Multiple acid-base and electrolyte disturbances upregulate NBCn1, NBCn2, IRBIT and L-IRBIT in the mTAL.

KEY POINTS: The roles of the Na+ /HCO3- cotransporters NBCn1 and NBCn2 as well as their activators IRBIT and L-IRBIT in the regulation of the mTAL transport of NH4+ , HCO3- , and NaCl are investigated. Dietary challenges of NH4 Cl, NaHCO3 or NaCl all increase the abundance of NBCn1 and NBCn2 in the outer medulla. The three challenges generally produce parallel increases in the abundance of IRBIT and L-IRBIT in the outer medulla. Both IRBIT and L-IRBIT powerfully stimulate the activities of the mTAL isoforms of NBCn1 and NBCn2 as expressed in Xenopus oocytes. Our findings support the hypothesis that NBCn1, NBCn2, IRBIT and L-IRBIT appropriately promote NH4+ shunting but oppose HCO3- and NaCl reabsorption in the mTAL, and thus are at the nexus of the regulation pathways for multiple renal transport processes. ABSTRACT: The medullary thick ascending limb (mTAL) plays a key role in urinary acid and NaCl excretion. NBCn1 and NBCn2 are present in the basolateral mTAL, where NBCn1 promotes NH4+ shunting. IRBIT and L-IRBIT (the IRBITs) are two powerful activators of certain acid-base transporters. Here we use western blotting and immunofluorescence to examine the effects of multiple acid-base and electrolyte disturbances on expression of NBCn1, NBCn2 and the IRBITs in rat kidney. We also use electrophysiology to examine the functional effects of IRBITs on NBCn1 and NBCn2 in Xenopus oocytes. NH4 Cl-induced metabolic acidosis (MAc) substantially increases protein expression of NBCn1 and NBCn2 in the outer medulla (OM) of rat kidney. Surprisingly, NaHCO3 -induced metabolic alkalosis (MAlk) and high-salt diet (HSD) also increase expression of NBCn1 and NBCn2 (effect of NaHCO3  > HSD). Moreover, all three challenges generally increase OM expression of the IRBITs. In Xenopus oocytes, the IRBITs substantially increase the activities of NBCn1 and NBCn2. We propose that upregulation of basolateral NBCn1 and NBCn2 plus the IRBITs in the mTAL: (1) promotes NH4+ shunting by increasing basolateral HCO3- uptake to neutralize apical NH4+ uptake during MAc; (2) inhibits HCO3- reabsorption during MAlk by opposing HCO3- efflux via the basolateral anion exchanger AE2; and (3) inhibits NaCl reabsorption by mediating (with AE2) net NaCl backflux into the mTAL cell during HSD. Thus, NBCn1, NBCn2 and the IRBITs are at the nexus of the regulatory pathways for multiple renal transport processes.

The Balance of [Formula: see text] Secretion vs. Reabsorption in the Endometrial Epithelium Regulates Uterine Fluid pH.

Uterine fluid contains a high concentration of [Formula: see text] which plays an essential role in sperm capacitation and fertilization. In addition, the [Formula: see text] concentration in uterine fluid changes periodically during the estrous cycle. It is well-known that the endometrial epithelium contains machineries involving the apical SLC26 family anion exchangers for secreting [Formula: see text] into the uterine fluid. In the present study, we find for the first time that the electroneutral Na+/[Formula: see text] cotransporter NBCn1 is expressed at the apical membrane of the endometrial epithelium. The protein abundance of the apical NBCn1 and that of the apical SLC26A4 and SLC26A6 are reciprocally regulated during the estrous cycle in the uterus. NBCn1 is most abundant at diestrus, whereas SLC26A4/A6 are most abundant at proestrus/estrus. In the ovariectomized mice, the expression of uterine NBCn1 is inhibited by ß-estradiol, but stimulated by progesterone, whereas that of uterine SLC26A4/A6 is stimulated by ß-estradiol. In vivo perfusion studies show that the endometrial epithelium is capable of both secreting and reabsorbing [Formula: see text]. Moreover, the activity for [Formula: see text] secretion by the endometrial epithelium is significantly higher at estrus than it is at diestrus. The opposite is true for [Formula: see text] reabsorption. We conclude that the endometrial epithelium simultaneously contains the activity for [Formula: see text] secretion involving the apical SLC26A4/A6 and the activity for [Formula: see text] reabsorption involving the apical NBCn1, and that the acid-base homeostasis in the uterine fluid is regulated by the finely-tuned balance of the two activities.

Na+/HCO3- Cotransporter NBCn2 Mediates HCO3- Reclamation in the Apical Membrane of Renal Proximal Tubules.

The kidney maintains systemic acid-base balance by reclaiming from the renal tubule lumen virtually all HCO3- filtered in glomeruli and by secreting additional H+ to titrate luminal buffers. For proximal tubules, which are responsible for about 80% of this activity, it is believed that HCO3- reclamation depends solely on H+ secretion, mediated by the apical Na+/H+ exchanger NHE3 and the vacuolar proton pump. However, NHE3 and the proton pump cannot account for all HCO3- reclamation. Here, we investigated the potential contribution of two variants of the electroneutral Na+/HCO3- cotransporter NBCn2, the amino termini of which start with the amino acids MCDL (MCDL-NBCn2) and MEIK (MEIK-NBCn2). Western blot analysis and immunocytochemistry revealed that MEIK-NBCn2 predominantly localizes at the basolateral membrane of medullary thick ascending limbs in the rat kidney, whereas MCDL-NBCn2 localizes at the apical membrane of proximal tubules. Notably, NH4Cl-induced systemic metabolic acidosis or hypokalemic alkalosis downregulated the abundance of MCDL-NBCn2 and reciprocally upregulated NHE3 Conversely, NaHCO3-induced metabolic alkalosis upregulated MCDL-NBCn2 and reciprocally downregulated NHE3 We propose that the apical membrane of the proximal tubules has two distinct strategies for HCO3- reclamation: the conventional indirect pathway, in which NHE3 and the proton pump secrete H+ to titrate luminal HCO3-, and the novel direct pathway, in which NBCn2 removes HCO3- from the lumen. The reciprocal regulation of NBCn2 and NHE3 under different physiologic conditions is consistent with our mathematical simulations, which suggest that HCO3- uptake and H+ secretion have reciprocal efficiencies for HCO3- reclamation versus titration of luminal buffers.

Effects of Nt-truncation and coexpression of isolated Nt domains on the membrane trafficking of electroneutral Na+/HCO3- cotransporters.

The SLC4 genes are all capable of producing multiple variants by alternative splicing or using alternative promoters. The physiological consequences of such diversity are of great interest to investigators. Here, we identified two novel variants of the electroneutral Na(+)/HCO3- cotransporter NBCn1, one full-length starting with "MIPL" and the other Nt-truncated starting with "MDEL". Moreover, we identified a new promoter of Slc4a10 encoding NBCn2 and a novel type of Nt-truncated NBCn2 starting with "MHAN". When heterologously expressed, the new NBCn1 variants were well localized to the plasma membrane and exhibited characteristic NBCn1 activity. However, MHAN-NBCn2 was poorly localized on the plasma membrane. By deletion mutations, we identified the Nt regions important for the surface localization of NBCn2. Interestingly, coexpressing the full-length NBCn2 greatly enhances the surface abundance of the Nt-truncated NBCn2. Co-immunoprecipitation and bimolecular fluorescence complementation studies showed that the full-length and Nt-truncated NBCn2 interact with each other to form heterodimers in neuro-2A cells. Finally, we showed that the isolated Nt domain interacts with and enhances the surface abundance of the Nt-truncated NBCn2. The present study expands our knowledge of the NBCn1 and NBCn2 transcriptome, and provides insights into how the Nt domain could affect transporter function by regulating its membrane trafficking.

[Bicarbonate reabsorption in proximal renal tubule: molecular mechanisms and metabolic acidosis].

HCO3(-) reabsorption in the renal tubules plays a critically important role in maintaining the global acid-base balance. Loss of HCO3(-) causes metabolic acidosis. Proximal renal tubule is the major site for HCO3(-) reabsorption, accounting for more than 80% of total HCO3(-) reabsorption along the nephron. Over the past more than half centuries, tremendous progresses have been made on understanding the molecular mechanisms underlying the HCO3(-) reabsorption in proximal tubules. The transepithelial movement of HCO3(-) involves the coordinated operation of machineries on both the apical and the basolateral membranes of the epithelial cells. On the apical domain, Na(+)-H(+) exchanger NHE3 and the vacuolar H(+)-ATPase are two major pathways mediating the apical uptake of HCO3(-)-related species. Taken together, NHE3 and H(+)-ATPase are responsible for about 80% of HCO3(-) reabsorption in the proximal tubule. The remaining 20% is likely mediated by pathways yet to be characterized. On the basolateral membrane, NBCe1 represents the only major known pathway mediating the extrusion of HCO3(-) coupled with Na(+) into the interstitial space. In the present article, we provide a historical view about the studies on the mechanisms of HCO3(-) reabsorption since 1940s. Moreover, we summarize the latest progresses emerging over the past decade in the physiological as well as pathological roles of acid-base transporters underlying the HCO3(-) reabsorption in proximal tubules.

Effects of optional structural elements, including two alternative amino termini and a new splicing cassette IV, on the function of the sodium-bicarbonate cotransporter NBCn1 (SLC4A7).

The SLC4A7 gene encodes the electroneutral sodium/HCO3 cotransporter NBCn1, which plays important physiological and pathophysiological roles in many cell types. Previous work identified six NBCn1 variants differing in the sequence of the extreme N terminus--MEAD in rat only, MERF in human only--as well as in the optional inclusion of cassettes I, II, and III. Earlier work also left open the question of whether optional structural elements (OSEs) affect surface abundance or intrinsic (per-molecule) transport activity. Here, we demonstrate for the first time that SLC4A7 from one species can express both MEAD- and MERF-NBCn1. We also identify a novel cassette IV of 20 aa, and extend by 10 the number of full-length NBCn1 variants. The alternative N termini and four cassettes could theoretically produce 32 major variants. Moreover, we identify a group of cDNAs predicted to encode just the cytosolic N-terminal domain (Nt) of NBCn1. A combination of electrophysiology and biotinylation shows that the OSEs can affect surface abundance and intrinsic HCO3(-) transport activity of NBCn1, as expressed in Xenopus oocytes. Specifically, MEAD tends to increase whereas novel cassette IV reduces surface abundance. Cassettes II, III and novel cassette IV all appear to increase the intrinsic activity of NBCn1.

[Effect of apelin on hypoxic pulmonary hypertension in rats: role of the NO pathway].

To investigate the effectiveness and mechanism of apelin against pulmonary hypertension and pulmonary vascular remodeling induced by hypoxia in rats, 24 male Sprague-Dawley rats were randomly divided into normal control (NC) group, 4-week hypoxia (HH) group and 4-week hypoxia with apelin (HA) group (each n=8). The rats of hypoxic group were placed in an isobaric hypoxic chamber, in which O2 and CO2 content was maintained at 9%-11% and <3%, respectively, for 4 weeks (8 h/d, 6 d/week). [pGlu]apelin-13 (10 nmol/kg per day, 28 d) was administered subcutaneously by osmotic mini-pump before hypoxia treatment in HA group. L-arginine (L-Arg) uptake of pulmonary artery was assay by [³H]-L-Arg, while nitric oxide synthase (NOS) activity of pulmonary tissue, and nitrate/nitrite (NO2(-)/NO3(-)) concentrations in pulmonary tissue and plasma were detected by colorimetric technique and nitrate reductase method, respectively. The results showed that mean pulmonary arterial pressure, the ratio value of right ventricle weight to left ventricle plus septum weight, the relative medial thickness, and the relative medial area of pulmonary arterioles were higher in HH group than those in NC group (all P<0.01), while these indices were lower in HA group than those in HH group (P<0.05 or P<0.01). Compared with those in HH group, the uptake of 0.5, 5 and 10 nmol/L [³H]-L-Arg in pulmonary artery in HA group increased by 121.4% (P<0.01), 85.0% (P<0.05) and 61.5% (P<0.05), respectively; cNOS activity of pulmonary tissue increased by 74.3%, while iNOS activity decreased by 25.0% (all P<0.01); and NO2(-)/NO3(-) concentrations in pulmonary tissue and plasma increased by 97.6% and 48.0% (all P<0.05), respectively. Taken together, our results suggest that apelin has a prophylactic effect against hypoxic pulmonary hypertension in rats, and that the mechanism of this effect is possibly associated with activation of the L-Arg/NOS /NO pathway.

[Change data capture implementation in HIS].

The paper introduces the Change Data Capture based on change-track-table implementation in hospital information system. It improves efficiency of the change data capture and distribution in the data flat.

[Effect of hypoxia on the expressions of intermedin/ adrenomedullin2 in plasma and the tissues of heart and lung in rats].

AIM: To study the effect and significances of two-week hypoxia on the expression of intermedin/adrenomedullin2 (IMD/ADM2) in plasma and the tissues of heart and lung in rats. METHODS: Twenty male SD rats were randomly divided into normal control group and hypoxia group. The concentrations of IMD/ADM2 and adrenomedullin (ADM) in plasma, right ventricle and lung tissue were measured by radioimmunoassay. RT-PCR was used to detect the mRNA levels of IMD/ADM2 and ADM in right ventricle and lung tissue. RESULTS: (1) The mean pulmonary arterial pressure (mPAP) and the weight ratio of right ventricle (RV) to left ventricle plus septum (LV + S) of hypoxia group were significantly higher than those of normal control group (P < 0.01). (2) The concentrations of IMD/ADM2 and ADM in plasma were significantly higher in hypoxia group, compared with normal control group (P < 0.01). (3) The concentration of ADM in right ventricle and lung tissue in hypoxia group was significantly higher than that in normal control group (P < 0.01), while there was no significant difference in IMD/ADM2 between the two groups. (4) The mRNA levels of IMD/ADM2 and ADM in right ventricle and lung tissues were significantly up-regulated in hypoxia group (P < 0.05). CONCLUSION: The expressions of IMD/ADM2 peptides and gene in plasma, right ventricular and pulmonary tissues are different in the early-middle pathological proceeding of pulmonary hypertension induced by two-week hypoxia in rats.

[Myocardial polyamine metabolism and the ischemia-reperfusion injury in the rat heart].

OBJECTIVE: To observe the polyamines metabolism changes in rat cardiomyocytes underwent ischemia-reperfusion (I/R) injury. METHODS: A branch of the descending left coronary artery was occluded to induce rat myocardial I/R injury (30 min ischemia followed by 2 h, 6 h, 12 h, and 24 h reperfusion). RT-PCR and Western blot were performed to detect the expression of spermidine/spermine N1-acetyltransferase (SSAT) and ornithine decarboxylase (ODC), the concentrations of polyamines were measured with high performance liquid chromatography in hearts with or without I/R. RESULTS: The myocardial transcription and expression of SSAT and ODC were significantly upregulated. Compared with the sham group, ODC mRNA and SSAT mRNA respectively increased 3.1 fold and 3.8 fold and their proteins respectively increased 3.1 fold and 2.9 fold at 24 h of reperfusion (P < 0.01); the concentrations of spermidine, spermine and the total polyamine pool respectively decreased by 33.6%, 35.3% and 32.9% while putrescine concentration increased by 58.9% at 24 h of reperfusion (P < 0.01). CONCLUSION: Our results suggest that ischemia-reperfusion in the heart may affect polyamine metabolism and the disturbance of polyamine metabolism might thus play a critical role in myocardial I/R injury in this model.

[Dimensional modeling analysis for outpatient payments].

This paper introduces a data warehouse model for outpatient payments, which is designed according to the requirements of the hospital financial management while dimensional modeling technique is combined with the analysis on the requirements. This data warehouse model can not only improve the accuracy of financial management requirements, but also greatly increase the efficiency and quality of the hospital management.

[Mechanism of apoptosis-inducing effects of dopamine on K562 leukemia cells].

OBJECTIVE: To investigate the mechanism of the apoptosis-inducing effects of dopamine on K562 leukemia cells. METHODS: K562 cells were treated with DP2785, the dopamine receptors were detected with fluorescence spectrophotometer, UV spectrophotometer and fluorescence microscope; the contents of cAMP in K562 cells were measured; and the subtypes of dopamine receptor on K562 cells were analyzed by receptor blocking. RESULT: The existence of dopamine receptors in K562 cells was demonstrated by fluorescence microscopy, UV spectrophotometer and fluorescence spectrophotometer. Dopamine enhanced the contents of cAMP in K562 cells. Dopamine receptors were blocked by both D1 and D2 antagonists. CONCLUSION: D1 and D2 dopamine receptors may be involved in dopamine-induced apoptosis of K562 cells, and dopamine can also increase the contents of cAMP in K562 cells.

Improvement of chronic heart failure by dexamethasone is not associated with downregulation of leptin in rats.

AIM: To demonstrate the hypothesis that dexamethasone (Dex) could improve chronic heart failure (CHF) by inhibiting the downstream signaling transduction of leptin but had no influence on the upregulation of leptin and its receptor in myocardium. METHODS: CHF was induced by left coronary artery ligation for 6 weeks. CHF rats were treated with Dex 50 mg.kg/d. Hemodynamics, histology, reactive oxygen species (ROS)-related parameters, and leptin concentrations in serum were measured. The mRNA expression of matrix metalloproteinases (MMP)2/9, tissue inhibitor of metalloproteinases (TIMP)1/2, tumor necrosis factor (TNF)-alpha, and OB-Rb were measured by RT-PCR. RESULTS: In the CHF rats, hemodynamic functions were deteriorated, which was accompanied with myocardium remodeling and histological changes. CHF rats showed hyperleptinemia and excessive ROS in the serum, and the upregulation of MMP-2/9, TNF-alpha, and leptin receptor mRNA and downregulation of TIMP-1/2 mRNA in the myocardium compared with the sham operation group. Dex treatment significantly ameliorated CHF in association with the reversion of the abnormalities of MMP-2/9, TIMP-1/2, TNF-alpha, and ROS. But Dex had no influence on the hyperleptinemia and the upregulated leptin and its receptor in the myocardium during CHF. CONCLUSION: Dex improves CHF by inhibiting TNF-alpha, MMP-2, MMP-9, and ROS. Dex had no effects on upregulated leptin and its receptor expression and hyperleptinemia induced by CHF.