Cartoons of two models of NHE1 function as a “coupled dimer” that can carry out 2Na/2H exchange. A “parallel” model is shown in A and a “serial” model is shown in B. The upper cartoons in each panel show the assumed ion translocation reactions, whereby binding of either Na ions or protons enables the same translocation reactions of both ions with the same rates. The lower cartoons show the relevant ion binding schemes, whereby Na ions and protons bind competitively to one or two sites. (A) Parallel model. In this model, it is assumed that monomers carry out Na/H exchange activity independently at low cytoplasmic pH (Mode 1). As cytoplasmic pH rises, proton dissociation from regulatory sites favors the development of an interaction between monomers, such that they become coupled to translocate two ions in a parallel or symport fashion (Mode 2). The ion binding scheme is a simple competition of Na and protons for a single site. (B) Serial model. Each monomer of the dimer can bind two substrates, and ion translocation requires occupation of both sites. Each monomer can translocate ions and allows them to dissociate on the opposite membrane side, but the rates of translocation (Kxw and Kwx) are higher when binding sites of both monomers are open to one membrane side (E1 and E2), Thus, transport reactions become coupled in a serial fashion: Translocation of two ions in one direction promotes the translocation of two ions in the opposite direction. The ion binding scheme for each monomer assumes that two protons or Na ions can bind in random order and that all configurations with two ions bound can undergo conformational changes that allow ion dissociation on the opposite membrane side.