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Kettritz R, Loffing J. Potassium homeostasis - Physiology and pharmacology in a clinical context. Pharmacol Ther 2023; 249:108489. [PMID: 37454737 DOI: 10.1016/j.pharmthera.2023.108489] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
Membrane voltage controls the function of excitable cells and is mainly a consequence of the ratio between the extra- and intracellular potassium concentration. Potassium homeostasis is safeguarded by balancing the extra-/intracellular distribution and systemic elimination of potassium to the dietary potassium intake. These processes adjust the plasma potassium concentration between 3.5 and 4.5 mmol/L. Several genetic and acquired diseases but also pharmacological interventions cause dyskalemias that are associated with increased morbidity and mortality. The thresholds at which serum K+ not only associates but also causes increased mortality are hotly debated. We discuss physiologic, pathophysiologic, and pharmacologic aspects of potassium regulation and provide informative case vignettes. Our aim is to help clinicians, epidemiologists, and pharmacologists to understand the complexity of the potassium homeostasis in health and disease and to initiate appropriate treatment strategies in dyskalemic patients.
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Affiliation(s)
- Ralph Kettritz
- Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Germany.
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2
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Arora N. Serum Chloride and Heart Failure. Kidney Med 2023; 5:100614. [PMID: 36911181 PMCID: PMC9995484 DOI: 10.1016/j.xkme.2023.100614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
Despite significant advances in management, heart failure continues to impose a significant epidemiologic burden with high prevalence and mortality rates. For decades, sodium has been the serum electrolyte most commonly associated with outcomes; however, challenging the conventional paradigm of sodium's influence, recent studies have identified a more prominent role in serum chloride in the pathophysiology of heart failure. More specifically, hypochloremia is associated with neurohumoral activation, diuretic resistance, and a worse prognosis in patients with heart failure. This review examines basic science, translational research, and clinical studies to better characterize the role of chloride in patients with heart failure and additionally discusses potential new therapies targeting chloride homeostasis that may impact the future of heart failure care.
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Affiliation(s)
- Nayan Arora
- University of Washington, Seattle, Washington
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3
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Petrillo F, Iervolino A, Angrisano T, Jelen S, Costanzo V, D’Acierno M, Cheng L, Wu Q, Guerriero I, Mazzarella MC, De Falco A, D’Angelo F, Ceccarelli M, Caraglia M, Capasso G, Fenton RA, Trepiccione F. Dysregulation of Principal Cell miRNAs Facilitates Epigenetic Regulation of AQP2 and Results in Nephrogenic Diabetes Insipidus. J Am Soc Nephrol 2021; 32:1339-1354. [PMID: 33727367 PMCID: PMC8259636 DOI: 10.1681/asn.2020010031] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 02/02/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND MicroRNAs (miRNAs), formed by cleavage of pre-microRNA by the endoribonuclease Dicer, are critical modulators of cell function by post-transcriptionally regulating gene expression. METHODS Selective ablation of Dicer in AQP2-expressing cells (DicerAQP2Cre+ mice) was used to investigate the role of miRNAs in the kidney collecting duct of mice. RESULTS The mice had severe polyuria and nephrogenic diabetes insipidus, potentially due to greatly reduced AQP2 and AQP4 levels. Although epithelial sodium channel levels were decreased in cortex and increased in inner medulla, amiloride-sensitive sodium reabsorption was equivalent in DicerAQP2Cre+ mice and controls. Small-RNA sequencing and proteomic analysis revealed 31 and 178 significantly regulated miRNAs and proteins, respectively. Integrated bioinformatic analysis of the miRNAome and proteome suggested alterations in the epigenetic machinery and various transcription factors regulating AQP2 expression in DicerAQP2Cre+ mice. The expression profile and function of three miRNAs (miR-7688-5p, miR-8114, and miR-409-3p) whose predicted targets were involved in epigenetic control (Phf2, Kdm5c, and Kdm4a) or transcriptional regulation (GATA3, GATA2, and ELF3) of AQP2 were validated. Luciferase assays could not demonstrate direct interaction of AQP2 or the three potential transcription factors with miR-7688-5p, miR-8114, and miR-409-3p. However, transfection of respective miRNA mimics reduced AQP2 expression. Chromatin immunoprecipitation assays demonstrated decreased Phf2 and significantly increased Kdm5c interactions at the Aqp2 gene promoter in DicerAQP2Cre+ mice, resulting in decreased RNA Pol II association. CONCLUSIONS Novel evidence indicates miRNA-mediated epigenetic regulation of AQP2 expression.
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Affiliation(s)
- Federica Petrillo
- Biogem, Institute of Genetic Research “Gaetano Salvatore”, Ariano Irpino, Italy,Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Anna Iervolino
- Biogem, Institute of Genetic Research “Gaetano Salvatore”, Ariano Irpino, Italy
| | - Tiziana Angrisano
- Department of Biology, University of Naples Federico II, Naples, Italy
| | - Sabina Jelen
- Biogem, Institute of Genetic Research “Gaetano Salvatore”, Ariano Irpino, Italy
| | - Vincenzo Costanzo
- Biogem, Institute of Genetic Research “Gaetano Salvatore”, Ariano Irpino, Italy
| | | | - Lei Cheng
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Qi Wu
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Ilaria Guerriero
- Biogem, Institute of Genetic Research “Gaetano Salvatore”, Ariano Irpino, Italy
| | | | - Alfonso De Falco
- Biogem, Institute of Genetic Research “Gaetano Salvatore”, Ariano Irpino, Italy
| | - Fulvio D’Angelo
- Biogem, Institute of Genetic Research “Gaetano Salvatore”, Ariano Irpino, Italy
| | - Michele Ceccarelli
- Biogem, Institute of Genetic Research “Gaetano Salvatore”, Ariano Irpino, Italy,Department of Electrical Engineering and Information Technology (DIETI) University of Naples “Federico II”, Naples, Italy
| | - Michele Caraglia
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giovambattista Capasso
- Biogem, Institute of Genetic Research “Gaetano Salvatore”, Ariano Irpino, Italy,Department of Translational Medical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | - Francesco Trepiccione
- Biogem, Institute of Genetic Research “Gaetano Salvatore”, Ariano Irpino, Italy,Department of Translational Medical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
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4
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Suzumoto Y, Columbano V, Gervasi L, Giunta R, Mattina T, Trimarchi G, Capolongo G, Simeoni M, Perna AF, Zacchia M, Toriello G, Pollastro RM, Rapisarda F, Capasso G, Trepiccione F. A case series of adult patients affected by EAST/SeSAME syndrome suggests more severe disease in subjects bearing KCNJ10 truncating mutations. Intractable Rare Dis Res 2021; 10:95-101. [PMID: 33996354 PMCID: PMC8122315 DOI: 10.5582/irdr.2020.03158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
EAST/SeSAME syndrome is a rare disease affecting the Central Nervous System (CNS), inner ear, and kidney. The syndrome is due to loss-of-function mutations in the KCNJ10 gene encoding the inward-rectifying potassium channel Kir4.1. EAST/SeSAME syndrome is mainly diagnosed during childhood with a tonic-clonic seizure being the usual first symptom. Due to a limited number of patients and recent identification of the disease, few data are available on the clinical progress of this disease in adulthood. In particular, neurologic and nephrological outcomes have not been reported. We present a case series of 4 adult patients harbouring homozygous missense mutation p.Ala167Val and homozygous frameshift mutations p.Asn232Glnfs*14 and p.Gly275Valfs*7. Effects of these mutations were predicted by in silico modelling and bioinformatic tools. Patients with truncating mutations were associated with more severe outcomes, both in tubulopathy severity and neurological symptomatology. Conversely, either missense or truncating mutations were correlated with similar severity of epilepsy, with a long free-of-event period up to 20 years old. No eGFR decline was documented. Modelling predicted that truncating mutations lead to complete Kir4.1 dysfunction. Finally, all patients had a mild increase in urinary protein excretion. Our study indicates that the prognosis of patients suffering from EAST/SeSAME syndrome is related to the severity of the mutation causing the disease. As predicted by in silico modelling, truncating mutations of KCNJ10 are associated with more severe disease, with recurrence of symptomatic hypokalemia and more severe neurological phenotype. The type of mutation should be considered for the therapy tailored to patients' phenotype.
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Affiliation(s)
| | - Valeria Columbano
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | - Luciano Gervasi
- School of Nephrology, Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Rosa Giunta
- School of Nephrology, Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Teresa Mattina
- Department of Biomedical and Biotechnological Sciences, University of Catania, Italy
| | - Gabriele Trimarchi
- Department of Biomedical and Biotechnological Sciences, University of Catania, Italy
| | - Giovanna Capolongo
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | - Mariadelina Simeoni
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | - Alessandra F. Perna
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | - Miriam Zacchia
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | | | - Rosa M. Pollastro
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | - Francesco Rapisarda
- School of Nephrology, Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Giovambattista Capasso
- Biogem Research Institute, Ariano Irpino, Italy
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | - Francesco Trepiccione
- Biogem Research Institute, Ariano Irpino, Italy
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
- Address correspondence to:Francesco Trepiccione, Department of Translational Medical Sciences University of Campania "L.Vanvitelli", Via Pansini n5, 80131 Naples, Italy. E-mail:
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Giglio S, Montini G, Trepiccione F, Gambaro G, Emma F. Distal renal tubular acidosis: a systematic approach from diagnosis to treatment. J Nephrol 2021; 34:2073-2083. [PMID: 33770395 PMCID: PMC8610947 DOI: 10.1007/s40620-021-01032-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/16/2021] [Indexed: 12/03/2022]
Abstract
Renal tubular acidosis (RTA) comprises a group of disorders in which excretion of hydrogen ions or reabsorption of filtered HCO3 is impaired, leading to chronic metabolic acidosis with normal anion gap. In the current review, the focus is placed on the most common type of RTA, Type 1 RTA or Distal RTA (dRTA), which is a rare chronic genetic disorder characterized by an inability of the distal nephron to secrete hydrogen ions in the presence of metabolic acidosis. Over the years, knowledge of the molecular mechanisms behind acid secretion has improved, thereby greatly helping the diagnosis of dRTA. The primary or inherited form of dRTA is mostly diagnosed in infancy, childhood, or young adulthood, while the acquired secondary form, as a consequence of other disorders or medications, can happen at any age, although it is more commonly seen in adults. dRTA is not as “benign” as previously assumed, and can have several, highly variable long-term consequences. The present review indeed reports and summarizes both clinical symptoms and diagnosis, long-term outcomes, genetic inheritance, epidemiology and current treatment options, with the aim of shedding more light onto this rare disorder. Being a chronic condition, dRTA also deserves attention in the transition between pediatric and adult nephrology care, and as a rare disease it has a place in the European and Italian rare nephrological diseases network.
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Affiliation(s)
- Sabrina Giglio
- Medical Genetics Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
| | - Giovanni Montini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Nephrology, Dialysis and PediatricTransplant Unit, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Francesco Trepiccione
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy.,Biogem Research Institute Ariano Irpino, Ariano Irpino, Italy
| | - Giovanni Gambaro
- Nephrology Department of Medicine, University of Verona, Verona, Italy
| | - Francesco Emma
- Division of Nephrology, Department of Pediatric Subspecialties, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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6
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Urinary proteomics reveals key markers of salt sensitivity in hypertensive patients during saline infusion. J Nephrol 2021; 34:739-751. [PMID: 33398797 DOI: 10.1007/s40620-020-00877-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/23/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hypertension is a complex disease and is the major cause of cardiovascular complications. In the vast majority of individuals, the aetiology of elevated blood pressure (BP) cannot be determined, thus impairing optimized therapies and prognosis for individual patients. A more precise understanding of the molecular pathogenesis of hypertension remains a pressing priority for both basic and translational research. Here we investigated the effect of salt on naive hypertensive patients in order to better understand the salt intake-blood pressure relationship. METHODS Patients underwent an acute saline infusion and were defined as salt-sensitive or salt-resistant according to mean blood pressure changes. Urinary proteome changes during the salt load test were analysed by a label-free quantitative proteomics approach. RESULTS Our data show that salt-sensitive patients display equal sodium reabsorption as salt-resistant patients, as major sodium transporters show the same behaviour during the salt load. However, salt-sensitive patients regulate the renin angiotensin system (RAS) differently from salt-resistant patients, and upregulate proteins, as epidermal growth factor (EGF) and plasminogen activator, urokinase (PLAU), involved in the regulation of epithelial sodium channel ENaC activity. CONCLUSIONS Salt-sensitive and salt-resistant subjects have similar response to a saline/volume infusion as detected by urinary proteome. However, we identified glutamyl aminopeptidase (ENPEP), PLAU, EGF and Xaa-Pro aminopeptidase 2 precursor XPNPEP2 as key molecules of salt-sensitivity, through modulation of ENaC-dependent sodium reabsorption along the distal tubule.
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7
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Abstract
Renal tubular acidosis (RTA) comprises a group of disorders characterized by low capacity for net acid excretion and persistent hyperchloremic metabolic acidosis, despite preserved glomerular filtration rate. RTA are classified into chiefly three types (1, 2 and 4) based on pathophysiology and clinical and laboratory characteristics. Most patients have primary RTA that presents in infancy with polyuria, growth retardation, rickets and/or hypotonia. Diagnosis requires careful evaluation, including exclusion of other entities that can cause acidosis. A variety of tests, administered stepwise, are useful for the diagnosis and characterization of RTA. A genetic or acquired basis can be determined in majority of patients through focused evaluation. Management involves correction of acidosis and dyselectrolytemia; patients with proximal RTA with Fanconi syndrome and rickets require additional supplements of phosphate and vitamin D.
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Affiliation(s)
- Arvind Bagga
- Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Aditi Sinha
- Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
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8
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Iervolino A, Prosperi F, De La Motte LR, Petrillo F, Spagnuolo M, D'Acierno M, Siccardi S, Perna AF, Christensen BM, Frische S, Capasso G, Trepiccione F. Potassium depletion induces cellular conversion in the outer medullary collecting duct altering Notch signaling pathway. Sci Rep 2020; 10:5708. [PMID: 32235870 PMCID: PMC7109050 DOI: 10.1038/s41598-020-61882-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 02/24/2020] [Indexed: 11/22/2022] Open
Abstract
Potassium depletion affects AQP2 expression and the cellular composition of the kidney collecting duct. This, in turn, contributes to the development of a secondary form of nephrogenic diabetes insipidus and hypokalemic nephropathy. Here we show that after 14 days of potassium depletion, the cellular fraction of A-type intercalated cells increases while the fraction of principal cells decreases along the outer medullary collecting duct in rats. The intercalated cells acquired a novel distribution pattern forming rows of cells attached to each other. These morphological changes occur progressively and reverse after 7 days of recovery on normal rat chow diet. The cellular remodeling mainly occurred in the inner stripe of outer medulla similar to the previously seen effect of lithium on the collecting duct cellular profile. The cellular remodeling is associated with the appearance of cells double labelled with both specific markers of principal and type-A intercalated cells. The appearance of this cell type was associated with the downregulation of the Notch signaling via the Hes1 pathways. These results show that the epithelium of the collecting duct has a high degree of plasticity and that Notch signaling likely plays a key role during hypokalemia.
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Affiliation(s)
- Anna Iervolino
- Biogem S.c.a.r.l., Istituto di Ricerche Genetiche "Gaetano Salvatore", Ariano Irpino, Italy
| | - Federica Prosperi
- Biogem S.c.a.r.l., Istituto di Ricerche Genetiche "Gaetano Salvatore", Ariano Irpino, Italy
| | - Luigi R De La Motte
- Biogem S.c.a.r.l., Istituto di Ricerche Genetiche "Gaetano Salvatore", Ariano Irpino, Italy
| | - Federica Petrillo
- Biogem S.c.a.r.l., Istituto di Ricerche Genetiche "Gaetano Salvatore", Ariano Irpino, Italy
| | - Manuela Spagnuolo
- Biogem S.c.a.r.l., Istituto di Ricerche Genetiche "Gaetano Salvatore", Ariano Irpino, Italy
| | - Mariavittoria D'Acierno
- Biogem S.c.a.r.l., Istituto di Ricerche Genetiche "Gaetano Salvatore", Ariano Irpino, Italy.,Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | - Sabrina Siccardi
- Biogem S.c.a.r.l., Istituto di Ricerche Genetiche "Gaetano Salvatore", Ariano Irpino, Italy.,Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | - Alessandra F Perna
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | | | | | - Giovambattista Capasso
- Biogem S.c.a.r.l., Istituto di Ricerche Genetiche "Gaetano Salvatore", Ariano Irpino, Italy.,Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | - Francesco Trepiccione
- Biogem S.c.a.r.l., Istituto di Ricerche Genetiche "Gaetano Salvatore", Ariano Irpino, Italy. .,Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy.
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9
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Recent insights into sodium and potassium handling by the aldosterone-sensitive distal nephron: a review of the relevant physiology. J Nephrol 2020; 33:431-445. [DOI: 10.1007/s40620-019-00684-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 12/02/2019] [Indexed: 02/07/2023]
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10
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Capolongo G, Suzumoto Y, D'Acierno M, Simeoni M, Capasso G, Zacchia M. ERK1,2 Signalling Pathway along the Nephron and Its Role in Acid-base and Electrolytes Balance. Int J Mol Sci 2019; 20:E4153. [PMID: 31450703 PMCID: PMC6747339 DOI: 10.3390/ijms20174153] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/14/2019] [Accepted: 08/22/2019] [Indexed: 12/17/2022] Open
Abstract
Mitogen-activated protein kinases (MAPKs) are intracellular molecules regulating a wide range of cellular functions, including proliferation, differentiation, apoptosis, cytoskeleton remodeling and cytokine production. MAPK activity has been shown in normal kidney, and its over-activation has been demonstrated in several renal diseases. The extracellular signal-regulated protein kinases (ERK 1,2) signalling pathway is the first described MAPK signaling. Intensive investigations have demonstrated that it participates in the regulation of ureteric bud branching, a fundamental process in establishing final nephron number; in addition, it is also involved in the differentiation of the nephrogenic mesenchyme, indicating a key role in mammalian kidney embryonic development. In the present manuscript, we show that ERK1,2 signalling mediates several cellular functions also in mature kidney, describing its role along the nephron and demonstrating whether it contributes to the regulation of ion channels and transporters implicated in acid-base and electrolytes homeostasis.
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Affiliation(s)
- Giovanna Capolongo
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | | | | | - Mariadelina Simeoni
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | - Giovambattista Capasso
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
- Biogem Scarl, 83031 Ariano Irpino, Italy
| | - Miriam Zacchia
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy.
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11
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Trepiccione F. ERA-EDTA fellowship, a 'bonne opportunité': the scientific and human experience of a fellow. Clin Kidney J 2019; 12:465-467. [PMID: 31384435 PMCID: PMC6671323 DOI: 10.1093/ckj/sfy123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Indexed: 12/02/2022] Open
Abstract
As a fellow of the ERA-EDTA long-term fellowship programme, I spent two fantastic years as a post-doc in Prof. D. Eladari’s laboratory at Inserm U970, Paris-Cardiovascular Research Centre. It was a highly formative and productive scientific experience. On a personal level, immersion into the French society and the international environment of the laboratory were added bonuses that enriched my experience. I am honoured to report my experience here from the ERA-EDTA fellowship programme. I hope this will inspire young fellows to apply for such a programme and pursue their career in science. Good mentorship, a passion for scientific investigation and determination are required.
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Affiliation(s)
- Francesco Trepiccione
- Biogem Scarl, Istituto di Ricerche Gaetano Salvatore, Ariano Irpino, Italy.,Department of Medical Translational Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy
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12
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Abstract
The epithelium of the kidney collecting duct (CD) is composed mainly of two different types of cells with distinct and complementary functions. CD principal cells traditionally have been considered to have a major role in Na+ and water regulation, while intercalated cells (ICs) were thought to largely modulate acid-base homeostasis. In recent years, our understanding of IC function has improved significantly owing to new research findings. Thus, we now have a new model for CD transport that integrates mechanisms of salt and water reabsorption, K+ homeostasis, and acid-base status between principal cells and ICs. There are three main types of ICs (type A, type B, and non-A, non-B), which first appear in the late distal convoluted tubule or in the connecting segment in a species-dependent manner. ICs can be detected in CD from cortex to the initial part of the inner medulla, although some transport proteins that are key components of ICs also are present in medullary CD, cells considered inner medullary. Of the three types of ICs, each has a distinct morphology and expresses different complements of membrane transport proteins that translate into very different functions in homeostasis and contributions to CD luminal pro-urine composition. This review includes recent discoveries in IC intracellular and paracrine signaling that contributes to acid-base regulation as well as Na+, Cl-, K+, and Ca2+ homeostasis. Thus, these new findings highlight the potential role of ICs as targets for potential hypertension treatments.
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Affiliation(s)
- Renee Rao
- University of Southern California/University Kidney Research Organization, Kidney Research Center, Division of Nephrology and Hypertension, Department of Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA
| | - Vivek Bhalla
- Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Núria M Pastor-Soler
- University of Southern California/University Kidney Research Organization, Kidney Research Center, Division of Nephrology and Hypertension, Department of Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA.
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13
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Trepiccione F, Soukaseum C, Baudrie V, Kumai Y, Teulon J, Villoutreix B, Cornière N, Wangemann P, Griffith AJ, Byung Choi Y, Hadchouel J, Chambrey R, Eladari D. Acute genetic ablation of pendrin lowers blood pressure in mice. Nephrol Dial Transplant 2018; 32:1137-1145. [PMID: 28064162 DOI: 10.1093/ndt/gfw393] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 10/02/2016] [Indexed: 11/14/2022] Open
Abstract
Background Pendrin, the chloride/bicarbonate exchanger of β-intercalated cells of the renal connecting tubule and the collecting duct, plays a key role in NaCl reabsorption by the distal nephron. Therefore, pendrin may be important for the control of extracellular fluid volume and blood pressure. Methods Here, we have used a genetic mouse model in which the expression of pendrin can be switched-on in vivo by the administration of doxycycline. Pendrin can also be rapidly removed when doxycycline administration is discontinued. Therefore, our genetic strategy allows us to test selectively the acute effects of loss of pendrin function. Results We show that acute loss of pendrin leads to a significant decrease of blood pressure. In addition, acute ablation of pendrin did not alter significantly the acid-base status or blood K + concentration. Conclusion By using a transgenic mouse model, avoiding off-target effects related to pharmacological compounds, this study suggests that pendrin could be a novel target to treat hypertension.
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Affiliation(s)
- Francesco Trepiccione
- INSERM U970, Paris Cardiovascular Research Center, Université Paris-Descartes, Paris, France
| | - Christelle Soukaseum
- INSERM U970, Paris Cardiovascular Research Center, Université Paris-Descartes, Paris, France
| | - Veronique Baudrie
- INSERM U970, Paris Cardiovascular Research Center, Université Paris-Descartes, Paris, France.,Hôpital Européen Georges Pompidou, Département de Physiologie, Assistance Publique-Hopitaux de Paris, Paris, France
| | - Yusuke Kumai
- INSERM U970, Paris Cardiovascular Research Center, Université Paris-Descartes, Paris, France
| | - Jacques Teulon
- CNRS ERL 8228, INSERM UMRS 1138, Université Pierre et Marie Curie, Centre de Recherche des Cordeliers, Paris, France
| | - Bruno Villoutreix
- INSERM U973, MTi-Bioinformatics; University Paris Diderot, Paris, France
| | - Nicolas Cornière
- Service d'Explorations Fonctionnelles Rénales, Hôpital Felix Guyon, CHU de la Réunion, St Denis, Ile de la Réunion, France
| | - Philine Wangemann
- Anatomy and Physiology Department, Kansas State University, Manhattan, KS, USA
| | - Andrew J Griffith
- Otolaryngology Branch, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
| | - Yoon Byung Choi
- Otolaryngology Branch, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
| | - Juliette Hadchouel
- INSERM U970, Paris Cardiovascular Research Center, Université Paris-Descartes, Paris, France
| | - Regine Chambrey
- INSERM U970, Paris Cardiovascular Research Center, Université Paris-Descartes, Paris, France.,Centre National de la Recherche Scientifique, Paris, France
| | - Dominique Eladari
- Service d'Explorations Fonctionnelles Rénales, Hôpital Felix Guyon, CHU de la Réunion, St Denis, Ile de la Réunion, France
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14
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Sbardella E, Isidori AM, Arnaldi G, Arosio M, Barone C, Benso A, Berardi R, Capasso G, Caprio M, Ceccato F, Corona G, Della Casa S, De Nicola L, Faustini-Fustini M, Fiaccadori E, Gesualdo L, Gori S, Lania A, Mantovani G, Menè P, Parenti G, Pinto C, Pivonello R, Razzore P, Regolisti G, Scaroni C, Trepiccione F, Lenzi A, Peri A. Approach to hyponatremia according to the clinical setting: Consensus statement from the Italian Society of Endocrinology (SIE), Italian Society of Nephrology (SIN), and Italian Association of Medical Oncology (AIOM). J Endocrinol Invest 2018; 41:3-19. [PMID: 29152673 DOI: 10.1007/s40618-017-0776-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 10/13/2017] [Indexed: 12/17/2022]
Affiliation(s)
- E Sbardella
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - A M Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - G Arnaldi
- Clinica di Endocrinologia e Malattie del Metabolismo, Università Politecnica delle Marche Azienda Ospedaliero-Universitaria, Ospedali Riuniti Umberto I-GM Lancisi-G Salesi, Ancona, Italy
| | - M Arosio
- Endocrinology and Diabetology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - C Barone
- UOC di Oncologia Medica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Benso
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - R Berardi
- Clinica Oncologica, Università Politecnica delle Marche Azienda Ospedaliero-Universitaria; Ospedali Riuniti Umberto I-GM Lancisi-G Salesi, Ancona, Italy
| | - G Capasso
- Dipartimento di Scienze Cardio-Toraciche e Respiratorie, Università della Campania "Luigi Vanvitelli", Caserta, Italy
| | - M Caprio
- Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Pisana, Rome, Italy
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - F Ceccato
- Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padua, Italy
| | - G Corona
- Endocrinology Unit, Medical Department, Azienda Usl Bologna Maggiore-Bellaria Hospital, Bologna, Italy
| | - S Della Casa
- Endocrinology and Metabolic Diseases Unit, Catholic University of the Sacred Heart, Rome, Italy
| | - L De Nicola
- Nephrology, Medical School, University of Campania Luigi Vanvitelli, Naples, Italy
| | - M Faustini-Fustini
- Pituitary Unit, IRCCS Institute of Neurological Sciences, Bellaria Hospital, Bologna, Italy
| | - E Fiaccadori
- Renal Unit, Parma University Medical School, Parma, Italy
| | - L Gesualdo
- Nephrology Dialysis and Transplantation, Bari University Medical School, Bari, Italy
| | - S Gori
- UOC Oncologia Medica, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy
| | - A Lania
- Endocrine Unit, Department of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano (MI), Italy
| | - G Mantovani
- Endocrinology and Diabetology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - P Menè
- Nephrology, Sapienza University of Rome, Rome, Italy
| | - G Parenti
- Endocrine Unit, Careggi Hospital, Florence, Italy
| | - C Pinto
- Oncologia Medica IRCCS Arcispedale S. Maria Nuova, Reggio Emilia, Italy
| | - R Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Naples, Italy
| | - P Razzore
- Endocrine Unit, AO Ordine Mauriziano, Turin, Italy
| | - G Regolisti
- Renal Unit, Parma University Medical School, Parma, Italy
| | - C Scaroni
- Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padua, Italy
| | - F Trepiccione
- Dipartimento di Scienze Cardio-Toraciche e Respiratorie, Università della Campania "Luigi Vanvitelli", Caserta, Italy
| | - A Lenzi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - A Peri
- Endocrine Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", AOU Careggi, University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy.
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15
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Lithium increases ammonium excretion leading to altered urinary acid-base buffer composition. J Nephrol 2017; 31:385-393. [PMID: 29178032 DOI: 10.1007/s40620-017-0460-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 11/16/2017] [Indexed: 12/26/2022]
Abstract
Previous reports identify a voltage dependent distal renal tubular acidosis (dRTA) secondary to lithium (Li+) salt administration. This was based on the inability of Li+-treated patients to increase the urine-blood (U-B) pCO2 when challenged with NaHCO3 and, the ability of sodium neutral phosphate or Na2SO4 administration to restore U-B pCO2 in experimental animal models. The underlying mechanisms for the Li+-induced dRTA are still unknown. To address this point, a 7 days time course of the urinary acid-base parameters was investigated in rats challenged with LiCl, LiCitrate, NaCl, or NaCitrate. LiCl induced the largest polyuria and a mild metabolic acidosis. Li+-treatment induced a biphasic response. In the first 2 days, proper urine volume and acidification occurred, while from the 3rd day of treatment, polyuria developed progressively. In this latter phase, the LiCl-treated group progressively excreted more NH4+ and less pCO2, suggesting that NH3/NH4+ became the main urinary buffer. This physiological parameter was corroborated by the upregulation of NBCn1 (a marker of increased ammonium recycling) in the inner stripe of outer medulla of LiCl treated rats. Finally, by investigating NH4+ excretion in ENaC-cKO mice, a model resistant to Li+-induced polyuria, a primary role of the CD was confirmed. By definition, dRTA is characterized by deficient urinary ammonium excretion. Our data question the presence of a voltage-dependent Li+-induced dRTA in rats treated with LiCl for 7 days and the data suggest that the alkaline urine pH induced by NH3/NH4+ as the main buffer has lead to the interpretation dRTA in previous studies.
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16
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Trepiccione F, Prosperi F, de la Motte LR, Hübner CA, Chambrey R, Eladari D, Capasso G. New Findings on the Pathogenesis of Distal Renal Tubular Acidosis. KIDNEY DISEASES 2017; 3:98-105. [PMID: 29344504 DOI: 10.1159/000478781] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/07/2017] [Indexed: 12/23/2022]
Abstract
Background Distal renal tubular acidosis (dRTA) is characterized by an impairment of the urinary acidification process in the distal nephron. Complete or incomplete metabolic acidosis coupled with inappropriately alkaline urine are the hallmarks of this condition. Genetic forms of dRTA are caused by loss of function mutations of either SLC4A1, encoding the AE1 anion exchanger, or ATP6V1B1 and ATP6V0A4, encoding for the B1 and a4 subunits of the vH+ATPase, respectively. These genes are crucial for the function of A-type intercalated cells (A-IC) of the distal nephron. Summary Alterations of acid-base homeostasis are variably associated with hypokalemia, hypercalciuria, nephrocalcinosis or nephrolithiasis, and a salt-losing phenotype. Here we report the diagnostic test and the underlying physiopathological mechanisms. The molecular mechanisms identified so far can explain the defect in acid secretion, but do not explain all clinical features. We review the latest experimental findings on the pathogenesis of dRTA, reporting mechanisms that are instrumental for the clinician and potentially inspiring a novel therapeutic strategy. Key Message Primary dRTA is usually intended as a single-cell disease because the A-IC are mainly affected. However, novel evidence shows that different cell types of the nephron may contribute to the signs and symptoms, moving the focus from a single-cell towards a renal disease.
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Affiliation(s)
- Francesco Trepiccione
- Department of Cardiothoracic and Respiratory Science, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Federica Prosperi
- Department of Cardiothoracic and Respiratory Science, University of Campania "Luigi Vanvitelli," Naples, Italy.,Biogem S.c.a.r.l., Research Institute Gaetano Salvatore, Ariano Irpino, Italy
| | - Luigi Regenburgh de la Motte
- Department of Cardiothoracic and Respiratory Science, University of Campania "Luigi Vanvitelli," Naples, Italy.,Biogem S.c.a.r.l., Research Institute Gaetano Salvatore, Ariano Irpino, Italy
| | - Christian A Hübner
- Institute of Human Genetics, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Regine Chambrey
- Inserm U1188, Diabète athérothrombose Thérapies Réunion Océan Indien (DéTROI), Université de La Réunion, France
| | - Dominique Eladari
- Service d'Explorations Fonctionnelles Rénales, Hôpital Felix Guyon, CHU de la Réunion, Saint-Denis, Ile de la Réunion, France
| | - Giovambattista Capasso
- Department of Cardiothoracic and Respiratory Science, University of Campania "Luigi Vanvitelli," Naples, Italy.,Biogem S.c.a.r.l., Research Institute Gaetano Salvatore, Ariano Irpino, Italy
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17
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Trepiccione F, Soukaseum C, Iervolino A, Petrillo F, Zacchia M, Schutz G, Eladari D, Capasso G, Hadchouel J. A fate-mapping approach reveals the composite origin of the connecting tubule and alerts on "single-cell"-specific KO model of the distal nephron. Am J Physiol Renal Physiol 2016; 311:F901-F906. [PMID: 27582101 DOI: 10.1152/ajprenal.00286.2016] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/24/2016] [Indexed: 11/22/2022] Open
Abstract
The distal nephron is a heterogeneous part of the nephron composed by six different cell types, forming the epithelium of the distal convoluted (DCT), connecting, and collecting duct. To dissect the function of these cells, knockout models specific for their unique cell marker have been created. However, since this part of the nephron develops at the border between the ureteric bud and the metanephric mesenchyme, the specificity of the single cell markers has been recently questioned. Here, by mapping the fate of the aquaporin 2 (AQP2) and Na+-Cl- cotransporter (NCC)-positive cells using transgenic mouse lines expressing the yellow fluorescent protein fluorescent marker, we showed that the origin of the distal nephron is extremely composite. Indeed, AQP2-expressing precursor results give rise not only to the principal cells, but also to some of the A- and B-type intercalated cells and even to cells of the DCT. On the other hand, some principal cells and B-type intercalated cells can develop from NCC-expressing precursors. In conclusion, these results demonstrate that the origin of different cell types in the distal nephron is not as clearly defined as originally thought. Importantly, they highlight the fact that knocking out a gene encoding for a selective functional marker in the adult does not guarantee cell specificity during the overall kidney development. Tools allowing not only cell-specific but also time-controlled recombination will be useful in this sense.
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Affiliation(s)
- Francesco Trepiccione
- Department of Cardio-Thoracic and Respiratory Science, Second University of Naples, Caserta, Italy; .,INSERM U970, Paris Cardiovascular Research Center, Université Paris-Descartes, Paris, France
| | - Christelle Soukaseum
- INSERM U970, Paris Cardiovascular Research Center, Université Paris-Descartes, Paris, France
| | - Anna Iervolino
- Biogem, Istituto di Ricerche Genetiche Gaetano Salvatore, Ariano Irpino, Italy; and
| | - Federica Petrillo
- Department of Cardio-Thoracic and Respiratory Science, Second University of Naples, Caserta, Italy.,Biogem, Istituto di Ricerche Genetiche Gaetano Salvatore, Ariano Irpino, Italy; and
| | - Miriam Zacchia
- Department of Cardio-Thoracic and Respiratory Science, Second University of Naples, Caserta, Italy
| | - Gunther Schutz
- German Cancer Research Center, Division Molecular Biology of the Cell, Heidelberg, Germany
| | - Dominique Eladari
- INSERM U970, Paris Cardiovascular Research Center, Université Paris-Descartes, Paris, France
| | - Giovambattista Capasso
- Department of Cardio-Thoracic and Respiratory Science, Second University of Naples, Caserta, Italy.,Biogem, Istituto di Ricerche Genetiche Gaetano Salvatore, Ariano Irpino, Italy; and
| | - Juliette Hadchouel
- INSERM U970, Paris Cardiovascular Research Center, Université Paris-Descartes, Paris, France
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18
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Liu Q, Xiao K, Wen L, Lu H, Liu Y, Kong XY, Xie G, Zhang Z, Bo Z, Jiang L. Engineered Ionic Gates for Ion Conduction Based on Sodium and Potassium Activated Nanochannels. J Am Chem Soc 2015; 137:11976-83. [DOI: 10.1021/jacs.5b04911] [Citation(s) in RCA: 155] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Qian Liu
- Beijing
Key Laboratory of Energy Conversion and Storage Materials, College
of Chemistry, Key Laboratory of Theoretical and Computational Photochemistry,
Ministry of Education, Beijing Normal University, Beijing 100875, PR China
| | - Kai Xiao
- Beijing
National Laboratory for Molecular Sciences (BNLMS), Key Laboratory
of Organic Solids, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, PR China
| | - Liping Wen
- Laboratory
of Bioinspired Smart Interfacial Science, Technical Institute of Physics
and Chemistry, Chinese Academy of Sciences, Beijing 100190, PR China
| | - Heng Lu
- Beijing
Key Laboratory of Energy Conversion and Storage Materials, College
of Chemistry, Key Laboratory of Theoretical and Computational Photochemistry,
Ministry of Education, Beijing Normal University, Beijing 100875, PR China
| | - Yahui Liu
- Beijing
Key Laboratory of Energy Conversion and Storage Materials, College
of Chemistry, Key Laboratory of Theoretical and Computational Photochemistry,
Ministry of Education, Beijing Normal University, Beijing 100875, PR China
| | - Xiang-Yu Kong
- Laboratory
of Bioinspired Smart Interfacial Science, Technical Institute of Physics
and Chemistry, Chinese Academy of Sciences, Beijing 100190, PR China
| | - Ganhua Xie
- Beijing
National Laboratory for Molecular Sciences (BNLMS), Key Laboratory
of Organic Solids, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, PR China
| | - Zhen Zhang
- Beijing
National Laboratory for Molecular Sciences (BNLMS), Key Laboratory
of Organic Solids, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, PR China
| | - Zhishan Bo
- Beijing
Key Laboratory of Energy Conversion and Storage Materials, College
of Chemistry, Key Laboratory of Theoretical and Computational Photochemistry,
Ministry of Education, Beijing Normal University, Beijing 100875, PR China
| | - Lei Jiang
- Laboratory
of Bioinspired Smart Interfacial Science, Technical Institute of Physics
and Chemistry, Chinese Academy of Sciences, Beijing 100190, PR China
- Beijing
National Laboratory for Molecular Sciences (BNLMS), Key Laboratory
of Organic Solids, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, PR China
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