A Model of Na/H Exchanger and Its Central Role in Regulation of pH and Na in Cardiac Myocytes

A new kinetic model of the Na⁺/H⁺ exchanger (NHE) was developed by fitting a variety of major experimental findings, such as ion-dependencies, forward/reverse mode, and the turnover rate. The role of NHE in ion homeostasis was examined by implementing the NHE model in a minimum cell model including intracellular pH buffer, Na⁺/K⁺ pump, background H⁺, and Na⁺ fluxes. This minimum cell model was validated by reconstructing recovery of pH_i from acidification, accompanying transient increase in Na⁺]_i due to NHE activity. Based on this cell model, steady-state relationships among pH_i, Na⁺]_I, and Ca²⁺]_i were quantitatively determined, and thereby the critical level of acidosis for cell survival was predicted. The acidification reported during partial blockade of the Na⁺/K⁺ pump was not attributed to a dissipation of the Na⁺ gradient across the membrane, but to an increase in indirect H⁺ production. This NHE model, though not adapted to the dimeric behavioral aspects of NHE, can provide a strong clue to quantitative prediction of degree of acidification and accompanying disturbance of ion homeostasis under various pathophysiological conditions.