Mao, Weike, Chikao Iwai, Fuzhong Qin, and Chang-seng Liang. Norepinephrine induces endoplasmic reticulum stress and downregulation of norepinephrine transporter density in PC12 cells via oxidative stress. Am J Physiol Heart Circ Physiol 288: H2381-H2389, 2005. First published December 30, 2004; doi:10.1152/ajpheart.00904.2004.-Cardiac norepinephrine (NE) uptake is reduced in cardiomyopathy. This change is associated with a decrease of NE transporter (NET) receptor and can be reproduced in PC12 cells by extracellular NE. To study whether this effect of NE is mediated via impaired glycosylation and trafficking of NET in the endoplasmic reticulum (ER), we measured the distribution of glycosylated 80-kDa NET and unglycosylated 46-kDa NET in the membrane and cytosolic fractions of PC12 cells. We found that NE decreased glycosylated NET in both membrane and cytosolic fractions and increased cytosolic unglycosylated NET protein. Similar results were produced by tunicamycin and thapsigargin, two agents that induce ER stress by inhibiting N-glycosylation of membrane proteins and disrupting calcium homeostasis, respectively. Also, like the ER stressors, NE not only increased phosphorylation of both the ␣-subunit of eukaryotic initiation factor-2 and its upstream RNA-dependent protein kinase-like ER kinase over 12 h of treatment but also increased ER chaperone molecule glucose-regulated protein 78 and the nuclear transcription factor C/EBP homologous protein.Antioxidants superoxide dismutase and catalase prevented the downregulation of NET proteins and induction of ER stress signals produced by NE but not by tunicamycin or thapsigargin. The results indicate that the downregulation of membrane NET by NE is mediated by decreased N-glycosylation of NET proteins secondary to induction of ER stress pathways by NE-derived oxidative metabolites. Interventions involving the ER stress pathways may provide novel therapeutic strategies for the treatment of sympathetic dysfunction in heart failure. norepinephrine uptake; superoxide dismutase; glucose-regulated protein 78; eukaryotic initiation factor-2 ␣-subunit; protein-like endoplasmic reticulum kinase NOREPINEPHRINE (NE) transporter (NET), a member of the gene family of Na ϩ /Cl Ϫ -dependent plasma membrane transporters, possesses 12 putative transmembrane domains, multiple Nlinked glycosylation sites, cytoplasmic NH 2 and COOH termini, and cytoplasmic phosphorylation sites (1,5). It is present in the noradrenergic cell type of the brain, peripheral sympathetic nerve terminals, and some cell types outside of the nervous system such as PC12 cells (26,32), with a primary function to remove NE from the synaptic space and quickly terminate the actions of extracellular NE on postsynaptic receptors (8). Dysfunction of NET in cardiac sympathetic nerve terminals has been demonstrated in hypertension and congestive heart failure and plays a role in the pathophysiology of heart failure (15, 24, 28). More recently, we have shown (29, 33) that decreases of NET density and NE uptake activity in...