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Cell and Transport Physiology |



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* Institute of Physiology and Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland;
Molecular and Vascular Medicine Unit and Renal Division, Beth Israel Deaconess Medical Center, and
Department of Medicine, Harvard Medical School, Boston, Massachusetts; and
Jackson Laboratories, Bar Harbor, Maine
Address correspondence to: Dr. Carsten A. Wagner, Institute of Physiology and Zurich Center for Integrative Human Physiology, University of Zurich, Winterthurerstrasse 190, CH-807 Zurich, Switzerland. Phone: +41-44-63-50569; Fax: +41-44-63-56814; E-mail: wagnerca{at}access.unizh.ch
Received for publication October 2, 2006. Accepted for publication February 14, 2007.
Mutations in the human gene that encodes the AE1 Cl/HCO3 exchanger (SLC4A1) cause autosomal recessive and dominant forms of distal renal tubular acidosis (dRTA). A mouse model that lacks AE1/slc4a1 (slc4a1/) exhibited dRTA characterized by spontaneous hyperchloremic metabolic acidosis with low net acid excretion and, inappropriately, alkaline urine without bicarbonaturia. Basolateral Cl/HCO3 exchange activity in acid-secretory intercalated cells of isolated superfused slc4a1/ medullary collecting duct was reduced, but alternate bicarbonate transport pathways were upregulated. Homozygous mice had nephrocalcinosis associated with hypercalciuria, hyperphosphaturia, and hypocitraturia. A severe urinary concentration defect in slc4a1/ mice was accompanied by dysregulated expression and localization of the aquaporin-2 water channel. Mice that were heterozygous for the AE1-deficient allele had no apparent defect. Thus, the slc4a1/ mouse is the first genetic model of complete dRTA and demonstrates that the AE1/slc4a1 Cl/HCO3 exchanger is required for maintenance of normal acid-base homeostasis by distal renal regeneration of bicarbonate in the mouse as well as in humans.
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