Potassium-chloride cotransport in resealed human red cell ghosts

Regulation of K-Cl cotransport: from function to genes

This review intends to summarize the vast literature on K-Cl cotransport (COT) regulation from a functional and genetic viewpoint. Special attention has been given to the signaling pathways involved in the transporter's regulation found in several tissues and cell types, and more specifically, in vascular smooth muscle cells (VSMCs). The number of publications on K-Cl COT has been steadily increasing since its discovery at the beginning of the 1980s, with red blood cells (RBCs) from different species (human, sheep, dog, rabbit, guinea pig, turkey, duck, frog, rat, mouse, fish, and lamprey) being the most studied model. Other tissues/cell types under study are brain, kidney, epithelia, muscle/smooth muscle, tumor cells, heart, liver, insect cells, endothelial cells, bone, platelets, thymocytes and Leishmania donovani. One of the salient properties of K-Cl-COT is its activation by cell swelling and its participation in the recovery of cell volume, a process known as regulatory volume decrease (RVD). Activation by thiol modification with N-ethylmaleimide (NEM) has spawned investigations on the redox dependence of K-Cl COT, and is used as a positive control for the operation of the system in many tissues and cells. The most accepted model of K-Cl COT regulation proposes protein kinases and phosphatases linked in a chain of phosphorylation/dephosphorylation events. More recent studies include regulatory pathways involving the phosphatidyl inositol/protein kinase C (PKC)-mediated pathway for regulation by lithium (Li) in low-K sheep red blood cells (LK SRBCs), and the nitric oxide (NO)/cGMP/protein kinase G (PKG) pathway as well as the platelet-derived growth factor (PDGF)-mediated mechanism in VSMCs. Studies on VSM transfected cells containing the PKG catalytic domain demonstrated the participation of this enzyme in K-Cl COT regulation. Commonly used vasodilators activate K-Cl COT in a dose-dependent manner through the NO/cGMP/PKG pathway. Interaction between the cotransporter and the cytoskeleton appears to depend on the cellular origin and experimental conditions. Pathophysiologically, K-Cl COT is altered in sickle cell anemia and neuropathies, and it has also been proposed to play a role in blood pressure control. Four closely related human genes code for KCCs (KCC1-4). Although considerable information is accumulating on tissue distribution, function and pathologies associated with the different isoforms, little is known about the genetic regulation of the KCC genes in terms of transcriptional and post-transcriptional regulation. A few reports indicate that the NO/cGMP/PKG signaling pathway regulates KCC1 and KCC3 mRNA expression in VSMCs at the post-transcriptional level. However, the detailed mechanisms of post-transcriptional regulation of KCC genes and of regulation of KCC2 and KCC4 mRNA expression are unknown. The K-Cl COT field is expected to expand further over the next decades, as new isoforms and/or regulatory pathways are discovered and its implication in health and disease is revealed.

Macromolecular crowding and its role as intracellular signalling of cell volume regulation

Macromolecular crowding has been proposed as a mechanism by means of which a cell can sense relatively small changes in volume or, more accurately, the concentration of intracellular solutes. According to the macromolecular theory, the kinetics and equilibria of enzymes can be greatly influenced by small changes in the concentration of ambient, inert macromolecules. A 10% change in the concentration of intracellular proteins can lead to changes of up to a factor of ten in the thermodynamic activity of putative molecular regulatory species, and consequently, the extent to which such regulator(s) may bind to and activate membrane-associated ion transporters. The aim of this review is to examine the concept of macromolecular crowding and how it profoundly affects macromolecular association in an intact cell with particular emphasis on its implication as a sensor and a mechanism through which cell volume is regulated.

Role of polyamine structure in inhibition of K+-Cl- cotransport in human red cell ghosts

1. K+-Cl- cotransport in human red cell ghosts is inhibited by divalent inorganic cations, soluble polycations and amphipathic organic cations. These findings suggest a common mechanism of inhibition, namely, binding of the cations to negative charges at the surface of a hydrophobic structure. 2. We have characterized the inhibitory capacity of a number of polyamines in order to obtain information about the nature of the charges with which they interact. Neomycin inhibited swelling-stimulated cotransport. The diquaternary amines dimethonium and decamethonium were relatively ineffective inhibitors. These compounds are thought to shield negative charges, but not bind to them. 3. Comparison of a homologous series of polyamines indicated that primary amines were better inhibitors than secondary amines, that inhibition increased with the charge of the polyamine, and that inhibition increased as the distance separating the amines increased. 4. The results indicate that the negative charges to which polycations bind are multiple and mobile. Since they must be associated with a hydrophobic environment, it is likely that they are negatively charged phospholipids located in the inner leaflet of the bilayer membrane. 5. Heating red cells or ghosts to 49 C denatures spectrin. Heating markedly increased K+ uptake in swollen ghosts but not in shrunken ghosts. The increase in uptake was reversed when swollen ghosts were shrunk even though denaturation of spectrin was not reversed. Polyamines, which inhibited swelling-activated K+ uptake in control ghosts, similarly inhibited the increased uptake in heated ghosts. 6. We speculate that spectrin, which is closely associated with the inner bilayer leaflet, shields negative charges in a volume-dependent manner and so regulates volume-sensitive K+ transport.

Cardiac cell volume: crystal clear or murky waters? A comparison with other cell types

The osmolarity of bodily fluids is strictly controlled so that most cells do not experience changes in osmotic pressure under normal conditions, but osmotic changes can occur in pathological states such as ischemia, septic shock, and diabetic coma. The primary effect of a change in osmolarity is to acutely alter cell volume. If the osmolarity around a cell is decreased, the cell swells, and if increased, it shrinks. In order to tolerate changes in osmolarity, cells have evolved volume regulatory mechanisms activated by osmotic challenge to normalise cell volume and maintain normal function. In the heart, osmotic stress is encountered during a period of myocardial ischemia when metabolites such as lactate accumulate intracellularly and to a certain degree extracellularly, and cause cell swelling. This swelling may be exacerbated further on reperfusion when the hyperosmotic extracellular milieu is replaced by normosmotic blood. In this review, we describe the theory and mechanisms of volume regulation, and draw on findings in extracardiac tissues, such as kidney, whose responses to osmotic change are well characterised. We then describe cell volume regulation in the heart, with particular emphasis on the effect of myocardial ischemia. Finally, we describe the consequences of osmotic cell swelling for the cell and for the heart, and discuss the implications for antiarrhythmic drug efficacy. Using computer modelling, we have summated the changes induced by cell swelling, and predict that swelling will shorten the action potential. This finding indicates that cell swelling is an important component of the response to ischemia, a component modulating the excitability of the heart.

Swelling activation of K-Cl cotransport in LK sheep erythrocytes: a three-state process

K-Cl cotransport in LK sheep erythrocytes is activated by osmotic swelling and inhibited by shrinkage. The mechanism by which changes in cell volume are transduced into changes in transport was investigated by measuring time courses of changes in transport after osmotic challenges in cells with normal and reduced Mg concentrations. When cells of normal volume and normal Mg are swollen, there is a delay of 10 min or more before the final steady-state flux is achieved, as there is for swelling activation of K-Cl cotransport in erythrocytes of other species. The delay was shown to be independent of the extent of swelling. There was also a delay after shrinkage inactivation of cotransport. Reducing cellular Mg concentration activates cotransport. Swelling of low-Mg cells activates cotransport further, but with no measurable delay. In contrast, there is a delay in shrinkage inactivation of cotransport in low-Mg cells. The results are interpreted in terms of a three-state model: [formula see text] in which A state, B state, and C state transporters have relatively slow, intermediate, and fast transport rates, respectively. Most transporters in shrunken cells with normal Mg are in the A state. Swelling converts transporters to the B state in the rate-limiting process, followed by rapid conversion to the C state. Reducing cell Mg also promotes the A-->B conversion. Swelling of low-Mg cells activates transport rapidly because of the initial predominance of B state transporters. The results support the following conclusions about the rate constants of the three-state model: k21 is the rate constant for a Mg-promoted process that is inhibited by swelling; k12 is not volume sensitive. Both k23 and k32 are increased by swelling and reduced by shrinkage; they are rate constants for a single process, whereas k12 and k21 are rate constants for separate processes. Finally, the A-->B conversion entails an increase in Jmax of the transporters, and the B-->C conversion entails an increase in the affinity of the transporters for K.

Na+/K+/Cl- cotransport in resealed ghosts from erythrocytes of the Milan hypertensive rats

The erythrocytes (RBC) of the Milan hypertensive rats (MHS) have a smaller volume and faster Na+/K+/Cl- cotransport than RBC from normotensive controls (MNS). The difference in Na+/K+/Cl- cotransport is no longer present in inside-out Vesicles (IOV) of RBC membrane. To differentiate between cytoplasmic or membrane skeleton abnormalities as possible causes of these differences. Resealed ghosts (RG) were used to measure ion transport systems. The following results have been obtained: (1) RG from MHS have a smaller volume than MNS (mean +/- S.E. 20.7 +/- 0.45 vs. 22.09 +/- 0.42 fl, P < 0.05). (2) RG showed a bumetanide-sensitive Na efflux that retains the characteristics of the Na+/K+/Cl- cotransport of the original RBC: it is K(+)- and Cl(-)-sensitive and dependent on the intracellular Na+ concentration. (3) The Na+/K+/Cl- cotransport was faster in RG from MHS than in those from MNS (mean +/- S.E. 0.095 +/- 0.01 vs. 0.066 +/- 0.01 rate constant h-1, P < 0.01). These results, together with those of IOV, support the hypothesis that an abnormality in the membrane skeletal proteins may play a role in the different Na+/K+/Cl- cotransport modulation between MHS and MNS erythrocytes.

Activation of ion transport pathways by changes in cell volume

Swelling-activated K+ and Cl- channels, which mediate RVD, are found in most cell types. Prominent exceptions to this rule include red cells, which together with some types of epithelia, utilize electroneutral [K(+)-Cl-] cotransport for down-regulation of volume. Shrinkage-activated Na+/H+ exchange and [Na(+)-K(+)-2 Cl-] cotransport mediate RVI in many cell types, although the activation of these systems may require special conditions, such as previous RVD. Swelling-activated K+/H+ exchange and Ca2+/Na+ exchange seem to be restricted to certain species of red cells. Swelling-activated calcium channels, although not carrying sufficient ion flux to contribute to volume changes may play an important role in the activation of transport pathways. In this review of volume-activated ion transport pathways we have concentrated on regulatory phenomena. We have listed known secondary messenger pathways that modulate volume-activated transporters, although the evidence that volume signals are transduced via these systems is preliminary. We have focused on several mechanisms that might function as volume sensors. In our view, the most important candidates for this role are the structures which detect deformation or stretching of the membrane and the skeletal filaments attached to it, and the extraordinary effects that small changes in concentration of cytoplasmic macromolecules may exert on the activities of cytoplasmic and membrane enzymes (macromolecular crowding). It is noteworthy that volume-activated ion transporters are intercalated into the cellular signaling network as receptors, messengers and effectors. Stretch-activated ion channels may serve as receptors for cell volume itself. Cell swelling or shrinkage may serve a messenger function in the communication between opposing surfaces of epithelia, or in the regulation of metabolic pathways in the liver. Finally, these transporters may act as effector systems when they perform regulatory volume increase or decrease. This review discusses several examples in which relatively simple methods of examining volume regulation led to the discovery of transporters ultimately found to play key roles in the transmission of information within the cell. So, why volume? Because it's functionally important, it's relatively cheap (if you happened to have everything else, you only need some distilled water or concentrated salt solution), and since it involves many disciplines of experimental biology, it's fun to do.

Okadaic acid inhibition of KCl cotransport. Evidence that protein dephosphorylation is necessary for activation of transport by either cell swelling or N-ethylmaleimide

The mechanism of activation of KCl cotransport has been examined in rabbit red blood cells. Previous work has provided evidence that a net dephosphorylation is required for activation of transport by cell swelling. In the present study okadaic acid, an inhibitor of protein phosphatases, was used to test this idea in more detail. We find that okadaic acid strongly inhibits swelling-stimulated KCl cotransport. The IC50 for okadaic acid is approximately 40 nM, consistent with the involvement of type 1 protein phosphatase in transport activation. N-Ethylmaleimide (NEM) is well known to activate KCl cotransport in cells of normal volume. Okadaic acid, added before NEM, inhibits the activation of transport by NEM, indicating that a dephosphorylation is necessary for the NEM effect. Okadaic acid added after NEM inhibits transport only very slightly. After a brief exposure to NEM and rapid removal of unreacted NEM, KCl cotransport activates with a time delay that is similar to that for swelling activation. Okadaic acid causes a slight increase in the delay time. These findings are all consistent with the idea that NEM activates transport not by a direct action on the transport protein but by altering a phosphorylation-dephosphorylation cycle. The simplest hypothesis that is consistent with the data is that both cell swelling and NEM cause inhibition of a protein kinase. Kinase inhibition causes net dephosphorylation of some key substrate (not necessarily the transport protein); dephosphorylation of this substrate, probably by type 1 protein phosphatase, causes transport activation.

Volume-sensitive K-Cl cotransport in inside-out vesicles made from erythrocyte membranes from sheep of low-K phenotype

Unidirectional K ion effluxes were measured from inside-out vesicles prepared from erythrocyte membranes from sheep of the low-K phenotype. Total K efflux was 150 nmol per mg of protein per hr in a Cl medium of 295 mosmol/kg (with the Na/K pump inhibited). Cl-dependent K efflux (determined with methanesulfonate replacing Cl) was 54 nmol/(mg.hr). Cl-dependent K efflux (K-Cl cotransport) increased to 77 nmol/(mg.hr) with osmotic swelling of approximately 30% in 230-mosmol/kg medium and decreased to 13 nmol/(mg.hr) after shrinkage of approximately 60% in 430-mosmol/kg medium. Osmotically induced changes in transport and vesicle volume were reversible. K-Cl cotransport was enhanced by ATP. Nonhydrolyzable ATP analogues failed to substitute for ATP, indicating that phosphorylation is involved. However, in the absence of added ATP there was significant K-Cl cotransport, suggesting that phosphorylation is not essential for function. The results provide clues about the nature of the signals detected by the sensor of cell volume changes and demonstrate that inside-out vesicles from sheep erythrocyte membranes provide an advantageous experimental system for investigation of the volume sensor.

K-Cl cotransport in LK sheep erythrocytes: kinetics of stimulation by cell swelling

The effects of osmotic cell swelling were studied on the kinetics of Cl-dependent K+ influx, K-Cl cotransport, in erythrocytes from sheep of the low K+ (LK) phenotype. Swelling approximately 25% stimulated transport by increasing maximum velocity (Jmax) approximately 1.5-fold and by increasing apparent affinity for external K (Ko) nearly twofold. Dithiothreitol (DTT) was shown to be a partial, reversible inhibitor of K-Cl cotransport. It inhibited in cells of normal volume by reducing Jmax more than twofold; apparent affinity for Ko was increased by DTT, suggesting that DTT stabilizes the transporter-Ko complex. Cell swelling reduced the extent of inhibition by DTT: Jmax was inhibited by only about one-third in swollen cells, and apparent affinity was only slightly affected. This result suggested that DTT does not act directly on the transporter, but on a hypothetical regulator, an endogenous inhibitor. Swelling relieves inhibition by the regulator, and reduces the effect of DTT. Reducing intracellular Mg2+, Mgc, stimulated cotransport. Swelling of low-Mg2+ cells stimulated transport further, but only by raising apparent affinity for Ko nearly threefold: Jmax was unaffected. Thus effects of swelling on Jmax and apparent affinity are separable processes. The inhibitory effects of Mgc and DTT were shown to be additive, indicating separate modes of action. There appear to be two endogenous inhibitors: the hypothetical regulator, which holds affinity for Ko, low; and Mgc, which affects Jmax, perhaps by holding some transporters in an inactive form. Swelling stimulates transport by relieving both types of inhibition.

Kinetics of activation and inactivation of swelling-stimulated K+/Cl- transport. The volume-sensitive parameter is the rate constant for inactivation

Red blood cells of several species are known to exhibit a ouabain-insensitive, anion-dependent K+ (Rb+) flux that is stimulated by cell swelling. We have used rabbit red cells to study the kinetics of activation and inactivation of the flux upon step changes in tonicity. Sudden hypotonic swelling (210 mosmol) activates the flux after a lag period of 10 min at 37 degrees C and 30-50 min at 25 degrees C. In cells that were preswollen to activate the transporter, sudden shrinkage (by addition of hypertonic NaCl) causes a rapid inactivation of the flux; the time lag for inactivation is less than 2 min at 37 degrees C. A minimal model of the volume-sensitive KCl transport system requires two states of the transporter. The activated (A) state catalyzes transport at some finite rate (turnover number unknown because the number of transporters is unknown). The resting (R) state has a much lower or possibly zero transport rate. The interconversion between the states is characterized by unimolecular rate constants R k12 in equilibrium with k21 A. The rate of relaxation to any new steady state is equal to the sum of the rate constants k12 + k21. Because the rate of transport activation in a hypotonic medium is lower than the rate of inactivation in an isotonic medium, we conclude that the volume-sensitive rate process is inactivation (the A to R transition); that is, cell swelling activates transport by lowering k21. Three phosphatase inhibitors (fluoride, orthovanadate, and inorganic phosphate) all inhibit the swelling-activated flux and also slow down the rate of approach to the swollen steady state. This finding suggests that a net dephosphorylation is necessary for activation of the flux and that the net dephosphorylation takes place as a result of swelling-induced inhibition of a kinase rather than stimulation of a phosphatase.

Selective inhibitors of KCl cotransport in human red cells

Two analogues of the loop diuretics furosemide and bumetanide have been identified as differential inhibitors of KCl and NaKCl cotransport systems, assayed by measuring K+ influx in 'young' human red cells. H25 inhibited both NaKCl and KCl cotransport, with I50% values of 0.03 and 30 microM respectively; H74 had no effect on NaKCl cotransport, even at 0.3 mM, but inhibited KCl cotransport with an I50% of 75 microM. These compounds are therefore useful for resolving the two transport systems.

The role of monovalent cation transport in Sindbis virus maturation and release

Alterations in intracellular monovalent cation concentrations in Sindbis virus-infected avian cells result, in part, from a reduction in Na+/K+ ATPase (Na+ pump) activity. Inhibition of Na+ pump activity was shown previously to temporally correlate with the appearance of viral envelope proteins on the cell surface and the release of virus particles. Cells infected with envelope-defective temperature-sensitive mutants exhibited reduced Na+ pump activity at the nonpermissive temperature, where viral particles are not released. By contrast, Na+ pump activity was not inhibited in Sindbis virus-infected cells treated with tunicamycin or with antiviral serum, which block virus maturation and release. Diuretic-sensitive transport of 86Rb+, aK+ tracer, was stimulated in cells which express virus envelope proteins, but fail to release virus particles. In these cells, the furosemide-sensitive 86Rb+ influx exhibited an increase in Vmax and was responsive to changes in the extracellular concentration of NaCl. Furosemide inhibited the rapid release of virus from low salt-inhibited cells after shift to isotonic conditions. Alterations in ion transport during alphavirus infection may, therefore, facilitate the efficient release of progeny virus particles.

Maintenance of cation gradients in cold-stored erythrocytes of guinea pig and ground squirrel: improvement by amiloride

Red blood cells of ground squirrel, a hibernator, gain Na at one-third the rate of guinea pig red blood cells when stored in saline medium at 5 degrees C for several days. This result correlates with the known slower loss of K during storage in ground squirrel cells. In ground squirrel cells Na gain is balanced by K loss, so that there is no net gain of solute; in guinea pig cells the total cation content rises progressively. Amiloride, a drug which inhibits Na entry, retards Na uptake in cells of both species. Surprisingly, amiloride also slowed K loss and, in guinea pig red cells, the decline of ATP content. In guinea pig cells amiloride reduced the gain of total cation by half. The results substantiate the difference in cold sensitivity of ion regulation of red blood cells of these two species and demonstrate the possible usefulness of amiloride-type drugs in nonfreezing preservation of red blood cells.

Volume-sensitive K influx in human red cell ghosts

K influx into resealed human red cell ghosts increases when the ghosts are swollen. The influx demonstrates properties similar to volume-sensitive K fluxes present in other cells. The influx is, for the most part, insensitive to the nature of the major intracellular cation and therefore is not a K-K exchange. The influx is much greater when the major anion is Cl than when the major anion is NO3; Cl stimulates the flux and, at constant Cl, NO3 inhibits it. Increase in the influx rate is rapid when shrunken ghosts are swollen or when NO3 is replaced by Cl. The volume-sensitive K influx requires intracellular MgATP at low concentrations, and ATP cannot be replaced by nonhydrolyzable ATP analogues. The volume-sensitive influx is inhibited by Mg2+ and by high concentrations of vanadate, but is stimulated by low concentrations of vanadate. It is not modified by cAMP, the removal of Ca2+ by EGTA, substances that activate protein kinase C, or by inhibition of phosphatidylinositol kinase. The influx is inhibited by neomycin and by trifluoperazine.

Stimulation of calcium-sodium exchange in dog red blood cells by hemolysis and resealing

Osmotic hemolysis and resealing greatly increase calcium influx in dog red blood cells. The resealed ghosts show a saturable calcium entry pathway with complex kinetics. As expected for a calcium-sodium exchanger, calcium uptake is stimulated by internal sodium and inhibited by external sodium. Compared to fresh, intact red cells the resealed ghost calcium-sodium exchanger is less responsive to quinidine and to alterations in medium tonicity. The differences in calcium uptake rate among cells from different donors are minimized in the ghost preparation. There are several ways to stimulate sodium-dependent calcium movements in these cells, of which hemolysis-resealing is the most potent. The results of these and previous studies suggest that dog red blood cells have a latent capacity for calcium-sodium exchange.

Thiol-dependent passive K/Cl transport in sheep red cells: VII. Volume-independent freezing by iodoacetamide, and sulfhydryl group heterogeneity

The sulfhydryl (SH) reagent iodoacetamide (IAAM) inhibits stimulation of Cl-dependent K transport in low K (LK) sheep red cells by another SH reagent, N-ethylmaleimide (NEM), without itself activating this transport pathway (J. Membrane Biol., 1983, 73:257-261). We now report that IAAM alone, acting with a kinetic slower than NEM, sharply reduced the capability of the Cl-dependent K transport system to regulate its activity in response to cell volume changes. This effect of IAAM did not depend on the cell volume maintained during chemical treatment, a fact ruling out that the reactivity of the SH groups with IAAM was a function of the volume-dependent turnover rate of the transporter. On the other hand, the prevention of the NEM-stimulatory effect on Cl-dependent K transport was found to be volume-dependent since 1) the rate with which IAAM blocked the subsequent NEM action was twice as fast in cells swollen in 250 mOSM as opposed to cells shrunken in 370 mOSM media, and 2) the dose response of the IAAM effect was different in swollen and shrunken cells. The action of IAAM with or without subsequent treatment with NEM seemed to be independent of cellular ATP which is required for full expression of the stimulatory modification of Cl-dependent K transport by NEM (Am. J. Physiol., 1983, 245:C445-C448). Clusters of SH groups on the Cl-dependent K transporter apparently react differently with IAAM and NEM when separately applied but, used in combination, reflect a complex volume-dependent effect that may reveal a "volume-sensing" component of the transport molecule.

Furosemide-sensitive K+ (Rb+) transport in human erythrocytes: modes of operation, dependence on extracellular and intracellular Na+, kinetics, pH dependency and the effect of cell volume and N-ethylmaleimide

The effect of extracellular and intracellular Na+ (Nao+, Nai+) on ouabain-resistant, furosemide-sensitive (FS) Rb+ transport was studied in human erythrocytes under varying experimental conditions. The results obtained are consistent with the view that a (1 Na+ + 1 K+ + 2 Cl-) cotransport system operates in two different modes: mode i) promoting bidirectional 1:1 (Na+-K+) cotransport, and mode ii) a Nao+-independent 1:1 ki+ exchange requiring Nai+ which, however, is not extruded. The activities of the two modes of operation vary strictly in parallel to each other among erythrocytes of different donors and in cell fractions of individual donors separated according to density. Rb+ uptake through Rbo+/Ki+ exchange contributes about 25% to total Rb+ uptake in 145 mM NaCl media containing 5 mM RbCl at normal Nai+ (pH 7.4). Na+-K+ cotransport into the cells occurs largely additive to K+/K+ exchange. Inward Na+-Rb+ cotransport exhibits a substrate inhibition at high Rbo+. With increasing pH, the maximum rate of cotransport is accelerated at the expense of K+/K+ exchange (apparent pK close to pH 7.4). The apparent KmRbo+ of Na+-K+ cotransport is low (2 mM) and almost independent of pH, and high for K+/K+ exchange (10 to 15 mM), the affinity increasing with pH. The two modes are discussed in terms of a partial reaction scheme of (1 Na+ + 1 K+ + 2 Cl-) cotransport with ordered binding and debinding, exhibiting a glide symmetry (first on outside = first off inside) as proposed by McManus for duck erythrocytes (McManus, T.J., 1987, Fed. Proc., in press). N-ethylmaleimide (NEM) chemically induces a Cl--dependent K+ transport pathway that is independent of both Nao+ and Nai+. This pathway differs in many properties from the basal, Nao+-independent K+/K+ exchange active in untreated human erythrocytes at normal cell volume. Cell swelling accelerates a Nao+-independent FS K+ transport pathway which most probably is not identical to basal K+/K+ exchange. Ko+ less than Nao+ less than Lio+ less than Mgo2+ reduce furosemide-resistant Rb+ inward leakage relative to cholineo+.