Key result
Principal cell CK2 or Ank-3 deletion boosts urinary sodium excretion by ~42% via abolishing ENaC activity.
Why the study?
Understanding the regulation of ENaC activity is critical to understanding the molecular origins of hypertension and renal salt wasting.
Absolute Event Rate: 439% vs 310%
p-value: p=<0.05
CK2-dependent Ank-3 scaffolding is an essential post-translational mechanism that maintains ENaC at the apical membrane for renal sodium reabsorption, presenting a potential target for blood pressure control.
Should not change practice; leaves open whether CK2-Ank3 targeting offers a natriuretic strategy in humans.
Kidneys play a pivotal role in long-term blood pressure regulation by controlling extracellular fluid volume through renal salt reabsorption. Discretionary control of the Epithelial Na+ Channel, ENaC, is the final step in fine-tuning renal Na+ excretion. Consequently, gain-of-function mutations in ENaC result in hypertension caused by inappropriate retention of Na+, whereas loss-of-function of this channel causes abnormal renal salt wasting. Thus, understanding how ENaC activity is regulated is important for a complete understanding of the molecular origins of hypertension. Our data show that casein kinase 2 (CK2) phosphorylates β-ENaC at a conserved motif homologous to the CK2 site in Nav1.2 and KCNQ channels, where phosphorylation controls ankyrin-3 (Ank-3) binding and channel membrane localization. In addition, CK2-dependent phosphorylation of β-ENaC is required for Ank-3 binding, which stabilizes ENaC at the apical membrane, sustains channel activity, and thereby ensures appropriate renal Na+ excretion. Using structure-guided mutagenesis of the β-ENaC C-terminus combined with advanced live-cell imaging (TIRF-FRAP, FRET) and patch-clamp electrophysiology, we found that mutation of the CK2 consensus site or disruption of the Ank-3-binding motif abolishes ENaC surface mobility and suppresses macroscopic current density. Principal cell-specific deletion of CK2 or Ank-3, or pharmacologic CK2 inhibition, eliminates ENaC activity in native collecting ducts and drives markedly accelerated urinary sodium loss in vivo. These results identify CK2-dependent Ank-3 scaffolding as an essential post-translational mechanism that maintains ENaC at the apical membrane and sustains renal Na+ reabsorption, thereby presenting a potential new targetable regulatory pathway with implications for sodium homeostasis and blood pressure control.
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El‐Aziz et al. (2026) studied Renal sodium handling. Principal cell-specific deletion of CK2 or Ank-3 vs. Wild-type littermates was evaluated on Cumulative sodium excretion at 9 hours after sodium load (% of administered load) (p=<0.05). Principal cell-specific deletion of CK2 or Ank-3 abolishes ENaC activity and markedly accelerates urinary sodium loss in vivo, increasing cumulative sodium excretion from 310% to 439% of load.
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