Calcitonin (CT), which regulates serum calcium through its actions in bone and the kidney tubule, also has a potent natriuretic effect in vivo. Na reabsorption in the proximal kidney tubule is mostly dependent on the activity of the Na,K-ATPase and the apical Na/H exchanger. We have previously shown that CT regulates the activity of the Na,KATPase in the proximal kidney tubule cell line LLC-PKj in a cell cycle-dependent manner. We report here that, in the same cells, CT also regulates the Na/H exchanger through a cell cycle-specific activation of the Ca/calmodulin-dependent protein kinase II. In G2 phase, no changes in ethylisopropyl amiloride-sensitive 22Na uptake is observed, despite an increase in cAMP. In contrast, the hormone inhibits the apical exchanger when the cells are in S phase, resulting in an 80% inhibition of 22Na uptake. These results demonstrate that CT affects the activity of the two major proximal tubule Na transport systems and may help clarify the mechanisms by which CT regulates Na+ reabsorption.Calcitonin (CT), a 32-amino acid hormone with profound hypocalcemic effects due to its action in bone and the kidney (1, 2), also increases urinary excretion of Na (3). The mechanisms underlying this effect of CT on the kidney tubule, however, have not been elucidated. In the kidney, Na reabsorption results mostly from activity of the basolateral Na,K-ATPase and the apical Na/H exchanger (NHE) in the proximal tubule and/or Na channels in the distal tubule (4, 5). We have reported (6) that CT regulates Na,K-ATPase in a proximal kidney tubule cell line (LLC-PK1) (7), with the effect of the hormone depending on the position of the cells in the cell cycle; during G2, CT increases cAMP via the stimulatory guanine nucleotide-binding protein (G, protein) (8)(9)(10). The second NHE isoform is found in the apical membrane domain of renal, intestinal, and gall bladder epithelia (10). This apical NHE is less sensitive to inhibition by amiloride and is primarily involved in Na+ reabsorption and proton secretion. A third isoform has recently been reported in the intestine (11) but it is not yet well characterized.CT activates several signal transduction pathways (6, 12-14), some differentially along the kidney tubule (15, 16), which could affect the activity of the NHEs (17). The major objective of this study was therefore to determine whether CT regulates the NHEs in LLC-PK1 cells, whether such effects varied with the phase of the cell cycle, and how the observed responses, if any, could be related to the changes in Na,K-ATPase activity and the natriuretic effect of the hormone.MATERIALS AND METHODS Materials. Salmon calcitonin was from Rorer Central Research (King of Prussia, PA). Ethylisopropyl amiloride (EIPA) was obtained from Merck Sharp and Dohme. Ouabain and all other chemicals were from Sigma. [3H]Ouabain (specific activity, 20 Ci/mmol; 1 Ci = 37 GBq), [3H]thymidine (specific activity, 15 Ci/mmol), and 22NaCl (specific activity, 100-1000 mCi per mg of sodium) were from Amersham.Cells. LLC-PK1 ...