Graf J, Haddad P, Haeussinger D, Lang F
Department of General and Experimental Pathology, University of Vienna, Austria.
Ren Physiol Biochem. 1988 May-Oct;11(3-5):202-20. doi: 10.1159/000173163.
The maintenance of liver cell volume in isotonic extracellular fluid requires the continuous supply of energy: sodium is extruded in exchange for potassium by the sodium/potassium ATPase, conductive potassium efflux creates a cell-negative membrane potential, which expelles chloride through conductive pathways. Thus, the various organic substances accumulated within the cell are osmotically counterbalanced in large part by the large difference of chloride concentration across the cell membrane. Impairment of energy supply leads to dissipation of ion gradients, depolarization and cell swelling. However, even in the presence of ouabain the liver cell can extrude ions by furosemide-sensitive transport in intracellular vesicles and subsequent exocytosis. In isotonic extracellular fluid cell swelling may follow an increase in extracellular potassium concentration, which impairs potassium efflux and depolarizes the cell membrane leading to chloride accumulation. Replacement of extracellular chloride with impermeable anions leads to cell shrinkage. During excessive sodium-coupled entry of amino acids and subsequent stimulation of sodium/potassium-ATPase by increase in intracellular sodium activity, an increase in cell volume is blunted by activation of potassium channels, which maintain cell membrane potential and allow for loss of cellular potassium. Cell swelling induced by exposure of liver cells to hypotonic extracellular fluid is followed by regulatory volume decrease (RVD), cell shrinkage induced by reexposure to isotonic perfusate is followed by regulatory volume increase (RVI). Available evidence suggests that RVD is accomplished by activation of potassium channels, hyperpolarization and subsequent extrusion of chloride along with potassium, and that RVI depends on the activation of sodium hydrogen ion exchange with subsequent activation of sodium/potassium-ATPase leading to the respective accumulation of potassium and bicarbonate. In addition, exposure of liver to anisotonic perfusates alters glycogen degradation, glycolysis and probably urea formation, which are enhanced by exposure to hypertonic perfusates and depressed by hypotonic perfusates.
钠钾ATP酶将钠泵出以交换钾,钾的传导性外流产生细胞负膜电位,该电位通过传导途径排出氯离子。因此,细胞内积累的各种有机物质在很大程度上通过细胞膜两侧氯离子浓度的巨大差异在渗透压上得到平衡。能量供应受损会导致离子梯度消散、去极化和细胞肿胀。然而,即使存在哇巴因,肝细胞仍可通过细胞内囊泡中呋塞米敏感的转运及随后的胞吐作用排出离子。在等渗细胞外液中,细胞肿胀可能继发于细胞外钾浓度升高,这会损害钾外流并使细胞膜去极化,导致氯离子积累。用不可渗透的阴离子替代细胞外氯离子会导致细胞皱缩。在氨基酸过度的钠耦联进入以及随后细胞内钠活性增加刺激钠钾ATP酶时,钾通道的激活会使细胞体积增加变钝,钾通道维持细胞膜电位并允许细胞内钾流失。肝细胞暴露于低渗细胞外液引起的细胞肿胀之后会出现调节性容积减小(RVD),重新暴露于等渗灌注液引起的细胞皱缩之后会出现调节性容积增加(RVI)。现有证据表明,RVD是通过钾通道激活、超极化以及随后氯离子与钾一起排出实现的,而RVI取决于钠氢交换的激活以及随后钠钾ATP酶的激活,导致钾和碳酸氢根各自积累。此外,肝脏暴露于非等渗灌注液会改变糖原降解、糖酵解以及可能的尿素形成,高渗灌注液暴露会增强这些过程,低渗灌注液暴露则会使其受到抑制。