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Am J Physiol Renal Physiol 275: F633-F650, 1998;
0363-6127/98 $5.00
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Vol. 275, Issue 5, F633-F650, November 1998

INVITED REVIEW
Isozymes of the Na-K-ATPase: heterogeneity in structure, diversity in function

Gustavo Blanco and Robert W. Mercer

Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri 63110

    ABSTRACT
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The Na-K-ATPase is characterized by a complex molecular heterogeneity that results from the expression and differential association of multiple isoforms of both its alpha - and beta -subunits. At present, as many as four different alpha -polypeptides (alpha 1, alpha 2, alpha 3, and alpha 4) and three distinct beta -isoforms (beta 1, beta 2, and beta 3) have been identified in mammalian cells. The stringent constraints on the structure of the Na pump isozymes during evolution and their tissue-specific and developmental pattern of expression suggests that the different Na-K-ATPases have evolved distinct properties to respond to cellular requirements. This review focuses on the functional properties, regulation, and possible physiological relevance of the Na pump isozymes. The coexistence of multiple alpha - and beta -isoforms in most cells has hindered the understanding of the roles of the individual polypeptides. The use of heterologous expression systems has helped circumvent this problem. The kinetic characteristics of different Na-K-ATPase isozymes to the activating cations (Na+ and K+), the substrate ATP, and the inhibitors Ca2+ and ouabain demonstrate that each isoform has distinct properties. In addition, intracellular messengers differentially regulate the activity of the individual Na-K-ATPase isozymes. Thus the regulation of specific Na pump isozymes gives cells the ability to precisely coordinate Na-K-ATPase activity to their physiological requirements.

ouabain; sodium pump; protein kinases

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THE DISCOVERY THAT MANY ENZYMES in the cell are expressed in multiple molecular forms has become one of the most fascinating and intriguing phenomena in biology. In 1959, Markert and Moller (134) first used the term "isozymes" to describe the separate proteins that catalyze the same biochemical reaction. Since then, researchers have looked for structural variants of enzymes to understand their physiological function. In some cases, duplication of genes or alternative posttranscriptional processing of the gene message results in isozymes with unique biological properties. The development of multiple isozymes often provides the functional versatility cells need to fulfill their physiological requirements. This review covers the present status in the continuously growing field of the isozymes of the Na-K-ATPase, emphasizing the functional properties and regulatory mechanisms of the individual Na pump polypeptides.

The Na-K-ATPase, or Na pump, is a membrane-bound protein that establishes and maintains the high internal K+ and low internal Na+ concentrations typical of most animal cells. By using the energy from the hydrolysis of one molecule of ATP, it transports three Na+ out in exchange for two K+ that are taken in. The electrochemical gradient the Na-K-ATPase generates is critical in maintaining the osmotic balance of the cell, the resting membrane potential of most tissues, and the excitable properties of muscle and nerve cells. In addition, the Na+ gradient provides the energy that fuels the Na-coupled transporters. These secondary transport systems mediate the translocation of ions (H+, Ca2+, Cl-, PO3-4, SO2-4), substrates (glucose and amino acids), and neurotransmitters across the plasma membrane (83, 84, 109, 190, 191). In the kidney, the Na-K-ATPase plays a primary role in driving the reabsorption of Na+ and water. Thus the enzyme is essential in the maintenance of body fluid and electrolyte homeostasis (83, 109).

The Na-K-ATPase or Na pump belongs to a widely distributed class of P-type ATPases that are responsible for the active transport of a variety of cations across cell membranes (127, 171). P-type ATPases are found in both prokaryotic and eukaryotic cells, and are responsible for transporting H+, Na+, Mg2+, K+, Ca2+, Cu2+, and Cd2+ (127). All these enzymes use the hydrolysis of ATP to drive the transport of cations against an electrochemical potential. The P-type designation refers to the unique characteristic of these enzymes in forming a transient, phosphorylated aspartyl residue during the catalytic cycle. Accompanying the phosphorylation-dephosphorylation process, the P-type ATPases bind, occlude, and transport ions by cycling between two different cation-dependent conformations, called E1 and E2 (167, 171, 191). The precise molecular mechanisms that couple the hydrolysis of ATP to the conformational changes and the translocation of ions remain unknown.

In addition to having a common reaction mechanism, P-type ATPases also display comparable tertiary structures, equivalent membrane topological organization, and several highly conserved protein domains (127). The region around the phosphorylated aspartate, the TGES/A (threonine, glycine glutamine, serine/alanine) motif between transmembrane domains two and three, and several regions involved in ATP binding exhibit a high degree of amino acid homology. In addition to implying a common evolutionary ancestor, the similarities in the structure and reaction mechanism of these diverse proteins often make conclusions drawn from one transporter relevant to the others (46).

The Na-K-ATPase is an oligomer composed of stoichiometric amounts of two major polypeptides, the alpha - and the beta -subunits. The primary structures and membrane organization of the Na-K-ATPase alpha - and beta -subunits are depicted in Fig. 1. The alpha -subunit is a multispanning membrane protein with a molecular mass of ~112,000 Da that is responsible for the catalytic and transport properties of the enzyme. The alpha -subunit contains the binding sites for the cations, ATP, and the inhibitor, ouabain (reviewed in Refs. 120, 147, 160, 165). The beta -subunit is a polypeptide that crosses the membrane once and, depending on the degree of glycosylation in different tissues, has a molecular weight between 40,000 and 60,000 Da. The beta -subunit is essential for the normal activity of the enzyme (31, 52, 139), and it appears to be involved in the occlusion of K+ (126) and the modulation of the K+ and Na+ affinity of the enzyme (33, 35, 62, 64, 102). In addition, in vertebrate cells, the beta -subunit may act as a chaperone, stabilizing the correct folding of the alpha -polypeptide to facilitate its delivery to the plasma membrane (reviewed in Refs. 52, 139).


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Fig. 1.   Scheme of the membrane topology of the alpha - and beta -isoforms of the Na-K-ATPase. Sequences of rat alpha 1- and beta 1-isoforms are shown. Residues are colored to indicate the amino acid homology among the different alpha -isoforms (alpha 1, alpha 2, alpha 3, and alpha 4) or beta -isoforms (beta 1, beta 2, and beta 3).

A third protein, termed the gamma -subunit, has also been identified in purified preparations of the enzyme (166). The gamma -subunit is a small, hydrophobic polypeptide of 8-14 kDa that was considered to be a contaminant of purification, until it was shown that it could be covalently labeled by photoaffinity derivatives of ouabain (78, 123, 169). Other evidence that the gamma -subunit is a component of the Na-K-ATPase is that the subunit colocalizes with the alpha -subunit in nephron segments and coimmunoprecipitates with alpha beta -complexes (148). Also, the high degree of homology among gamma -subunits from several species suggests that the subunit may be important in Na-K-ATPase function.

Expression studies have shown that the gamma -subunit is not required for normal Na-K-ATPase activity (59, 91, 176). However, recently it was shown that the gamma -subunit can modify the voltage dependence of K+ activation of the alpha 1 beta 1-isozyme when expressed in Xenopus oocytes (20). In addition, it appears that the gamma -subunit can stabilize the E1 conformation of the enzyme (204) and may be required for cavitation in mouse embryos (108). Interestingly, the gamma -subunit belongs to a family of small membrane proteins involved in the passage of ions across the plasma membrane. This family of proteins, which includes phospholemman (158), channel inducing factor (CHIF; Ref. 12), and Mat-8 (mammary tumor, 8 kDa; Ref. 152), induces ion channel activity when expressed in Xenopus oocytes. Consistent with these findings, the human gamma -subunit induces cation-selective channels when expressed in Xenopus oocytes (150). The physiological significance of this activity and whether it requires the other Na-K-ATPase subunits is unknown. Although there is increasing evidence that the gamma -subunit can modify Na-K-ATPase function, the exact role of the subunit in Na-K-ATPase function awaits further experimentation.

Na Pump Isoform Diversity

As with many other essential proteins in the cell, the Na-K-ATPase is expressed as several isozymes. Indeed, there are different genes encoding distinct molecular forms of both the alpha - and beta -polypeptides (reviewed in Refs. 69, 117, 120, 121, 196, 197). Evidence for the existence of Na pump isozymes can be traced to experiments that analyzed the cardiotonic steroid sensitivity of Na-K-ATPase preparations from rodents. Marks and Seeds (135) found heterogeneous ouabain inhibition curves for the Na-K-ATPase from mouse brain. The activity could be resolved into two components of high (Ki = 10-7 M) and low (Ki = 10-4 M) affinity for the inhibitor. This was in clear contrast to the single inhibition profile for enzyme preparations from the kidney (135). The earliest structural evidence for variants of the Na pump was found in brine shrimp. In this crustacean, the alpha -subunit could be resolved into two distinct forms on SDS-polyacrylamide gels (163). The first direct demonstration of Na-K-ATPase isoforms in mammals was accomplished by Sweadner (194), who found two forms of the alpha -subunit, the already identified renal alpha -form and a brain form that was termed alpha +. This novel catalytic subunit of the enzyme had a slower migration in SDS-polyacrylamide gels and a higher sensitivity to ouabain (194). This pioneering work was followed by studies that focused on the biochemical properties of both isoforms. Thus alpha + was shown to display a higher reactivity toward N-ethylmaleimide (208), a higher sensitivity to the vitamin B derivative pyrithiamine (137), and an increased resistance to trypsin digestion compared with alpha  (209). These properties suggested distinct structural differences between the isoforms. Later, the demonstration of dissimilarities at the NH2 terminus of alpha  and alpha + (129) suggested a genetic basis for the isoform difference. The advent of molecular biological techniques resulted in the identification of at least three alpha -polypeptides in vertebrates, presently known as alpha 1, alpha 2, and alpha 3 (186, 187, 193). More recently, Shamraj and Lingrel (185) identified a fourth alpha -isoform (alpha 4) in rat testis.

The alpha -isoforms of the Na-K-ATPase have been cloned from several mammalian species. An analysis of the phylogenetic distribution of the alpha -proteins using antibodies directed to conserved and specific regions of the isoforms indicates that isoforms appear to exist in all mammals, including both placental and marsupial species (164). The identifications of Na-K-ATPase alpha -isoforms in the chicken (70) and teleost fishes (164) imply their broad presence among vertebrates (201). Moreover, the finding of alpha -isoforms in crustaceans (14) and possibly in hydra (45) and platyhelminths (159) indicates that the divergence of Na-K-ATPase genes occurred early in evolution.

Further studies have shown that the Na pump molecular diversity also extends to its beta -subunit. At present, three different Na-K-ATPase beta -isoforms have been identified. Two of the isoforms, beta 1 and beta 2, have been found in different tissues of mammals (82, 136) and birds (115), whereas beta 3 has been detected in amphibians (85), mouse (27), rat, and human (82, 136). Moreover, in the zebra fish, an Na-K-ATPase beta -subunit highly homologous to beta 3 has been isolated (7). In this species, however, a detailed characterization of other beta -isoforms has not been accomplished, making it difficult to establish a correlation with the subunits of other species.

Both the alpha - and beta -isoforms of the Na pump exhibit a tissue-specific pattern of expression. The alpha 1-isoform in association with the beta 1-subunit is found in nearly every tissue (reviewed in Refs. 69, 117, 119, 121, 196). In addition, alpha 1 beta 1 is the principal isozyme of the kidney, a tissue that has classically been used as the source of Na-K-ATPase (reviewed in Refs. 83, 84, 109, 191). The presence of other Na-K-ATPase isoforms in the kidney has been a matter of debate (2, 8, 51, 53, 71, 73, 88, 104, 140, 206). The alpha 2- and alpha 3-isoforms have been detected in renal cortex, medulla, and papilla using both reverse-transcription followed by polymerase chain reaction amplification and [3H]ouabain titration analysis (125). Measurement of mRNA and protein levels indicates that the alpha 2- and alpha 3-isoforms correspond to only 0.1% of the alpha 1 beta 1 enzyme of the kidney (125). In contrast to the broad tissue distribution of alpha 1 and beta 1, the other alpha - and beta -polypeptides are more restricted in their expression. The pattern of Na-K-ATPase isoform expression, at both the mRNA and protein level, has been studied with most detail in the rat. The alpha 4-isoform is a testis-specific isoform (185). The alpha 2-isoform predominates in adipocytes (130), muscle (99, 114), heart (215), and brain (143), and alpha 3 is abundant in nervous tissues (95, 143). In the nervous system, the expression of Na-K-ATPase isoforms reaches its greatest intricacy. Neuronal cells may express a unique isozyme or multiple isozymes consisting of the various alpha beta -heterodimer combinations (117, 119, 121, 196). Whereas neurons are the principal source of the alpha 3 polypeptide (reviewed in Refs. 117, 198), glial cells preferentially express alpha 2 (40, 43, 76). Also, the beta -isoforms are distributed in a tissue-dependent manner. The beta 2-isoform is found in skeletal muscle (114), pineal gland (189), and nervous tissues (162), whereas beta 3 is present in testis, retina, liver, and lung (11, 133). In addition, the pattern of expression of the Na-K-ATPase isoforms is subjected to developmental as well as hormonal regulation and can be altered during disease (39, 49, 50, 68, 217).

Additional Mechanisms Involved in the Production of Na-K-ATPase Isozymes

In addition to the expression of different genes for the alpha - and beta -subunits, several other mechanisms are involved in the generation of Na-K-ATPase isozymes. For example, variations in the transcriptional processing of the Na pump subunit messages occur in some cells. This is the case for a truncated form of the alpha 1-subunit, named alpha 1-T, which has been found in canine vascular smooth muscle (146). Alternative splicing of the alpha 1 mRNA results in a polypeptide of ~65,000 Da. The alpha 1-T includes the first 554 amino acids of alpha 1 and terminates with a peptide of 27 amino acids from the retained intron sequence. Although alpha 1-T lacks 40% of the COOH-terminal sequence, it retains the ATP binding and phosphorylation site. This, added to the observation that cells containing alpha 1-T show undetectable levels of the other alpha -isoforms, has led to the suggestion that the truncated isoform may function as an ATPase (4, 146). However, it remains unknown whether alpha 1-T is catalytically competent and, if so, whether it is able to support the transport of ions. Interestingly, truncated transcripts of both the alpha 1- and beta 1-isoforms have also been found in human retinal epithelium. The truncated alpha 1 sequence in this tissue encodes the first 681 amino acids of the alpha 1 polypeptide. The deletion produces a shift in the open-reading frame of the message to produce a unique COOH terminus of 44 residues, which surprisingly displays similarity to the COOH-terminal sequence of the sarcoplasmic reticulum (SR) Ca-ATPase. The truncated beta -polypeptide of retina is two amino acids shorter at the COOH terminus than the typical beta 1-isoform. In addition, the last two COOH-terminal residues differ from those of the full-length subunit (170).

Other short variants of the alpha 1 polypeptide have been found in Xenopus laevis embryos. In Xenopus, deletions at the NH2 terminus of the protein result from the alternative initiation of translation at codons encoding either Met34 or Met43. Sequential mutation of each of these residues and expression of the corresponding cRNAs in Xenopus oocytes shows that both truncated subunits are catalytically competent when coexpressed with the beta -isoform. Moreover, the alpha -subunit with Met43 at the NH2 terminus exhibits a lower affinity for K+ than the Met34 truncated or full-length polypeptides (42). These results support the hypothesis that the NH2 terminus of the alpha 1-subunit, which is rich in lysine and contains an excess of positively charged amino acids, forms a cation-selective gate (187, 210).

Another mechanism that contributes to the heterogeneity of the Na pump is the association of the alpha - and beta -isoforms into different alpha beta -heterodimers. The possibility that combinations of different heterodimers could be formed was suggested from the expression of multiple isoforms in several tissues and cells (43, 117, 162, 181, 182, 221). For example, in the pineal gland, both the alpha 1 beta 2 and alpha 3 beta 2 Na-K-ATPase isozymes are present (189). The alpha 3 beta 2-isoform combination is also found in retinal photoreceptor cells (181, 182), whereas the cells of the choroid plexus express the alpha 1 beta 1- and alpha 2 beta 1-isozymes (221). Specific cell populations within the central nervous system (117, 198), the ciliary epithelial cells of the eye (81), the sensory organ of the ear (202), and the choroid plexus (221) express several isoforms with the potential of multiple alpha  and beta  combinations. The promiscuous association between alpha - and beta -isoforms was confirmed in insect cells expressing different combinations of the rat Na-K-ATPase polypeptides. In this expression system, each alpha -isoform could properly assemble with either the beta 1- or the beta 2-subunit into catalytically active complexes (30, 33, 35, 36). Similarly, nonspecific alpha beta association was found for the Na-K-ATPase chicken isoforms exogenously expressed in mammalian cells (116). In this manner, multiple Na-K-ATPase isozymes (alpha 1 beta 1, alpha 1 beta 2, alpha 2 beta 1, alpha 2 beta 2, alpha 3 beta 1, and alpha 3 beta 2) can result from the pairing of the various alpha - and beta -polypeptides (33, 35).

The complexity of the Na-K-ATPase may also extend to the oligomeric structure of the enzyme. We have recently demonstrated that the different alpha -isoforms are able to specifically and stably associate into oligomeric complexes (32). The existence of multiple sets of oligomers raises the possibility of an even greater degree of intricacy in the molecular heterogeneity of the Na pump. However, whether the quaternary structure of the Na pump influences the functional properties of the enzyme is still unclear.

Structure of alpha - and beta -Isoforms

The complete amino acid sequence of the alpha -isoforms has been deduced from the cDNAs coding for the polypeptides from rat (180, 186), chicken (70), and human (121, 193). The alpha -subunits in the rat vary slightly in length; the alpha 3-isoform is the smallest with 1,014 amino acids, alpha 1 possesses 1,024, alpha 2 possesses 1,021, and alpha 4 is the largest with 1,028 residues. The amino acid sequence, site-specific labeling, and immunologic and proteolytic digestion studies have provided some insight into the possible transmembrane orientation of the alpha -subunit (9, 44, 120, 122, 151, 160, 199, 210, 213). These studies predict an NH2-terminal segment with four transmembrane spanning domains, a large cytoplasmic domain consisting of roughly one-third of the polypeptide, and a carboxy-terminal region containing six membrane spanning domains (Fig. 1). This membrane topography is also similar to the models suggested for the Ca-, H-, and H-K-ATPases (44, 46).

Across species the degree of identity for the alpha 1- and alpha 2-isoforms is ~92% and is over 96% for alpha 3. There is also a high degree of identity (approx 87%) among the alpha 1-, alpha 2-, and alpha 3-isoforms. In contrast, alpha 4 is the most divergent, sharing a 78% identity with the alpha 1-isoform. As shown in Fig. 1, the highest structural variability among the isoforms occurs at the NH2 terminus, the extracellular ouabain binding site between transmembrane segments 1 and 2, and the cytoplasmic region between amino acids 403 and 503. In contrast, the greatest similarities occur in the cytoplasmic middle region where the ATP binding and phosphorylation sites are located, the transmembrane hydrophobic regions and the COOH-terminal region (reviewed in Refs. 117, 120, 147).

The alpha -subunit undergoes translational or posttranslational modifications, some of which appear to be isoform specific. In the mature alpha 1- and alpha 2-polypeptides, the first 5 amino acids are cleaved (129). It is not known whether the alpha 3-isoform is processed in a similar fashion. A tissue-specific, posttranslational modification has been suggested for the alpha 3-isoform. An isoform-specific antibody that reacts with a region near the ATP binding site identifies alpha 3 in the brain but does not react to the same isoform from heart. This lack of reactivity has been interpreted as a blockage of the antibody epitope by a modification of the protein during synthesis (10). The nature of this modification, as well as its occurrence in other tissues and alpha -isoforms, is unknown.

The amino acid sequence of the beta -isoforms has been deduced from the rat, human, chicken, Xenopus, and mouse cDNAs (82, 115, 133, 136). In the rat, the beta 1-isoform has 304, the beta 2-isoform has 290, and the beta 3-isoform has 279 amino acids. All beta -isoforms share a common basic structure (Fig. 1). The beta -isoforms consist of a short NH2-terminal cytoplasmic region, a transmembrane spanning segment, and a large extracellular domain. The homology of the beta 1- and beta 2-isoforms across mammalian species is ~95%. This value drops to 60% when nonmammalian species are included in the comparison. The homology among different beta -isoforms is lower than that found for the catalytic subunit (Fig. 1). Compared with beta 1-, the beta 2-polypeptide exhibits 58% similarity (34% identity, 24% favored substitutions), whereas the beta 3-subunit is 68% homologous, with an identity of 39%. The similarity between beta 2 and beta 3 reaches 61%, with 49% of the residues conserved (133). Interestingly, the beta 2-subunit primary structure is more closely related to the H-K-ATPase beta -isoform than to the beta 1-isoform, suggesting that the beta 2- and H-K-ATPase beta -isoform genes diverged more recently than beta 1 and beta 2 (188). The transmembrane domain of the beta -subunit is the most highly conserved region both among isoforms and species.

All beta -isoforms are heavily glycosylated. The beta 1-isoform from mammals has three N-linked glycosylation sites. The putative N-linked glycosylation sites for the beta 2-isoform vary depending on the species. Thus the chicken subunit has four potential glycosylation sites, the rat has seven, the human has eight, and the mouse beta 2-polypeptide has nine (reviewed in Ref. 52). It is not known whether all the sites are used. Inhibition of glycosylation of the Na-K-ATPase beta 1-subunit with tunicamycin results in catalytically competent Na pumps with normal affinity for ouabain (200, 218, 219). Expression of an enzyme in which all beta -subunit N-linked glycosylation sites are mutated also renders an active enzyme with conserved K+ and ouabain affinities. However, the reduction in the ability of the nonglycosylated beta -subunit to assemble with the alpha -subunit and the higher sensitivity of the enzyme to proteolysis suggest that glycosylation may play a role in protein folding (16).

Another important feature in the structure of the beta 1-subunit is the presence of three disulfide bridges, which in the rat polypeptide occur between Cys125---Cys148, Cys158---Cys174, and Cys212---Cys275. All the cysteines, but not their relative positions within the sequences, are conserved in the beta 2- and beta 3-isoforms, suggesting similarities in the tertiary structure of the polypeptides. Treatment of the Na-K-ATPase with reducing agents results in inactivation of Na-K-ATPase, suggesting that the disulfide bonds are required for enzyme function. The removal of just one of the disulfide bonds by site-directed mutagenesis of the involved cysteines has been shown to be sufficient to abolish proper assembly of the alpha beta -subunits (16). The location and role of sulfhydryl bridges in the other Na pump beta -isoforms are unknown.

Enzymatic Properties of Na-K-ATPase Isozymes

Understanding of the enzymatic properties of the individual isozymes may help in determining the basis for the complex molecular diversity that characterizes the Na-K-ATPase. The characterization of the functional properties of the different alpha - and beta -polypeptide combinations has been a difficult task. Often more than one isoform is expressed in the same cell, complicating the analysis of the individual isoforms. Because it constitutes nearly all the Na pump in the kidney, the functional properties of the alpha 1 beta 1-isozyme have been extensively analyzed. With its high levels of Na-K-ATPase activity, the kidney has been of immense value in understanding the structure, biochemical reaction mechanism, and kinetic properties of the Na-K-ATPase. In contrast, the lack of natural sources for each of the other Na pump isozymes has made their characterization more difficult. The first attempt to evaluate the catalytic properties of the Na pump isozymes was the comparison of the substrate affinities of the enzymes from kidney and brain (208). This early work suggested that the Na-K-ATPase isozymes have distinct differences in their affinities to Na+, K+, and ATP. Later, Sweadner (195) compared the properties of Na-K-ATPases from rat axolemma and rat kidney. The renal alpha 1 beta 1-isozyme displayed a lower ATP, similar K+, and higher Na+ affinities than the neuronal enzyme composed of the alpha 2- and alpha 3-subunits. Also, differences in Na+ or K+ apparent affinities have been found between Na-K-ATPases partially purified from brine shrimp (55, 56) or different tissues of the rat (41, 72, 211). Moreover, the transport properties of rat kidney- and axolemma-derived enzyme delivered into dog erythrocytes by membrane fusion differ in their dependence on Na+ and K+ (154). In whole adipocytes from rat, it was found that the alpha 1-isozyme has a Km for Na+ that is threefold lower than that of the alpha 2-isozyme (128, 130). This difference, however, was not retained when membranes from the same source were prepared (41). Such discrepancies were also encountered for the Na+ affinity of alpha 1 and alpha 2 from entire or disrupted rat brain synaptosomes (41). Other differences in isoform enzymatic properties were found for the alpha 3 beta 2 Na-K-ATPase from the pineal gland, which exhibits a higher Na+ affinity than the renal alpha 1 beta 1 (189). On the other hand, similar Na+ and K+ kinetics were identified in cerebellar or hippocampal Na-K-ATPases at different stages of development, despite variations in the amount of isoforms expressed (13, 24, 25, 28).

Although several studies suggested differences in the enzymatic behavior of the Na pump isozymes, discrepancies in the reported kinetic parameters led to uncertainties in the functional characteristics of the isozymes. In contrast, the reactivity of the Na pump isoforms toward ouabain is less controversial. Because of their broad sensitivities to cardiotonic steroids, this is particularly evident for the rodent Na-K-ATPase isozymes. In the rat, for example, alpha 1 was reported to be 100-fold more resistant to ouabain than alpha + (alpha 2 + alpha 3) (67, 100, 135, 194, 195). On the basis of the differential sensitivities to trypsin, early experimental evidence also suggested that the alpha 3-isoform has a high affinity for ouabain (209). Working with partially purified Na-K-ATPase from rat brain stem, researchers identified three populations of Na-K-ATPase with different sensitivities to ouabain, possibly corresponding to alpha 1, alpha 2, and alpha 3 (22, 29). In rabbit, pig, dog, and human, the differences in the cardiotonic steroid affinity may not be as marked, since the alpha 1-isoform in these species is much more sensitive to ouabain (23, 88, 90, 92, 104, 131, 179).

With the introduction of molecular biology techniques to the Na pump field, a better understanding of the function of each isoform became possible. The availability of the cDNAs for the different Na pump isoforms allowed studies in heterologous expression systems. Consequently, several investigators have used mammalian cells to separately express each Na pump isoform. Thus, when expressed in cultured rodent cells, the rat alpha 2- and alpha 3-isoforms have been shown to display Ki values for ouabain of ~40 and 80 nM, respectively (89, 113). Through study of the molecular basis for the difference between primate and rodent cells in their sensitivities to the cardiac glycosides, it was shown that the rat alpha 1-isoform could confer ouabain resistance to ouabain-sensitive CV-1 cells (65, 113). Using the differences in ouabain sensitivities between rodents and other mammals, Jewell and Lingrel (105) studied the kinetic properties of the rat alpha 1-, alpha 2-, and alpha 3-subunits. By changing two residues in the extracellular loop between the first and second transmembrane segments, they converted the rat alpha 2 and alpha 3 into ouabain-resistant forms. The mutated isoforms were stably transfected into HeLa cells by their ability to support growth in 1 mM ouabain (105). Through this method, the expressed isoforms could be functionally separated from the endogenous ouabain-sensitive Na-K-ATPase. Analysis of the individual isozymes demonstrated that the alpha 1 beta 1 and alpha 2 beta 1 display similar affinities for Na+, K+, and ATP, whereas the alpha 3 beta 1-isozyme exhibits a lower affinity for Na+ compared with alpha 1 beta 1 and alpha 2 beta 1. Subsequently, the highly ouabain-sensitive Na-K-ATPase from rat brain or dog heart, ascribed to alpha 3beta 1, was also reported to have a lower apparent affinity for Na+ than the intermediate and resistant components (alpha 1 and alpha 2) from the same tissues (23, 80). To identify the structural basis for the difference in the Na+ requirements between the isoforms, a series of chimeric alpha 1/alpha 3-subunits were expressed in HeLa cells. Analysis of the Na+ affinities of each chimera did not reveal a region clearly responsible for the differences in Na+ dependence between the isoforms, indicating that multiple residues spanning the alpha -polypeptide may be cooperating in the binding and transport of the cation (106).

Expression of hybrid Na-K-ATPase molecules between alpha - and beta -isoforms from different species in Xenopus oocytes has also helped in elucidating the characteristics of the Na pump isozymes. Through this system, the alpha 1 beta 1 Na-K-ATPase has been shown to exhibit a higher activation by Rb+ than the alpha 1 beta 2- and alpha 1 beta 3-isozymes (102, 177). Utilizing heterologous expression in yeast, which lack endogenous Na-K-ATPase activity, Farley and colleagues (97, 98) successfully obtained catalytically competent Na pump molecules by expressing the alpha 1-subunit from sheep and the beta -subunit from dog. Later, they determined that the ouabain binding constant of the sheep alpha 1 and rat alpha 3 is between 5 and 10 nM (63). In addition, coexpression of the alpha 1- or alpha 3-isoforms with chimeric molecules between the Na-K- and H-K-ATPase beta -subunits indicated that the beta -polypeptide modulates the K+ and Na+ dependence of the enzyme (62, 64).

Our approach to the study of the Na-K-ATPase isozymes has included the use of the baculovirus expression system. This system employs the Autographica californica virus to express foreign genes in insect cells. By using recombinant baculoviruses coding for different alpha - and beta -isoforms we have been able to successfully obtain functional Na pump molecules in cultured Sf-9 insect cells, a cell line derived from the ovary of the fall armyworm, Spodoptera frugiperda. Sf-9 cells are able to produce high amounts of the virally directed Na-K-ATPase polypeptides. Moreover, Sf-9 cells contain very low levels of endogenous Na-K-ATPase, allowing the analysis of the expressed enzymes in an environment relatively free from contaminating Na-K-ATPase activity (36, 59). In addition, the recombinant viruses can be used independently and in combination to study assembly and activity of the various Na-K-ATPase isoforms.

The insect cells are able to correctly assemble the various alpha - and beta -isoforms into functional enzyme (30, 33, 35, 36, 59). Infecting cells with the various recombinant baculoviruses has demonstrated that all alpha -isoforms can stably assemble with either the beta 1- or the beta 2-polypeptides. This is consistent with the results of other investigators (1, 116, 177). Although all possible alpha  and beta  pairs result in active enzyme, some combinations, such as alpha 1 beta 2, exhibit lower activity, suggesting that not all associations are equally favored. Evidence for a selective interaction of certain alpha - and beta -subunits has been reported using Xenopus oocytes (178). The importance of this preferential assembly in directing isozyme expression is unknown.

By analyzing the dose-response curves toward Na+, K+, ATP, and the inhibitor ouabain, the enzymatic properties of the various Na pump isozymes were determined. Table 1 summarizes the kinetic parameters for the rat Na-K-ATPase isozymes expressed in the insect cells. As shown, the apparent affinity for Na+ varies with a rank of order alpha 2 beta 2 > alpha 2 beta 1 > alpha 1 beta 1 = alpha 3 beta 2 > alpha 3 beta 1. Also, the apparent affinity for K+ differs among the isozymes, following the sequence alpha 1 beta 1 > alpha 2 beta 1 = alpha 2 beta 2 > alpha 3 beta 1 = alpha 3 beta 2. For the activation by ATP, the enzymes composed of the alpha 2- and alpha 3-isoforms display equivalent Km values, which are approximately four times lower than that of the alpha 1 beta 1. Altogether, these results indicate that the major kinetic differences occur among Na-K-ATPases that differ in the alpha -subunit composition. These observations are in reasonably good agreement with the kinetic properties reported for the rat alpha 1-, alpha 2-, and alpha 3-isoforms expressed in HeLa cells (57, 58, 105, 154, 203). The only difference between our results and those obtained in HeLa cells is the K+ affinity of the alpha 3-isozymes, which we found to be lower than that of the alpha 1 or alpha 2. The differences in the membrane environment of mammalian and invertebrate cells, the analysis of hybrid Na pump molecules in the HeLa cells, or the alteration of the isoforms by mutation of their ouabain binding site may be responsible for the disparity in results.

                              
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Table 1.   Kinetic characteristics of the rat Na-K-ATPase isozymes expressed in Sf-9 insect cells

As mentioned before, the most conspicuous kinetic difference among the isozymes corresponds to the reactivity toward ouabain, with alpha 3 beta 1 and alpha 3 beta 2 displaying a high, the alpha 2 beta 1 and alpha 2 beta 2 an intermediate, and alpha 1 beta 1 a low sensitivity to the cardiotonic steroid (36, 155). Interestingly, the rat alpha 1 beta 1 enzyme expressed in insect cells is over 2-fold more sensitive and the alpha 3 beta 1 approximately 20-fold less sensitive to ouabain than the native enzyme. This difference in sensitivity between the native and expressed Na-K-ATPase may be a result of the different lipid environments of the enzyme. Alternatively, the sensitivity to ouabain may be influenced by the gamma -subunit or by the oligomeric structure of the alpha -subunit.

At present, the enzymatic properties of Na-K-ATPases composed of the alpha 4-isoform have not been analyzed. To determine the ouabain sensitivity of the alpha 4-isoform, we performed dose-response curves for the ouabain inhibition of Na-K-ATPase activity in membrane preparations from rat testis, the only tissue known to contain this isoform. As shown in Fig. 2A, the experimental data is best fitted assuming the existence of two isozymes with different sensitivities to the cardiotonic steroid. One of the components corresponding to ~45% of the total Na-K-ATPase has a calculated Ki of 1.4 ± 0.3 × 10-4 M and very likely represents the alpha 1-isozyme. The second component represents ~55% of the total activity and exhibits a high affinity for the inhibitor, with a Ki of 1.8 ± 1.0 × 10-9 M. As previously shown (185), immunoblot analysis of the testis preparation showed that the tissue does not express the alpha 2- or alpha 3-isoforms (Fig. 2B). A complete characterization of the beta -subunits in the rat testis has not been performed. However, beta 1 and beta 3 mRNAs have been detected in the gonad (133). The possibility that alpha 1 beta 3 represents the component of high affinity for ouabain is unlikely, since the other beta -subunits do not influence the kinetics of the enzyme toward the cardiotonic steroids. Therefore, the highly ouabain-sensitive Na-K-ATPase encountered probably corresponds to alpha 4. It is unknown which beta -isoform naturally associates with alpha 4. Consequently, the highly ouabain-inhibitable ATPase activity could correspond to alpha 4 beta 1 or alpha 4 beta 3. Undoubtedly, a complete determination of the kinetic characteristics of this isoform will provide insight into its role in Na-K-ATPase function.


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Fig. 2.   A: dose-response curves for the ouabain inhibition of Na-K-ATPase from rat testis membranes. Na-K-ATPase activity was determined after preincubation of the samples for 30 min at 37°C in the reaction mixture containing 120 mM NaCl, 30 mM KCl, 3 mM MgCl2, 0.2 mM EGTA, 30 mM Tris · HCl (pH 7.4), and the indicated ouabain concentrations. The reaction was started by the addition of [gamma -32P]ATP. Values are expressed as percentage of maximal activity in the absence of the inhibitor. Curves represent the best fit of the data assuming the existence of two enzyme populations with different ouabain affinities. Each value is the mean, and error bars represent the standard errors of the mean of 4 experiments performed in triplicate. B: immunoblot analysis of the Na-K-ATPase alpha -subunit expression in rat testis. Testis proteins (30 µg) were separated by SDS-PAGE (7.5% gel) and transferred to nitrocellulose. Na-K-ATPase alpha -polypeptides were detected using isoform-specific antibodies as before (32). A membrane preparation from rat brain (20 µg) is shown as control.

As shown in Table 1, the beta -isoform composition does not influence the kinetic properties of the Na-K-ATPase isozymes as much as the alpha -polypeptides do. However, the beta -subunit is able to influence the Na+ requirement of the enzyme. Thus, for the alpha 2- and alpha 3-isoforms, the apparent affinity for Na+ increases when associated with beta 2. A modulatory effect of the beta -isoform on the catalytic properties of the alpha -subunit has also been shown using Xenopus oocytes. Hybrid alpha 1 beta 1- and alpha 1 beta 2-isozymes consisting of a Torpedo alpha - and a rat beta -subunit, have different affinities for Rb+ (102, 103, 177). Moreover, comparison of results from transfected HeLa cells (57, 105) with native enzyme from pineal gland (189) suggests an effect of the beta -isoform on the Na+ dependence of the rat alpha 3-isoform. At present, the role the beta -subunit plays in the reaction cycle of the Na-K-ATPase is uncertain. Characterization of the kinetics of hybrid Na-K-ATPases composed of the alpha 1- or alpha 3-isoforms and chimeric beta -subunits containing the NH2 terminus of beta 1 and the COOH terminus of the H-K beta -subunit suggests that the beta -subunit influences the interaction of the enzyme with Na+ and reduces the ability of Na+ in forming the phosphoenzyme complex from ATP (64). It also appears that the beta -subunit can influence the K+ affinity of the Na-K-ATPase (62). With use of the Xenopus oocytes as an expression system, the alpha 1 beta 2 enzyme exhibits a lower affinity for K+ than alpha 1 beta 1 (102, 103, 177). Similarly, this trend was maintained in Sf-9 cells where the alpha 2- and alpha 3-isoforms in combination with beta 2 exhibit a slightly lower affinity for K+ than the beta 1 counterparts (33, 35). In addition, the beta -subunit has been shown to be actively involved in forming or stabilizing the K+-occluding complex of the enzyme (126). Because in insect cells the beta -isoforms are mainly expressed in their core-glycosylated forms (36, 59), the difference in Na+ affinity between isozymes containing beta 1 or beta 2 most likely depends on the dissimilar amino acid structure of the beta -isoforms rather than the sugar composition. Additional evidence of the importance of the beta -subunit in modulating the activity of the Na-K-ATPase has been suggested from the kinetic analysis of the human alpha 1 beta 3 Na-K-ATPase expressed in insect cells. The beta 3-isoform slightly influences the Na+, K+, and ouabain affinities of the enzyme (214).

A physiological role for the difference between Na-K-ATPases composed of beta 1 and beta 2 is difficult to infer. Although beta 2 confers alpha 2 and alpha 3 with a similar apparent affinity for Na+ as the alpha 1 beta 1 enzyme, alpha 2 beta 2 and alpha 3 beta 2 still retain the particular K+, ATP, and ouabain reactivities of their counterpart beta 1-containing isozymes. The importance of the beta 2-polypeptide in Na-K-ATPase function may be related to other properties intrinsic to this subunit. For example, an unexpected functional property of the beta 2-isoform is that, in addition to its role as a constituent of the Na pump, it serves as a cell adhesion molecule that mediates Ca2+ independent neuron-astrocyte interactions (82, 177). In addition, beta 2 has been shown to be involved in neuronal migration and neurite outgrowth (5, 82, 153). Coinciding with its role in cell-cell interaction, the decrease in beta 2 mRNA levels in human kidney, lung, and liver carcinomas suggests that this subunit may be involved in tumorigenesis (3). Although the link between cell recognition and ion transport is unknown, it is conceivable that beta 2 might modulate Na pump function to provide the ionic environment required in such specific cellular processes. The importance of the beta 2 has recently been demonstrated in mice carrying a targeted deletion of the gene for this isoform (132). The beta 2-deficient animals exhibit motor incoordination at 15 days of age, develop tremors and paralysis of extremities, and subsequently die at 17-18 days after birth. The observation that at different areas of the nervous system there is swelling and vacuolization of astrocyte processes suggested the requirement of beta 2 in maintaining ionic homeostasis. However, the cause of death in these rodents is unclear, since beta 2 is not necessary for the long-term survival of cultured telencephalic grafts obtained from the transgenic mice (101).

Physiological Relevance of Na Pump Isozymes

It seems plausible that the existence of Na-K-ATPase isozymes is based, at least in part, on their specific kinetic characteristics (30, 33, 35, 57, 105, 107). The subtle differences in their affinities for cations and ATP may be essential in adapting cellular Na-K-ATPase activity to specific physiological requirements. Because of its ubiquitous expression, the alpha 1 beta 1-isozyme may function as the housekeeping Na-K-ATPase in the cell, whereas the other isozymes may mediate tissue-specific roles. For example, in neurons where all the isozymes are present, while the alpha 1- and alpha 2-isoforms are maintaining the basal ionic gradients, alpha 3, because of its low affinity for the cations, will be operating very slowly. With depolarization and the repeated firing of action potentials, the Na+ and K+ gradients are dissipated. Under these conditions, while the alpha 1- and alpha 2-isoforms are working at saturation, the alpha 3-isoform will be activated. In this manner, alpha 3 functions as a spare pump to help restore the resting membrane potential. Also, the high affinity for ATP endows alpha 3 with the ability to utilize the low nucleotide concentrations occurring near the cell membrane after intense neuronal activity. Moreover, the higher Na+ affinity of the alpha 2-isoform gives it a steady working capability, since Na+ will be rate limiting only at very low concentrations. This is important in glial cells, where after neuronal activity, alpha 2 can efficiently clear the high extracellular K+ to prevent further depolarization. In addition, as discussed below, multiple Na-K-ATPase isozymes with different apparent affinities for Na+ may be physiologically important in secondary control of intracellular Ca2+ levels. These variations in cytoplasmic Ca2+ are important in the regulation of contraction, secretion, and excitability (37).

A differential function for the Na-K-ATPase isozymes is suggested by the stringent regulation of the expression of the alpha - and beta -polypeptides under various physiological conditions. During development, a change in the relative amount of Na pump isoforms occurs in several tissues (157). A remarkable example of regulation of Na-K-ATPase isoform expression is found in the developing rat heart. In this tissue, between the second and third week of life, there is a switch from the alpha 3-isoform to alpha 2-isoform, which becomes the predominant isoform of the adult myocardium (124). Interestingly, this event coincides with important changes in the electrophysiological properties of the myocardium (121, 124). The Na pump isozymes may also be differentially regulated by hormones (reviewed in Ref. 68). Hormones can elicit their action by modulating the expression of a particular isoform or by directly affecting the activity of an individual Na-K-ATPase (68). For example, in rat skeletal muscle, insulin is able to produce a rapid translocation of preexisting alpha 2 Na-K-ATPase from intracellular stores to the plasma membrane (99). This results in the recruitment of additional functional Na pumps to the cell surface and increased Na-K-ATPase activity. In addition, the normal expression of Na-K-ATPase isoforms can be altered by pathological conditions. For instance, in several cardiac diseases, the Na-K-ATPase isoform composition of the heart is modified. These changes may reflect the cellular attempt to reestablish the altered homeostasis associated with the disease. Consequently, it seems conceivable that the preferential regulation or modification of a specific isoform may be important in finely adjusting cellular ionic homeostasis.

The difference among rodent Na-K-ATPase isozymes in ouabain affinity is intriguing, although its physiological relevance remains unknown. It is possible that differences in ouabain binding may have a role in the regulation of Na-K-ATPase activity. Only rodents are known to have Na-K-ATPases that vastly differ in their ouabain affinities. In other species, the alpha 1 beta 1-isozyme is much more sensitive to the cardiotonic steroids, making the isoform differences in ouabain sensitivity less conspicuous. A detailed study of the ouabain binding constants for species other than rodents has not been accomplished. Nevertheless, more than one ouabain affinity site has been reported in non-rodent species (66, 67, 88, 90, 104, 131). In humans, both single as well as complex ouabain binding have been found in the heart (66, 67, 184), which is known to express the alpha 1-, alpha 2-, and alpha 3-isoforms of the Na pump (216). In the heart, the existence of multiple isoforms is undoubtedly important in mediating the action of the cardiotonic steroids. It is clear that cardiotonic steroids act through their ability to inhibit the Na-K-ATPase. This inhibition results in a transient increase in intracellular Na+, which induces through the Na/Ca exchange system an increase in intracellular Ca2+. The rise in internal Ca2+ is taken up by the SR via an SR Ca-ATPase. Because of the elevated Ca2+ content in the SR, more Ca2+ can be released when the cardiocyte is stimulated, leading to an augmented force of contraction and an increased cardiac output (37, 48, 118, 141, 145, 205). The relevance of the cardiotonic glycosides as Na-K-ATPase modulators is supported by the finding of endogenous, digitalis-like compounds in mammals (reviewed in Refs. 37, 38, 60, 61, 111, 168). An isomer of ouabain has been found to be produced in the bovine hypothalamus (93, 94, 220), and ouabain itself is present in the adrenal glands of several species including humans (37, 38, 86, 87). Thus endogenous ouabain may regulate cardiovascular tonicity by inhibiting a discrete number of Na-K-ATPase pumps to modulate cellular excitability and heart and vascular muscle contractility.

Studying the effect of Ca2+ on the activity of the different rat Na-K-ATPase isozymes expressed in Sf-9 cells, we found that the cation differentially affects the function of each isoform (34). As has been shown before, the alpha 1 beta 1-isozyme is quite resistant to Ca2+ (15). In contrast, the alpha 2 beta 1- and alpha 3 beta 1-isozymes display Ki values 10- and 100-fold lower than that of the alpha 1 beta 1, respectively (Table 1). Similarly, in rat axolemma, myometrium, and skeletal muscle, the Na-K-ATPase activity that has a high sensitivity to ouabain is inhibited by physiological concentrations of Ca2+ (142, 207). This suggests that in excitable cells after depolarization, when the intracellular Ca2+ concentration rises to 5-10 µM, the alpha 1 beta 1-isozyme remains active, while the alpha 2 beta 1- and alpha 3 beta 1-isozymes are functioning at approximately one-half of their maximal capability. This may be particularly relevant in the heart, where the rise in intracellular Ca2+ elicited by the cardiotonic steroids may be enhanced by further inhibition of the ouabain-sensitive alpha 2- and alpha 3-isoforms in a positive feedback mechanism. The differential affinity to Ca2+ also ensures that only a fraction of the total enzyme is inhibited, the same fraction that is sensitive to the cardiotonic steroids. Interestingly, in contrast to the alpha 1-isoform, alpha 2-isoform in astrocytes and alpha 3-isoform in neurons and myocytes exhibit a reticular distribution on the plasma membrane which parallels the underlying endoplasmic reticulum or SR (110). This distribution is identical to that of the Na/Ca exchanger. Thus, while alpha 1 is regulating bulk cytosolic Na+, alpha 2 and alpha 3 may adjust Na+ concentrations in the restricted cytosolic space between the plasma membrane and reticulum to indirectly control Ca2+ (110).

Regulation of Na-K-ATPase Isozymes

Regulation of the Na-K-ATPase activity occurs by different cellular mechanisms and can be achieved by modulation of the number of enzyme molecules present at the plasma membrane or by influencing the activity of the Na-K-ATPase already at the cell surface. For example, the amount of the enzyme at the plasma membrane can be modified by changes in the rate of synthesis or degradation of the individual Na pump polypeptides as well as by mobilization of Na pump molecules from the endosomal pools to the cell surface (reviewed in Refs. 68, 138). Alternatively, the activity of the Na pump at the cell surface can be directly regulated (26, 68, 138, 149), providing a rapid adjustment in Na pump function. Several effectors have been implicated in this acute response; the primary one is the intracellular Na+ concentration, which at steady state is rate limiting. Also, as mentioned before, endogenous ouabain and intracellular Ca2+ are potential short-term modulators of Na pump activity (34, 37, 212).

Recent evidence suggests that intracellular messengers can also affect Na-K-ATPase activity. Depending on the tissue, activation of protein kinases can induce an increase or decrease in Na pump activity (26, 54, 68, 138, 149, 172). Agents that increase cellular cAMP, as well as exogenous derivatives of cAMP, lead to Na-K-ATPase inhibition in the medullary thick ascending limb of the loop of Henle and the cortical collecting duct (18, 26, 96, 149, 172, 174) and to Na-K-ATPase stimulation in the proximal convoluted tubules (47, 74). This response seems to be mediated, at least in part, by protein kinase A (PKA)-directed phosphorylation of Ser943 of the Na pump alpha -subunit (77). Phosphorylation of the Na pump alpha -subunit is reversible, as demonstrated by the decrease in Na-K-ATPase activity after activation of a dopamine- and cAMP- regulated phosphoprotein (DARPP-32), an endogenous inhibitor of protein phosphatase 1 (PP1) (6). This suggests that a phosphorylation/dephosphorylation event may dynamically regulate the activity of the Na pump. Moreover, in the proximal nephron and in cultured canine kidney cells, the Na-K-ATPase is inhibited by phorbol esters or diacylglycerol analogs, in a process that involves protein kinase C (PKC) activation (79, 172, 183) and, possibly, the phosphorylation of the Na pump alpha -subunit at Ser16 (17). In addition, several other mechanisms have been postulated concerning the way by which protein kinases exert their effects on the Na pump. For example, in amphibian nephron cells, PKC produces Na-K-ATPase inhibition by increasing cell endocytosis and internalization of Na pump molecules (21), and in isolated nephron segments, PKA may stimulate phospholipase A2 (PLA2) and the production of arachidonic acid and its metabolites (173). Moreover, in the kidney another kinase, protein kinase G (PKG), and the production of cGMP appear to mediate the loss of salt and water produced by acetylcholine, bradykinin, and atrial natriuretic peptide (144, 175). In contrast, in the duck salt gland cGMP stimulates ouabain-sensitive p-nitrophenylphosphatase hydrolysis by the Na pump (192).

Although the effect of intracellular messengers on the function of the alpha 1 beta 1-isozyme has been well documented (26, 68, 138), the regulation of the other Na-K-ATPase isozymes by protein kinases is poorly understood. We studied the effect of different protein kinases on the rat Na-K-ATPase isoforms expressed in Sf-9 cells. Similar to mammalian cells, insect cells glycosylate, phosphorylate, acylate, and perform most other posttranslational modifications dictated by the primary amino acid sequence. In addition, they display a complex signal transduction machinery comparable to that of their mammalian counterparts (156). As shown in Fig. 3, activation of PKA, PKC, and PKG, using dibutyryl-cAMP, phorbol 12-myristate 13 acetate (PMA), or dibutyryl-cGMP, respectively, is able to differentially modify the function of the Na-K-ATPase isozymes. Specificity of the response is demonstrated by the reversibility of the effect by the respective protein kinase competitive inhibitors. As shown, PKC activation leads to inhibition of all isozymes, PKA activation stimulates the activity of the Na-K-ATPase alpha 3 beta 1 and decreases that of the