THE Na+/Ca2+ exchanger, driven by a transmembrane Na+ gradient, plays
a key role in regulating Ca2+ concentration in many cells1,2. Although
the exchanger influences Ca2+ concentration, its activity in smooth m
uscle appears to be closely coupled to Ca2+ availability from intracel
lular stores3. This linkage might result if the exchanger were positio
ned close to Ca2+ storage sites within the sarcoplasmic reticulum. To
test this hypothesis we have developed methods to assess the relative
three-dimensional distribution of proteins involved in Na+/K+ pumping,
Na+/Ca2+ exchange, Ca2+ storage within the sarcoplasmic reticulum, an
d attachment of contractile filaments to the membrane in smooth muscle
. Here we report that the Na+/Ca2+ exchanger is largely co-distributed
with the Na+/K+ pump on unique regions, of the plasma membrane in reg
ister with, and close to, calsequestrin-containing regions of the sarc
oplasmic reticulum in sites distinct from the sites where contractile
filaments attach to the membrane. This molecular organization suggests
that the plasma membrane is divided into at least two functional doma
ins, and appear to provide a mechanism for the strong linkage seen in
smooth muscle between Na+/K+ pumping and Na+/Ca2+ exchange, and betwee
n Na+/Ca2+ exchange and Ca2+ release from the sarcoplasmic reticulum4-
7.