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). β€œIntestinal absorption of sugars.” Physiol. Rev., 40, 789–825.

β€’ Wright, E. M. & Loo, D. D. F. (2000). β€œCoupling between Na+, sugar, and water transport across the intestine.” Ann. NY Acad. Sci., 915, 54–66.

β€’ Wright, E. M. et al. (2017). β€œNovel and unexpected functions of SGLTs.” Physiology, 32, 435–443.

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