Part 6 Β· Chapter 6.2
Transcellular Transport
Transcellular transport moves solutes from one side of an epithelium to the other by sequential apical and basolateral transporters. Epithelial polarity β different proteins on the two membrane faces β is the architecture that makes directional transport possible. Primary active Na-K ATPase sets up ion gradients that drive secondary active cotransport via SGLT, NHE, and related carriers.
1. Epithelial Polarity
Epithelial cells display distinct apical(luminal, ~10% of membrane) and basolateraldomains separated by the tight junction (M6.1). Vesicular trafficking of membrane proteins is sorted at the trans-Golgi network by apical vs. basolateral sorting signals. This asymmetry is what distinguishes epithelial transport from simple diffusion.
2. The Crane Gradient Hypothesis
Crane 1960 proposed that Na+ cotransport drives uphill solute uptake. In enterocyte sugar absorption: Na-K ATPase on basolateral membrane pumps 3 Na+ out / 2 K+ in (ATP hydrolysis, primary active); this creates [Na+]cell ~10 mM vs [Na+]lumen~140 mM. Apical SGLT1 cotransports Na+ + glucose down the Na+gradient (secondary active), concentrating glucose inside the cell. Basolateral GLUT2 facilitates glucose exit down its gradient. The full circuit absorbs glucose against its blood-side gradient.
Simulation: SGLT1 & Oral Rehydration
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3. Cotransporter Families
- SGLT1/2: Na/glucose. SGLT2 inhibitors (empagliflozin, dapagliflozin) are major type-2 diabetes drugs.
- NHE3: Na/H exchanger in proximal tubule and jejunum.
- NKCC2: Na/K/2Cl in thick ascending limb of Henle. Loop diuretics (furosemide) target this.
- NCC: Na/Cl in distal tubule. Thiazide diuretic target.
- PepT1: H/peptide cotransport in enterocyte.
4. Oral Rehydration Therapy
Cholera produces massive intestinal fluid loss by CFTR hyperactivation (M6.5) but leaves SGLT1 intact. Hirschhorn & Pierce 1968 showed that glucose + NaCl solution drives Na+/H2O absorption via SGLT1, recovering fluid. WHO oral rehydration solution (2% glucose + salts) saves an estimated 50 million lives per year and is perhaps the single most important medical therapy ever developed.
Key References
β’ Crane, R. K. (1960). βIntestinal absorption of sugars.β Physiol. Rev., 40, 789β825.
β’ Wright, E. M. & Loo, D. D. F. (2000). βCoupling between Na+, sugar, and water transport across the intestine.β Ann. NY Acad. Sci., 915, 54β66.
β’ Wright, E. M. et al. (2017). βNovel and unexpected functions of SGLTs.β Physiology, 32, 435β443.