Sodium-calcium exchangers have long been considered inert with respect to monovalent cations such as lithium, choline, and N-methyl-D-glucamine. A key question that has remained unsolved is how despite this, Li ؉ catalyzes calcium exchange in mammalian tissues. Here we report that a Na ؉ /Ca 2؉ exchanger, NCLX cloned from human cells (known as FLJ22233), is distinct from both known forms of the exchanger, NCX and NCKX in structure and kinetics. Surprisingly, NCLX catalyzes active Li ؉ /Ca 2؉ exchange, thereby explaining the exchange of these ions in mammalian tissues. The NCLX protein, detected as both 70-and 55-KDa polypeptides, is highly expressed in rat pancreas, skeletal muscle, and stomach. We demonstrate, moreover, that NCLX is a K ؉ -independent exchanger that catalyzes Ca 2؉ flux at a rate comparable with NCX1 but without promoting Na ؉ /Ba 2؉ exchange. The activity of NCLX is strongly inhibited by zinc, although it does not transport this cation. NCLX activity is only partially inhibited by the NCX inhibitor, KB-R7943. Our results provide a cogent explanation for a fundamental question. How can Li ؉ promote Ca 2؉ exchange whereas the known exchangers are inert to Li ؉ ions? Identification of this novel member of the Na ؉ / Ca 2؉ superfamily, with distinct characteristics, including the ability to transport Li ؉ , may provide an explanation for this phenomenon.Plasma membrane Na ϩ /Ca 2ϩ exchange is an important element in cellular Ca 2ϩ homeostasis. It has been extensively investigated in mammals, especially in cardiac and neuronal tissues (1), where this mechanism is essential for regulation of Ca 2ϩ homeostasis. Na ϩ /Ca 2ϩ exchange also plays a key role in many other organs and tissues by modulating the intracellular Ca 2ϩ response (2). The Na ϩ /Ca 2ϩ exchangers described to date are members of four major families (1). Of these, only NCX1-3 and NCKX1-4 are found in mammalian cells, whereas the other two are expressed in plants, yeast, and bacteria.The stoichiometry of NCX exchangers is based on 3-4Na ϩ / 1Ca 2ϩ , and the protein is structurally organized as nine transmembrane helixes divided by a large cytoplasmic loop (3). NCKX family proteins have a stoichiometry of 4Na/1Ca/1K, and their topology is thought to consist of two sets of five membrane helixes divided by a cytoplasmic loop and NH 2 -terminal extracellular domain (4). The two families share several important functional and structural motifs: a structural hallmark of the Na ϩ /Ca 2ϩ exchanger superfamily is the presence of two regions of sequence similarity, called ␣1 and ␣2, which are considered necessary and sufficient for generating exchange activity (1, 5). Functionally, these exchangers are considered catalytically inert to inorganic and organic monovalent cations such as Li ϩ , NMG ϩ , 1 and choline ϩ , which are often used in "sodium-free" solutions to reverse Na ϩ /Ca 2ϩ exchange activity (2).Although Li ϩ ions are not transported by either NCX or NCKX, numerous physiological studies have reported a significant effect of this ion ...