The cystic fibrosis transmembrane conductance regulator (CFTR) is associated with expression of a chloride conductance that is defective in cystic fibrosis (CF). Xenopus oocytes injected with RNA coding for CFTR that contained mutations in the first nucleotide binding fold (NBF1) expressed chloride currents in response to raising adenosine 3',5'-monophosphate (cAMP) with forskolin and 3-isobutyl-1-methylxanthine (IBMX). The mutant CFTRs were less sensitive than wild-type CFTR to this activating stimulus, and the reduction in sensitivity correlated with the severity of cystic fibrosis in patients carrying the corresponding mutations. This demonstration provides the basis for detailed analyses of NBF1 function and suggests potential pharmacologic treatments for cystic fibrosis.

Mutations in the SLC26A3 (DRA (down-regulated in adenoma)) gene constitute the molecular etiology of congenital chloride-losing diarrhea in humans. To ascertain its role in intestinal physiology, gene targeting was used to prepare mice lacking slc26a3. slc26a3-deficient animals displayed postpartum lethality at low penetrance. Surviving dra-deficient mice exhibited high chloride content diarrhea, volume depletion, and growth retardation. In addition, the large intestinal loops were distended, with colonic mucosa exhibiting an aberrant growth pattern and the colonic crypt proliferative zone being greatly expanded in slc26a3-null mice. Apical membrane chloride/base exchange activity was sharply reduced, and luminal content was more acidic in slc26a3-null mouse colon. The epithelial cells in the colon displayed unique adaptive regulation of ion transporters; NHE3 expression was enhanced in the proximal and distal colon, whereas colonic H,K-ATPase and the epithelial sodium channel showed massive up-regulation in the distal colon. Plasma aldosterone was increased in slc26a3-null mice. We conclude that slc26a3 is the major apical chloride/base exchanger and is essential for the absorption of chloride in the colon. In addition, slc26a3 regulates colonic crypt proliferation. Deletion of slc26a3 results in chloride-rich diarrhea and is associated with compensatory adaptive up-regulation of ion-absorbing transporters.The SLC26A3 or DRA (down-regulated in adenoma) gene was originally identified in a subtractive hybridization screen comparing the mRNAs expressed in colon cancer and normal colon tissue (1). DRA is expressed in normal colonic epithelium, but is absent or reduced in adenomas and adenocarcinomas (1). Subsequent studies identified SLC26A3 (DRA) as a member of a large conserved family of anion exchangers (SLC26) that encompass at least 10 distinct genes (2-20). Except for SLC26A5 (prestin), all function as anion exchangers with versatility with respect to transported anions (2-20). Immunohistochemical studies localized SLC26A3 on the apical membrane of colonic mucosa, with lower levels in the small intestine (4, 25). In humans, SLC26A3 encodes a 764-amino acid protein and is located on chromosome 7 in a head-to-tail arrangement with SLC26A4 (pendrin), indicating ancient gene duplication.Genetic analysis studies linked mutations in DRA (SLC26A3) to congenital chloride-losing diarrhea (CLD 5 ; OMIM accession number 214700), a disease manifested by enhanced chloride loss in the stool and volume depletion (4). Functional studies in vitro have demonstrated that SLC26A3 can mediate multiple anion exchange modes, including Cl Ϫ /HCO 3 Ϫ , Cl Ϫ /oxalate, and Cl Ϫ /hydroxyl, and possibly sulfate/hydroxyl exchanges (6, 21-26). Similar anion exchange activities have been described previously in apical membranes of the colon (27, 28), the site of abundant DRA expression.To initiate an investigation into the role of DRA in an in vivo model, we created slc26a3 (dra) gene-targeted mice that are null for expression of the slc2...

The chloride-secreting colonic cell line, T84, was studied under whole cell patch clamp with Cl as the permeant ion in pipette and bath solutions. Transmembrane current was initially small (approximately 50 pA at +100 mV) but increased steadily to average values of 1-3 nA within 5-10 min. The development of this current was associated with visible cell swelling, either without a shape change or with membrane blebbing. Basal, preswelling current levels were restored by the addition of 50-75 mM sucrose to the bath or when pipette osmolality was reduced by an equivalent amount. These findings suggest that an isosmotic pipette filling solution behaves as if it is hypertonic by approximately 60 mosmol/kgH2O to the bath. Currents traversing the swelling-induced conductance were outwardly rectified and showed activation at hyperpolarizing voltages and inactivation at depolarizing voltages. They were Cl selective because the reversal potential for current flow approached the Cl equilibrium potential when bath [Cl] was varied. Under nonswelling conditions (bath solution, 300 mosmol/kgH2O; pipette solution, 240 mosmol/kgH2O), single-channel steps (approximately 9 pA at +100 mV) could be resolved. The single-channel characteristics were similar to the macroscopic currents recorded from swollen cells, showing inactivation at positive voltages and an outwardly rectified current-voltage relation. Summation of these single-channel events yielded currents that were similar to those from swollen cells, implying that activation of multiple channels with these properties is the basis of the swelling-induced Cl conductance. This volume-sensitive Cl conductance would contribute to a regulatory volume decrease when T84 cells swell. Its relation to the secretory Cl conductance in these cells is unknown.

The majority of antibiotic-induced diarrhea is caused by Clostridium difficile (C. difficile). Hospitalizations for C. difficile infection (CDI) have tripled in the last decade, emphasizing the need to better understand how the organism colonizes the intestine and maintain infection. The mucus provides an interface for bacterial-host interactions and changes in intestinal mucus have been linked host health. To assess mucus production and composition in healthy and CDI patients, the main mucins MUC1 and MUC2 and mucus oligosaccharides were examined. Compared with healthy subjects, CDI patients demonstrated decreased MUC2 with no changes in surface MUC1. Although MUC1 did not change at the level of the epithelia, MUC1 was the primary constituent of secreted mucus in CDI patients. CDI mucus also exhibited decreased N-acetylgalactosamine (GalNAc), increased N-acetylglucosamine (GlcNAc), and increased terminal galactose residues. Increased galactose in CDI specimens is of particular interest since terminal galactose sugars are known as C. difficile toxin A receptor in animals. In vitro, C. difficile is capable of metabolizing fucose, mannose, galactose, GlcNAc, and GalNAc for growth under healthy stool conditions (low Na(+) concentration, pH 6.0). Injection of C. difficile into human intestinal organoids (HIOs) demonstrated that C. difficile alone is sufficient to reduce MUC2 production but is not capable of altering host mucus oligosaccharide composition. We also demonstrate that C. difficile binds preferentially to mucus extracted from CDI patients compared with healthy subjects. Our results provide insight into a mechanism of C. difficile colonization and may provide novel target(s) for the development of alternative therapeutic agents.