Ouabain and other cardiotonic steroids (CTS) inhibit Na+ pumps and are wide
ly believed to exert their cardiovascular effects by raising the cytosolic
Na+ concentration ([Na+](cyt)) and Ca2+. This view has not been rigorously
reexamined despite evidence that low-dose CTS may act without elevating [Na
+](cyt); also, it does not explain the presence of multiple, functionally d
istinct isoforms of the Na+ pump in many cells. We investigated the effects
of Na+ pump inhibition on [Na+](cyt) (with Na+ binding benzofuran isophtha
late) and Ca2+ transients (with fura 2) in primary cultured arterial myocyt
es. Low concentrations of ouabain (3-100 nM) or human ouabain-like compound
or reduced extracellular K+ augmented hormone-evoked mobilization of store
d Ca2+ but did not increase bulk [Na+](cyt). Augmentation depended directly
on external Na+, but not external Ca2+, and was inhibited by 10 mM Mg2+ or
10 mu M La3+. Evoked Ca2+ transients in pressurized small resistance arter
ies were also augmented by nanomolar ouabain and inhibited by Mg2+. These r
esults suggest that Na+ enters a tiny cytosolic space between the plasmalem
ma (PL) and the adjacent sarcoplasmic reticulum (SR) via an Mg2+- and La3+-
blockable mechanism that is activated by SR store depletion. The Na+ and Ca
2+ concentrations within this space may be controlled by clusters of high o
uabain affinity (alpha 3) Na+ pumps and Na/Ca exchangers located in PL micr
odomains overlying the SR. Inhibition of the alpha 3 pumps by low-dose ouab
ain should raise the local concentrations of Na+ and Ca2+ and augment hormo
ne-evoked release of Ca2+ from SR stores. Thus the clustering of small numb
ers of specific PL ion transporters adjacent to the SR can regulate global
Ca2+ signaling. This mechanism may affect vascular tone and blood flow and
may also influence Ca2+ signaling in many other types of cells.