick out the correct ions to transport from a mixture of many different types of ions. However, it was not clear how the pump succeeds in doing this efficiently. Rui et al. have now used a computational method called molecular dynamics simulations to model how the sodium-potassium pump transports the desired ions across the cell membrane.

The pump works via a so-called 'alternating-access' mechanism, repeatedly transitioning between inward-facing and outward-facing conformations. In each cycle, it binds three sodium ions from the cell’s interior and exports them to the outside. Then, the pump binds to two potassium ions from outside the cell and imports them inside. Although the bound sodium and potassium ions interact with similar binding sites in the pump, the pump sometimes preferentially binds sodium, and sometimes potassium. The study performed by Rui et al. shows that this preference is driven by how protons (hydrogen ions) bind to the amino acids that make up the binding site.

The simulations also suggest that the pump uses a ‘self-correcting’ mechanism to prevent the pump from transporting the wrong types of ions. When incorrect ions are present at the binding sites, the pump cycle pauses temporarily until the ions detach from the pump. Only when the correct ions are bound will the pump cycle continue again.

In the future, Rui et al. hope to use long time-scale molecular dynamics simulations to show the conformational transition in action. In addition, the 'self-correcting' mechanism will be directly tested by letting the wrong and correct ions compete for the binding sites to see whether the pump will transport only the correct ions.

DOI:http://dx.doi.org/10.7554/eLife.16616.002

ATP1A2 Mutations in Migraine: Seeing through the Facets of an Ion Pump onto the Neurobiology of Disease

Mutations in four genes have been identified in familial hemiplegic migraine (FHM), from which CACNA1A (FHM type 1) and SCN1A (FHM type 3) code for neuronal voltage-gated calcium or sodium channels, respectively, while ATP1A2 (FHM type 2) encodes the α2 isoform of the Na(+),K(+)-ATPase's catalytic subunit, thus classifying FHM primarily as an ion channel/ion transporter pathology. FHM type 4 is attributed to mutations in the PRRT2 gene, which encodes a proline-rich transmembrane protein of as yet unknown function. The Na(+),K(+)-ATPase maintains the physiological gradients for Na(+) and K(+) ions and is, therefore, critical for the activity of ion channels and transporters involved neuronal excitability, neurotransmitter uptake or Ca(2+) signaling. Strikingly diverse functional abnormalities have been identified for disease-linked ATP1A2 mutations which frequently lead to changes in the enzyme's voltage-dependent properties, kinetics, or apparent cation affinities, but some mutations are truly deleterious for enzyme function and thus cause full haploinsufficiency. Here, we summarize structural and functional data about the Na(+),K(+)-ATPase available to date and an overview is provided about the particular properties of the α2 isoform that explain its physiological relevance in electrically excitable tissues. In addition, current concepts about the neurobiology of migraine, the correlations between primary brain dysfunction and mechanisms of headache pain generation are described, together with insights gained recently from modeling approaches in computational neuroscience. Then, a survey is given about ATP1A2 mutations implicated in migraine cases as documented in the literature with focus on mutations that were described to completely destroy enzyme function, or lead to misfolded or mistargeted protein in particular model cell lines. We also discuss whether or not there are correlations between these most severe mutational effects and clinical phenotypes. Finally, perspectives for future research on the implications of Na(+),K(+)-ATPase mutations in human pathologies are presented.