No abstract

The sodium/proton exchanger isoform 3 (NHE3) is expressed in the intestine and the kidney where it facilitates sodium (re)absorption and proton secretion. The importance of NHE3 in the kidney for sodium chloride homeostasis, relative to the intestine, is unknown. Constitutive tubule-specific NHE3 knockout mice (NHE3loxloxCre) did not show significant differences compared to control mice in body weight, blood pH or bicarbonate and plasma sodium, potassium or aldosterone levels. Fluid intake, urinary flow rate, urinary sodium/creatinine and pH were significantly elevated in NHE3loxloxCre mice while urine osmolality and GFR were significantly lower. Water deprivation revealed a small urinary concentrating defect in NHE3loxloxCre mice on a control diet; exaggerated on low sodium chloride. Ten days of low or high sodium chloride diet did not affect plasma sodium in control mice; however, NHE3loxloxCre mice were susceptible to low sodium chloride (about −4 mM) or high sodium chloride intake (about +2 mM) versus baseline, effects without differences in plasma aldosterone between groups. Blood pressure was significantly lower in NHE3loxloxCre mice and was sodium chloride-sensitive. In control mice, the expression of the sodium/phosphate co-transporter Npt2c was sodium chloride-sensitive. However, lack of tubular NHE3 blunted Npt2c expression. Alterations in the abundances of sodium/chloride cotransporter and its phosphorylation at threonine 58 as well as the abundances of the α-subunit of the epithelial sodium channel, and its cleaved form, were also apparent in NHE3loxloxCre mice. Thus, renal NHE3 is required to maintain blood pressure and steady state plasma sodium levels when dietary sodium chloride intake is modified.

Caffeine is one of the most widely consumed behavioral substances. We have previously shown that caffeine- and theophylline-induced inhibition of renal reabsorption causes diuresis and natriuresis, an effect that requires functional adenosine A1 receptors. In this study, we tested the hypothesis that blocking the Gi protein-coupled adenosine A1 receptor via the nonselective adenosine receptor antagonist caffeine changes Na(+)/H(+) exchanger isoform 3 (NHE3) localization and phosphorylation, resulting in diuresis and natriuresis. We generated tubulus-specific NHE3 knockout mice (Pax8-Cre), where NHE3 abundance in the S1, S2, and S3 segments of the proximal tubule was completely absent or severely reduced (>85%) in the thick ascending limb. Consumption of fluid and food, as well as glomerular filtration rate, were comparable in control or tubulus-specific NHE3 knockout mice under basal conditions, while urinary pH was significantly more alkaline without evidence for metabolic acidosis. Caffeine self-administration increased total fluid and food intake comparably between genotypes, without significant differences in consumption of caffeinated solution. Acute caffeine application via oral gavage elicited a diuresis and natriuresis that was comparable between control and tubulus-specific NHE3 knockout mice. The diuretic and natriuretic response was independent of changes in total NHE3 expression, phosphorylation of serine-552 and serine-605, or apical plasma membrane NHE3 localization. Although caffeine had no clear effect on localization of the basolateral Na(+)/bicarbonate cotransporter NBCe1, pretreatment with DIDS inhibited caffeine-induced diuresis and natriuresis. In summary, NHE3 is not required for caffeine-induced diuresis and natriuresis.

The Na/H exchanger isoform 3 (NHE3) facilitates Na absorption and H secretion and is expressed in the intestine, proximal tubule, and thick ascending limb of the kidney. While the function of NHE3 for Na and [Formula: see text](re)absorption has been defined using conventional NHE3 knockout mice (NHE3), the recent generation of conditional NHE3 knockout mice started to give critical new insight into the role of this protein by allowing for temporal and spatial control of NHE3 expression. For example, in contrast to NHE3 mice, knockout of NHE3 in the S1 and S2 segments of the proximal tubule or along the entire tubule/collecting duct does not cause any lethality. Nonabsorbable NHE3 inhibitors have been developed, and preclinical as well as clinical trials indicate possible pharmacological use in fluid overload, hypertension, chronic kidney disease, hyperphosphatemia, and constipation. Some of the therapeutic considerations seem to be directly related to the pharmacodynamic properties of these drugs; however, little is known about the effects of these nonabsorbable NHE3 inhibitors on intestinal phosphate transport and the mechanisms so far remain elusive. This review focuses on novel findings of NHE3 in the intestine and the kidney as well as novel drug developments targeting NHE3.

To investigate the role of the renal nerves in the control of renin secretion during pregnancy, we prepared sheep with one denervated kidney, bilateral renal vein catheters, and an inflatable aortic occluder. The renin secretory responses to step reductions of renal perfusion pressure (RPP) of the innervated and denervated kidneys were compared in eight nonpregnant and nine pregnant (115-130 days gestation) sheep in a normal conscious state. Nonpregnant sheep had average basal levels of mean arterial pressure (MAP) of 91 +/- 3 mmHg, plasma renin activities (PRA) of 2.3 +/- 0.4 ng ANG I.ml-1.3 h-1, and plasma angiotensin (ANG) concentrations of 8.4 +/- 1.1 pg/ml. Pregnant sheep had reduced levels (P < 0.01) of MAP (76 +/- 3 mmHg) but elevated levels of PRA (3.8 +/- 0.4 ng ANG I.ml-1.h 3-1; P < 0.5) and ANG II (12.0 +/- 1.6 pg/ml; P = 0.08). Four successively reduced levels of RPP were observed for 15 min each in both groups of sheep. In both groups, RPP was reduced to a final level of 51 +/- 2 mmHg. The renal venous-arterial difference of PRA (v-aPRA) from the innervated kidneys was increased as RPP was reduced. However, there was little response of v-aPRA to RPP in denervated kidneys. In nonpregnant sheep, the relationship between RPP and renin secretion rate was characterized by an initially slow phase, over which small reductions of RPP resulted in small increases in renin secretion. As RPP fell, this relationship became progressively steeper in nonpregnant ewes.(ABSTRACT TRUNCATED AT 250 WORDS)