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1 Physiologisches Institut, University of Wuerzburg, Wuerzburg, Germany
2 Department of Molecular Genetics, Biochemistry, and Microbiology, The University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
3 Physiologisches Institut, University of Duisburg-Essen, Essen, Germany
* To whom correspondence should be addressed. E-mail: michael.gekle{at}mail.uni-wuerzburg.de.
Proximal tubular receptor-mediated endocytosis (RME) of filtered proteins prevents proteinuria. Pharmacological and genetic studies in cultured OK cells have shown that the apical Na+/H+ exchanger isoform 3 (NHE3) supports RME by interference with endosomal pH homeostasis and endocytic fusion events. However, it is not known whether NHE3 also supports proximal tubular RME in vivo. We analyzed proximal tubular protein reabsorption by microinfusion experiments in rats and investigated renal protein excretion in NHE3 knockout (Nhe3-/-) mice. Inhibition of NHE3 by EIPA or S3226 reduced the fractional reabsorption of 14C-cytochrome C by ~50% during early proximal microinfusion. During early distal microinfusion no protein reabsorption could be detected. Urinary protein excretion of Nhe3-/- or heterozygous mutant mice was significantly higher as compared to wild-type mice. SDS-PAGE analysis of urinary proteins revealed that Nhe3-/- animals excreted proteins the size of albumin or smaller. Thus, a reduction in NHE3 activity or abundance causes tubular proteinuria. These data show that NHE3 supports proximal tubular receptor-mediated endocytosis of filtered proteins in vivo.
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