Krapf R
Department of Medicine, University of California, San Francisco 94143-0532.
J Clin Invest. 1989 Mar;83(3):890-6. doi: 10.1172/JCI113973.
The hyperbicarbonatemia of chronic respiratory acidosis is maintained by enhanced bicarbonate reabsorption in the proximal tubule. To investigate the cellular mechanisms involved in this adaptation, cell and luminal pH were measured microfluorometrically using (2",7')-bis(carboxyethyl)-(5,6)-carboxyfluorescein in isolated, microperfused S2 proximal convoluted tubules from control and acidotic rabbits. Chronic respiratory acidosis was induced by exposure to 10% CO2 for 52-56 h. Tubules from acidotic rabbits had a significantly lower luminal pH after 1-mm perfused length (7.03 +/- 0.09 vs. 7.26 +/- 0.06 in controls, perfusion rate = 10 nl/min). Chronic respiratory acidosis increased the initial rate of cell acidification (dpHi/dt) in response to luminal sodium removal by 63% and in response to lowering luminal pH (7.4-6.8) by 69%. Chronic respiratory acidosis also increased dpHi/dt in response to peritubular sodium removal by 63% and in response to lowering peritubular pH by 73%. In conclusion, chronic respiratory acidosis induces a parallel increase in the rates of the luminal Na/H antiporter and the basolateral Na/(HCO3)3 cotransporter. Therefore, the enhanced proximal tubule reabsorption of bicarbonate in chronic respiratory acidosis may be, at least in part, mediated by a parallel adaptation of these transporters.
慢性呼吸性酸中毒时的高碳酸氢血症是由近端小管中碳酸氢盐重吸收增强所维持的。为了研究参与这种适应性变化的细胞机制,我们使用(2",7')-双(羧乙基)-(5,6)-羧基荧光素,通过微量荧光法在来自对照兔和酸中毒兔的分离、微量灌注的S2近端曲管中测量了细胞内pH和管腔pH。通过暴露于10%二氧化碳52 - 56小时诱导慢性呼吸性酸中毒。在灌注1毫米长度后,酸中毒兔的小管管腔pH显著降低(7.03±0.09,而对照组为7.26±0.06,灌注速率 = 10 nl/分钟)。慢性呼吸性酸中毒使细胞酸化的初始速率(dpHi/dt)在因管腔钠去除时增加了63%,在因管腔pH降低(从7.4降至6.8)时增加了69%。慢性呼吸性酸中毒还使细胞酸化的初始速率(dpHi/dt)在因肾小管周围钠去除时增加了63%,在因肾小管周围pH降低时增加了73%。总之,慢性呼吸性酸中毒导致管腔Na/H逆向转运体和基底外侧Na/(HCO3)3协同转运体的速率平行增加。因此,慢性呼吸性酸中毒时近端小管对碳酸氢盐重吸收的增强可能至少部分是由这些转运体的平行适应性变化介导的。