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Am J Physiol Gastrointest Liver Physiol (January 22, 2009). doi:10.1152/ajpgi.90520.2008
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Submitted on August 28, 2008
Revised on January 7, 2009
Accepted on January 14, 2009

Reduced NHE3-Mediated Na+ Absorption Increases Survival and Decreases the Incidence of Intestinal Obstructions in Cystic Fibrosis Mice

Emily M Bradford1, Maureen A Sartor1, Lara R. Gawenis2, Lane L. Clarke3, and Gary E Shull4*

1 University of Cincinnati
2 University of Utah
3 University of Missouri-Columbia
4 University of Cincinnati College of Medicine

* To whom correspondence should be addressed. E-mail: gary.shull{at}uc.edu.

In cystic fibrosis, impaired secretion resulting from loss of activity of the cystic fibrosis transmembrane conductance regulator (CFTR) causes dehydration of intestinal contents and life-threatening obstructions. Conversely, impaired absorption resulting from loss of the NHE3 Na+/H+ exchanger causes increased fluidity of the intestinal contents and diarrhea. To test the hypothesis that reduced NHE3-mediated absorption could increase survival and prevent some of the intestinal pathologies of cystic fibrosis, Cftr/Nhe3 double heterozygous mice were mated and their offspring analyzed. Cftr-null mice lacking one or both copies of the Nhe3 gene exhibited increased fluidity of their intestinal contents, which prevented the formation of obstructions and increased survival. Goblet cell hyperplasia, but not the accumulation of Paneth cell granules or increased cell proliferation in the crypts, was eliminated. Microarray analysis of small intestine RNA from Cftr-null, Nhe3-null, and double-null mice all revealed down-regulation of genes involved in xenobiotic metabolism, including a cohort of genes involved in glutathione metabolism. Expression of energy metabolism genes was altered, but there was no effect on genes involved in inflammation. Total intracellular glutathione was increased in the jejunum of all of the mutants and the ratio of reduced to oxidized glutathione was reduced in Cftr-null mutants, indicating that CFTR-deficiency affects intestinal glutathione metabolism. The data establish a major role for NHE3 in regulating the fluidity of the intestinal contents and show that reduced NHE3-mediated absorption reverses some of the intestinal pathologies of cystic fibrosis, thus suggesting that it may serve as a potential therapeutic target.







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