Role of Genetic Mutations of the Na+/H+ Exchanger Isoform 1, in Human Disease and Protein Targeting and Activity

Mol Cell Biochem. 2021 Feb;476(2):1221-1232. doi: 10.1007/s11010-020-03984-4. Epub 2020 Nov 17.


The mammalian Na+/H+ exchanger isoform one (NHE1) is a plasma membrane protein that is ubiquitously present in human cells. It functions to regulate intracellular pH removing an intracellular proton in exchange for one extracellular sodium and is involved in heart disease and in promoting metastasis in cancer. It is made of a 500 amino acid membrane domain plus a 315 amino acid, regulatory cytosolic tail. The membrane domain is thought to have 12 transmembrane segments and a large membrane-associated extracellular loop. Early studies demonstrated that in mice, disruption of the NHE1 gene results in locomotor ataxia and a phenotype of slow-wave epilepsy. Defects included a progressive neuronal degeneration. Growth and reproductive ability were also reduced. Recent studies have identified human autosomal homozygous recessive mutations in the NHE1 gene (SLC9A1) that result in impaired development, ataxia and other severe defects, and explain the cause of the human disease Lichtenstein-Knorr syndrome. Other human mutations have been identified that are stop codon polymorphisms. These cause short non-functional NHE1 proteins, while other genetic polymorphisms in the NHE1 gene cause impaired expression of the NHE1 protein, reduced activity, enhanced protein degradation or altered kinetic activation of the protein. Since NHE1 plays a key role in many human physiological functions and in human disease, genetic polymorphisms of the protein that significantly alter its function and are likely play significant roles in varying human phenotypes and be involved in disease.

Keywords: Cerebellar ataxia; Lichtenstein-Knorr syndrome; NHE1; Na+/H+ exchanger; Protein degradation; Protein mistargeting; SLC9A1; Stop codon polymorphism.

Publication types

  • Review

MeSH terms

  • Amino Acid Sequence
  • Animals
  • Facies
  • Fibrous Dysplasia of Bone / genetics
  • Fibrous Dysplasia of Bone / metabolism
  • Fibrous Dysplasia of Bone / pathology*
  • Humans
  • Immunologic Deficiency Syndromes / genetics
  • Immunologic Deficiency Syndromes / metabolism
  • Immunologic Deficiency Syndromes / pathology*
  • Mutation*
  • Neurodegenerative Diseases / genetics
  • Neurodegenerative Diseases / metabolism
  • Neurodegenerative Diseases / pathology*
  • Neutropenia / genetics
  • Neutropenia / metabolism
  • Neutropenia / pathology*
  • Protein Transport
  • Proteolysis
  • Sodium-Hydrogen Exchanger 1 / genetics*
  • Sodium-Hydrogen Exchanger 1 / metabolism


  • SLC9A1 protein, human
  • Slc9a1 protein, mouse
  • Sodium-Hydrogen Exchanger 1

Supplementary concepts

  • Lichtenstein syndrome

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