Centre de recherche des Cordeliers, Université Pierre et Marie Curie, ERL CNRS 7226, INSERM UMRS 872 Equipe 3, Paris, France.
J Clin Invest. 2010 May;120(5):1627-35. doi: 10.1172/JCI40145. Epub 2010 Apr 12.
Regulation of sodium balance is a critical factor in the maintenance of euvolemia, and dysregulation of renal sodium excretion results in disorders of altered intravascular volume, such as hypertension. The amiloride-sensitive epithelial sodium channel (ENaC) is thought to be the only mechanism for sodium transport in the cortical collecting duct (CCD) of the kidney. However, it has been found that much of the sodium absorption in the CCD is actually amiloride insensitive and sensitive to thiazide diuretics, which also block the Na-Cl cotransporter (NCC) located in the distal convoluted tubule. In this study, we have demonstrated the presence of electroneutral, amiloride-resistant, thiazide-sensitive, transepithelial NaCl absorption in mouse CCDs, which persists even with genetic disruption of ENaC. Furthermore, hydrochlorothiazide (HCTZ) increased excretion of Na+ and Cl- in mice devoid of the thiazide target NCC, suggesting that an additional mechanism might account for this effect. Studies on isolated CCDs suggested that the parallel action of the Na+-driven Cl-/HCO3- exchanger (NDCBE/SLC4A8) and the Na+-independent Cl-/HCO3- exchanger (pendrin/SLC26A4) accounted for the electroneutral thiazide-sensitive sodium transport. Furthermore, genetic ablation of SLC4A8 abolished thiazide-sensitive NaCl transport in the CCD. These studies establish what we believe to be a novel role for NDCBE in mediating substantial Na+ reabsorption in the CCD and suggest a role for this transporter in the regulation of fluid homeostasis in mice.
钠平衡的调节是维持血容量正常的关键因素,而肾脏排钠的失调会导致血管内体积的改变,如高血压。人们认为,上皮钠通道(ENaC)是肾脏皮质集合管(CCD)中钠转运的唯一机制。然而,现已发现,CCD 中的大部分钠吸收实际上对阿米洛利不敏感,而对噻嗪类利尿剂敏感,噻嗪类利尿剂也可阻断位于远曲小管的 Na-Cl 共转运体(NCC)。在这项研究中,我们已经证明了在小鼠 CCD 中存在电中性、阿米洛利抗性、噻嗪敏感的跨上皮 NaCl 吸收,即使 ENaC 的遗传破坏也能持续存在。此外,氢氯噻嗪(HCTZ)增加了缺乏噻嗪靶标 NCC 的小鼠的 Na+和 Cl-的排泄,这表明可能存在另一种机制来解释这种作用。对分离的 CCD 的研究表明,Na+-驱动的 Cl--HCO3-交换体(NDCBE/SLC4A8)和 Na+-非依赖性 Cl--HCO3-交换体(pendrin/SLC26A4)的平行作用解释了电中性的噻嗪敏感的钠转运。此外,SLC4A8 的基因缺失消除了 CCD 中噻嗪敏感的 NaCl 转运。这些研究确立了我们认为 NDCBE 在介导 CCD 中大量 Na+重吸收中的新作用,并表明该转运体在调节小鼠的液体平衡中发挥作用。