Division of Nephrology, Hypertension and Transplantation, University of Florida College of Medicine, Gainesville, FL 32610, USA.
Am J Physiol Renal Physiol. 2011 Jan;300(1):F11-23. doi: 10.1152/ajprenal.00554.2010. Epub 2010 Nov 3.
Renal ammonia excretion is the predominant component of renal net acid excretion. The majority of ammonia excretion is produced in the kidney and then undergoes regulated transport in a number of renal epithelial segments. Recent findings have substantially altered our understanding of renal ammonia transport. In particular, the classic model of passive, diffusive NH3 movement coupled with NH4+ "trapping" is being replaced by a model in which specific proteins mediate regulated transport of NH3 and NH4+ across plasma membranes. In the proximal tubule, the apical Na+/H+ exchanger, NHE-3, is a major mechanism of preferential NH4+ secretion. In the thick ascending limb of Henle's loop, the apical Na+-K+-2Cl- cotransporter, NKCC2, is a major contributor to ammonia reabsorption and the basolateral Na+/H+ exchanger, NHE-4, appears to be important for basolateral NH4+ exit. The collecting duct is a major site for renal ammonia secretion, involving parallel H+ secretion and NH3 secretion. The Rhesus glycoproteins, Rh B Glycoprotein (Rhbg) and Rh C Glycoprotein (Rhcg), are recently recognized ammonia transporters in the distal tubule and collecting duct. Rhcg is present in both the apical and basolateral plasma membrane, is expressed in parallel with renal ammonia excretion, and mediates a critical role in renal ammonia excretion and collecting duct ammonia transport. Rhbg is expressed specifically in the basolateral plasma membrane, and its role in renal acid-base homeostasis is controversial. In the inner medullary collecting duct (IMCD), basolateral Na+-K+-ATPase enables active basolateral NH4+ uptake. In addition to these proteins, several other proteins also contribute to renal NH3/NH4+ transport. The role and mechanisms of these proteins are discussed in depth in this review.
肾脏氨排泄是肾脏净酸排泄的主要组成部分。大部分氨的排泄是在肾脏中产生的,然后在多个肾上皮段中进行调节性转运。最近的发现极大地改变了我们对肾脏氨转运的理解。特别是,经典的被动、扩散 NH3 运动与 NH4+“捕获”相结合的模型正被一种新的模型所取代,该模型认为特定的蛋白质介导 NH3 和 NH4+穿过质膜的调节性转运。在近端肾小管中,顶端 Na+/H+交换器 NHE-3 是优先分泌 NH4+的主要机制。在 Henle 袢升支厚段,顶端 Na+-K+-2Cl-共转运体 NKCC2 是氨重吸收的主要贡献者,基底外侧 Na+/H+交换器 NHE-4 似乎对基底外侧 NH4+的排出很重要。集合管是肾脏氨分泌的主要部位,涉及平行的 H+分泌和 NH3 分泌。恒河猴糖蛋白 Rh B 糖蛋白(Rhbg)和 Rh C 糖蛋白(Rhcg)是最近在远曲小管和集合管中被发现的氨转运体。Rhcg 存在于顶端和基底外侧质膜中,与肾脏氨排泄平行表达,并介导肾脏氨排泄和集合管氨转运的关键作用。Rhbg 特异性表达于基底外侧质膜,其在肾脏酸碱平衡中的作用存在争议。在内髓集合管(IMCD)中,基底外侧 Na+-K+-ATPase 使 NH4+主动摄取。除了这些蛋白质外,还有其他几种蛋白质也参与肾脏 NH3/NH4+转运。本文深入讨论了这些蛋白质的作用和机制。