Biomedical subjects

Ira Kurtz

Publications and source records attributed to Ira Kurtz.

41 records · Page 3Linked to original sources

PubMed2002

Green urine in a critically ill patient.

The development of discolored urine in the critically ill patient, although uncommon, may have many possible causes, with the most likely source related to medication administration. Studies were undertaken in a 39-year-old man who developed dark green urine while in the intensive care unit for neutropenic sepsis. Although the patient had developed prior nonoliguric renal failure stemming from his sepsis, his renal function at the time of presentation of urine discoloration was considered normal. Review of his medications and intravenous infusions suggested the most likely cause was the food dye placed in his enteral tube feedings. Spectrophotometric evaluation of the urine confirmed the presence of Food Dye and Color Blue Number 1 (FD&C Blue No. 1). This case shows that significant gastrointestinal absorption of FD&C Blue No. 1 can occur. FD&C Blue No. 1 should be considered in the differential diagnosis of dark green discolored urine.

Adult↗

PubMed2002

Functional characterization of NBC4: a new electrogenic sodium-bicarbonate cotransporter.

Sodium-bicarbonate cotransporters are homologous membrane proteins mediating the electrogenic or electroneutral transport of sodium and bicarbonate. Of the functionally characterized sodium-bicarbonate cotransporters (NBC), NBC1 proteins are known to be electrogenic. Here we report the cloning and functional characterization of NBC4c, a new splice variant of the NBC4 gene. At the amino acid level, NBC4c is 56% identical to NBC1 protein variants and 40% identical to electroneutral NBC3. When expressed in mammalian cells, NBC4c mediates electrogenic sodium-bicarbonate cotransport. The transport of sodium and bicarbonate is chloride independent and is completely inhibited by DIDS. NBC4c transcripts were detected in several tissues including brain, heart, kidney, testis, pancreas, muscle, and peripheral blood leukocytes. The data indicate that NBC4c is an electrogenic sodium-bicarbonate cotransporter. The finding that both NBC1 and NBC4c proteins function as electrogenic sodium-bicarbonate cotransporters will aid in determining the structural motifs responsible for this unique functional property, which distinguishes these transporters from other members of the bicarbonate transporter superfamily.

4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid↗

PubMed2002

Chronic metabolic acidosis upregulates rat kidney Na-HCO cotransporters NBCn1 and NBC3 but not NBC1.

Several members of the Na-HCO cotransporter (NBC) family have recently been identified functionally and partly characterized, including rkNBC1, NBCn1, and NBC3. Regulation of these NBCs may play a role in the maintenance of intracellular pH and in the regulation of renal acid-base balance. However, it is unknown whether the expressions of these NBCs are regulated in response to changes in acid-base status. We therefore tested whether chronic metabolic acidosis (CMA) affects the abundance of these NBCs in kidneys using two conventional protocols. In protocol 1, rats were treated with NH(4)Cl in their drinking water (12 +/- 1 mmol. rat(-1). day(-1)) for 2 wk with free access to water (n = 8). Semiquantitative immunoblotting demonstrated that whole kidney abundance of NBCn1 and NBC3 in rats with CMA was dramatically increased to 995 +/- 87 and 224 +/- 35%, respectively, of control levels (P < 0.05), whereas whole kidney rkNBC1 was unchanged (88 +/- 14%). In protocol 2, rats were given NH(4)Cl in their food (10 +/- 1 mmol. rat(-1). day(-1)) for 7 days, with a fixed daily water intake (n = 6). Consistent with protocol 1, whole kidney abundances of NBCn1 (262 +/- 42%) and NBC3 (160 +/- 31%) were significantly increased compared with controls (n = 6), whereas whole kidney rkNBC1 was unchanged (84 +/- 17%). In both protocols, immunocytochemistry confirmed upregulation of NBCn1 and NBC3 with no change in the segmental distribution along the nephron. Consistent with the increase in NBCn1, measurements of pH transients in medullary thick ascending limb (mTAL) cells in kidney slices revealed two- to threefold increases in DIDS- sensitive, Na(+)-dependent HCO uptake in rats with CMA. In conclusion, CMA is associated with a marked increase in the abundance of NBCn1 in the mTAL and NBC3 in intercalated cells, whereas the abundance of NBC1 in the proximal tubule was not altered. The increased abundance of NBCn1 may play a role in the reabsorption of NH in the mTAL and increased NBC3 in reabsorbing HCO.

4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid↗

PubMed2002

Structural determinants and significance of regulation of electrogenic Na(+)-HCO(3)(-) cotransporter stoichiometry.

Na(+)-HCO(3)(-) cotransporters play an important role in intracellular pH regulation and transepithelial HCO(3)(-) transport in various tissues. Of the characterized members of the HCO(3)(-) transporter superfamily, NBC1 and NBC4 proteins are known to be electrogenic. An important functional property of electrogenic Na(+)-HCO(3)(-) cotransporters is their HCO(3)(-):Na(+) coupling ratio, which sets the transporter reversal potential and determines the direction of Na(+)-HCO(3)(-) flux. Recent studies have shown that the HCO(3)(-):Na(+) transport stoichiometry of NBC1 proteins is either 2:1 or 3:1 depending on the cell type in which the transporters are expressed, indicating that the HCO(3)(-):Na(+) coupling ratio can be regulated. Mutational analysis has been very helpful in revealing the molecular mechanisms and signaling pathways that modulate the coupling ratio. These studies have demonstrated that PKA-dependent phosphorylation of the COOH terminus of NBC1 proteins alters the transport stoichiometry. This cAMP-dependent signaling pathway provides HCO(3)(-) -transporting epithelia with an efficient mechanism for modulating the direction of Na(+)-HCO(3)(-) flux through the cotransporter.

Animals↗

PubMed2002

Apical H(+)/base transporters mediating bicarbonate absorption and pH(i) regulation in the OMCD.

The outer medullary collecting duct (OMCD) plays an important role in mediating transepithelial HCO transport [J(HCO(3)(-))] and urinary acidification. HCO absorption by type A intercalated cells in the OMCD inner stripe (OMCD(is)) segment is thought to by mediated by an apical vacuolar H(+)-ATPase and H(+)-K(+)-ATPase coupled to a basolateral Cl(-)-HCO exchanger (AE1). Besides these Na(+)-independent transporters, previous studies have shown that OMCD(is) type A intercalated cells have an apical electroneutral EIPA-sensitive, DIDS-insensitive Na(+)-HCO cotransporter (NBC3); a basolateral Na(+)/H(+) antiporter; and a basolateral Na(+)-K(+)-ATPase. In this study, we reexamined the Na(+) dependence of transepithelial Na(+) transport in the OMCD(is) and determined the role of apical NBC3 in intracellular (pH(i)) regulation in OMCD(is) type A intercalated cells. Control tubules absorbed HCO at a rate of approximately 13 pmol. min(-1). mm(-1). Lowering luminal Na(+) from 140 to 40 mM decreased [J(HCO(3)(-))] by approximately 15% without a change in transepithelial potential (V(te)). Furthermore, 50 microM EIPA (lumen) also decreased [J(HCO(3)(-))] by approximately 13% without a change in V(te). The effect of lowering luminal Na(+) and adding EIPA were not additive. These results demonstrate that [J(HCO(3)(-))] in the OMCD(is) is in part Na(+) dependent. In separate experiments, the pH(i) recovery rate after an NH prepulse was monitored in single type A intercalated cells with confocal fluorescence microscopy. The pH(i) recovery rate was approximately 0.21 pH/min in Na(+)-containing solutions and decreased to approximately 0.16 pH/min with EIPA (50 microM, lumen). In tubules perfused/bathed without Na(+), luminal Na(+) addition resulted in a pH(i) recovery rate of approximately 0.36 pH/min, whereas the Na(+)-independent recovery rate was approximately 0.16 pH/min. EIPA (50 microM, lumen) decreased the Na(+)-dependent pH(i) recovery rate to approximately 0.07 pH/min. The Na(+)-independent recovery rate was decreased to approximately 0.06 pH/min by bafilomycin (10 nM, lumen) and to approximately 0.10 pH/min using Schering 28080 (10 microM, lumen). These findings indicate that NBC3 contributes to pH(i) regulation in OMCD(is) type A intercalated cells and plays only a minor role in mediating [J(HCO(3)(-))] in the OMCD(is).

Acid-Base Equilibrium↗