Summary
The distal segments beyond the macula densa — distal convoluted tubule, connecting tubule, cortical collecting duct — display cellular heterogeneity. The four different cell types, namely the DCT cell, CNT cell, the principal cell and intercalated cell differ mainly by the pattern of membrane amplification and they reveal also qualitative differences as to some cytoplasmic proteins.
Each of the four cell types adapts to chronic changes in electrolyte metabolism with structural alteration, concerning essentially the membrane area over which the active transport step of the cell proceeds, in DCT-, CNT- and P-cells the basolateral cell membrane with the Na-K-ATPase, in intercalated cells the luminal cell membrane with a H+ ATPase. Since each cell type responds only to specific conditions with changes in membrane area and associated transcellular transport activity, morphological studies can help to determine the specific role of each cell type in the regulation of renal electrolyte excretion. Such investigations demonstrated that besides mineralocorticoid hormones the transport capacity of certain cells should depend on the solute composition of tubular fluid. Thus, changes in the transport pattern specifically induced in only one segment alters also the transport patterns of segments downstream. Cellular heterogeneity seems to guarantee the optimal regulation of renal electrolyte excretion.
Zusammenfassung
Die distalen Tubuli in der Nierenrinde gliedern sich nach der Macula densa in drei morphologisch verschieden gebaute Abschnitte: in die pars convoluta des distalen Tubulus (DCT), den Verbindungstubulus (CNT) und das corticale Sammelrohr (CCD). In den drei Segmenten sind insgesamt vier Zelltypen vorhanden: die DCT-Zelle, die CNT-Zelle, die Haupt-Zelle (P-Zelle) und die Schaltzelle (I-Zelle), die sich unter anderem an Hand der Ausbildung ihrer Zellmembranfläche unterscheiden lassen. In der DCT-, CNT- und P-Zelle ist in verschiedenem Ausmaß jeweils die basolaterale Membranfläche vergrößert, in der die Na-K-ATPase lokalisiert ist. In der I-Zelle ist die luminale Zellmembran vergrößert, in der wahrscheinlich eine H+-ATPase vorhanden ist.
Bei längerdauernden Änderungen im Elektrolythaushalt treten in den Zellen strukturelle Anpassungserscheinungen auf, die vor allem das Ausmaß der aktiv transportierenden Membranflächen betreffen (basolaterale Membranflächen in DCT-, CNT- und P-Zellen; luminale Membran in I-Zellen). Die Veränderungen der basolateralen Membranfläche verhalten sich proportional zu den Änderungen der Na-K-ATPase-Aktivität und zeigen daher eine entsprechende Änderung der transzellulären Transportkapazität an.
Morphologische Untersuchungen haben gezeigt, daß jeder Zelltyp nur auf für ihn spezifische Veränderungen im Elektrolythaushalt reagiert und erlauben daher gewisse Rückschlüsse auf die spezifische Rolle der einzelnen Zelltypen bei der Regulierung des Elektrolytausscheidung. Aus dem Muster der strukturellen Veränderungen läßt sich ableiten, daß bei bestimmten Zelltypen außer Hormonen offenbar auch die Elektrolytzusammensetzung der Tubulusflüssigkeit den transzellulären Transport beeinflußt. Daher müssen Veränderungen des Elektrolyttransports, die in einem Abschnitt spezifisch induziert werden (z.B. durch Furosemid), sich auch in nachgeschalteten Abschnitten auf den transzellulären Transport auswirken. Die zelluläre Heterogenität der distalen Abschnitte scheint eine differenzierte Regulierung der Elektrolytausscheidung unter unterschiedlichsten Bedingungen zu garantieren.
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Kaissling, B. Cellular heterogeneity of the distal nephron and its relation to function. Klin Wochenschr 63, 868–876 (1985). https://doi.org/10.1007/BF01738139
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DOI: https://doi.org/10.1007/BF01738139