Background/Aims: Fructose causes a sodium-sensitive hypertension and acutely reduces the urinary Na⁺ excretion, suggesting that it may regulate the activity of renal tubular sodium transporters. NHE3 is highly expressed in proximal tubule (PT), along with proteins that mediate fructose transport and metabolism. The present work was outlined to investigate whether fructose modulates proximal NHE3 activity and to elucidate the molecular mechanisms underlying this modulation. Methods/Results: Using in vivo stationary microperfusion, we observed that fructose stimulates NHE3 mediated JHCO₃^- reabsorption. The MAPK pathway is not involved in this activation, as demonstrated by using of MEK/MAPK inhibitors, whereas experiments using a PKA inhibitor suggest that PKA inhibition plays a role in this response. These results were confirmed in vitro by measuring the cell pH recovery rate after NH₄Cl pulse in LLC-PK1, a pig PT cell line, which showed reduced cAMP levels and NHE3 phosphorylation at serine-552 (PKA consensus site) after fructose treatment. Conclusions: NHE3 activity is stimulated by fructose, which increases proximal tubule Na⁺ reabsorption. The molecular mechanisms involved in this process are mediated, at least in part, by downregulation of the PKA signaling pathway. Future studies are needed to address whether fructose-stimulated NHE3 activity may contribute to renal injury and hypertension.

Angiotensin II (Ang II) exerts an acute bimodal effect on proximal tubule NHE3: while low doses stimulate the exchanger, high doses inhibit it. In the present study, we have investigated the chronic effects of Ang II on NHE3 expression and transcriptional regulation. Treatment of a tubular epithelial cell line, OKP, with Ang II 10(-11)M significantly increased NHE protein expression and mRNA levels, without evidence of bimodal effect. No change in mRNA half-life was detected, but transient transfection studies showed a significant increase in NHE3 promoter activity. Binding sites for Sp1/Egr-1 and AP2 transcription factors of the NHE3 proximal promoter were mutated and we observed that the Sp1/Egr-1 binding site integrity is necessary for Ang II stimulatory effects. Inhibition of cytochrome P450, PI3K, PKA and MAPK pathways prevented the Ang II stimulatory effect on the NHE3 promoter activity. Taking all the results together, our data reveal that chronic Ang II treatment exerts a stimulatory effect on NHE3 expression and promoter activity. The Ang II up-regulation of the NHE3 promoter activity appears to involve the Sp1/Egr-1 binding site and the interplay of several intracellular signaling pathways.

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High fructose (F) intake adversely affects the kidneys. This study was outlined to investigate F effects on NHE3 activity. Microperfusion showed that 2 and 3mM F stimulate JHCO3‐(nmol/cm2 × s) (2.87 ± 0.19, P < 0.001 and 2.78 ± 0.14, P < 0.01 × 2.08 ± 0.10, control). Action of F on S3226 (NHE3 inhibitor) sensitive‐component showed NHE3 stimulation (1.18 ± 0.07 × 1.81 ± 0.01, P < 0.0001). MAPK pathway is not involved in this activation, as demonstrated by using U1026 and SB203580 (MEK and p38 MAPK inhibitors), whereas 8 br cAMP (cAMP analogue) and forskolin (phosphodiesterase inhibitor) + IBMX (adenylyl cyclase activator) showed that PKA inhibition plays a role in this response. F stimulated JH+ (mM/min) after an acid pulse in LLC‐PK1, a pig PT cell line (11.44 ± 1.09 3mM F × 5.98 ± 0.82 control, P < 0.01). HOE694 (NHE1 inhibitor) and S3226 showed that F increases NHE3, not NHE1 activity. Signaling pathways investigation showed similar results in PT and LLC‐PK1. Cells were treated or not with F for 5, 15 and 30 min and the ATP and cAMP contents were examined. There was a significant decrease in ATP (47, 53 and 37%, respectively) and in cAMP (45 and 31%, respectively) and a not significant reduction at 30 min. Antibody against phosphorylated substrates showed PKA inhibition in F treated cells. Thus, F stimulates NHE3 activity through PKA inhibition, which increases Na+ reabsorption and can contribute to renal injury.Support: CNPq, FAPESP.