Enhanced Na–Li countertransport: a marker of inherited susceptibility to type 2 diabetes

The Less Well-Known Little Brothers: The SLC9B/NHA Sodium Proton Exchanger Subfamily—Structure, Function, Regulation and Potential Drug-Target Approaches

The SLC9 gene family encodes Na+/H+ exchangers (NHEs), a group of membrane transport proteins critically involved in the regulation of cytoplasmic and organellar pH, cell volume, as well as systemic acid-base and volume homeostasis. NHEs of the SLC9A subfamily (NHE 1–9) are well-known for their roles in human physiology and disease. Much less is known about the two members of the SLC9B subfamily, NHA1 and NHA2, which share higher similarity to prokaryotic NHEs than the SLC9A paralogs. NHA2 (also known as SLC9B2) is ubiquitously expressed and has recently been shown to participate in renal blood pressure and electrolyte regulation, insulin secretion and systemic glucose homeostasis. In addition, NHA2 has been proposed to contribute to the pathogenesis of polycystic kidney disease, the most common inherited kidney disease in humans. NHA1 (also known as SLC9B1) is mainly expressed in testis and is important for sperm motility and thus male fertility, but has not been associated with human disease thus far. In this review, we present a summary of the structure, function and regulation of expression of the SLC9B subfamily members, focusing primarily on the better-studied SLC9B paralog, NHA2. Furthermore, we will review the potential of the SLC9B subfamily as drug targets.

A report on the Gubbio Study thirty-eight years after its inception

BACKGROUND

The Gubbio Population Study ("Gubbio Study") is a prospective epidemiological study carried out on the resident population of the city of Gubbio, Italy. The study's objectives are both of public health nature (the control and awareness of hypertension), and experimental (the role of electrolyte handling at the cellular membrane level and its relation to hypertension). Additional objectives were addressed during the 30+ year activity of the study, in particular the role of kidney dysfunction.

METHODS

Three active screenings ('Exams') were performed beginning 38 years ago; the first (Exam 1) in 1983-1986 (5376 individuals - response rate 92%) and two follow-up exams, were completed between 1989-92 (Exam 2) and 2001-2007 (Exam 3). Data collected include demographics, personal and family medical history, lifestyle (smoking, alcohol, diet and physical activity), education, type of work, anthropometry, blood pressure, pulse rate, blood biochemistry, urine biochemistry and special investigations on cellular electrolyte handling. Additional measurements were performed in selected sub-groups of participants. Data on hospitalizations, mortality and causes of death were collected after the completion of Exam 1.

RESULTS

The main results of the study, presented in this paper, identify new variables to consider in screening for cardiovascular risk factors, and show the impact that the focused and coordinated effort of a longitudinal program can have on a free-living population'.

CONCLUSIONS

The data are of relevance to Public Health and to experimental medicine alike, and vouch to the importance of the control of risk factors at the community level.

Cohort profile: The Gubbio Population Study

The Gubbio Study is a prospective epidemiological study on the population residing in the city of Gubbio, Italy. Original objectives of the study were the control of hypertension and the role of cellular electrolyte handling in hypertension. Other objectives were added during the 30-year activity of the study. The original target cohort consists of individuals aged ≥5 years residing within the medieval walls of the city. To complete family genealogies, individuals residing outside the city were also included. Three active screenings (exams) were conducted. A total of 5376 individuals (response rate 92%) participated in Exam 1 which was performed in 1983-86. Follow-up exams were completed between 1989-92 and 2001-2007. Data categories included demographics, personal and family medical history, lifestyle habits, education, type of work, anthropometry, blood pressure, pulse rate, blood biochemistry, urine biochemistry and special investigations on cellular electrolyte handling. Electrocardiogram, echocardiogram, 24-h ambulatory blood pressure and uroflowmetry were performed in selected subgroups defined by age and/or sex. Data about hospitalizations, mortality and causes of death were collected starting from completion of Exam 1. The study shared the data with other studies.

An association study between catalase -262C>T gene polymorphism, sodium-lithium countertransport activity, insulin resistance, blood lipid parameters and their response to atorvastatin, in Greek dyslipidaemic patients and normolipidaemic controls

This study attempted to examine the effect of a functional catalase gene polymorphism, CAT -262C>T, on sodium-lithium countertransport (Na-Li CT) activity, insulin resistance determined as the homeostasis model assessment index (HOMA-IR), blood lipid parameters (cholesterol, triglycerides, low density lipoprotein cholesterol, high density lipoprotein cholesterol, apolipoprotein B, apolipoprotein A-I) and their response to atorvastatin, in previously characterized Greek dyslipidaemic patients and normolipidaemic controls. Putative associations were examined by running univariate analyses with a general linear model, using age, sex, smoking and hypertension as covariates. While no statistically significant associations were detected between the CAT -262C>T polymorphism and either baseline values or their modulation by atorvastatin in the patient group, HOMA-IR values were significantly (p=0.028) lower among CAT -262CC controls compared to their T allele carrier counterparts. A trend towards higher plasma triglyceride values among CAT -262CC genotypes was also detected, in both dyslipidaemic patients and normolipidaemic controls.

Effects of atorvastatin on red-blood cell Na(+)/Li(+) countertransport in hyperlipidemic patients with and without hypertension

BACKGROUND

To explore the effect of short-term cholesterol-lowering treatment with atorvastatin on erythrocyte sodium-lithium countertransport (Na(+)/Li(+) CT) activity.

METHODS

Group A consisted of 30 patients (14 men) with mild essential hypertension (systolic blood pressure (SBP), 140-159 mm Hg and/or diastolic BP, 90-99 mm Hg) and primary hypercholesterolemia low-density lipoprotein (LDL) cholesterol >4.1 mmol/l and triglycerides (TG) <2.8 mmol/l), group B of 30 normotensive patients (16 men) with primary hypercholesterolemia, while 37 (18 men) healthy volunteers comprised the control group. After a 6-week dietary lead-in, all eligible patients were prescribed 20 mg/day of atorvastatin. Anthropometric data, blood-pressure (BP) measurements and determinations of lipid, non-lipid metabolic parameters (including homeostasis model assessment index, (HOMA-IR)) and erythrocyte Na(+)/Li(+) CT activity were collected at baseline and after 12 weeks of treatment.

RESULTS

At baseline Na(+)/Li(+) CT activity was significantly higher in group A and B compared with the control group and correlated directly with obesity indices, systolic and diastolic BP, total cholesterol, LDL-cholesterol, TG, apolipoprotein B (apoB), HOMA-IR, uric acid and inversely with high-density lipoprotein (HDL)-cholesterol and apoA1. Systolic and diastolic BP levels, HOMA-IR and Na(+)/Li(+) CT activity were significantly decreased after atorvastatin treatment in both patient groups. The reduction in Na(+)/Li(+) CT activity correlated with baseline Na(+)/Li(+) CT activity and the changes in HOMA-IR values.

CONCLUSIONS

Short-term treatment with atorvastatin for patients with hypercholesterolemia, and with or without essential hypertension, is associated with a significant reduction in the erythrocyte Na(+)/Li(+) CT activity, BP levels and insulin resistance independent of concomitant changes in lipid parameters.

Cellular cation transport studied by 6/7Li and 23Na NMR in a porous Mo132 Keplerate type nano-capsule as model system

Li+ ions can interplay with other cations intrinsically present in the intra- and extra-cellular space (i.e. Na+, K+, Mg2+ and Ca2+) have therapeutic effects (e.g. in the treatment of bipolar disorder) or toxic effects (at higher doses), likely because Li+ interferes with the intra-/extra-cellular concentration gradients of the mentioned physiologically relevant cations. The cellular transmembrane transport can be modelled by molybdenum-oxide-based Keplerates, i.e. nano-sized porous capsules containing 132 Mo centres, monitored through 6/7Li as well as 23Na NMR spectroscopy. The effects on the transport of Li+ cations through the 'ion channels' of these model cells, caused by variations in water amount, temperature, and by the addition of organic cationic 'plugs' and the shift reagent [Dy(PPP)2](7-) are reported. In the investigated solvent systems, water acts as a transport mediator for Li+. Likewise, the counter-transport (Li+/Na+, Li+/K+, Li+/Cs+ and Li+/Ca2+) has been investigated by 7Li NMR and, in the case of Li+/Na+ exchange, by 23Na NMR, and it has been shown that most (in the case of Na+ and K+, all (Ca2+) or almost none (Cs+) of the Li cations is extruded from the internal sites of the artificial cell to the extra-cellular medium, while Na+, K+ and Ca2+ are partially incorporated.