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Computational and Experimental Analysis of Genetic Variants. 遗传变异的计算与实验分析。
IF 5.8 2区 医学 Q1 PHYSIOLOGY Pub Date : 2022-03-29 DOI: 10.1002/cphy.c210012
Jeremy W Prokop, Vladislav Jdanov, Lane Savage, Michele Morris, Neil Lamb, Elizabeth VanSickle, Cynthia L Stenger, Surender Rajasekaran, Caleb P Bupp

Genomics has grown exponentially over the last decade. Common variants are associated with physiological changes through statistical strategies such as Genome-Wide Association Studies (GWAS) and quantitative trail loci (QTL). Rare variants are associated with diseases through extensive filtering tools, including population genomics and trio-based sequencing (parents and probands). However, the genomic associations require follow-up analyses to narrow causal variants, identify genes that are influenced, and to determine the physiological changes. Large quantities of data exist that can be used to connect variants to gene changes, cell types, protein pathways, clinical phenotypes, and animal models that establish physiological genomics. This data combined with bioinformatics including evolutionary analysis, structural insights, and gene regulation can yield testable hypotheses for mechanisms of genomic variants. Molecular biology, biochemistry, cell culture, CRISPR editing, and animal models can test the hypotheses to give molecular variant mechanisms. Variant characterizations can be a significant component of educating future professionals at the undergraduate, graduate, or medical training programs through teaching the basic concepts and terminology of genetics while learning independent research hypothesis design. This article goes through the computational and experimental analysis strategies of variant characterization and provides examples of these tools applied in publications. © 2022 American Physiological Society. Compr Physiol 12:3303-3336, 2022.

基因组学在过去十年中呈指数级增长。通过全基因组关联研究(GWAS)和定量追踪位点(QTL)等统计策略,常见变异与生理变化相关。通过广泛的过滤工具,包括群体基因组学和基于三人的测序(父母和先证者),罕见变异与疾病相关。然而,基因组关联需要后续分析,以缩小因果变异,识别受影响的基因,并确定生理变化。存在大量数据,可用于将变异与基因变化、细胞类型、蛋白质途径、临床表型和建立生理基因组学的动物模型联系起来。这些数据与生物信息学相结合,包括进化分析、结构洞察和基因调控,可以为基因组变异的机制产生可测试的假设。分子生物学、生物化学、细胞培养、CRISPR编辑和动物模型可以验证这些假设,从而给出分子变异机制。在学习独立研究假设设计的同时,通过教授遗传学的基本概念和术语,变体特征可以成为教育本科生、研究生或医学培训项目中未来专业人员的重要组成部分。本文介绍了变异表征的计算和实验分析策略,并提供了这些工具在出版物中应用的示例。©2022美国生理学会。中国生物医学工程学报(英文版),2012。
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引用次数: 4
Polycystic Ovary Syndrome and the Neuroendocrine Consequences of Androgen Excess. 多囊卵巢综合征和雄激素过量的神经内分泌后果。
IF 5.8 2区 医学 Q1 PHYSIOLOGY Pub Date : 2022-03-29 DOI: 10.1002/cphy.c210025
Mauro S B Silva, Rebecca E Campbell

Polycystic ovary syndrome (PCOS) is a major endocrine disorder strongly associated with androgen excess and frequently leading to female infertility. Although classically considered an ovarian disease, altered neuroendocrine control of gonadotropin-releasing hormone (GnRH) neurons in the brain and abnormal gonadotropin secretion may underpin PCOS presentation. Defective regulation of GnRH pulse generation in PCOS promotes high luteinizing hormone (LH) pulsatile secretion, which in turn overstimulates ovarian androgen production. Early and emerging evidence from preclinical models suggests that maternal androgen excess programs abnormalities in developing neuroendocrine circuits that are associated with PCOS pathology, and that these abnormalities are sustained by postpubertal elevation of endogenous androgen levels. This article will discuss experimental evidence, from the clinic and in preclinical animal models, that has significantly contributed to our understanding of how androgen excess influences the assembly and maintenance of neuroendocrine impairments in the female brain. Abnormal central gamma-aminobutyric acid (GABA) signaling has been identified in both patients and preclinical models as a possible link between androgen excess and elevated GnRH/LH secretion. Enhanced GABAergic innervation and drive to GnRH neurons is suspected to contribute to the pathogenesis and early manifestation of neuroendocrine derangement in PCOS. Accordingly, this article also provides an overview of GABA regulation of GnRH neuron function from prenatal development to adulthood to discuss possible avenues for future discovery research and therapeutic interventions. © 2022 American Physiological Society. Compr Physiol 12:3347-3369, 2022.

多囊卵巢综合征(PCOS)是一种与雄激素过多密切相关的主要内分泌疾病,常导致女性不孕。虽然传统上认为PCOS是卵巢疾病,但大脑中促性腺激素释放激素(GnRH)神经元的神经内分泌控制改变和促性腺激素分泌异常可能是PCOS的基础。多囊卵巢综合征中GnRH脉冲产生的调节缺陷促进高黄体生成素(LH)脉冲分泌,这反过来过度刺激卵巢雄激素的产生。来自临床前模型的早期和新出现的证据表明,母体雄激素过量会导致与多囊卵巢综合征病理相关的发育中的神经内分泌回路异常,而这些异常是由青春期后内源性雄激素水平升高维持的。本文将讨论来自临床和临床前动物模型的实验证据,这些证据对我们理解雄激素过量如何影响女性大脑中神经内分泌损伤的组装和维持有重要贡献。中枢γ -氨基丁酸(GABA)信号异常已在患者和临床前模型中被确定为雄激素过量和GnRH/LH分泌升高之间的可能联系。gaba能神经支配的增强和GnRH神经元的驱动可能与PCOS神经内分泌紊乱的发病机制和早期表现有关。因此,本文也提供了从产前发育到成年期GABA调节GnRH神经元功能的概述,以讨论未来发现研究和治疗干预的可能途径。©2022美国生理学会。中国生物医学工程学报(英文版),2012。
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引用次数: 4
Cell Networks in Endocrine/Neuroendocrine Gland Function. 内分泌/神经内分泌腺功能中的细胞网络。
IF 5.8 2区 医学 Q1 PHYSIOLOGY Pub Date : 2022-03-29 DOI: 10.1002/cphy.c210031
Nathalie C Guérineau, Pauline Campos, Paul R Le Tissier, David J Hodson, Patrice Mollard

Reproduction, growth, stress, and metabolism are determined by endocrine/neuroendocrine systems that regulate circulating hormone concentrations. All these systems generate rhythms and changes in hormone pulsatility observed in a variety of pathophysiological states. Thus, the output of endocrine/neuroendocrine systems must be regulated within a narrow window of effective hormone concentrations but must also maintain a capacity for plasticity to respond to changing physiological demands. Remarkably most endocrinologists still have a "textbook" view of endocrine gland organization which has emanated from 20th century histological studies on thin 2D tissue sections. However, 21st -century technological advances, including in-depth 3D imaging of specific cell types have vastly changed our knowledge. We now know that various levels of multicellular organization can be found across different glands, that organizational motifs can vary between species and can be modified to enhance or decrease hormonal release. This article focuses on how the organization of cells regulates hormone output using three endocrine/neuroendocrine glands that present different levels of organization and complexity: the adrenal medulla, with a single neuroendocrine cell type; the anterior pituitary, with multiple intermingled cell types; and the pancreas with multiple intermingled cell types organized into distinct functional units. We give an overview of recent methodologies that allow the study of the different components within endocrine systems, particularly their temporal and spatial relationships. We believe the emerging findings about network organization, and its impact on hormone secretion, are crucial to understanding how homeostatic regulation of endocrine axes is carried out within endocrine organs themselves. © 2022 American Physiological Society. Compr Physiol 12:3371-3415, 2022.

生殖、生长、应激和代谢是由调节循环激素浓度的内分泌/神经内分泌系统决定的。在各种病理生理状态下,所有这些系统都会产生节律和激素搏动的变化。因此,内分泌/神经内分泌系统的输出必须在一个狭窄的有效激素浓度窗口内调节,但也必须保持可塑性的能力,以应对不断变化的生理需求。值得注意的是,大多数内分泌学家仍然对内分泌腺组织持“教科书”式的观点,这种观点源于20世纪对薄二维组织切片的组织学研究。然而,21世纪的技术进步,包括特定细胞类型的深入3D成像,极大地改变了我们的知识。我们现在知道,在不同的腺体中可以发现不同水平的多细胞组织,不同物种的组织结构也不同,可以通过修改来增强或减少激素的释放。本文主要研究细胞组织如何通过三种不同组织和复杂程度的内分泌/神经内分泌腺来调节激素输出:肾上腺髓质,具有单一的神经内分泌细胞类型;垂体前叶,具有多种混杂的细胞类型;胰腺有多种混杂的细胞类型组成不同的功能单位。我们给出了最近的方法,允许研究内分泌系统内的不同组成部分,特别是它们的时间和空间关系的概述。我们相信关于网络组织及其对激素分泌的影响的新发现对于理解内分泌轴在内分泌器官内部如何进行稳态调节至关重要。©2022美国生理学会。中国生物医学工程学报(英文版),2016。
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引用次数: 0
Developmental Effects of Electronic Cigarette Use. 电子烟使用对发育的影响。
IF 5.8 2区 医学 Q1 PHYSIOLOGY Pub Date : 2022-03-29 DOI: 10.1002/cphy.c210018
Joseph M Collaco, Sharon A McGrath-Morrow

Electronic cigarettes have gained widespread acceptance among adolescents and young adults. As a result of this popularity, there are concerns regarding the potential harm of primary, secondhand and thirdhand electronic cigarette exposures on fetal and postnatal development. In vitro studies have shown that constituents in electronic cigarette liquids, including nicotine, flavorings, and carrier agents can alter cellular processes and growth. Additionally, aerosolized electronic cigarette emissions have been shown to disrupt organ development and immune responses in preclinical studies. In clinical studies, an association between electronic cigarette use and frequent respiratory symptoms, greater asthma severity and impaired mucociliary clearance has been demonstrated with adolescent and young adult users of electronic cigarettes having twice the frequency of cough, mucus production, or bronchitis compared to nonusers. Along with the popularity of electronic cigarette use, secondhand electronic cigarette exposure has increased substantially; with almost one-fourth of middle and high school children reporting exposure to secondhand vapors. The health consequences of secondhand electronic cigarette exposure on children and other vulnerable populations are poorly understood but detectable levels of cotinine have been measured in nonusers. Pregnant women and their offspring are another vulnerable group at increased risk for health consequences from electronic cigarette exposure. Nicotine crosses the placenta and can disrupt brain and lung development in preclinical studies. This article will focus on the physiological and health effects associated with primary or secondhand exposure to electronic cigarettes. It is expected that with ongoing availability of electronic cigarettes as well as the accumulation of additional follow-up time for long-term outcomes, the risks associated with exposure will become better clarified. © 2022 American Physiological Society. Compr Physiol 12:3337-3346, 2022.

电子烟在青少年和年轻人中得到了广泛的接受。由于电子烟的流行,人们担心接触一手、二手和三手电子烟对胎儿和产后发育的潜在危害。体外研究表明,电子烟液体中的成分,包括尼古丁、调味剂和载体剂,可以改变细胞的过程和生长。此外,在临床前研究中,雾化电子烟的排放物已被证明会破坏器官发育和免疫反应。在临床研究中,电子烟的使用与频繁的呼吸道症状、更严重的哮喘严重程度和粘膜纤毛清除受损之间存在关联,与不使用电子烟的青少年和年轻成人相比,电子烟使用者咳嗽、产生粘液或支气管炎的频率是前者的两倍。随着电子烟使用的普及,二手电子烟暴露量大幅增加;近四分之一的中学生和高中生报告接触二手烟。接触二手电子烟对儿童和其他弱势群体的健康影响尚不清楚,但在不使用电子烟的人群中测量了可替宁的可检测水平。孕妇及其后代是另一个易受电子烟危害的弱势群体。临床前研究显示,尼古丁会穿过胎盘,扰乱大脑和肺部的发育。这篇文章将重点讨论与初次或二手接触电子烟有关的生理和健康影响。预计随着电子烟的持续可获得性以及对长期结果的额外随访时间的积累,与接触相关的风险将得到更好的阐明。©2022美国生理学会。中国生物医学工程学报(英文版),2012。
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引用次数: 0
State of Knowledge on Molecular Adaptations to Exercise in Humans: Historical Perspectives and Future Directions. 关于人类运动分子适应性的知识现状:历史展望与未来方向。
IF 4.2 2区 医学 Q1 PHYSIOLOGY Pub Date : 2022-03-09 DOI: 10.1002/cphy.c200033
Kaleen M Lavin, Paul M Coen, Liliana C Baptista, Margaret B Bell, Devin Drummer, Sara A Harper, Manoel E Lixandrão, Jeremy S McAdam, Samia M O'Bryan, Sofhia Ramos, Lisa M Roberts, Rick B Vega, Bret H Goodpaster, Marcas M Bamman, Thomas W Buford

For centuries, regular exercise has been acknowledged as a potent stimulus to promote, maintain, and restore healthy functioning of nearly every physiological system of the human body. With advancing understanding of the complexity of human physiology, continually evolving methodological possibilities, and an increasingly dire public health situation, the study of exercise as a preventative or therapeutic treatment has never been more interdisciplinary, or more impactful. During the early stages of the NIH Common Fund Molecular Transducers of Physical Activity Consortium (MoTrPAC) Initiative, the field is well-positioned to build substantially upon the existing understanding of the mechanisms underlying benefits associated with exercise. Thus, we present a comprehensive body of the knowledge detailing the current literature basis surrounding the molecular adaptations to exercise in humans to provide a view of the state of the field at this critical juncture, as well as a resource for scientists bringing external expertise to the field of exercise physiology. In reviewing current literature related to molecular and cellular processes underlying exercise-induced benefits and adaptations, we also draw attention to existing knowledge gaps warranting continued research effort. © 2021 American Physiological Society. Compr Physiol 12:3193-3279, 2022.

几个世纪以来,经常锻炼被认为是促进、维持和恢复人体几乎所有生理系统健康功能的有效刺激。随着人们对人体生理学复杂性的认识不断加深,方法论的可能性不断发展,以及日益严峻的公共卫生形势,将运动作为预防或治疗手段的研究从未像现在这样跨学科,也从未像现在这样影响深远。在美国国立卫生研究院共同基金(NIH Common Fund)"体育锻炼分子传导者联盟"(MoTrPAC)计划的早期阶段,该领域已做好充分准备,在现有对运动相关益处的内在机制的理解的基础上进行深入研究。因此,我们提出了一个全面的知识体系,详细介绍了当前围绕人类运动分子适应性的文献基础,以在这一关键时刻提供该领域的现状,并为将外部专业知识引入运动生理学领域的科学家提供资源。在回顾与运动引起的益处和适应性的分子和细胞过程相关的现有文献时,我们还提请注意需要继续研究的现有知识差距。© 2021 美国生理学会。Compr Physiol 12:3193-3279, 2022.
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引用次数: 0
The Cardiac Na+ -Ca2+ Exchanger: From Structure to Function. 心脏Na+ -Ca2+交换器:从结构到功能。
IF 5.8 2区 医学 Q1 PHYSIOLOGY Pub Date : 2021-12-29 DOI: 10.1002/cphy.c200031
Michela Ottolia, Scott John, Adina Hazan, Joshua I Goldhaber

Ca2+ homeostasis is essential for cell function and survival. As such, the cytosolic Ca2+ concentration is tightly controlled by a wide number of specialized Ca2+ handling proteins. One among them is the Na+ -Ca2+ exchanger (NCX), a ubiquitous plasma membrane transporter that exploits the electrochemical gradient of Na+ to drive Ca2+ out of the cell, against its concentration gradient. In this critical role, this secondary transporter guides vital physiological processes such as Ca2+ homeostasis, muscle contraction, bone formation, and memory to name a few. Herein, we review the progress made in recent years about the structure of the mammalian NCX and how it relates to function. Particular emphasis will be given to the mammalian cardiac isoform, NCX1.1, due to the extensive studies conducted on this protein. Given the degree of conservation among the eukaryotic exchangers, the information highlighted herein will provide a foundation for our understanding of this transporter family. We will discuss gene structure, alternative splicing, topology, regulatory mechanisms, and NCX's functional role on cardiac physiology. Throughout this article, we will attempt to highlight important milestones in the field and controversial topics where future studies are required. © 2021 American Physiological Society. Compr Physiol 12:1-37, 2021.

Ca2+稳态对细胞功能和存活至关重要。因此,细胞质内Ca2+浓度受到大量专门的Ca2+处理蛋白的严格控制。其中之一是Na+ -Ca2+交换器(NCX),这是一种普遍存在的质膜转运体,利用Na+的电化学梯度将Ca2+驱逐出细胞,而不是其浓度梯度。在这一关键作用下,这种二级转运蛋白指导重要的生理过程,如Ca2+稳态、肌肉收缩、骨形成和记忆等。本文就近年来有关哺乳动物NCX结构及其与功能关系的研究进展进行综述。由于对该蛋白进行了广泛的研究,因此将特别强调哺乳动物心脏异构体NCX1.1。鉴于真核交换体之间的保守程度,本文强调的信息将为我们理解这种转运体家族提供基础。我们将讨论基因结构、选择性剪接、拓扑结构、调控机制以及NCX在心脏生理学中的功能作用。在这篇文章中,我们将试图强调该领域的重要里程碑和未来需要研究的有争议的话题。©2021美国生理学会。中国生物医学工程学报(英文版),2012。
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引用次数: 10
Structure and Function of Na,K-ATPase-The Sodium-Potassium Pump. Na, k - atp酶-钠钾泵的结构与功能。
IF 5.8 2区 医学 Q1 PHYSIOLOGY Pub Date : 2021-12-29 DOI: 10.1002/cphy.c200018
Natalya U Fedosova, Michael Habeck, Poul Nissen

Na,K-ATPase is an ubiquitous enzyme actively transporting Na-ions out of the cell in exchange for K-ions, thereby maintaining their concentration gradients across the cell membrane. Since its discovery more than six decades ago the Na-pump has been studied extensively and its vital physiological role in essentially every cell has been established. This article aims at providing an overview of well-established biochemical properties with a focus on Na,K-ATPase isoforms, its transport mechanism and principle conformations, inhibitors, and insights gained from crystal structures. © 2021 American Physiological Society. Compr Physiol 11:1-21, 2021.

Na, k - atp酶是一种普遍存在的酶,它积极地将Na离子运输出细胞以交换k离子,从而维持它们在细胞膜上的浓度梯度。自从60多年前钠泵被发现以来,人们对其进行了广泛的研究,并确定了它在每个细胞中的重要生理作用。本文旨在概述Na, k - atp酶同种异构体,其运输机制和主要构象,抑制剂以及从晶体结构中获得的见解。©2021美国生理学会。中国生物医学工程学报(英文版),2011。
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引用次数: 14
Control of Mammalian Locomotion by Somatosensory Feedback. 通过体感反馈控制哺乳动物的运动
IF 4.2 2区 医学 Q1 PHYSIOLOGY Pub Date : 2021-12-29 DOI: 10.1002/cphy.c210020
Alain Frigon, Turgay Akay, Boris I Prilutsky

When animals walk overground, mechanical stimuli activate various receptors located in muscles, joints, and skin. Afferents from these mechanoreceptors project to neuronal networks controlling locomotion in the spinal cord and brain. The dynamic interactions between the control systems at different levels of the neuraxis ensure that locomotion adjusts to its environment and meets task demands. In this article, we describe and discuss the essential contribution of somatosensory feedback to locomotion. We start with a discussion of how biomechanical properties of the body affect somatosensory feedback. We follow with the different types of mechanoreceptors and somatosensory afferents and their activity during locomotion. We then describe central projections to locomotor networks and the modulation of somatosensory feedback during locomotion and its mechanisms. We then discuss experimental approaches and animal models used to investigate the control of locomotion by somatosensory feedback before providing an overview of the different functional roles of somatosensory feedback for locomotion. Lastly, we briefly describe the role of somatosensory feedback in the recovery of locomotion after neurological injury. We highlight the fact that somatosensory feedback is an essential component of a highly integrated system for locomotor control. © 2021 American Physiological Society. Compr Physiol 11:1-71, 2021.

动物在地面行走时,机械刺激会激活位于肌肉、关节和皮肤中的各种感受器。这些机械感受器的传入神经投射到脊髓和大脑中控制运动的神经元网络。神经轴不同层次的控制系统之间的动态互动确保运动能适应环境并满足任务需求。在本文中,我们将描述和讨论躯体感觉反馈对运动的重要贡献。我们首先讨论身体的生物力学特性如何影响体感反馈。接着,我们将介绍不同类型的机械感受器和体感传入及其在运动过程中的活动。然后,我们将介绍运动网络的中枢投射和运动过程中的体感反馈调节及其机制。然后,我们讨论用于研究体感反馈对运动控制的实验方法和动物模型,最后概述体感反馈对运动的不同功能作用。最后,我们简要介绍了体感反馈在神经损伤后运动恢复中的作用。我们强调,躯体感觉反馈是运动控制系统高度整合的重要组成部分。© 2021 美国生理学会。Compr Physiol 11:1-71, 2021.
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引用次数: 0
Oxalate Flux Across the Intestine: Contributions from Membrane Transporters. 草酸通量通过肠道:膜转运蛋白的贡献。
IF 5.8 2区 医学 Q1 PHYSIOLOGY Pub Date : 2021-12-29 DOI: 10.1002/cphy.c210013
Jonathan M Whittamore, Marguerite Hatch

Epithelial oxalate transport is fundamental to the role occupied by the gastrointestinal (GI) tract in oxalate homeostasis. The absorption of dietary oxalate, together with its secretion into the intestine, and degradation by the gut microbiota, can all influence the excretion of this nonfunctional terminal metabolite in the urine. Knowledge of the transport mechanisms is relevant to understanding the pathophysiology of hyperoxaluria, a risk factor in kidney stone formation, for which the intestine also offers a potential means of treatment. The following discussion presents an expansive review of intestinal oxalate transport. We begin with an overview of the fate of oxalate, focusing on the sources, rates, and locations of absorption and secretion along the GI tract. We then consider the mechanisms and pathways of transport across the epithelial barrier, discussing the transcellular, and paracellular components. There is an emphasis on the membrane-bound anion transporters, in particular, those belonging to the large multifunctional Slc26 gene family, many of which are expressed throughout the GI tract, and we summarize what is currently known about their participation in oxalate transport. In the final section, we examine the physiological stimuli proposed to be involved in regulating some of these pathways, encompassing intestinal adaptations in response to chronic kidney disease, metabolic acid-base disorders, obesity, and following gastric bypass surgery. There is also an update on research into the probiotic, Oxalobacter formigenes, and the basis of its unique interaction with the gut epithelium. © 2021 American Physiological Society. Compr Physiol 11:1-41, 2021.

上皮草酸运输是胃肠(GI)在草酸稳态中所起作用的基础。饮食中草酸盐的吸收,连同其分泌到肠道,以及肠道微生物群的降解,都可以影响这种无功能的终代谢物在尿液中的排泄。对转运机制的了解与理解高草酸尿的病理生理有关,高草酸尿是肾结石形成的危险因素,肠道也提供了一种潜在的治疗手段。下面的讨论对肠道草酸转运进行了广泛的回顾。我们首先概述草酸盐的命运,重点是草酸盐的来源、速率和吸收和分泌在胃肠道中的位置。然后我们考虑通过上皮屏障的转运机制和途径,讨论跨细胞和细胞旁成分。重点是膜结合阴离子转运体,特别是那些属于大型多功能Slc26基因家族的阴离子转运体,其中许多在整个胃肠道中表达,我们总结了目前已知的它们参与草酸盐转运的情况。在最后一节,我们研究了被认为参与调节这些途径的生理刺激,包括肠道适应慢性肾脏疾病、代谢性酸碱紊乱、肥胖和胃旁路手术后的肠道适应。还有关于益生菌,草酸杆菌formigenes的最新研究,以及它与肠道上皮的独特相互作用的基础。©2021美国生理学会。中国生物医学工程学报(英文版),2011。
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引用次数: 2
Renal Tubular Handling of Glucose and Fructose in Health and Disease. 健康和疾病中肾小管对葡萄糖和果糖的处理。
IF 5.8 2区 医学 Q1 PHYSIOLOGY Pub Date : 2021-12-29 DOI: 10.1002/cphy.c210030
Volker Vallon, Takahiko Nakagawa

The proximal tubule of the kidney is programmed to reabsorb all filtered glucose and fructose. Glucose is taken up by apical sodium-glucose cotransporters SGLT2 and SGLT1 whereas SGLT5 and potentially SGLT4 and GLUT5 have been implicated in apical fructose uptake. The glucose taken up by the proximal tubule is typically not metabolized but leaves via the basolateral facilitative glucose transporter GLUT2 and is returned to the systemic circulation or used as an energy source by distal tubular segments after basolateral uptake via GLUT1. The proximal tubule generates new glucose in metabolic acidosis and the postabsorptive phase, and fructose serves as an important substrate. In fact, under physiological conditions and intake, fructose taken up by proximal tubules is primarily utilized for gluconeogenesis. In the diabetic kidney, glucose is retained and gluconeogenesis enhanced, the latter in part driven by fructose. This is maladaptive as it sustains hyperglycemia. Moreover, renal glucose retention is coupled to sodium retention through SGLT2 and SGLT1, which induces secondary deleterious effects. SGLT2 inhibitors are new anti-hyperglycemic drugs that can protect the kidneys and heart from failing independent of kidney function and diabetes. Dietary excess of fructose also induces tubular injury. This can be magnified by kidney formation of fructose under pathological conditions. Fructose metabolism is linked to urate formation, which partially accounts for fructose-induced tubular injury, inflammation, and hemodynamic alterations. Fructose metabolism favors glycolysis over mitochondrial respiration as urate suppresses aconitase in the tricarboxylic acid cycle, and has been linked to potentially detrimental aerobic glycolysis (Warburg effect). © 2022 American Physiological Society. Compr Physiol 12:2995-3044, 2022.

肾脏近端肾小管会重吸收所有滤过的葡萄糖和果糖。葡萄糖由肾顶端的钠-葡萄糖共转运体 SGLT2 和 SGLT1 吸收,而 SGLT5 以及潜在的 SGLT4 和 GLUT5 则与肾顶端的果糖吸收有关。近端肾小管摄取的葡萄糖通常不会被代谢,而是通过基底侧的促进性葡萄糖转运体 GLUT2 离开肾小管,经基底侧的 GLUT1 吸收后返回全身循环或被远端肾小管用作能量来源。在代谢性酸中毒和吸收后阶段,近端肾小管会产生新的葡萄糖,而果糖是一种重要的底物。事实上,在生理条件和摄入量下,近端肾小管吸收的果糖主要用于葡萄糖生成。在糖尿病肾脏中,葡萄糖被保留下来,而糖元生成得到加强,后者部分是由果糖驱动的。这种情况是不适应的,因为它会维持高血糖。此外,肾脏葡萄糖潴留通过 SGLT2 和 SGLT1 与钠潴留耦合,从而诱发继发性有害影响。SGLT2 抑制剂是新型抗高血糖药物,可保护肾脏和心脏免受衰竭,与肾功能和糖尿病无关。膳食中过量的果糖也会诱发肾小管损伤。在病理条件下,肾脏形成的果糖会加剧这种损伤。果糖代谢与尿酸盐的形成有关,这也是果糖诱发肾小管损伤、炎症和血液动力学改变的部分原因。果糖代谢有利于糖酵解而非线粒体呼吸,因为尿酸盐会抑制三羧酸循环中的丙酮酸酶,并与潜在的有害有氧糖酵解(沃伯格效应)有关。© 2022 美国生理学会。Compr Physiol 12:2995-3044, 2022.
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Comprehensive Physiology
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