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Am J Physiol Renal Physiol (February 4, 2009). doi:10.1152/ajprenal.90451.2008
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Submitted on August 5, 2008
Revised on February 2, 2009
Accepted on February 2, 2009

Effects of receptor-mediated endocytosis and tubular protein composition on volume retention in experimental glomerulonephritis

Christian Kastner1, Marcus Pohl1, Mauricio Sendeski, Gerti Stange2, Carsten A Wagner3, Boye L. Jensen4, Andreas Patzak5, Sebastian Bachmann6, and Franziska Theilig7*

1 Institute of Anatomy
2 Institute of Physiology
3 University of Zurich
4 University of Southern Denmark
5 'Humboldt - University, Charite
6 Charité - Universitaetsmedizin Berlin
7 Charite - Universitatsmedizin Berlin

* To whom correspondence should be addressed. E-mail: franziska.theilig{at}charite.de.

Human glomerulonephritis (GN) is characterized by sustained proteinuria, sodium retention, hypertension, and edema formation. Increasing quantities of filtered protein enter the renal tubule where they may alter epithelial transport functions. Exaggerated endocytosis and consequent protein overload may affect proximal tubules, but intrinsic malfunction of distal epithelia has also been reported. A straightforward assignment to a particular tubule segment causing salt retention in GN is still controversial. We hypothesized that (I) trafficking and surface expression of major transporters and channels involved in volume regulation were altered in GN, and (II) proximal tubular endocytosis may influence locally as well as downstream expressed tubular transporters and channels. Effects of anti-glomerular basement membrane GN were studied in controls and megalin-deficient mice with blunted proximal endocytosis. Mice displayed salt retention and elevated systolic blood pressure when proteinuria had reached 10 to 15 mg/24 h. Surface expression of proximal Na+-coupled transporters and water channels was in part (NaPi-IIa and AQP1) increased by megalin deficiency alone, but unchanged (NHE3) or reduced (NaPi-IIa and AQP1) in GN irrespective of the endocytosis defect. In distal epithelia, significant increases in proteolytic cleavage products of {alpha}ENaC and {gamma}ENaC were observed, suggesting enhanced tubular sodium reabsorption. The effects of glomerular proteinuria dominated over those of blunted proximal endocytosis in contributing to ENaC cleavage. Our data indicate that ENaC-mediated sodium entry may be the rate-limiting step in proteinuric sodium retention. Enhanced proteolytic cleavage of ENaC points to a novel mechanism of channel activation which may involve the action of filtered plasma proteases.







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