Institute of Physiology, University of Zurich, Zurich, Switzerland.
Institute of Anatomy, University of Zurich, Zurich, Switzerland.
J Am Soc Nephrol. 2024 Jan 1;35(1):7-21. doi: 10.1681/ASN.0000000000000259. Epub 2023 Nov 22.
In the kidney, the B1 H + -ATPase subunit is mostly expressed in intercalated cells (IC). Its importance in acid-secreting type A ICs is evident in patients with inborn distal renal tubular acidosis and ATP6V1B1 mutations. However, the protein is also highly expressed in alkali-secreting non-type A ICs where its function is incompletely understood. We demonstrate in Atp6v1b1 knock out mice that the B1 subunit is critical for the renal response to defend against alkalosis during an alkali load or chronic furosemide treatment. These findings highlight the importance of non-type A ICs in maintaining acid-base balance in response to metabolic challenges or commonly used diuretics.
Non-type A ICs in the collecting duct system express the luminal Cl - /HCO 3- exchanger pendrin and apical and/or basolateral H + -ATPases containing the B1 subunit isoform. Non-type A ICs excrete bicarbonate during metabolic alkalosis. Mutations in the B1 subunit (ATP6V1B1) cause distal renal tubular acidosis due to its role in acid secretory type A ICs. The function of B1 in non-type A ICs has remained elusive.
We examined the responses of Atp6v1b1-/- and Atp6v1b1+/+ mice to an alkali load and to chronic treatment with furosemide.
An alkali load or 1 week of furosemide resulted in a more pronounced hypokalemic alkalosis in male ATP6v1b1-/- versus Atp6v1b1+/+ mice that could not be compensated by respiration. Total pendrin expression and activity in non-type A ICs of ex vivo microperfused cortical collecting ducts were reduced, and β2 -adrenergic stimulation of pendrin activity was blunted in ATP6v1b1-/- mice. Basolateral H + -ATPase activity was strongly reduced, although the basolateral expression of the B2 isoform was increased. Ligation assays for H + -ATPase subunits indicated impaired assembly of V 0 and V 1 H + -ATPase domains. During chronic furosemide treatment, ATP6v1b1-/- mice also showed polyuria and hyperchloremia versus Atp6v1b1+/+ . The expression of pendrin, the water channel AQP2, and subunits of the epithelial sodium channel ENaC were reduced.
Our data demonstrate a critical role of H + -ATPases in non-type A ICs function protecting against alkalosis and reveal a hitherto unrecognized need of basolateral B1 isoform for a proper H + -ATPase complexes assembly and ability to be stimulated.
在肾脏中,B1 H + -ATPase 亚基主要在闰细胞(IC)中表达。在先天性远端肾小管酸中毒和 ATP6V1B1 突变患者中,其在分泌酸的 A 型 IC 中的重要性是显而易见的。然而,该蛋白在碱分泌非 A 型 IC 中也高度表达,其功能尚不完全清楚。我们在 Atp6v1b1 敲除小鼠中证明,B1 亚基对于肾脏在碱负荷或慢性呋塞米治疗期间抵抗碱中毒的反应至关重要。这些发现强调了非 A 型 IC 在应对代谢挑战或常用利尿剂时维持酸碱平衡中的重要性。
集合管系统中的非 A 型 IC 表达腔侧 Cl--HCO3-交换体 pendrin 以及含有 B1 亚基同工型的顶端和/或基底外侧 H + -ATPase。非 A 型 IC 在代谢性碱中毒时分泌重碳酸盐。B1 亚基(ATP6V1B1)的突变导致远端肾小管酸中毒,因为它在分泌酸的 A 型 IC 中起作用。B1 在非 A 型 IC 中的功能仍然难以捉摸。
我们检查了 Atp6v1b1-/-和 Atp6v1b1+/+ 小鼠对碱负荷和慢性呋塞米治疗的反应。
碱负荷或 1 周的呋塞米导致雄性 ATP6v1b1-/-与 Atp6v1b1+/+ 小鼠更明显的低钾性碱中毒,无法通过呼吸代偿。非 A 型 IC 中 ex vivo 微灌注皮质集合管的总 pendrin 表达和活性降低,β2-肾上腺素能刺激 pendrin 活性减弱在 ATP6v1b1-/-小鼠中。基底外侧 H + -ATPase 活性明显降低,尽管 B2 同工型的基底外侧表达增加。H + -ATPase 亚基的结扎测定表明 V0 和 V1 H + -ATPase 结构域的组装受损。在慢性呋塞米治疗期间,ATP6v1b1-/-小鼠还表现出多尿和高氯血症,而非 Atp6v1b1+/+。pendrin、水通道 AQP2 和上皮钠通道 ENaC 的亚基表达减少。
我们的数据表明 H + -ATPases 在非 A 型 IC 功能中发挥着至关重要的作用,可抵抗碱中毒,并揭示了基底外侧 B1 同工型对于适当的 H + -ATPase 复合物组装和刺激能力的先前未被认识到的需求。