Kamisako T, Gabazza E C, Ishihara T, Adachi Y
Second Department of Internal Medicine, Kinki University School of Medicine, Osakasayama, Japan.
J Gastroenterol Hepatol. 1999 May;14(5):405-12. doi: 10.1046/j.1440-1746.1999.01886.x.
Many organic compounds are taken up from the blood by membrane transporters, taken across the sinosuidal membrane of hepatocytes and then excreted into bile via the bile canalicular membrane. The hepatic uptake of conjugated bile acids is mediated by the sodium taurocholate cotransporting polypeptide. Many organic anions and bulky organic cations are incorporated into hepatocytes by the organic anion transporting polypeptide, while small organic cations are transported by the organic cation transporter. At the canalicular membrane, organic compounds are excreted into bile by ATP-binding cassette transporters which hydrolyse ATP to ADP. Excretion of monovalent bile acids is mediated by the canalicular bile salt transporter and that of organic anions, including divalent bile acid, conjugates, are mediated by the multi-drug resistance-associated protein 2, also termed canalicular multi-specific organic anion transporter. Organic cations are excreted into bile by the multi-drug resistance gene product (MDR) 1 and phospholipids are excreted by MDR3 (mdr2 in mice and rats). The clinical syndromes associated with alterations of these transporters are also discussed.
许多有机化合物通过膜转运蛋白从血液中摄取,穿过肝细胞的窦状隙膜,然后通过胆小管膜排入胆汁。结合型胆汁酸的肝摄取由牛磺胆酸钠共转运多肽介导。许多有机阴离子和大分子有机阳离子通过有机阴离子转运多肽进入肝细胞,而小分子有机阳离子则由有机阳离子转运体转运。在胆小管膜处,有机化合物通过水解ATP为ADP的ATP结合盒转运蛋白排入胆汁。单价胆汁酸的排泄由胆小管胆盐转运体介导,包括二价胆汁酸结合物在内的有机阴离子的排泄由多药耐药相关蛋白2介导,该蛋白也称为胆小管多特异性有机阴离子转运体。有机阳离子通过多药耐药基因产物(MDR)1排入胆汁,磷脂则通过MDR3(小鼠和大鼠中的mdr2)排泄。还讨论了与这些转运体改变相关的临床综合征。