Transportadores de iones en pulmón: Uso como dianas terapéuticas / Ion transporters in the lungs. Use as therapeutic targets

Los canales de cloruros, de sodio, de bicarbonato y los de agua (aquaporinas) se coordinan para mantener la cubierta líquido superficial de las vías respiratorias, que es necesaria para el aclaramiento mucociliar. El mecanismo general para el transporte de electrolitos y agua depende principalmente de la expresión diferencial y distribución de los transportadores y bombas de iones. Los iones y el agua se mueven a través de las vía paracelular o transcelular. La ruta transcelular del transporte de electrolitos requiere un transporte activo (dependiente de ATP) o pasivo (siguiendo gradientes electroquímicos) de iones. La ruta paracelular es un proceso pasivo que está controlado, en última instancia, por los gradientes electroquímicos transepiteliales predominantes. La fibrosis quística es una enfermedad hereditaria que se produce por mutaciones en el gen que codifica la proteína reguladora de la conductibilidad transmembrana de la fibrosis quística (CFTR) que actúa como un canal de cloro y cumple funciones de hidratación del líquido periciliar y mantenimiento del pH luminal. La disfunción del canal de cloro en el epitelio respiratorio determina una alteración en las secreciones bronquiales, con aumento de su viscosidad y alteración de la depuración mucociliar y que asociado a procesos infecciosos puede conducir a daño pulmonar irreversible. La disfunción del CFTR, también se ha visto implicado en la patogénesis de la pancreatitis aguda, en la enfermedad pulmonar obstructiva crónica y la hiperreactividad en el asma. Existen fármacos que aprovechan los mecanismos fisiológicos en el transporte de iones, con un objetivo terapéutico.

The chloride channels, sodium and bicarbonate channels, and aquaporin water channels are coordinated to maintain the airway surface liquid that is necessary for mucociliary clearance. The general mechanism for the transport of electrolytes and fluids depends mainly on the differential expression and distribution of ion transporters and pumps. Ions and water move through the paracellular or transcellular pathways. The transcellular route of electrolyte transport requires an active transport (dependent on ATP) or passive (following electrochemical gradients) of ions. The paracellular pathway is a passive process that is ultimately controlled by the predominant transepithelial electrochemical gradients. Cystic fibrosis is a hereditary disease that is produced by mutations in the gene that encode cystic fibrosis transmembrane conductance regulatory protein (CFTR) that acts as a chloride channel and performs functions of hydration of periciliary fluid and maintenance of luminal pH. The dysfunction of the chlorine channel in the respiratory epithelium determines an alteration in the bronchial secretions, with an increase in its viscosity and alteration of the mucociliary clearance and that associated with infectious processes can lead to irreversible lung damage. CFTR dysfunction has also been implicated in the pathogenesis of acute pancreatitis, chronic obstructive pulmonary disease, and bronchial hyperreactivity in asthma. There are drugs that exploit physiological mechanisms in the transport of ions with a therapeutic objective.

Impact of acute undernutrition on growth, ileal morphology and nutrient transport in a murine model

Undernutrition represents a major public health challenge for middle- and low-income countries. This study aimed to evaluate whether a multideficient Northeast Brazil regional basic diet (RBD) induces acute morphological and functional changes in the ileum of mice. Swiss mice (∼25 g) were allocated into two groups: i) control mice were fed a standard diet and II) undernourished mice were fed the RBD. After 7 days, mice were killed and the ileum collected for evaluation of electrophysiological parameters (Ussing chambers), transcription (RT-qPCR) and protein expression (western blotting) of intestinal transporters and tight junctions. Body weight gain was significantly decreased in the undernourished group, which also showed decreased crypt depth but no alterations in villus height. Electrophysiology measurements showed a reduced basal short circuit current (Isc) in the undernourished group, with no differences in transepithelial resistance. Specific substrate-evoked Isc related to affinity and efficacy (glutamine and alanyl-glutamine) were not different between groups, except for the maximum Isc (efficacy) induced by glucose. Transcription of Sglt1 and Pept1 was significantly higher in the undernourished group, while SN-2 transcription was decreased. No changes were found in transcription of CAT-1 and CFTR, while claudin-2 and occludin transcriptions were significantly increased in the undernourished group. Despite mRNA changes, SGLT-1, PEPT-1, claudin-2 and occludin protein expression showed no difference between groups. These results demonstrate early effects of the RBD on mice, which include reduced body weight and crypt depth in the absence of significant alterations to villus morphology, intestinal transporters and tight junction expression.

Resveratrol plays important role in protective mechanisms in renal disease - mini-review / Resveratrol desempenha importante papel no mecanismo de proteção na doença renal - mini-revisão

Resveratrol (RESV) is a polyphenolic compound found in various plants, including grapes, berries and peanuts, and its processed foods as red wine. RESV possesses a variety of bioactivities, including antioxidant, anti-inflammatory, cardioprotective, antidiabetic, anticancer, chemopreventive, neuroprotective, renal lipotoxicity preventative, and renal protective effects. Numerous studies have demonstrated that polyphenols promote cardiovascular health. Furthermore, RESV can ameliorate several types of renal injury in animal models, including diabetic nephropathy, hyperuricemic, drug-induced injury, aldosterone-induced injury, ischemia-reperfusion injury, sepsis-related injury, and endothelial dysfunction. In addition, RESV can prevent the increase in vasoconstrictors, such as angiotensin II (AII) and endothelin-1 (ET-1), as well as intracellular calcium, in mesangial cells. Together, these findings suggest a potential role for RESV as a supplemental therapy for the prevention of renal injury.

Resveratrol (RESV) é um composto fenólico encontrado em várias plantas, como a uva e amendoim, e seus produtos derivados, como o vinho tinto. RESV possui uma variedade de bioatividades, incluindo antioxidantes, anti-inflamatória, cardioprotetoras, antidiabetes, anticancerígeno, quimiopreventivo, neuroprotetor, lipotoxicidade renal, e efeitos protetores renais. Numerosos estudos demonstraram que os polifenois promovem a saúde cardiovascular e podem reparar vários tipos de lesões renais em modelos animais, incluindo a nefropatia diabética, hiperuricemia, lesão induzida por droga, lesão induzida pela aldosterona, lesão de isquemia-reperfusão, lesões relacionadas com sepsis, e disfunção endotelial. Além disso, RESV pode prevenir o aumento de vasoconstritores, tais como angiotensina II (AII) e endotelina-1 (ET-1), bem como o cálcio intracelular, em células mesangiais. Em conjunto, estes resultados sugerem um importante papel para o RESV como uma terapia complementar na prevenção de lesões renais.

Anatomopathology of the Superstructure of the Stapes in Patients with Otosclerosis

Introduction Otosclerosis is a disease that causes bone resorption and deposition in the auditory structures, leading to deafness. Many studies have evaluated the histopathology of the stapes footplate in this disease (osteoblasts, osteoclasts, vascular proliferation, fibroblasts, and histiocytes), but we found no studies in the literature involving the histology of the superstructure of the stapes. Objectives To perform an analysis under optical microscopy of histopathologic findings of the superstructure of the stapes from patients with otosclerosis. Methods A contemporary cross-sectional cohort study of pathology analysis of superstructures of the stapes of patients with otosclerosis. Results Fifteen superstructures of stapes in patients with otosclerosis operated in our service and four stapes of cadavers used for dissection (controls) were evaluated. No areas of bone resorption or deposition or presence of osteoclasts and osteoblasts in the superstructure of the stapes were found. However, we found in themore distal portions of the crura areas with prominent cementitious lines and woven bone, which was different than the mature trabecular bone found in the head of the stapes or in the controls. Conclusion There were histologic changes in the superstructure of the stapes in patients with otosclerosis operated in our service. .

Total clipless cholecystectomy by means of harmonic sealing / Colecistectomia laparoscópica totalmente ultrassônica sem uso de clipe metálico

BACKGROUND: In traditional laparoscopic cholecistectomy, the cystic duct and artery are commonly closed by metallic clips just before their division. Although the placement of these clips for occluding cystic artery and duct can be considered safe, biliary leaks and bleeding may occur especially by its dislodgement. AIM: To report a prospective case-series in total clipless cholecystectomy by means of harmonic shears for closure and division of the artery and cystic duct as well removal of the gallbladder from the liver. METHODS: Was evaluate a series of 125 patients who underwent laparoscopic cholecystectomy where the sealing and division of cystic artery and duct was carried out only by harmonic shears. The intact extracted gallbladder was submitted to a reverse pressure test for assessment of the technique safety by means of CO2 insuflation. RESULTS: The most common indication for surgery was gallstones. The mean operative time was 26 min and all gallbladders were dissected intact from the liver bed. There was no mortality and the overall morbidity rate was 0.8% with no hemorrhage or leaks. The reverse pressure test showed that all specimens support at least 36-mmHg of pressure without leaking. CONCLUSION: The harmonic shears is effective and safe in laparoscopic cholecystectomy as a sole instrument for sealing and division of the artery and cystic duct. The main advantages could be related to the safety and decreased operative time. .

RACIONAL: A colecistectomia laparoscópica na técnica tradicional oclui o ducto cístico e a artéria cística por clipes cirúrgicos, que podem se deslocar ou desprender no pós-operatório, possibilitando a ocorrência de fístula biliar ou hemorragia. OBJETIVO: Relato prospectivo de série de casos de colecistectomias laparoscópicas sem uso de clipe cirúrgico, sendo que a ligadura e secção da artéria cística e do ducto cístico foram realizadas por meio de bisturi ultrassônico. MÉTODO: Foram incluídos 125 pacientes submetidos à colecistectomia laparoscópica sem utilização de clipe cirúrgico metálico, onde a ligadura da artéria e do ducto cístico e também a remoção da vesícula biliar de seu leito hepático foram realizadas por meio de tesoura ultrassônica. Realizou-se teste de pressão reversa na vesícula biliar removida intacta do leito hepático para verificar a segurança da técnica. RESULTADOS: A principal indicação cirúrgica foi a colelitíase. O tempo cirúrgico médio foi de 26 min e todas as vesículas biliares foram retiradas intactas do leito hepático. Não houve mortalidade e a taxa global de morbidade foi de 0,8%, sem hemorragias ou fístulas. O teste de pressão reversa mostrou que o ducto cístico ocluído pelo bisturi harmônico suportou ao pelo menos 36 mmHg de pressão sem que ocorresse nenhum vazamento. CONCLUSÃO: O bisturi harmônico é eficaz e seguro em colecistectomias laparoscópicas eletivas como um instrumento único para ocluir e seccionar tanto a artéria cística quanto o ducto cístico. Vantagens podem ser apontadas ao método com relação a sua segurança e diminuição do tempo cirúrgico. .

The effect of Cratylia floribunda lectin on renal hemodynamics and ion transport

Lectins have been described as glycoproteins that reversibly and specifically bind to carbohydrates. Legume lectins isolated from the subtribe Diocleinae (Canavalia, Dioclea andCratylia) are structurally homologous with respect to their primary structures. The Diocleinae lectins of Canavalia brasiliensis, Dioclea guianensis andCanavalia ensiformis have been shown to distinctly alter physiological parameters in isolated rat kidneys. Thus, the aim of this study was to investigate the effect of Cratylia floribunda lectin (CFL) on renal hemodynamics and ion transport in rats. In isolated perfused kidneys, CFL (10 mg/mL, n=5) increased RPP, RVR and decreased %TK+, but did not change urinary flow, glomerular filtration rate, sodium or chloride tubular transport. In isolated perfused mesenteric bed, CFL (3 and 10 mg/mL/min; n=4) did not alter tissue basal tonus or tissue contraction by phenylephrine (1 mM/mL/min). In conclusion, the seed lectin of Cratylia floribunda increased renal hemodynamic parameters showing a kaliuretic effect. This effect could be of tubular origin, rather than a result from haemodynamic alterations.

As lectinas são descritas como (glico)proteínas que se ligam, especificamente e reversivelmente, a carboidratos. Lectinas de leguminosas isoladas da subtribo Diocleinae (Canavalia, Dioclea eCratylia) são estruturalmente homólogas em relação às suas estruturas primárias. Demonstrou-se que as lectinas de DiocleinaeCanavalia brasiliensis, Dioclea guianensis eCanavalia ensiformis alteram diferentemente parâmetros fisiológicos em rins isolados de ratos. Dessa maneira, o objetivo deste estudo foi investigar o papel da lectina de Cratylia floribunda (CFL) na hemodinâmica renal e no transporte de íons em ratos. Em rins isolados perfundidos, CFL (10 mg/mL, n=5) aumentou a pressão de perfusão renal, a resistência vascular renal e reduziu o percentual do transporte tubular de K+, mas não alterou o fluxo urinário, a taxa de filtração glomerular e o percentual de transporte tubular dos íons sódio e cloreto. No leito mesentérico isolado perfundido, CFL (3 e 10 mg/mL/min, n=4) não alterou o tônus basal ou a contração do tecido induzida por fenilefrina (1 mM/mL/min). Em conclusão, a lectina de sementes de Cratylia floribunda altera parâmetros hemodinâmicos renais, provavelmente de origem tubular, e não por alterações hemodinâmicas.

El Ca2+ y los esfingolípidos como moduladores de la apoptosis y el cáncer / Ca2+ and sphingolipids as modulators for apoptosis and cancer

El Ca2+ es un segundo mensajero que regula funciones directamente relacionadas con el cáncer como la proliferación, diferenciación y la apoptosis. La concentración intracelular de Ca2+ ([Ca2+]i) está altamente regulada por diversos mecanismos entre los que destacan canales iónicos, la Ca2+-ATPasa del retículo endoplasmático (SERCA) y de la membrana plasmática (PMCA), y el transporte de Ca2+ mitocondrial. En el cáncer, la célula tumoral prolifera sin control tras su incapacidad de reconocer señales apoptóticas. La apoptosis es mediada a través de cambios en la actividad de ciertas proteínas como las caspasas y miembros de la familia Bcl-2. Adicionalmente, el “estrés del retículo”, promovido por la acumulación y agregación de proteínas mal plegadas en el interior del retículo endoplasmático (RE), puede desencadenar la apoptosis. El “estrés del retículo” es inducido por una variedad de agentes, entre los que destaca la tapsigargina, inhibidor específico de la SERCA, la cual promueve un notable aumento en la [Ca2+]i, induciendo además apoptosis. En consecuencia, actualmente se están ensayando exitosamente derivados de la tapsigargina como agentes antineoplásicos. El Ca2+ es transferido a la mitocondria desencadenando señales apoptóticas. Por otra parte, los esfingolípidos, como la ceramida y la esfingosina, y sus derivados fosforilados, la ceramida-1-fosfato y la esfingosina-1-fosfato, los cuales regulan la [Ca2+]i, también están estrechamente vinculados con la señalización intracelular en procesos relacionados con el cáncer. Esta revisión discute nuevas evidencias sobre el efecto de estos esfingolípidos en la homeostasis de Ca+2 intracelular y su conexión con la apoptosis y el cáncer.

Ca2+ is a second messenger which regulates many functions directly related with cancer such as proliferation, differentiation and apoptosis. The intracellular Ca2+ concentration ([Ca2+]i) is finely regulated by several mechanisms, among them ionic channels, the endoplasmic reticulum Ca2+-ATPase (SERCA), the plasma membrane calcium pump (PMCA) and the mitochondrial Ca2+ transport. In cancer, the tumour cell proliferates without control since the capacity to recognize apoptotic signals has been lost. The apoptosis is regulated by changes in several proteins, as caspases and the Bcl-2 family members, among others. Additionally, the “reticulum stress”, promoted by the accumulation and aggregation of unfolded proteins in the interior of the endoplasmic reticulum (ER), ussually leads to apoptosis. The “reticulum stress” can be induced by several agents, remarkably with thapsigargin, a selective inhibitor of the SERCA, which in turn induces a large increment in [Ca2+]I, leading to apoptosis. As a consequence, currently, derivatives of thapsigargin are successfully been assayed as anti-neoplastic agents. Ca2+ is then transferred to the mitochondria, where it is known to constitute a main apoptotic signal. On the other hand, several sphingolipids, such as ceramide and sphingosine, and their phosphorylated derivatives ceramide-1-phosphate and sphingosine-1-phosphate, directly involved in the [Ca2+]I regulation, are also recognized as signal messengers related with cancer processes. In this review we discuss new evidences on the effect of several sphingolipids in the intracellular Ca2+ homeostasis and its relationship with apoptosis and cancer.

Diferença de potencial nasal: um novo teste para diagnóstico de fibrose cística / Nasal potential difference: a new test for cystic fibrosis diagnosis

Introdução: Fibrose Cística (FC) é uma doença cujo diagnóstico é essencialmente clínico, confirmada por dosagem de cloro no suor acima de 60 mEq/L e/ou identificação das mutações do CFTR causadoras da doença nos dois alelos. Casos atípicos necessitam ser investigados através do exame da diferença de potencial nasal (DPN). Na FC a DPN é mais negativa, há maior despolarização com o amiloride e pouca resposta ao isoproterenol. Objetivo: Determinar os valores da DPN para portadores de FC e grupos controle. Métodos: A DPN foi medida em 24 portadores de FC, 19 portadores de outras doenças não FC e 18 sadios e foram determinadas a média e desvio-padrão da DPN máxima, 8 amil, 8ØCl, 8iso, 8Cl, 8amil+iso e index DPN. Resultados: A média da DPN máxima foi -32 mV no grupo FC, -14 mV no grupo Não FC e -16 mV no grupo Sadio (P<0,0001). No grupo FC a média do 8 amil foi -18 mV, no grupo Não FC -6 mV e no grupo Sadio -7mV (P<0,0001). No grupo FC a média do 8Cl foi 4mV, 17mV no grupo Não FC e 11mV no grupo Sadio. A média do index 8 amil + iso foi - 16mV e o index DPN foi 0,85 no grupo FC, comparado com -0,6 mV e 0,26 no grupo Não FC e -2mV e 0,23 no grupo Sadio. Conclusões: O teste da DPN pode claramente diferenciar o grupo FC, com valores semelhantes aos descritos na literatura, possibilitando seu emprego futuro como teste diagnóstico complementar nos casos atípicos de FC.

Cystic Fibrosis (CF) is a disease whose diagnosis is essentially clinical, confirmed by measurement of sweatchloride above 60mEq / L and / or identification of CFTR mutations that cause disease in two alleles. Atypical cases need to be investigated by the nasal potential difference test (NPD). In CF the NPD is more negative, there is increased depolarization with amiloride (Eamil ) and a poor response to the isoproterenol (Eiso). Aim: To determine the values of NPD for CF patients and control groups. Methods: DPN was measured in 24 CF patients, 19 carriers of other diseases non-CF and 18 healthy and the mean plus standard deviation of NPD maximum, E amyl, EØCl, Eiso, ECl, E amil+iso and index NPD were determined. Results: NPD maximum in the FC group was -32 mV, -14 mV In the non-CF and-16mV in healthy group (p <0.0001). In the CF group the mean Eamil was - 18mV, -6mV in the non-FC group and -7mV in healthy (p <0.0001). The ECl mean was 4mV in CF group, 17mV in non-CF and 11mV in healthy. The average of the index E amil+iso was-16mV and DPN index was 0.85 in FC group compared with -0.6 mV and 0.26 in non-CF and -2mV, and 0.23 in healthy. Conclusions: The test of DPN can clearly distinguish the CF group, with values similar to those described in the literature, enabling their future use as a complementary diagnostic test in atypical cases of CF.

Passagens de ions peróxido para a superfície dentária externa após clareamento com peróxido de hidrogênio / Peroxide íons passage throug external dental surface after internal bleaching with hydrogen peroxide

O objetivo deste trabalho foi avaliar a quantidade de peróxido que passa da câmara pulpar para a superfície dentária externa durante o clareamento interno no esmalte, cemento e dentina. Foram utilizados 50 incisivos bovinos extraídos que receberam aberturas coronárias, as raízes foram cortadas a 5 mm da junção amelo-cementária e foi realizado um tampão de 2mm de ionômero de vidro selando a entrada do canal. A extremidade apical dos espécimes foi isolada externamente com resina composta fotoativada. Os dentes foram então impermeabilizados completamente, deixando exposto somente as áreas a serem estudadas. As câmaras coronárias foram preenchidas com peróxido de hidrogênio a 35%. Os dentes foram divididos em três grupos experimentais e dois grupos controles, com 10 espécimes cada. GE – esmalte exposto a ser avaliado; GC – cemento exposto a ser avaliado; GD – dentina exposta a ser avaliada; e dois grupos Controle: GC1 – sem a presença de clareador internamente e sem impermeabilização e GC2 – câmara pulpar preenchida com clareador e impermeabilização total. Cada amostra foi colocado no interior de reservatórios individuais com 1000μl de solução tampão de acetato 2M (pH 4,5). Após 7 dias a 37±1ºC a solução foi transferida para um tubo de ensaio onde foram adicionados 100μl do corante violeta leucocristal e 50 μl de peroxidase, resultando em uma solução de coloração azul. A mensuração da absorbância foi feita em um espectrofotômetro e convertida em μg/ml de peróxido. Para avaliar se houve diferença entre os grupos experimentais e controle, realizou-se os testes de Kruskall-Walis e Dunn-Bunferroni e os resultados mostraram os íon passaram mais pela dentina exposta, seguida da dentina recoberta pelo esmalte e dentina recoberta pelo cemento, sem diferenças estatísticas. Todos os grupos experimentais foram diferentes dos controles...

The aim of this study was evaluated the pulp chamber penetration of peroxide bleaching agent to the root surface during the internal bleach technique in the enamel, dentin and cement. Bovine teeth were sectioned 5mm apical of the cemento-enamel junction and was performed a 2mm cervical seal with glass ionomer cement. The external apical part of samples was filled with composite resin. The teeth were divided into three experimental groups and two control groups: GE – exposition of enamel; GC – exposition of cement; GD – exposition of dentin and control groups: GC1 – no presence of internal agent bleaching e no waterproof and GC2 – pulp chamber filled with bleaching agent and total waterproof. Each sample was placed inside of individual flasks with 1000μl of acetate buffer solution 2M (pH 4.5). After 7 days, the buffer solution was transferred to a glass tube where leuco crystal violet and horseradish peroxidase were added, producing a blue solution. The optical density of the blue solution was determined by spectrophotometer and converted into microgram equivalents of hydrogen peroxide. Data were submitted to Kruskal-Wallis, and Dunn-Bunferroni tests. The results showed that the ions penetration was higher in dentin followed by enamel and cement. All experimental groups presented statistical differences to the control groups.

Rhodnius prolixus Malpighian tubules and control of diuresis by neurohormones

Rhodnius prolixus Malpighian tubules (MTs) are a good model for fluid and ion secretion studies in view of the dramatic postprandial diuresis, which follows its massive blood meals. Ingestion of a blood meal equals to 10-12 times their initial body mass, leads to rapid activation of high output by excretory system, which eliminates 40-50 percent of the fluid mass. Secretion of ions and water is stimulated 1000-fold by serotonin and diuretic hormone. These hormones cooperate synergistically to activate adenylate cyclase activity from MTs cells, which increase the level of intracellular cAMP. The anti-diuretic hormones have also an important role in the fluid maintenance of Rhodnius prolixus. Several hours after insect feeding occurs a reduction in urine flow, that has been thought to result from a decreased diuretic hormone release or from a novel mechanism of anti-diuresis involving insect cardioacceleratory peptide 2b (CAP2b) and cyclic GMP. In this article it is discussed how the hormone regulation of fluid transport is done in Rhodnius prolixus MTs.

Os túbulos de Malpighi (TMs) de Rhodnius prolixus são reconhecidos por serem excelentes modelos para o estudo da secreção de fluidos e íons devido a grande diurese que ocorre quando esses animais se alimentam de sangue. O inseto, após alimentação, pode aumentar seu peso corporal inicial em até 10-12 vezes, o que leva a rápida ativação do sistema excretor, que elimina 40-50 por cento do fluido corporal. A secreção de íons e água é estimulada 1000 vezes pela serotonina e pelos hormônios diuréticos. Esses hormônios agem sinergicamente ativando a adenil ciclase das células dos TMs, aumentando os níveis intracelulares de AMPc. Os hormônios anti-diuréticos também têm um importante papel na manutenção dos fluídos corporais do Rhodnius prolixus. Várias horas após a alimentação do inseto ocorre uma redução do fluxo urinário, o que foi sugerido ser decorrente da diminuição da liberação dos hormônios diuréticos ou da anti-diurese envolvendo o peptídeo cardioaceleratório 2b (CAP2b) e o GMPc. Neste artigo é discutida a regulação hormonal do transporte de fluido nos MTs de Rhodnius prolixus.

Nuevas perspectivas en el síndrome de QT largo / New perspectives in long QT syndrome

Long QT Syndrome (LQTS) is a cardiac channelopathy characterized by prolonged ventricular repolarization and increased risk to sudden death secondary to ventricular dysrrhythmias. Was the first cardiac channelopathy described and is probably the best understood. After a decade of the sentinel identification of ion channel mutation in LQTS, genotype-phenotype correlations have been developed along with important improvement in risk stratification and genetic guided-treatment. Genetic screening has shown that LQTS is more frequent than expected and interestingly, ethnic specific polymorphism conferring increased susceptibility to drug induced QT prolongation and torsades de pointes have been identified. A better understanding of ventricular arrhythmias as an adverse effect of ion channel binding drugs, allow the development of more safety formulas and better control of this public health problem. Progress in understanding the molecular basis of LQTS has been remarkable; eight different genes have been identified, however still 25% of patients remain genotype-negative. This article is an overview of the main LQTS knowledge developed during the last years.

El síndrome de QT largo (SQTL) es una canalopatía que genera grave alteración en la repolarización ventricular predispone a arritmias malignas y muerte súbita. Fue la primera canalopatía arritmogénica descrita y quizá la mejor entendida hasta ahora. Transcurrida ya más de una década de la identificación de la primera mutación asociada al SQTL, se ha hecho evidente que este trastorno es mucho más frecuente de lo que inicialmente se pensaba; los avances en el conocimiento de la fisiopatología molecular de esta enfermedad han permitido hacer una correlación genotipo-fenotipo, optimizando el tratamiento y permitiendo estratificar el riesgo en forma precisa. Se ha logrado entender con mayor detalle los efectos adversos de distintas drogas que interactúan con los canales iónicos, permitiendo así generar fármacos más seguros y, en su defecto, monitorizar de cerca aquellos que a pesar de tener este efecto adverso, es necesaria su administración. Los avances son importantes pero no todo está dicho, 25% de los casos no tienen mutaciones en los genes descritos hasta la fecha, por lo que el SQTL continúa siendo motivo de investigación. El presente artículo constituye un resumen de los principales conceptos desarrollados en los últimos diez años que han sido cruciales en el manejo de esta enfermedad.

Papel de la vacuola parasitófora de macrófagos de ratón infectados por Leishmania amazonensis en la adquisición de de moléculas / Role of the parasitophorous vacuole of murine macrophages infected with Leishmania amazonensis in molecule acquisition

Introducción. Leishmania son parásitos intracelulares de macrófagos, confinados en compartimentos denominados vacuolas parasitóforas. La permeabilidad de este compartimento depende de su interacción con el tráfico vesicular y transportadores presentes en su membrana. Objetivo. En este trabajo se estudió la permeabilidad de la membrana de la vacuola parasitófora en la línea celular J774.A1 infectada con Leishmania amazonensis, in situ y en compartimentos aislados. Materiales y métodos. El aislamiento de vacuolas parasitóforas se hizo por gradiente de densidad. La permeabilidad de la membrana de estas se valoró por distribución de sondas fluorescentes y electrofisiología. Para establecer indirectamente el transporte de protones se usó naranja de acridina. La presencia de transportadores ABC sensibles a probenecid se estableció con amarillo lucifer y calceína. Por primera vez con la técnica de patch-clamp se registraron corrientes en la membrana de este compartimento aislado. Resultados. La vacuola parasitófora colorea de rojo con naranja de acridina indicando un pH ácido. Concentra amarillo lucifer a través de un transportador sensible a probenecid, pero excluye la sonda calceína. Vacuolas aisladas se marcan de rojo con naranja de acridina y concentran amarillo lucifer a través de un transportador sensible a probenecid. Estas vacuolas excluyeron calceína y presentaron en su membrana una corriente iónica que se activa a diferencias de potencial cercanas a 60 mV, con una conductancia de 46 ± 3 pS. Conclusiones. Se pueden aislar vacuolas parasitóforas con propiedades de permeabilidad que preservan mecanismos de transporte similares a los encontrados in situ. Se registra por primera vez la presencia de una corriente iónica poco selectiva en la membrana de este compartimiento.

Introduction. Leishmania are intracellular parasites of macrophages, confined into compartments known as parasitophorous vacuoles. The permeability of this compartment depends on its interaction with the endocytic pathway and transport proteins present on its membrane. Objective. The membrane permeability of the parasitophorous vacuole was studied in J774.A1- macrophage like cells infected with Leishmania amazonensis, in situ and on isolated compartments. Materials and methods. The parasitophorous vacuoles were isolated by density gradients. Fluorescent probe distribution and electrophysiological recordings were used to determine parasitophorous vacuole membrane permeability. Proton transport was evaluated indirectly by acridine orange staining. Probenecid sensitive ABC transporters were detected using the fluorescent probes lucifer yellow and calcein. For the first time ion currents were recorded on the membrane of isolated parasitophorous vacuoles using the patch clamp technique. Results. The parasitophorous vacuole stains red with acridine orange indicating an acidic compartment. It concentrates lucifer yellow by means of a probenecid sensitive transporter but excludes calcein. Isolated vacuoles stained red with acridine orange and concentrated lucifer yellow by means of a probenecid sensitive transporter. These vacuoles excluded calcein and showed an ion current in their membrane which is activated at potentials close to 60 mV with a mean conductance of 46 ± 3 pS. Conclusions. Isolated parasitophorous vacuoles with permeability properties preserving transport mechanisms similar to those found in situ can be purified. A poorly selective ion current on the parasitophorous vacuole membrane is reported for the first time.

Apical Maxi-chloride channel from human placenta: 12 years after the first electrophysiological recordings

The Maxi-chloride channel was the first ion channel described by electrophysiological methods in placenta. Because it is difficult to access a complex epithelium such as the placenta for electrophysiological procedures, the studies of ion channels from placental membranes have been performed only very recently. It was only in 1993 that a direct demonstration of a high-conductance chloride channel in apical membranes of intact trophoblastic epithelium was mentioned, and two years later, the description of this channel was reported from purified placental apical membranes reconstituted into artificial lipid membranes suitable for patch-clamp recordings. This brief review comments on the work done with regard to the electrophysiological characterization and regulation of the large-conductance or "Maxi" chloride channel and its contribution to the development of a cellular model for syncytiotrophoblast ion transport.

Estudio de los mecanismos de transporte iónico involucrados en la secreción en túbulos de malpighi de chipo (Rhodnius prolixus) / Study of the mechanism of ionic transport involved on the secretion of malpighian tubes of chipos (Rhodnius prolixus)

Se midió la tasa de secreción y los cambios en la concentración interna de sodio y protones de los túbulos demalpighi (UMT) en Rhodnius prolixus bajo estimulación con 5-OH-Triptamina. Para medir secreción utilizamos un sistema de doble perfusión para tener acceso por separado a las membranas basolateral y/o apical de la célula. Los flujos iónicos se midieron por microfluorometría. Se aplicaron hasta trece agentes farmacológicos: Ouabaina, Bafilomicina A1, Furosamida, Bumetanida, DIOA, Probenecina, SITS, Acetazolamida, Amilorida, DPC, BaCl2, pCMBS y DTT. Estos agentes son bloqueadores conocidos de diferentes funciones de transporte de iones, conocidos como ATPasas, co- y/o contratransportadores asi como de canales iónicos y de agua. La asunción básica es que los cambios en los movimientos de agua reflejan los cambios en los mecanismos del transporte de iones que se localizan de la siguiente manera: (i) en la membrana basolateral de la célula, los principales son un cotransportador de Na+-K+-2Cl– y el intercambiador de Cl--HCO- 3; la ATPasa de Na+- K+ y la ATPasa de Na+ y los canales de Cl- y de agua (Rp-MIP) son de importancia intermedia, mientras que los canales de K+ son menos importantes: (ii) en la membrana celular apical, la mayor importancia la tiene un cotransportador de K+-Cl-, que ha sido localizado por primera vez, una ATPasa de H+ tipo V, y un intercambiador de Na+-H+; el intercambiador urato-anión y los canales de K+ son importantes mientras que los canales de Clno lo son. En este trabajo presentamos un modelo actualizado que explica la secreción del UMT.

We have measured fluid secretion rate and intracelular concentration of sodium and protons, in Rhodnius prolixusUMT stimulated to secrete with 5-OH-tryptamine. We used double perfusions in order to have access separately to the basolateral and to the apical cell membranes. The ionic fluxes has been measured using microfluorimetry. 13 pharmacological agents were applied: Ouabain, Bafilomycin A1, Furosemide, Bumetanide, DIOA, Probenecid, SITS, Acetazolamide, Amiloride, DPC, BaCl2, pCMBS and DTT. These agents are known to block different ion transport functions, namely ATPases, co- and/or counter- transporters and ionic and water channels. The basic assumption is that water movement changes reflect changes on ion transport mechanisms which we localize as follows: (i) At the basolateral cell membrane: a Na+ - K+ - 2Cl- cotransport; a Cl- - HCO3 - exchange; the Na+ - K+ - ATPase, Cl- channels and Rp-MIP water channels are fundamental; K+ channels play a lesser role. (ii) At the apical cell membrane, a K+ - Cl- cotransport that is located for the first time; a V - H+ - ATPase; an Na+– H+ exchange; an urate - anion exchange and K+ channels are important, while Cl- channels are not. The present experiments allow us to build a tentative model for the function of the UMT cell, which includes a paracellular pathway for fluid flow. In this work we propose a new actualized model to explain the UMT secretion.

The Shiga toxin 2 B subunit inhibits net fluid absorption in human colon and elicits fluid accumulation in rat colon loops

Shiga toxin (Stx)-producing Escherichia coli (STEC) colonizes the large intestine causing a spectrum of disorders, including watery diarrhea, bloody diarrhea (hemorrhagic colitis), and hemolytic-uremic syndrome. It is estimated that hemolytic-uremic syndrome is the most common cause of acute renal failure in infants in Argentina. Stx is a multimeric toxin composed of one A subunit and five B subunits. In this study we demonstrate that the Stx2 B subunit inhibits the water absorption (Jw) across the human and rat colonic mucosa without altering the electrical parameters measured as transepithelial potential difference and short circuit current. The time-course Jw inhibition by 400 ng/ml purified Stx2 B subunit was similar to that obtained using 12 ng/ml Stx2 holotoxin suggesting that both, A and B subunits of Stx2 contributed to inhibit the Jw. Moreover, non-hemorrhagic fluid accumulation was observed in rat colon loops after 16 h of treatment with 3 and 30 ng/ml Stx2 B subunit. These changes indicate that Stx2 B subunit induces fluid accumulation independently of A subunit activity by altering the usual balance of intestinal absorption and secretion toward net secretion. In conclusion, our results suggest that the Stx2 B subunit, which is non-toxic for Vero cells, may contribute to the watery diarrhea observed in STEC infection. Further studies will be necessary to determine whether the toxicity of Stx2 B subunit may have pathogenic consequences when it is used as a component in an acellular STEC vaccine or as a vector in cancer vaccines.

Ion movements in cell death: from protection to exection

Cell death is preceded by severe disruption of inorganic ion homeostasis. Seconds to minutes after an injury, calcium, protons, sodium, potassium and chloride are exchanged between the cell and its environment. Simultaneously, ions are shifted between membrane compartments inside the cell, whereby mitochondria and endoplasmic reticulum play a crucial role. Depending of the type and severity of injury, two mutually exclusive metastable states can be reached, which predict the final outcome. Cells characterized by large increases in cytosolic [Ca2+], [Na+] and [Mg2+] swell and die by necrosis; alternatively, cells characterized by high [H+] and low [K+], with normal [Na+] and normal to moderate [Ca2+] increases die by apoptosis. The levels of these ions represent central determinants in signaling events leading to cell death. Their movements are explained mechanistically by specific modulation of membrane transport proteins including channels, pumps and carriers

Efectos del AMPc sobre la actividad de la ATPasa de Na/K en células aisladas del epitelio cilar de ojos de conejo / Effects of AMPc on Na/K ATPase activity in isolated cells from ciliar epithelium of rabbit eyes

Evaluar el efecto del AMPc sobre los mecanismos de transporte activo de iones responsables de la secreción de humor acuoso en células aisladas del epitelio ciliar de los ojos del conejo, usando el radioisótopo 86Rb como trazador. Se aislaron células de epitelio ciliar de ojos de conejo en las cuales se evaluó el efecto de dibutiril AMPc y forskolín (estimulador de la enzima edenilato ciclasa)sobre las actividades de la ATPasa de Na/K (Captación de 86Rb sensible a ouabaina) y el cotransporte Na/K/2CI (Captación de 86Rb sensible a bumetanida). La radioactividad intrecelular fue determinada a través de centelleo líquido. El dibutiril AMPc 10-ü M produjo una inhibición significativa de la actividad de la ATPasa de Na/K en relación al control (n= 6 218ñ11 vs. 124ñ08 nmoles./mg. protein. min. P= 0,0008) mientras que no afectó al cotransporte de Na/K/2CI (m= 6114ñ07 Vs. 110ñ09 nmoles/mg. protein. min). El forskolín (5x10-ü M), produjo también una inhibición significativa de la actividad de la ATPasa de Na/K (n= 6 262ñ19 Vs. 200ñ16 nmoles/mg. protein.min. P= 0,0113) sin afectar al cotransporte de Na/K/2Cl (n= 6128ñ10 Vs. 119ñ06 nmoles/mg.protein.min). Nuestros resultados indican que el AMPc posiblemente actúa como regulador de la producción de humor acuoso a través de su efecto inhibitorio sobre la ATPasa de Na/K presentes en las células de epitelio ciliar

Human red blood cells from prenatal hemopoiesis. Lithium flux (sodium dependent) asymmetry

In red cells from umbilical cord blood it has been referred the existence of lithium fluxes (contralateral sodium dependent) asymmetry. On account of the relevancy of this transport system in some pathologies it is pertinent the study of its kinetics to relate normal with pathological states in which it is affected. Lithium fluxes--contralateral sodium dependent were determined in N-ethylmaleimide treated neonatal red blood cells. Experimental data were fitted by simple Michaelis-Menten kinetics, finding Km and Vmax variables. It was shown the persistency of asymmetry. The independence of sulfhydryl groups (or the occultation of the groups involved to this inhibitor) could explain asymmetry persistence.