Balance of unidirectional monovalent ion fluxes in cells undergoing apoptosis: why does Na+/K+ pump suppression not cause cell swelling?

Cells dying according to the apoptotic program, unlike cells dying via an unprogrammed mode, are able to avoid swelling and osmotic bursting with membrane disruption.There are indications that apoptosis is accompanied by suppression of the Na+/K+ pump and changes in the K+ and Cl− channels. It remains unclear how ion fluxes through individual ion pathways are integrated so as to induce loss of intracellular ions and concomitant apoptotic volume decrease. A decrease in activity of the sodium pump during apoptosis should cause cell swelling rather than shrinkage. We have made the first systemic analysis of the monovalent ion flux balance in apoptotic cells. Experimental data were obtained for human U937 cells treated with staurosporine for 4–5 h, which is known to induce apoptosis. The data include cellular Cl− content and fluxes, K+, Na+, water content and ouabain-sensitive and -resistant Rb+ fluxes.Unidirectional monovalent ion fluxeswere calculated using these data and a cell model comprising the double Donnan system with the Na+/K+ pump, Cl−, K+, Na+ channels, the Na+–K+–2Cl−cotransporter (NKCC), the Na+–Cl− cotransporter (NC), and the equivalent Cl−/Cl− exchange.Apoptotic cell shrinkage was found to be caused, depending on conditions, either by an increase in the integral channel permeability of membrane for K+ or by suppression of the pump coupledwith a decrease in the integral channel permeability of membrane for Na+. The decrease in the channel permeability of membrane for Na+ plays a crucial role in cell dehydration in apoptosis accompanied by suppression of the pump. Supplemental Table S1 is given for easy calculating flux balance under specified conditions.