Linde CI, Antos LK, Golovina VA, Blaustein MP. Nanomolar ouabain increases NCX1 expression and enhances Ca 2ϩ signaling in human arterial myocytes: a mechanism that links salt to increased vascular resistance? Am J Physiol Heart Circ Physiol 303: H784 -H794, 2012. First published July 27, 2012; doi:10.1152/ajpheart.00399.2012.-The mechanisms by which NaCl raises blood pressure (BP) in hypertension are unresolved, but much evidence indicates that endogenous ouabain is involved. In rodents, arterial smooth muscle cell (ASMC) Na ϩ pumps with an ␣2-catalytic subunit (ouabain EC50 Յ1.0 nM) are crucial for some hypertension models, even though Ϸ80% of ASMC Na ϩ pumps have an ␣1-subunit (ouabain EC50 Ϸ 5 M). Human ␣1-Na ϩ pumps, however, have high ouabain affinity (EC50 Ϸ 10 -20 nM). We used immunoblotting, immunocytochemistry, and Ca 2ϩ imaging (fura-2) to examine the expression, distribution, and function of Na ϩ pump ␣-subunit isoforms in human arteries and primary cultured human ASMCs (hASMCs). hASMCs express ␣1-and ␣2-Na ϩ pumps. Further, ␣2-, but not ␣1-, pumps are confined to plasma membrane microdomains adjacent to sarcoplasmic reticulum (SR), where they colocalize with Na/Ca exchanger-1 (NCX1) and C-type transient receptor potential-6 (receptor-operated channels, ROCs). Prolonged inhibition (72 h) with 100 nM ouabain (blocks nearly all ␣1-and ␣2-pumps) was toxic to most cultured hASMCs. Treatment with 10 nM ouabain (72 h), however, increased NCX1 and sarco(endo)plasmic reticulum Ca 2ϩ -ATPase expression and augmented ATP (10 M)-induced SR Ca 2ϩ release in 0 Ca 2ϩ , ouabain-free media, and Ca 2ϩ influx after external Ca 2ϩ restoration. The latter was likely mediated primarily by ROCs and store-operated Ca 2ϩ channels. These hASMC protein expression and Ca 2ϩ signaling changes are comparable with previous observations on myocytes isolated from arteries of many rat hypertension models. We conclude that the same structurally and functionally coupled mechanisms (␣2-Na ϩ pumps, NCX1, ROCs, and the SR) regulate Ca 2ϩ homeostasis and signaling in hASMCs and rodent ASMCs. These ouabain/endogenous ouabainmodulated mechanisms underlie the whole body autoregulation associated with increased vascular resistance and elevation of BP in human, salt-sensitive hypertension. human artery; ␣ 2-Na ϩ pumps; ouabain; Na/Ca exchanger-1; sarco-(endo)plasmic reticulum Ca 2ϩ -ATPase; receptor-operated channels THE ROLE OF SALT IN THE PATHOGENESIS of human essential hypertension is widely accepted, but the specific mechanisms by which salt elevates blood pressure (BP) are still poorly understood (28). Numerous studies link hypertension in rodents to elevated plasma endogenous ouabain (EO), an adrenocortical hormone (6, 24, 30), and to Na ϩ pumps with high affinity for ouabain (12,38,61). Increased expression and function of arterial myocyte Na/Ca exchanger-1 (NCX1) and cation channels with C-type transient receptor potential (TRPC) subunits are also involved (7,17,25,34,49,66). We have speculated that similar mechanisms are involved in h...