Species-specific peculiarities of functional reactions of the sodium pump to phosphorylation by protein kinase A

The Na⁺,K⁺-ATPase isolated from shark rectal gland or pig kidney was inserted into liposomes and phosphorylated with cAMP-dependent protein kinase without detergent. Stoichiometry of phosphorylation of α-subunit of the enzyme was 0.9 and 0.2 mol P_i/mol α-subunit of the pig kidney and shark gland, respectively. The phosphorylation of the shark Na⁺,K⁺-ATPase led to an increase in maximum of hydrolytic activity dependent on the cytoplasmic sodium concentration and the extracellular activation with potassium ions. On the contrary, the phosphorylation of the sodium pump of the pig kidney did not produce any significant functional effect.     

Dual Mechanisms of Allosteric Acceleration of the Na,K-ATPase by ATP

Investigations of the E2 → E1 conformational change of Na⁺,K⁺-ATPase from shark rectal gland and pig kidney via the stopped-flow technique have revealed major differences in the kinetics and mechanisms of the two enzymes. Mammalian kidney Na⁺,K⁺-ATPase appears to exist in a diprotomeric (αβ)₂ state in the absence of ATP, with protein-protein interactions between the α-subunits causing an inhibition of the transition, which occurs as a two-step process: E2:E2 → E2:E1 → E1:E1. This is evidenced by a biphasicity in the observed kinetics. Binding of ATP to the E1 or E2 states causes the kinetics to become monophasic and accelerate, which can be explained by an ATP-induced dissociation of the diprotomer into separate αβ protomers and relief of the preexisting inhibition. In the case of enzyme from shark rectal gland, the observed kinetics are monophasic at all ATP concentrations, indicating a monoprotomeric enzyme; however, an acceleration of the E2 → E1 transition by ATP still occurs, to a maximum rate constant of 182 (± 6) s⁻¹. This indicates that ATP has two separate mechanisms whereby it accelerates the E2 → E1 transition of Na⁺,K⁺-ATPase αβ protomers and (αβ)₂ diprotomers.     

Regulation of Human and Pig Renal Na+,K+-ATPase Activity by Tyrosine Phosphorylation of Their α1-Subunits

Modulation of the physiologically influential Na⁺,K⁺-ATPase is a complex process involving a wide variety of factors. To determine the possible effects of the protein tyrosine phosphatase (PTP) inhibitors dephostatin and Et-3,4-dephostatin on human and pig, renal cells and enzymatic extracts, we treated our samples (15 min–24 h) with those PTP inhibitors (0–100 μM). PTP inhibitors were found to possess a concentration-dependent inhibition of Na⁺,K⁺-ATPase activity in both human and pig samples. The inhibition was similarly demonstrated on all cellular, microsomal fraction and purified Na⁺,K⁺-ATPase levels. Despite rigorous activity recovery attempts, the PTP inhibitors’ effects were sustained on Na⁺,K⁺-ATPase activity. Western blotting experiments revealed the expression of both α₁- and β₁-subunits in both human and pig tissues. α₁-Subunits possessed higher tyrosine phosphorylation levels with higher concentrations of PTP inhibitors. Meanwhile, serine/threonine residues of both α₁- and β₁-subunits demonstrated diminished phosphorylation levels upon dephostatin treatment. Accordingly, we provide evidence that Na⁺,K⁺-ATPase can be regulated through tyrosine phosphorylation of primarily their α₁-subunits, using PTP inhibitors.     

Kinetics of K(+) occlusion by the phosphoenzyme of the Na(+),K(+)-ATPase

Investigations of K⁺-occlusion by the phosphoenzyme of Na⁺,K⁺-ATPase from shark rectal gland and pig kidney by stopped-flow fluorimetry reveal major differences in the kinetics of the two enzymes. In the case of the pig enzyme, a single K⁺-occlusion step could be resolved with a rate constant of 342 (±26) s⁻¹. However, in the case of the shark enzyme, two consecutive K⁺-occlusions were detected with rate constants of 391 (±19) s⁻¹ and 48 (±2) s⁻¹ at 24°C and pH 7.4. A conformational change of the phosphoenzyme associated with K⁺-occlusion is, thus, the major rate-determining step of the shark enzyme under saturating concentrations of all substrates, whereas for the pig enzyme the major rate-determining step under the same conditions is the E2 → E1 transition and its associated K⁺ deocclusion and release to the cytoplasm. The differences in rate constants of the K⁺ occlusion reactions of the two enzymes are paralleled by compensating changes to the rate constant for the E2 → E1 transition, which explains why the differences in the enzymes' kinetic behaviors have not previously been identified.     

Sulfatide content and (Na++K+)-ATPase activity of skin and gill during larval development of the chilean frog,Calyptocephalella caudiverbera

Summary The sulfatide content, phospholipid concentration, and (Na⁺+K⁺)-ATPase activity from skin and gills of different stages of larval development ofCalyptocephalella caudiverbera (a Chilean frog) were analyzed. Additionally, the short-circuit current in skin was studied. When skin and gills, depending on the stage of larval development, present (Na⁺+K⁺)-ATPase activity, they have a high ratio of sulfatide to amount of membrane and the phosphatidylserine concentration remains unchanged. Sulfatide content and (Na⁺+K⁺)-ATPase activity in skin are in direct relationship with the level of sodium flux present during development. The specific enzymatic hydrolysis of sulfatide with partially purified arylsulfatase of pig kidney inhibits 100% of the ouabain-sensitive (Na⁺+K⁺)-ATPase. The ouabain-insensitive ATPase remains virtually unchanged with the treatment, even with a high concentration of arylsulfatase or with ouabain present in the medium. These experiments strongly suggest a role of sulfatides in the (Na⁺+K⁺)-ATPase activity and, as a consequence, in sodium ion transport.     

Role of Na<Superscript>+</Superscript>/K<Superscript>+</Superscript>-ATPase in natriuretic effect of prolactin in a model of cholestasis of pregnancy

Participation of Na⁺/K⁺-ATPase in the natriuretic effect of prolactin in a cholestasis of pregnancy model was investigated. The Na⁺/K⁺-ATPase activity in rat kidney medulla, where active sodium reabsorption occurs, decreased in the model of cholestasis of pregnancy and other hyperprolactinemia types compared with intact animals. This effect was not connected with the protein level of α1- and β-subunits of Na⁺/K⁺-ATPase measured by Western blotting in the kidney medulla. Decrease in Na⁺/K⁺-ATPase activity in the kidney cortex was not significant, as well as decrease in the quantity of mRNA and proteins of the α1- and β-subunits of Na⁺/K⁺-ATPase. There were no correlations between the Na⁺/K⁺-ATPase activity and sodium clearance, although sodium clearance increased significantly in the model of cholestasis of pregnancy and other hyperprolactinemia groups under conditions of stable glomerular filtration rate measured by creatinine clearance. We conclude that the Na⁺/K⁺-ATPase is not the only mediator of the natriuretic effect of prolactin in the model of cholesta- sis of pregnancy.     

(Na (+) + K (+)-stimulated ATPase of human kidney, normal and adenocarcinoma. Phosphorylation and inhibition by antitumor proteins

(Na⁺+K⁺)-ATPase was purified from human kidney of normal and tumor tissue with specific activities of 100.0 and 16.6 μmol Pi/mg/h, respectively. The antitumor proteins, macromomycin, largomycin, and NSC 327459 (50 μg/ml each) caused 70 to 90% inhibition of (Na⁺+K⁺)-ATPase from tumor tissue, whereas auromomycin had no effect. (Na⁺+K⁺)-ATPase from both sources could be phosphorylated by rabbit muscle protein kinase; there was 3 to 6-fold stimulation of phosphorylation by cyclic AMP. Phosphorylation resulted in 70 to 80% decrease in (Na⁺+K⁺)-ATPase activity, and caused the normal enzyme to become sensitive to inhibition by macromomycin.     

Inhibition of K+ Transport through Na+, K+-ATPase by Capsazepine: Role of Membrane Span 10 of the α-Subunit in the Modulation of Ion Gating

Capsazepine (CPZ) inhibits Na⁺,K⁺-ATPase-mediated K⁺-dependent ATP hydrolysis with no effect on Na⁺-ATPase activity. In this study we have investigated the functional effects of CPZ on Na⁺,K⁺-ATPase in intact cells. We have also used well established biochemical and biophysical techniques to understand how CPZ modifies the catalytic subunit of Na⁺,K⁺-ATPase. In isolated rat cardiomyocytes, CPZ abolished Na⁺,K⁺-ATPase current in the presence of extracellular K⁺. In contrast, CPZ stimulated pump current in the absence of extracellular K⁺. Similar conclusions were attained using HEK293 cells loaded with the Na⁺ sensitive dye Asante NaTRIUM green. Proteolytic cleavage of pig kidney Na⁺,K⁺-ATPase indicated that CPZ stabilizes ion interaction with the K⁺ sites. The distal part of membrane span 10 (M10) of the α-subunit was exposed to trypsin cleavage in the presence of guanidinum ions, which function as Na⁺ congener at the Na⁺ specific site. This effect of guanidinium was amplified by treatment with CPZ. Fluorescence of the membrane potential sensitive dye, oxonol VI, was measured following addition of substrates to reconstituted inside-out Na⁺,K⁺-ATPase. CPZ increased oxonol VI fluorescence in the absence of K⁺, reflecting increased Na⁺ efflux through the pump. Surprisingly, CPZ induced an ATP-independent increase in fluorescence in the presence of high extravesicular K⁺, likely indicating opening of an intracellular pathway selective for K⁺. As revealed by the recent crystal structure of the E₁.AlF₄ ^-.ADP.3Na⁺ form of the pig kidney Na⁺,K⁺-ATPase, movements of M5 of the α-subunit, which regulate ion selectivity, are controlled by the C-terminal tail that extends from M10. We propose that movements of M10 and its cytoplasmic extension is affected by CPZ, thereby regulating ion selectivity and transport through the K⁺ sites in Na⁺,K⁺-ATPase.     

Regulation of Na,K-ATPase Transport Activity by Protein Kinase C

Considerable evidence indicates that the renal Na⁺,K⁺-ATPase is regulated through phosphorylation/dephosphorylation reactions by kinases and phosphatases stimulated by hormones and second messengers. Recently, it has been reported that amino acids close to the NH₂-terminal end of the Na⁺,K⁺-ATPase α-subunit are phosphorylated by protein kinase C (PKC) without apparent effect of this phosphorylation on Na⁺,K⁺-ATPase activity. To determine whether the α-subunit NH₂-terminus is involved in the regulation of Na⁺,K⁺-ATPase activity by PKC, we have expressed the wild-type rodent Na⁺,K⁺-ATPase α-subunit and a mutant of this protein that lacks the first thirty-one amino acids at the NH₂-terminal end in opossum kidney (OK) cells. Transfected cells expressed the ouabain-resistant phenotype characteristic of rodent kidney cells. The presence of the α-subunit NH₂-terminal segment was not necessary to express the maximal Na⁺,K⁺-ATPase activity in cell membranes, and the sensitivity to ouabain and level of ouabain-sensitive Rb⁺-transport in intact cells were the same in cells transfected with the wild-type rodent α1 and the NH₂-deletion mutant cDNAs. Activation of PKC by phorbol 12-myristate 13-acetate increased the Na⁺,K⁺-ATPase mediated Rb⁺-uptake and reduced the intracellular Na⁺ concentration of cells transfected with wild-type α1 cDNA. In contrast, these effects were not observed in cells expressing the NH₂-deletion mutant of the α-subunit. Treatment with phorbol ester appears to affect specifically the Na⁺,K⁺-ATPase activity and no evidence was observed that other proteins involved in Na⁺-transport were affected. These results indicate that amino acid(s) located at the α-subunit NH₂-terminus participate in the regulation of the Na⁺,K⁺-ATPase activity by PKC. Received: 10 July 1996/Revised: 19 September 1996     

Studies of (Na+ + K+)-sensitive ATPase activity in pig lymphocytes. Effects of concanavalin A

(Na⁺ + K⁺)-ATPase activity is demonstrated in plasma membranes from pig mesenteric lymph nodes. After dodecyl sulfate treatment plasma membranes have an 18-fold higher (Na⁺ + K⁺)-ATPase activity, while their ouabain-insensitive Mg²⁺-ATPase is markedly lowered. A solubilized (Na⁺ + K⁺)-ATPase fraction, obtained by Lubrol WX treatment of the membranes, has very high specific activity (21μmol P_i/h per mg protein). Concanavalin A has no effect on these partially purified (Na⁺ + K⁺)-ATPase, while it inhibits (40%) this activity in less purified fractions which still contain Mg²⁺-ATPase activity.     

Partial purification and characterization of (Na++K+)-ATPase from garfish olfactory nerve axon plasma membrane

Summary The (Na⁺+K⁺)-ATPase of garfish olfactory nerve axon plasma membrane was purified about sixfold by treatment of the membrane with sodium dodecyl sulfate followed by sucrose density gradient centrifugation. The estimated molecular weights of the two major polypeptide components of the enzyme preparation on sodium dodecyl sulfate gels were 110,000 and 42,000 daltons, which were different from those of the corresponding peptides of rabbit kidney (Na⁺+K⁺)-ATPase. No carbohydrate was detected in the 42,000-dalton component either by the periodic acid-Schiff reagent or by the more sensitive concanavalin A-peroxidase staining procedure. The molecular properties of the garfish (Na⁺+K⁺)-ATPase, such as theK _m for ATP, pH optimum, energies of activation, Na and K ion dependence and vanadium inhibition, were, however, similar to those of the kidney enzyme.The partially purified garfish (Na⁺+K⁺)-ATPase was reconstituted into phospholipid vesicles by a freeze-thaw-sonication procedure. The reconstituted enzyme was found to catalyze a time and ATP dependent²²Na⁺ transport. The ratio of²²Na⁺ pumped to ATP hydrolyzed was about 1; under the same reconstitution and assay conditions, eel electroplax (Na⁺+K⁺)-ATPase, however, gave a²²Na⁺ pumped to ATP hydrolyzed ratio of nearly 3.     

Death of ouabain-treated renal epithelial cells: evidence for p38 MAPK-mediated Na i + /K i + -independent signaling

Recent studies demonstrate that cytotoxic actions of ouabain and other cardiotonic steroids (CTS) on renal epithelial cells (REC) are triggered by their interaction with the Na⁺,K⁺-ATPase α-subunit but not the result of inhibition of Na⁺,K⁺-ATPase-mediated ion fluxes and inversion of the [Na⁺]_i/[K⁺]_i ratio. This study examined the role of mitogen-activated protein kinases (MAPK) in the death of ouabain-treated REC. Exposure of C7-MDCK cells that resembled principal cells from canine kidney to 3 μM ouabain led to phosphorylation of p38 without significant impact on phosphorylation of ERK and JNK MAPK. Maximal increment of p38 phosphorylation was observed at 4 h followed by cell death at 12 h of ouabain addition. In contrast to ouabain, neither cell death nor p38 MAPK phosphorylation were affected by elevation of the [Na⁺]_i/[K⁺]_i ratio triggered by Na⁺,K⁺-ATPase inhibition in K⁺-free medium. p38 phosphorylation was noted in all other cell types exhibiting death in the presence of ouabain, such as intercalated cells from canine kidney and human colon rectal carcinoma cells. We did not observe any action of ouabain on p38 phosphorylation in ouabain-resistant smooth muscle cells from rat aorta and endothelial cells from human umbilical vein. Both p38 phosphorylation and death of ouabain-treated C7-MDCK cells were suppressed by p38 inhibitor SB 202190 but were resistant to its inactive analogue SB 202474. Our results demonstrate that death of CTS-treated REC is triggered by Na_i⁺,K_i⁺—independent activation of p38 MAPK.     

Radiation inactivation of (Na+ + K+)-ATPase a small target size for the K+-occluding mechanism

Radiation inactivation of partially purified (Na⁺ + K⁺)-ATPase (ATP phosphohydrolase, EC 3.6.1.3) from pig kidney outer medulla shows that the target size for Rb⁺ occlusion by the enzyme (in the absence of phosphorylation) is much smaller than the target size for $\text{p-}\text{nitrophenyl phosphatase activity}$, which is itself smaller than the reported target size for (Na⁺ + K⁺)-ATPase activity.     

Lack of stimulation of renal (Na+ + K+)-ATPase by thyroid hormones in the rabbit

The effect of l-3,5,3′-triiodothyronine (T₃) and thyroxine (T₄) on (Na⁺ + K⁺)-ATPase activities was examined in rabbit kidneys because in this tissue almost 80% of the metabolism is connected to active sodium transport. T₃-receptor concentrations were estimated as 0.62 and 0.80 pmol/mg per DNA in the cortex and outer medulla, respectively. A dose of 0.5 mg T₃/kg body weight for 3 days increased basal metabolic rate by almost 60%, and the mitochondrial 1-α-glycerophosphate dehydrogenase activity was increased by 50% in both the cortex and medulla. (Na⁺ + K⁺)-ATPase activity in the liver was raised by almost 50%. However, no changes in (Na⁺ + K⁺)-ATPase activities or binding sites for [³H]ouabain in either the kidney cortex or medulla could be observed. T₄ at 16 mg/kg daily for 14 days was also without effect on renal (Na⁺ + K⁺)-ATPase activities. Furthermore, the response to T₃ was absent at high sodium excretion rates induced by unilateral nephrectomy and extracellular volume expansion. Thus, despite stimulation of basal metabolic rate and renal 1-α-glycerophosphate dehydrogenase activity by T₃ and T₄, the (Na⁺ + K⁺)-ATPase activity in the rabbit kidney is identical in euthyroid and hyperthyroid states. However, thyroid hormones prevent the normal natriuretic response to extracellular volume expansion.     

Estimation of ouabian specifically bound to dog renal (Na+ + K+)-ATPase in vivo

It is not known whether ouabain injected into the kidney in vivo is bound exclusively to the (Na⁺ + K⁺)-ATPase and whether the reduction of sodium pumping capacity is large enough to account for the reduction in sodium reabsorption. In the present study on dogs the total amount of parenchymal ouabain was therefore estimated and the specific renal binding compared to the reduction in (Na⁺ + K⁺)-ATPase activity. Ouabain, 120 nmol/kg body weight, was injected into the renal artery in vivo reducing the (Na⁺ + K⁺)-ATPase activity by 3lmost 80%. After nephrectomy, tissue ouabain could be quantified by radioimmunoassay after heating the homogenate to 70°C for 30 min; negligible amounts were detectable without heating. No correlation between ouabain binding and tissue volume, protein content, DNA content or Mg²⁺-ATPase content could be found when comparing the following four fractions of the kidney: outer cortex, inner cortex, outer medulla and papilla. For the whole kidney, mean parenchymal tissue concentration of ouabain equalled 0.58 ± 0.03 μmol/100 g wet tissue. Only 21.3 ± 1.2% of the ouabain was confined to the outer medulla corresponding to 54 ± 4 nmol giving a tissue concentration of 1.08 ± 0.05 μmol/100 g wet tissue. The renal ouabain concentrations were highly correlated to the reduction in (Na⁺ + K⁺)-ATPase activity, giving a ratio between the reduction in hydrolysis rate and bound ouabain (turnover number) of 6105 min^?1 which is close to the value of 7180 min^?1 found by in vitro Scatchard analysis. No ouabain seems to be bound to other tissue components than the (Na⁺ + K⁺)-ATPase and the present method is therefore a simple way of measuring the number of inhibited (Na⁺ + K⁺)-ATPase molecules after in vivo injection of ouabain.     

Purification and characterization of an (Na++K+)-ATPase proteolipid labeled with a photoaffinity derivative of ouabain

Highly purified lamb kidney (Na⁺+K⁺)-ATPase was photoaffinity labeled with the tritiated 2-nitro-5-azidobenzoyl derivative of ouabain (NAB-ouabain). The labeled (Na⁺+K⁺)-ATPase was mixed with unlabeled carrier enzyme. Two proteolipid (γ1 and γ2) fractions were then isolated by chromatography on columns of Sepharose CL-6B and Sephadex LH-60. The two fractions were interchangeable when rechromatographed on the LH-60 column, suggesting that γ1 is an aggregated form of γ2. The total yield was 0.8–1.5 mol of γ component per mol of catalytic subunit recovered. This indicates that the γ component is present in stoichiometric amounts in the (Na⁺+K⁺)-ATPase. The proteolipids that were labeled with NAB-ouabain copurified with the unlabeled proteolipids.     

Gel electrophoretic identity of the (Na+ + Mg2+)- and (Na+ + Ca2+)-stimulated phosphorylations of rat brain ATPase

The classical E₂-P intermediate of (Na⁺ + K⁺)-ATPase dephosphorylates readily in the presence of K⁺ and is not affected by the addition of ADP. To determine the significane in the reaction cycle of (Na⁺ + K⁺)-ATPase of kinetically atypical phosphorylations of rat brain (Na⁺ + K⁺)-ATPase we compared these phosphorylated components with the classical E₂-P intermediate of this enzyme by gel electrophoresis. When rat brain (Na⁺ + K⁺)-ATPase was phosphorylated in the presence of high concentrations of Na⁺ a proportion of the phosphorylated material formed was sensitive to ADP but resistant to K⁺. Similarly, if phosphorylation was carried out in the presence of Na⁺ and Ca²⁺ up to 300 pmol/mg protein of a K⁺-resistant, ADP-sensitive material were formed. If phosphorylation was from [γ-³²P]CTP up to 800 pmol ³²P/mg protein of an ADP-resistant, K⁺-sensitive phosphorylated matterial were formed. On gel electrophoresis these phosphorylated materials co-migrated with authentic Na⁺-stimulated, K⁺-sensitive, E₂-P-phosphorylated intermediate of (Na⁺ + K⁺)-ATPase, supporting suggestions that they represent phosphorylated intermediates in the reaction sequence of this enzyme.     

Antibodies to pig kidney (Na++K+)-ATPase inhibit the Na+ pump in human red cells provided they have access to the inner surface of the cell membrane

Antisera from rabbits that had been immunized with a highly active membrane preparation of (Na⁺ + K⁺)-ATPase from the outer medulla of pig kidney strongly inhibited (Na⁺ + K⁺)-ATPase activity in various tissues. When the antiserum was incorporated into released human red cell ghosts, the ouabain-sensitive efflux of Na⁺ into both 15 mM K⁺ and K⁺-free high Na⁺ media was completely abolished. This effect was not observed when non-immune serum was used, or when the immune serum was allowed access only to the outer surface of the red cell membranes.     

Ligand-Dependent Effects on the Conformational Equilibrium of the Na,K-ATPase As Monitored by Voltage Clamp Fluorometry

Voltage clamp fluorometry was used to monitor conformational changes associated with electrogenic partial reactions of the Na⁺,K⁺-ATPase after changes in the concentration of internal sodium (Na⁺_i) or external potassium (K⁺_o). To probe the effects of the Na⁺_i concentration on the Na⁺ branch of the Na⁺,K⁺-ATPase, oocytes were depleted of Na⁺_i and then loaded with external sodium (Na⁺_o) using the amiloride-sensitive epithelial sodium channel. The K⁺ branch of the Na⁺,K⁺-ATPase was studied by exposing the oocytes to different K⁺_o concentrations in the presence and absence of Na⁺_o to obtain additional information on the apparent affinity for K⁺_o. Our results demonstrate that lowering the concentration of Na⁺_i or increasing the amount of K⁺_o in the external solution shifts the equilibrium toward E₁/E₁P. Furthermore, the K⁺_o-induced relocation toward E₁ occurs at a much lower K⁺_o concentration when Na⁺_o is absent, indicating a higher apparent affinity. Finally, voltage-dependent steps associated with the K⁺ branch or the Na⁺ branch of the Na⁺,K⁺-ATPase are affected by the K⁺_o concentration or the Na⁺_i concentration, respectively.     

Kinetic studies on the (Na+ + K+)-dependent ATPase. Evidence for coexisting sites for Na+, K+ and Mg2+

Na⁺-ATPase activity of a dog kidney (Na⁺ + K⁺)-ATPase enzyme preparation was inhibited by a high concentration of NaCl (100 mM) in the presence of 30 μM ATP and 50 μM MgCl₂, but stimulated by 100 mM NaCl in the presence of 30 μM ATP and 3 mM MgCl₂. The $\text{K}{}_{0.5}$ for the effect of MgCl₂ was near 0.5 mM. Treatment of the enzyme with the organic mercurial thimerosal had little effect on Na⁺-ATPase activity with 10 mM NaCl but lessened inhibition by 100 mM NaCl in the presence of 50 μM MgCl₂. Similar thimerosal treatment reduced (Na⁺ + K⁺)-ATPase activity by half but did not appreciably affect the $\text{K}{}_{0.5}$ for activation by either Na⁺ or K⁺, although it reduced inhibition by high Na⁺ concentrations. These data are interpreted in terms of two classes of extracellularly-available low-affinity sites for Na⁺: Na⁺-discharge sites at which Na⁺-binding can drive E₂-P back to E₁-P, thereby inhibiting Na⁺-ATPase activity, and sites activating E₂-P hydrolysis and thereby stimulating Na⁺-ATPase activity, corresponding to the K⁺-acceptance sites. Since these two classes of sites cannot be identical, the data favor co-existing Na⁺-discharge and K⁺-acceptance sites. Mg²⁺ may stimulate Na⁺-ATPase activity by favoring E₂-P over E₁-P, through occupying intracellular sites distinct from the phosphorylation site or Na⁺-acceptance sites, perhaps at a coexisting low-affinity substrate site. Among other effects, thimerosal treatment appears to stimulate the Na⁺-ATPase reaction and lessen Na⁺-inhibition of the (Na⁺ + K⁺)-ATPase reaction by increasing the efficacy of Na⁺ in activating E₂-P hydrolysis.