Effect of neuroregulators on the intracellular calcium level in the outer hair cell isolated from the guinea pig

Diverse identities and sites of action of cochlear neurotransmitters

Accurate encoding of acoustic stimuli requires temporally precise responses to sound integrated with cellular mechanisms that encode the complexity of stimuli over varying timescales and orders of magnitude of intensity. Sound in mammals is initially encoded in the cochlea, the peripheral hearing organ, which contains functionally specialized cells (including hair cells, afferent and efferent neurons, and a multitude of supporting cells) to allow faithful acoustic perception. To accomplish the demanding physiological requirements of hearing, the cochlea has developed synaptic arrangements that operate over different timescales, with varied strengths, and with the ability to adjust function in dynamic hearing conditions. Multiple neurotransmitters interact to support the precision and complexity of hearing. Here, we review the location of release, action, and function of neurotransmitters in the mammalian cochlea with an emphasis on recent work describing the complexity of signaling.

Swelling-activated Ca2+ channels trigger Ca2+ signals in Merkel cells

Merkel cell-neurite complexes are highly sensitive touch receptors comprising epidermal Merkel cells and sensory afferents. Based on morphological and molecular studies, Merkel cells are proposed to be mechanosensory cells that signal afferents via neurotransmission; however, functional studies testing this hypothesis in intact skin have produced conflicting results. To test this model in a simplified system, we asked whether purified Merkel cells are directly activated by mechanical stimulation. Cell shape was manipulated with anisotonic solution changes and responses were monitored by Ca²⁺ imaging with fura-2. We found that hypotonic-induced cell swelling, but not hypertonic solutions, triggered cytoplasmic Ca²⁺ transients. Several lines of evidence indicate that these signals arise from swelling-activated Ca²⁺-permeable ion channels. First, transients were reversibly abolished by chelating extracellular Ca²⁺, demonstrating a requirement for Ca²⁺ influx across the plasma membrane. Second, Ca²⁺ transients were initially observed near the plasma membrane in cytoplasmic processes. Third, voltage-activated Ca²⁺ channel (VACC) antagonists reduced transients by half, suggesting that swelling-activated channels depolarize plasma membranes to activate VACCs. Finally, emptying internal Ca²⁺ stores attenuated transients by 80%, suggesting Ca²⁺ release from stores augments swelling-activated Ca²⁺ signals. To identify candidate mechanotransduction channels, we used RT-PCR to amplify ion-channel transcripts whose pharmacological profiles matched those of hypotonic-evoked Ca²⁺ signals in Merkel cells. We found 11 amplicons, including PKD1, PKD2, and TRPC1, channels previously implicated in mechanotransduction in other cells. Collectively, these results directly demonstrate that Merkel cells are activated by hypotonic-evoked swelling, identify cellular signaling mechanisms that mediate these responses, and support the hypothesis that Merkel cells contribute to touch reception in the Merkel cell-neurite complex.

Gene-Based Deafness Research: Ion Transport and Hearing

The cochlea is a sensory organ that converts physical (sound) stimulation into electrical signals. This process is fundamentally and substantially based upon the ion transport system. Here, I summarize the physiological and molecular biological aspects of transporters, channels and receptors expressed in the cochlea. With reference to these findings, recent advances in genetic research on hereditary deafness are discussed.

Rapid correction of vestibular imbalance by intracochlear administration of ATP in a guinea pig model of unilateral peripheral vestibular disorder

The effect of inner ear administration of adenosine triphosphate (ATP) on vestibular function was investigated in guinea pigs with vestibular disorder. The right lateral semicircular canal was cut surgically. Animals were then treated with saline, 5 mM ATP, 50 mM ATP, or 50 mM ATP+10 mM pyridoxal-phosphate-6-azophenyl-2', 4'-disulfonic acid (PPADS), a P2X receptor antagonist, administered directly into the scala tympani by osmotic pump. Before treatment, and at 3, 5 and 7 days after treatment, trapezoid rotation tests were performed on all animals, and the post-rotatory nystagmus (PRN) ratio (number of nystagmus beats after counterclockwise rotation/number of nystagmus beats after clockwise rotation) was calculated and compared between groups. The PRN ratio was statistically greater at 5 days after treatment in the 50 mM ATP group than in the saline group. A statistical difference was also observed in animals treated with 50 mM ATP+10 mM PPADS. Our results indicate that ATP plays an important role in the vestibular periphery to correct vestibular imbalance and that this action may not occur via P2X receptors.

Immunohistochemical localization of phospholipase C isozymes in mature and developing gerbil cochlea

The possibility that phospholipase C contributes to intracellular signaling in the cochlea was investigated by immunostaining for eight different isoforms of the enzyme. In the mature gerbil cochlea, expression of the isozymes varied widely among different cell types. The phospholipase C-beta1 isoform was detected in inner and outer hair cells, and spiral ganglion neurons where it may participate in regulating Ca(2+) flux. The beta3 isozyme was expressed in epithelial cells thought to mediate lateral and medial circulation of potassium. The beta2 isozyme was present in border, inner phalangeal and Hensen cells, the stria vascularis, and suprastrial and supralimbal fibrocytes where it also may be involved in regulating ion transport activities. The phospholipase C-gamma isozymes were expressed in supporting cells, the stria vascularis, and certain fibrocytes where they possibly participate in activating tyrosine kinase and modulating ion conductances. The delta2 isoform was found in pillar, outer sulcus and strial marginal cells as well as spiral ganglion neurons and their radial processes. Documentation of changes in the expression pattern of phospholipase C isoforms during postnatal development and knowledge of their distribution in several positive control tissues provided further data for speculation about the biologic significance of the cochlear reactivity. The results demonstrate a wide diversity of isozyme distribution in the cochlea and suggest that the enzymes affect activities of various cochlear cell types in different ways.

Extracellular nucleotide signaling in the inner ear

Extracellular nucleotides, particularly adenosine 5'-triphosphate (ATP), act as signaling molecules in the inner ear. Roles as neurotransmitters, neuromodulators, and as autocrine or paracrine humoral factors are evident. The diversity of the signaling pathways for nucleotides, which include a variety of ATP-gated ion channels (assembled from different subtypes of P2X-receptor subunit) and also different subtypes of G protein-coupled nucleotide receptors (P2Y receptors) supports a major physiological role for ATP in the regulation of hearing and balance. Almost invariably both P2X and P2Y receptor expression is apparent in the complex tissue structures associated with the inner-ear labyrinth. However P2X-receptor expression, commonly associated with fast neurotransmission, is apparent not only with the cochlear and vestibular primary afferent neurons, but also appears to mediate humoral signaling via ATP-gated ion channel localization to the endolymphatic surface of the cochlear sensory epithelium (organ of Corti). This is the site of the sound-transduction process and recent data, including both electrophysiological, imaging, and immunocytochemistry, has shown that the ATP-gated ion channels are colocalized here with the mechano-electrical transduction channels of the cochlear hair cells. In contrast to this direct action of extracellular ATP on the sound-transduction process, an indirect effect is apparent via P2Y-receptor expression, prevalent on the marginal cells of the stria vascularis, a tissue that generates the standing ionic and electrical gradients across the cochlear partition. The site of generation of these gradients, including the dark-cell epithelium of the vestibular labyrinth, may be under autocrine or paracrine regulation mediated by P2Y receptors sensitive to both purines (ATP) and pyrimidines such as UTP. There is also emerging evidence that the nucleoside adenosine, formed as a breakdown product of ATP by the action of ectonucleotidases and acting via P1 receptors, is also physiologically significant in the inner ear. P1-receptor expression (including A1, A2, and A3 subtypes) appear to have roles associated with stress, acting alongside P2Y receptors to enhance cochlear blood flow and to protect against the action of free radicals and to modulate the activity of membrane conductances. Given the positioning of a diverse range of purinergic-signaling pathways within the inner ear, elevations of nucleotides and nucleosides are clearly positioned to affect hearing and balance. Recent data clearly supports endogenous ATP- and adenosine-mediated changes in sensory transduction via a regulation of the electrochemical gradients in the cochlea, alterations in the active and passive mechanical properties of the cells of the sensory epithelium, effects on primary afferent neurons, and control of the blood supply. The field now awaits conclusive evidence linking a physiologically-induced modulation of extracellular nucleotide and nucleoside levels to altered inner ear function.

Differences in the distribution of responses to ATP and acetylcholine between outer hair cells of rat and guinea pig

Adenosine 5' triphosphate (ATP) and acetylcholine (ACh) are neurotransmitters (ACh) and/or modulators (ATP) in the mammalian cochlea. In guinea pig, it appears that both neurotransmitters have a similar response distribution, with larger responses being evoked by the ligands in short hair cells compared to long hair cells (e.g., Chen et al., 1995b. Noise exposure alters the response of outer hair cells to ATP. Hear. Res. 88, 215-221.; Erostegui et al., 1994. In vitro pharmacologic characterization of a cholinergic receptor on outer hair cells. Hear. Res. 74, 135 147). The purpose of the present study was to test whether the distribution of responses to ACh and ATP in the OHCs of rat is the same as guinea pig. The ligand-induced current was monitored using the whole-cell configuration of the patch-clamp technique. Results show that in guinea pig OHCs, extracellular application of 100 microM ATP induced a current response in a majority of the same cells that responded to the application of 100 microM ACh. In contrast in rat OHCs, 100 microM ATP did not induce a current in the majority of cells that responded to the application of 100 microM ACh. N-methyl-glucamine (NMG+) substituted for K+ in the pipette solution failed to unmask an ATP-evoked inward current in rat OHCs. In addition, no response was produced in rat or guinea pig OHCs by adenosine, adenosine 5'-monophosphate (AMP) or adenosine 5'-diphosphate (ADP) at 100 microM. Results suggest that in guinea pig ACh-gated channels are present on most of the same OHCs that have ATP-gated ion channels, whereas in rat ACh-gated ion channels are present without ATP-gated channels on some OHCs.

Chemical synaptic transmission in the cochlea

The last two decades have witnessed major progress in the understanding of cochlear mechanical functioning, and in the emergence of cochlear neurochemistry and neuropharmacology. Recent models describe active processes within the cochlea that amplify and sharpen the mechanical response to sound. Although it is widely accepted that outer hair cells (OHCs) contribute to these processes, the nature of the medial efferent influence on cochlear mechanics needs further clarification. Acetylcholine (ACh) is the major transmitter released onto OHCs during the stimulation of these efferents. The inhibitory influence of this system is mediated by post- and presynaptic nicontinic and muscarinic receptors and the role of other neuroactive substances [gamma-aminobutyric acid (GABA), calcitonin gene-related peptide (CGRP), adenosine 5'-triphosphate (ATP) or nitric oxide (NO)] remains to be determined. The inner hair cells (IHCs) that transduce the mechanical displacements into neural activity, release glutamate on receptor-activated channels of AMPA, kainate, and NMDA types. This synapse is in turn controlled and/or regulated by the lateral efferents containing a cocktail of neuroactive substances (ACh, GABA, dopamine, enkephalins, dynorphin, CGRP). This glutamatergic nature of the IHCs is responsible for the acute destruction of the nerve endings and subsequently for neuronal death, damage usually described in various cochlear diseases (noise-induced hearing losses, neural presbycusis and certain forms of sudden deafness or peripheral tinnitus). These pathologies also include a regrowth of new dendritic processes by surviving neurons up to IHCs. Understanding the subtle molecular mechanisms which underly the control of neuronal excitability, synaptic plasticity and neuronal death in cochlear function and disease is a very important issue for the development of future therapies.

Calcium mobilization and entry induced by extracellular ATP in the non-sensory epithelial cell of the cochlear lateral wall

Effects of external ATP application on the intracellular Ca2+ concentration ([Ca2+]i) of the epithelial lining cells of the cochlear lateral wall, the stria vascularis (SV), spiral prominence (SP), and external sulcus (ES) cells, were examined by the fluorescent Ca2+ indicator, Fura-2. ATP induced an increase in [Ca2+]i of these epithelial cells loaded with Fura-2 in a dose-dependent manner (1-100 microM). The strongest response was observed in SP and ES cells, whereas SV cells showed a weak response. The increase in [Ca2+]i was a biphasic response consisting of a rapid transient peak followed by a sustained phase. Removal of the external Ca2+ caused a slight transient increase in [Ca2+]i without a subsequent sustained phase. The Mn2(+)-quenching method revealed the Ca2+ entry across the plasma membrane immediately after the ATP application. The initial peak results from both the release of Ca2+ from intracellular stores and the Ca2+ influx from the extracellular space. The sustained phase is totally derived from the external Ca2+. The effective order of purinergic agonists was 2-methylthio ATP > or = ATP > 3'-O-(4-benzoyl)benzoyl ATP > alpha, beta-methylene ATP > or = ADP, but adenosine or UTP showed no response. The ATP-induced [Ca2+]i response was inhibited by reactive blue 2. The [Ca2+]i was partially dependent on the concentration of the fully ionized form, ATP-4. These findings indicate the presence of both P2y- and P2z-purinergic receptors in the non-sensory epithelial cells of the lateral wall.

ATP modulation of L-type calcium channel currents in guinea pig outer hair cells

Ca2+ channel currents and their modulation by adenosine 5'-triphosphate (ATP) in acutely isolated guinea pig outer hair cells (OHCs) were investigated using the whole-cell patch-clamp technique. The current-voltage (I-V) relation of OHCs indicated that the Ca2+ channel opened near -30 mV, and the current reached a maximum at +10 and 0 mV in 20 mM Ca2+ and Ba2+ external solutions, respectively. BayK 8644 (BayK, 2 microM) caused a 3.5-fold increase in peak Ca2+ currents and shifted the I-V curves toward more negative potentials. These results suggest that the majority of Ca2+ channels in OHCs have L-type characteristics. The effects of ATP on Ca2+ channels of OHCs were heterogenous. ATP (100 microM) decreased Ca2+ channel currents by 31.7 +/- 5.6% at 0 mV and shifted Ca2+ tail activation curves toward more depolarized potentials in some cells (N = 6). By contrast, in others, ATP enhanced the currents by 43.5 +/- 12.5% at +10 mV (N = 6). In the presence of BayK, however, ATP-induced inhibition or enhancement of Ca2+ channel currents was attenuated. In addition, 100 microM ATP produced little effect on Ca2+ channel currents in another subpopulation of cells (N = 12). This heterogenous neuromodulation of Ca2+ channel currents by ATP may reflect a functional diversity among OHCs.

Indirect evidence for the presence and physiological role of endogenous extracellular ATP in the semicircular canal

Previous studies have shown that low concentrations of exogenous ATP, added to the perilymphatic fluid, could modify the bioelectrical activity of the isolated semicircular canal of the frog (Rana pipiens). To test the hypothesis that ATP is endogenously present and active in the perilymphatic fluid, the influence of two ATP-purinoceptor antagonists, Reactive Blue 2 and suramin, and of the enzyme, nucleotide pyrophosphatase, were examined. When applied by perilymphatic bath substitution, the three compounds reduced, in a dose-dependent manner, the firing of the afferent fibers monitored in the absence of mechanically-applied stimulation. The response of the afferent fibers, recorded when the sensory cells were mechanically inhibited, was also reduced. No modification of the response of the excitatory phase of the mechanical stimulus was observed in the presence of the two antagonists. In contrast, the signal was significantly reduced by the enzyme. None of the three compounds exhibited an influence on the transepithelial potential, or its variation in response to mechanical stimulation. The ATP-induced modification of the firing rate of the afferent fibers, monitored in the absence of mechanical stimulation, was reduced in the presence of the three drugs. No influence of Reactive Blue 2 and suramin was observed on the increase of the spontaneous firing induced by carbachol. In contrast, the effect of carbachol was decreased by nucleotide pyrophosphatase. The excitatory influence of glutamate on the spontaneous firing was not modified by Reactive Blue 2, while it was slightly increased by suramin and nucleotide pyrophosphatase.(ABSTRACT TRUNCATED AT 250 WORDS)

Influence of ATP and ATP agonists on the physiology of the isolated semicircular canal of the frog (Rana pipiens)

In the present study, the influence of extracellular ATP and ATP agonists in the physiology of the vestibular organs was examined, using the in vitro model of the isolated semicircular canal of the frog (Rana pipiens). The firing activity of the afferent nerve, the d.c. nerve potential and the transepithelial potential were measured in the absence and presence of mechanical stimulation of the sensory epithelium. Administration of ATP into the perilymphatic compartment, from 10(-12) to 10(-3) M, increased the firing rate of the afferent fibers recorded in the absence of mechanical stimulation. Recordings of the d.c. nerve potential indicated that the afferent fibers were hyperpolarized. The presence of the purine also modified the transepithelial potential. During mechanical stimulation of the sensory epithelium, both the evoked afferent firing and the evoked variation of the d.c. nerve potential were reduced in the presence of ATP. However, ATP did not effect the evoked modulation of the transepithelial potential, evoked by the mechanical stimulation. Administration of the P2x purinoceptor agonists, alpha, beta-methylene-ATP and beta, gamma-methylene-ATP, at concentrations between 10(-12) and 10(-3) M, did not significantly modify the different bioelectrical activities investigated. In contrast, 2-methylthio-ATP, a P2y purinoceptor agonist, more potent and efficacious than ATP in its effect on the spontaneous firing. Concurrently, no modification of the d.c. nerve potential, the transepithelial potential and their variation during mechanical stimulation was observed. In opposition to the ATP effect, the total amplitude of the evoked firing was increased in the presence of 2-methylthio-ATP. These data suggest that extracellular ATP, present in the perilymphatic compartment, may act as a neuromodulator in the vestibular physiology. The effects of the purine appear to be mediated by the activation of a P2y subtype of purinoceptor. The absence of an effect of ATP and 2-methylthio-ATP on the evoked variation of the transepithelial potential suggest that the purine did not affect the processes responsible for the generation of the receptor potential but more likely modified the mechanisms involved in the release of the neurotransmitter from the hair cells and/or acted on the afferent endings.

Effects of adenosine 5'-triphosphate and related agonists on cochlear function

Several lines of evidence implicate a neurotransmitter/modulator role for ATP in the cochlea. Most of the work supporting such a notion has been accomplished using in vitro preparations of sensory hair cells or other cochlear tissues. Little is known regarding the functional consequences of ATP receptor activation in vivo. In the present experiments, we tested ATP and related agonist analogs for their effects on sound-evoked responses of the cochlea (cochlear microphonic, CM; summating potential, SP; distortion product otoacoustic emissions, DPOAE) and auditory nerve (compound action potential, CAP) in vivo and on outer hair cell (OHC) currents and cell length in vitro. In vivo, local application of these compounds was associated with concentration- and intensity-dependent response alterations. The slowly-hydrolyzable P2y agonist, ATP-gamma-S, was clearly of greatest in vivo potency: At low to moderate stimulus intensities, micromolar concentrations of this drug reduced all responses, in particular CAP and DPOAEs, which fell to the level of the noise floor. At high intensities, response suppression was smaller and SP was increased. In vivo effects of ATP, ATP-alpha-S and 2-Me-S-ATP were qualitatively similar to, but smaller in magnitude and requiring higher concentrations than those observed for ATP-gamma-S. Adenosine was without significant effect on responses of the cochlea and auditory nerve. In vitro, effects of ATP-gamma-S and ATP were similar: both induced inward currents in OHCs held at -60 mV without producing observable (> 0.3 micron) changes in OHC length. Results suggest that endogenous ATP influences cochlear function through receptors at several sites in the cochlea. Results suggest further that these response alterations are mediated, at least in part, by receptors of the P2y subtype.

ATP-induced cytoplasmic [Ca2+] increases in isolated cochlear outer hair cells. Involved receptor and channel mechanisms

Outer hair cells (OHC) of the mammalian cochlea are thought to preprocess the sound signal by active movements, which can be induced by electrical or chemical stimulation, e.g. depolarization evoked by high [K+] or increased cytoplasmic [Ca2+]. Extracellular ATP has been found to induce cytoplasmic [Ca2+] increases in OHC but involved mechanisms have not been elucidated. Cytoplasmic [Ca2+] was measured in non-enzymatically isolated single OHC using Fura-2 microspectrometry. Results, using ATP/derivatives and other P2-purinergic receptor (P2R) ligands, as well as Ca(2+)-channel blockers and pertussis toxin, revealed several signal transduction pathways that increase cytoplasmic [Ca2+] in OHC: a P2-purinergic receptor (P2R)--G-protein--effector (phospholipase C or an ion channel) system and a voltage-dependent Ca2+ channel. Agonist potency studies denote a pattern analogous to that found in skeletal muscle, i.e. ATP-alpha-S > ATP = 2-methyl-S-ATP >> ADP > alpha,beta-methylene-ATP, but no activation by ADP beta F or UTP, leaving a choice of P2y or P2zR subtypes. The latter possibility gained strength from calculations showing that up to 8% of ATP may have formed the P2zR agonist ATP4- in the experimental medium. Experiments in Ca(2+)-free medium and with pertussis toxin revealed that the main Ca2+ source was intracellular. Pertussis toxin did not affect [Ca2+] increase induced by carbachol. Acetylcholine, administered a few seconds before ATP, did not affect total cytoplasmic [Ca2+] increases. Induced cytoplasmic [Ca2+] increases were high enough (> 500 nM at 50 microM ATP/derivatives) to hyperpolarize the OHC membrane by opening K(+)-channels and decreased little with time.(ABSTRACT TRUNCATED AT 250 WORDS)

Differences of inner and outer hair cells in the organ of Corti of the guinea pig in respect to the cellular content of precipitable calcium

Differences between inner and outer hair cells in the cellular content of precipitable calcium were detected using a potassium pyroantimonate precipitation method and the electron spectroscopic imaging (ESI-) technique. The cytoplasm of the inner hair cells was scattered with a high number of calcium precipitates in all analysed animals, but only a few reaction products could be identified in the cytoplasm of the outer hair cells in all analyzed specimens. Even the well developed system of the subsurface fenestrated cisternae in the outer hair cells was nearly empty of calcium precipitates. A relatively high amount of reaction products could be identified in the nuclei of both types of nerve endings of the receptor cells. Significant differences regarding the content of precipitable calcium were found in the different types of nerve endings, which come into contact with the basal parts of both receptor cells. The observed differences in the content of precipitable calcium between the two types of hair cells are discussed with respect to their probable different roles in signal transduction processes.

Calcium and magnesium transport by isolated goldfish hair cells

We used electron-probe analysis (EPA) to investigate the transport of the divalent cations calcium and magnesium across the plasma membranes of hair cells. Unlike ion-sensitive fluorescent dyes, EPA detects these ions regardless of the state of chemical combination inside the cell; changes in these cell ions determined by EPA indicate net transport across the cell membrane. Raising or lowering either extracellular divalent cation within 1 mM of its control level raised or lowered its cell contents, but further increases in extracellular concentration of either ion had little additional effect on the cell content of that ion. New steady-state contents could be obtained within minutes, but the net divalent cation currents required to account for the observed changes would have been smaller than most currents recorded electrophysiologically, less than 1 pA. The effects of replacing extracellular Na+ with other ions were consistent with the presence in hair cells of exchangers for divalent cations thought to occur in other tissues: electrically neutral sodium/magnesium exchange (2 Na+ per Mg2+) and electrogenic sodium/calcium exchange (at least 3 Na+ per Ca2+). The increase in cell Ca after 1 minute of potassium-depolarization was similar to that expected from electrophysiological studies of voltage-sensitive calcium currents in goldfish hair cells. After that time in elevated potassium, however, either calcium-entry pathways were inhibited or calcium-export mechanisms were enhanced.

Effects of free radicals on the intracellular calcium concentration in the isolated outer hair cell of the guinea pig cochlea

The cytosolic free calcium concentration ([Ca2+]i) isolated from the cochlear outer hair cell (OHC) of the guinea pig was measured using microfluorimetric imaging technique and the effects of free radicals were investigated. Hypoxanthine (HX) plus xanthine oxidase (XO) induced a rise in [Ca2+]i in the presence of external Ca2+. Elimination of external Ca2+ (pCa = 7) did not show an increase in [Ca2+i, indicating that the increased [Ca2+]i is dependent on external Ca2+. The elevation of [Ca2+]i induced by HX-XO was reduced by addition of superoxide dismutase or nifedipine but not by addition of catalase. A single admission of HX or XO failed to affect [Ca2+]i. These findings suggest that superoxide anion generated in the OHC increases the Ca2+ influx across the membrane, presumably leading to some pathological changes in the acoustic transduction by modulating the OHC motility.

Na(+)-Ca2+ exchange in the isolated cochlear outer hair cells of the guinea-pig studied by fluorescence image microscopy

The outer hair cell isolated from the guinea-pig was superfused in vitro and the cytosolic calcium concentration ([Ca2+]i) and sodium concentration ([Na+]i) were measured using fluorescence indicators. Under the resting condition, [Ca2+]i and [Na+]i were 91 +/- 9 nM (n = 51) and 110 +/- 5 mM (n = 12), respectively. Removal of external Na+ by replacing with N-methyl-D-glucamine (NMDG+) increased [Ca2+]i by 270 +/- 79% (n = 27) and decreased [Na+]i by 23 +/- 4 mM (n = 6). Both changes in [Ca2+]i and [Na+]i were totally reversible on returning external Na+ to the initial value and were inhibited by addition of 0.1 mM La3+ or 100 microM amiloride 5-(N,N-dimethyl) hydrochloride. Elevation of external Ca2+ ions to 20 mM reversibly decreased [Na+]i by 8 +/- 6 mM (n = 5). Moreover, the chelation of the intracellular Ca2+ with 1,2-bis (2-aminophenoxy) ethane-N,N,N',N'-tetraacetic acid (BAPTA) exerted an inhibitory action on the NMDG(+)-induced reduction in [Na+]i. Exposure to 5 mM NaCN for 2 min significantly and reversibly increased [Ca2+]i by 290 +/- 37% (n = 5), but did not affect the [Ca2+]i elevation induced by the NMDG+ solution. The rise in [Ca2+]i induced by the NMDG+ solution was not enhanced by ouabain pretreatment. Addition of ouabain did not alter the [Na+]i. The present results are best explained by the presence of an Na(+)-Ca2+ exchanger in cell membrane and indicate that the activity of Na+/K+ pump is poor in outer hair cells.