Department of Applied Mathematics, University of Waterloo, Waterloo, Ontario, Canada.
Department of Biology, University of Waterloo, Waterloo, Ontario, Canada.
Am J Physiol Renal Physiol. 2024 Sep 1;327(3):F386-F396. doi: 10.1152/ajprenal.00117.2024. Epub 2024 Jul 11.
Type 1 Bartter's syndrome and Gitelman's syndrome are characterized by mutations in two key renal Na transporters, Na-K-2Cl cotransporter (NKCC2) and Na-Cl cotransporter (NCC). Since these two transporters play an important role in regulating magnesium (Mg) and calcium (Ca) transport in the kidney, significant alterations in the transport of these two electrolytes are observed in type 1 Bartter's syndrome and Gitelman's syndrome. In this study, we used our sex-specific computational models of renal electrolyte transport in rats to understand the complex compensatory mechanisms, in terms of alterations in tubular dimensions and ion transporter activities, that lead to Mg and Ca preservation or wasting in these two genetic disorders. Given the sexual dimorphism in renal transporter patterns, we also assessed how the magnitude of these alterations may differ between males and females. Model simulations showed that in type 1 Bartter's syndrome, nephron adaptations prevent salt wasting and favor Mg preservation but not Ca, whereas in Gitelman's syndrome, those adaptations favor Ca preservation over Mg. In addition, our models predicted that the compensatory alterations in tubular dimensions and ion transporter activities are stronger in females than in males. Although changes in Ca excretion in type 1 Bartter's syndrome and Gitelman's syndrome are well understood, Mg excretion displays an interesting paradox. This computational modeling study provides insights into how renal adaptations in these two disorders impact Ca and Mg transport along different nephron segments. Model simulations showed that nephron adaptations favor Mg preservation over Ca in Bartter's syndrome and Ca preservation over Mg in Gitelman's syndrome and are stronger in females than in males.
1 型巴特综合征和吉特曼综合征的特征是两种关键肾脏 Na 转运体(NKCC2 和 NCC)的突变。由于这两种转运体在调节肾脏中镁(Mg)和钙(Ca)的转运中起着重要作用,因此在 1 型巴特综合征和吉特曼综合征中观察到这两种电解质的转运发生了重大改变。在这项研究中,我们使用了大鼠肾脏电解质转运的性别特异性计算模型,以了解导致这两种遗传疾病中 Mg 和 Ca 保留或浪费的管状尺寸和离子转运体活性改变的复杂代偿机制。鉴于肾脏转运体模式的性别二态性,我们还评估了这些改变的幅度在男性和女性之间可能有何不同。模型模拟表明,在 1 型巴特综合征中,肾单位适应防止盐浪费并有利于 Mg 保留,但不利于 Ca;而在吉特曼综合征中,这些适应有利于 Ca 保留而不是 Mg。此外,我们的模型预测,管状尺寸和离子转运体活性的代偿性改变在女性中比在男性中更强。尽管 1 型巴特综合征和吉特曼综合征中 Ca 排泄的变化得到了很好的理解,但 Mg 排泄显示出一个有趣的悖论。这项计算模型研究提供了对这两种疾病中肾脏适应如何影响不同肾单位段 Ca 和 Mg 转运的深入了解。模型模拟表明,在巴特综合征中,肾单位适应有利于 Mg 保留而不是 Ca,而在吉特曼综合征中则有利于 Ca 保留而不是 Mg,并且在女性中比在男性中更强。