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J Appl Physiol 93: 1881-1887, 2002. First published July 12, 2002; doi:10.1152/japplphysiol.00413.2002
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Vol. 93, Issue 5, 1881-1887, November 2002

HIGHLIGHTED TOPICS
Lung Edema Clearance: 20 Years of Progress
Selected Contribution: Limiting Na+ transport rate in airway epithelia from alpha -ENaC transgenic mice: a model for pulmonary edema

Reynald Olivier1, Urs Scherrer2, Jean-Daniel Horisberger1, Bernard C. Rossier1, and Edith Hummler1

1 Institut de Pharmacologie et de Toxicologie, Université de Lausanne, CH-1005 Lausanne; 2 Département de Médecine Interne, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland


    ABSTRACT
TOP
ABSTRACT
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES

The amiloride-sensitive epithelial Na+ channel (ENaC) is essential for fluid clearance from the airways. An experimental animal model with a reduced expression of ENaC, the alpha -ENaC transgenic rescue mouse, is prone to develop edema under hypoxia exposure. This strongly suggests an involvement of ENaC in the pathogenesis of pulmonary edema. To investigate the pathogenesis of this type of edema, primary cultures of tracheal cells from these mice were studied in vitro. An ~60% reduction in baseline amiloride-sensitive Na+ transport was observed, but the pharmacological characteristics and physiological regulation of the channel were similar to those observed in cells from wild-type mice. Aprotinin, an inhibitor of serine proteases, blocked 50-60% of the basal transepithelial current, hypoxia induced downregulation of Na+ transport, and beta -adrenergic stimulation was effective to stimulate Na+ transport after the hypoxia-induced decrease. When downregulation of ENaC activity (such as observed under hypoxia) is added to a low "constitutive" ENaC expression, the resulting reduced Na+ transport rate may be insufficient for airway fluid clearance and favor pulmonary edema.

epithelial sodium channel; sodium channel; mouse model; gene targeting; transgenic; Scnn1a


    INTRODUCTION
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ABSTRACT
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES

IN HUMANS, PULMONARY EDEMA is a severe condition with a high death rate. It results from an imbalance between alveolar fluid production and clearance, which results in alveolar space flooding. There is a large body of evidence supporting the hypothesis that active Na+ transport across alveolar epithelium in vivo contributes to both reabsorption of the fetal fluid during the postnatal period and maintenance of the adult alveolar spaces free of fluid (for review, see Ref. 19). Inhibition of ion transport might cause a reduced clearance of Na+ and water from alveolar fluid and, therefore, contribute to the formation of alveolar edema. Clinical evidence for a possible defect in Na+ reabsorption was indeed recently reported in subjects susceptible to high-altitude pulmonary edema (28, 33). These subjects had decreased transepithelial nasal potential difference (PD) and a decreased amiloride-sensitive component of the PD in normoxia relative to nonsusceptible control subjects.

In very premature infants, several studies clearly indicated that, in addition to a relative surfactant deficiency, immaturity of the liquid absorptive transport system may be an important factor in the pathogenesis of the respiratory distress syndrome (2, 21). Nasal transepithelial PDs (PDte) were measured in preterm infants, demonstrating that impairment of Na+ absorption is a major determinant of respiratory distress syndrome (2). Inactivation of the mouse alpha -epithelial Na+ channel (ENaC) gene (Scnn1a) locus by gene targeting in mouse embryonic stem cells revealed the crucial role of this channel in lung liquid clearance at birth (12). alpha -ENaC-deficient neonates developed respiratory distress and died within 40 h after birth. In those animals, amiloride-sensitive electrogenic Na+ transport was completely abolished (12). This suggests that channels made of beta - and gamma -ENaC subunits do not confer enough Na+ transport activity to substitute for the normal alpha -, beta -, or gamma -ENaC function in the lung.

Because of the neonatal mortality of the alpha -ENaC mice, this model did not allow to address the question of the role of ENaC in the adult lung. We then generated another animal model by reintroducing a rat alpha -ENaC transgene under a heterologous cytomegalovirus promoter into the alpha -ENaC knockout (Scnn1atm1) background (13). These animals no longer died because of a failure in lung liquid clearance. They showed near-normal wet-to-dry lung weight ratios in the postnatal period but presented reduced Na+ channel activity in colon in vivo (to ~20% of wild type) (13). These mice, however, exhibit a predisposition to at least two forms of pulmonary edema: thiourea- and hypoxia-induced edema (Hummler et al., unpublished observations; Refs. 9, 10, 17). In addition, under hypoxic conditions [inspired oxygen fraction (FIO2) of 0.08], these mice suffer from a defective transepithelial ENaC-mediated Na+ transport and a diminished alveolar liquid clearance (9, 10). This strongly suggests that ENaC-mediated Na+ transport is also important in adulthood, at least under some kind of specific conditions.

Although we have previously shown that adult transgenic rescue mice (alpha -ENaC-/-Tg+) have a reduced ability to transport Na+ in their colon (lower amiloride-sensitive PDte) and probably in their kidney [persistent pseudohypoaldosteronism type 1 (PHA-1) syndrome (12)], it is presently not known how the rate of Na+ transport by airway epithelial cells and its regulation are affected in adult transgenic rescue mice (alpha -ENaC-/-Tg+) compared with wild-type animals. We therefore evaluated the transepithelial transport of Na+ in primary cultures of tracheal cells isolated from mice with wild-type and mutated ENaC alleles under baseline conditions or its response to physiological, pathophysiological, and pharmacological stimuli. Clarke et al. (6) showed that the pattern of bioelectric responses to transport inhibitors and ion substitutions in mouse trachea indicate the presence of basal Na+ and Cl- conductance in the apical membrane. The response to the Na+ channel blocker amiloride indicates that Na+ absorption is a major basal ion transport activity (6). Here, we studied the pharmacological properties of these altered channels and their response to various regulatory factors or physiological situations, such as adrenergic stimulation (terbutaline), effect of protease inhibitors, or hypoxia. Our data show that alpha -ENaC-/-Tg+ mice have a low level of ENaC expression but seem to respond normally to various stimuli, which suggests that the absolute level of expression is responsible for the phenotype rather that an abnormal regulation.


    METHODS
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ABSTRACT
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES

Experimental animal groups. Protocols involving animals were reviewed and approved by the state authorities (Service Véterinaire Cantonal, Lausanne, Switzerland). Transgenic rescue mice (Scnn1atm1/Scnn1atm1Tgralpha ENaC), alpha -ENaC heterozygous mutant (Scnn1atm1/+) and alpha -ENaC wild-type (Scnn1a+/+) mice were obtained by interbreeding mice heterozygous mutant for alpha -ENaC allele [Scnn1atm1 (14)] ± the transgene Tgralpha ENaC on a NMRI genetic background. Polymerase chain reaction (PCR)-based genotyping for the gene targeting status (+/+, +/-, and -/-) and the transgene (Tg+, Tg-) was performed by using specific primers as described (13). Animals were kept under standard light (12:12-h light-dark cycle) and standard food conditions with free access to tap water.

Cell culture and transepithelial current measurements under normoxic and hypoxic conditions. Primary tracheal cells were cultured at 37°C, 5% CO2, in humidified incubators in Ham's F-12 based medium (Life Technologies) containing 1 µg/ml insulin, 7.5 µg/ml transferrin, 1 µM hydrocortisone, 30 nM 3,5,3,'-triiodothyronine, 1 ng/ml cholera toxin, 2.5 ng/ml epidermal growth factor, 10 ng/ml endothelial cell growth substance, and 50 nM retinoic acid supplemented (1:1) with STO fibroblast-conditioned Dulbecco's MEM (Life Technologies) containing 2% FBS principally as described (6). If not otherwise stated, all substances were obtained from Sigma Chemical, Germany. Cells were seeded at a concentration of 104 on permeable collagen-coated filters (Transwell-COL, 6.5-mm diameter, Costar) to ensure high rates of basal transport. After the fourth day in culture, the PDte (in mV) and transepithelial resistance (Rte; Omega /cm2) were measured by using the double-electrode system (Millicell-ERS, Millipore). The equivalent transepithelial short-circuit current (Isc; µA/cm2) was calculated from the relationship Isc = PDte/Rte. Hypoxic (FIO2 = 0.01, balance N2) exposures were performed in a Bioblock Scientific three-gas incubator at 37% for 6-h periods. Culture preparations were routinely studied within 1-2 days of the development of the maximal resistance, i.e., 7-10 days after seeding.

RT-PCR analysis. RT-PCR was performed on total RNA from primary culture of tracheal cells from newborn and adults and whole lung tissue from adult mice. Briefly, 3 µg of total RNA were treated with DNase I (Roche, Switzerland) followed by RT using Superscript II (Life Technologies) and random primers (Pharmacia). PCR was performed by using 1/10 of the cDNA digested with RNase (Life Technologies) at 55°C for 15 min. PCR was done in 50-µl reactions that contained 1.5 mM MgCl2, 50 mM KCl, 10 mM Tris · HCl, pH 8.3, 150 µM of each deoxynucleoside 5'-triphospate, 0.5 µM of each primer, and 2.5 U of Taq DNA polymerase (Roche, Switzerland). Forty cycles each consisting of 30 s at 94°C, 30 s at 48°C, and 1 min at 72°C were run by using primers for alpha -, beta -, and gamma -ENaC (Scnn1a, b, c) as described (12). Amplified PCR products were separated on a 1.2% agarose gel visualized by ethidium bromide staining.

Pharmacological Tools

Amiloride. Confluent primary culture of tracheal cells were treated with increasing concentrations (10-9 to 10-3 M) of amiloride in the apical side solution, and PDte and Rte were measured after a 15-min incubation in each amiloride concentration. In part of the experiments, 100 µM ATP was added in the presence of 100 µM amiloride for 1 min to the apical side, and Isc was measured.

Aprotinin. Tracheal cells were incubated with 100 µg/ml of aprotinin in the apical side solution. After 6 and 24 h of incubation, Isc was measured.

Terbutaline. Tracheal cells were incubated with 100 µM terbutaline in the basolateral solution, a beta -adrenergic agonist, and Isc was measured after 5, 10, 15, and 30 min, 1 and 2 h, and 1 and 2 days.

Calculations and Statistics

All data are expressed as means ± SE. Values of n refer to the number of replicate cultures in each group. Individual groups were compared by using Student's t-test for all pairwise comparisons. A level of P <=  0.05 was accepted as statistically significant for all comparisons.


    RESULTS
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ABSTRACT
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES

Expression of ENaC Subunits in Primary Tracheal Cells

RT-PCR analysis demonstrated the expression of all three ENaC subunits in primary tracheal cells from littermates with different genotypes arising from alpha -ENaC heterozygous mutant ± alpha -ENaC transgenic interbreeding (Fig. 1). alpha -ENaC-/- (knock out, Scnn1tm1 homozygous mutant) mice lack alpha -ENaC mRNA transcripts (Fig. 1). mRNA transcripts for beta - and gamma -ENaC were present independent of the genotype (Fig. 1). Expression of the rat alpha -ENaC transgene was also clearly detectable in cells from transgenic animals.


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Fig. 1.   Detection of mRNA transcripts for alpha -, beta -, and gamma -epithelial Na+ channel (ENaC) subunits (Scnn1a, b, c, respectively) in tracheal cells (lanes 3-8) and lung (lane 9) from newborn (lane 7) and adult (lanes 3-6, 8, 9) alpha -ENaC wild-type (+/+) and alpha -ENaC mutant (+/-, -/-) transgenic (Tg+) and nontransgenic (Tg-) mice. RT-PCR resulted in a 556-bp band specific for alpha -ENaC, 632-bp band specific for beta -ENaC, and a 652-bp band specific for gamma -ENaC. In -/-Tg+ mice, rat alpha -ENaC mRNA transcript was detected by using the same primers as for the mouse alpha -ENaC mRNA (lane 6). No alpha -ENaC mRNA transcript was found in tracheal cells from homozygous mutant alpha -ENaC (-/-) mice (lane 7). RT-PCR analysis was controlled by detection of GAPDH message. Positive control (C) (lane 1), alpha -ENaC cDNA; negative control (N), PCR reaction without RNA (lane 10). Marker used was a 50-bp DNA ladder.

Amiloride Sensitivity in Primary Tracheal Cells from ENaC Mutant and Wild-Type Mice

As shown in Fig. 2A, the equivalent Isc had a significantly lower baseline value in tracheal cells from alpha -ENaC transgenic rescue mice [2.6 ± 0.6 µA/cm2 (-/-Tg+) vs. 7.4 ± 1.0 µA/cm2 (+/+ and +/-), i.e., ~40% of wild-type activity, P < 0.001]. However, the sensitivity to amiloride was similar in the alpha -ENaC-/-Tg+ mice (KI = 0.33 ± 0.02 µM, n = 3) and in the alpha -ENaC+/+ and alpha -ENaC+/- mice (pooled values in these two groups KI = 0.38 ± 0.09, n = 6). The amiloride-insensitive current was similar in all groups.


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Fig. 2.   A: dose-response curve for amiloride. Effect of amiloride (ranging from 10-9 to 10-3 M) on the equivalent short circuit current (Isc) in tracheal cells from alpha -ENaC wild-type (+/+), heterozygous mutant (+/-), and transgenic rescue (-/-Tg+) mice. Values are means ± SE; n = 3 for all groups; *P < 0.05; **P < 0.001. B: effect of aprotinin on Isc in cells from alpha -ENaC wild-type (+/+) and mutant (+/-, -/-Tg+) mice. Isc was measured before and after 6- and 24-h incubation with 100 µM aprotinin. Values are means ± SE; n = 4 (+/+), n = 3 (+/-, -/-Tg+). *P < 0.05 and **P < 0.001 vs. basal Isc.

Application of ATP in the presence of amiloride resulted in an increase of Isc most likely due to Cl- secretion (+/+: Isc = 3.4 ± 1.24; n = 4 vs. -/-Tg: Isc = 5.2 ± 0.47; n = 3).

Effect of Protease Inhibition

Twenty-four-hour incubation of primary tracheal cells with aprotinin (100 µg/ml), an inhibitor of serine proteases, significantly reduced Na+ transport independently of the ENaC genotype. In wild-type (+/+) mice, Isc decreased by ~60% in heterozygous mutant (+/-) and by ~50% in transgenic rescue mice (-/-Tg+) (see Fig. 2B for the absolute values). The effect of aprotinin on transepithelial current was slowly reversible (data not shown).

Effect of Terbutaline on Transepithelial Na+ Transport Under Normal and Hypoxic Conditions

To further study the regulation of transepithelial transport, we measured PDte and Rte in the three different genotypes on beta -adrenergic stimulation. We first established that a significant stimulation of Isc could be observed in primary tracheal cell culture from wild-type animals by exposure to 100 µM terbutaline. Isc was significantly increased after 30 min (1.3-fold stimulation, P < 0.05) and reached a maximum 2.2-fold stimulation after ~2 h of incubation (P < 0.001; Fig. 3A). We then tested the effect of terbutaline (100 µM) on tracheal cells from wild-type mice after a 6-h period of exposure to hypoxia (FIO2 = 0.01) that led to a decrease of Isc of ~50% (P < 0.05). Terbutaline was added for 2 h under hypoxia. Terbutaline induced a stimulation of Isc to a level approximately similar to the initial value before hypoxia (Fig. 3B; P < 0.01 compared with hypoxia alone). Final measurements of transepithelial current after addition of amiloride demonstrated a nearly complete inhibition of Isc, which supports the hypothesis that the terbutaline-induced increase of Isc was due, at least to a large part, to an increased rate of Na+ transport (Fig. 3, B and C; P < 0.05).


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Fig. 3.   A: time course of terbutaline on the stimulation of Isc in tracheal cells from wild-type (+/+) mice. Time points of 100 µM terbutaline application (at time 0 and 2 days thereafter) are indicated (arrows). Values are means ± SE; n = 9 filters for each condition. *P < 0.05, **P < 0.001 vs. basal Isc. B: effect of hypoxia followed by terbutaline (100 µM) treatment on Isc in +/+ cells. Application of 100 µM amiloride blocked ENaC-mediated Na+ current. Values are means ± SE; n = 4 per condition. *P < 0.05 vs. basal Isc.

Cells from alpha -ENaC-/-Tg+ mice showed a similar response on exposure to hypoxia compared with cells from +/+ (49.3%) and +/- (42.8%) mice (P < 0.001; -/-Tg+: 48.5% of basal Isc, P < 0.05; Fig. 4A). In these three groups, the baseline Na+ transport rate could be completely restored within 5 days when cells were returned to normoxia (FIO2 = 0.21; Fig. 4A). After exposure to hypoxia for 6 h, application of terbutaline (2-h incubation, still under hypoxia) induced an increase of the transepithelial current to a level similar to that recorded initially under normoxia without adrenergic stimulation, and this effect was observed in the three tested ENaC genotypes; it was even slightly higher than baseline in cells from alpha -ENaC-/- Tg+ mice (Fig. 4B). Final application of amiloride (100 µM) showed again that ~70% of the terbutaline-stimulated Isc represents an amiloride-sensitive ENaC-mediated current.


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Fig. 4.   A: effect of hypoxia (6 h, inspired oxygen fraction = 0.01) on Isc in tracheal cells from +/+, +/-, and -/-Tg+ mice and recovery after reoxygenation (24 h and 5 days later). Values are means ± SE; n = 8 for all conditions. **P < 0.001 vs. basal Isc. B: effect of terbutaline treatment under hypoxic condition (6 h, inspired oxygen fraction = 0.01) on transepithelial current. Application of 100 µM amiloride blocked ENaC-mediated Na+ current. Values are means ± SE; +/+ and +/-, n = 8; -/-Tg+, n = 4. *P < 0.05, **P < 0.001.


    DISCUSSION
TOP
ABSTRACT
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES

Fluid clearance in lung cells is an active, energy-dependent process and has been shown to be driven by active transepithelial Na+ transport due to the presence of ENaC in the apical and Na+ pumps (Na+-K+-ATPase) in their basolateral membrane. Several lines of evidence show that ENaC represents the rate-limiting step in Na+ reabsorption in epithelia of organs like the lung (19). In our present experimental model, in the alpha -ENaC transgenic rescue mice (alpha ENaC-/-Tg+), alpha -ENaC endogenous gene expression has been replaced by transgenic expression from the human cytomegalovirus promoter (Fig. 1 and Ref. 13). Despite the generally lower ENaC-mediated Na+ transport that might be explained by variegated expression of the transgene or by the absence of corresponding regulatory sequences in the cytomegalovirus promoter, expression of the transgene resulted in a neonatal phenotypic rescue. Newborn mice were able to clear their lungs of liquid, and, under normoxic conditions, adult mice exhibit a near-normal wet-to-dry lung weight ratio (13). Recent findings demonstrated that alpha -ENaC dysfunction in these mice impairs alveolar fluid removal and predisposes the mice to lung edema. Under hypoxic conditions, alpha -ENaC-/-Tg+ mice develop pulmonary edema, indicated by an increased wet-to-dry lung weight ratio (Egli et al., unpublished observations; Ref. 10). In our present cell culture study, we were interested to study the underlying mechanism(s) that predispose to edema formation in this mouse model with altered ENaC function.

In tracheal cells from alpha -ENaC-/-Tg+ mice studied in culture, we observed a lower total and amiloride-sensitive transepithelial Isc, which reflects a significantly lower ENaC-mediated Na+ transport similar to what has already been reported for the rectal epithelium in vivo (Figs. 2-4; Ref. 13). Incubation of renal or airway cells with aprotinin, a serine protease inhibitor, has been shown to result in a decreased amiloride-sensitive ENaC-mediated transport in several types of epithelia, and this effect has been attributed to inhibition of the stimulatory effect of serine proteases like CAP1 (Xenopus, mouse) or prostasin (human) on ENaC activity (8, 29, 32). Further evidence for an action of these serine proteases came from a recent study in which a recombinant Kunitz-type serine protease inhibitor efficiently blocked ENaC-mediated Na+ transport in human bronchial epithelial cells (4). Our present data are in accordance with these findings that show that ~50% of the transepithelial current in primary tracheal cells can be blocked by aprotinin and may require the activity of a serine protease (Fig. 2B). There was no obvious difference in the response to aprotinin between wild-type and alpha -ENaC-/-Tg+ mice.

The rate of transepithelial Na+ transport can be stimulated by beta -adrenergic agonists acting through the cAMP/PKA pathway in respiratory epithelia (5). The exact mechanism by which cAMP influences Na+ transport in vivo is disputed. Marunaka et al. (18) found that terbutaline increased the open probability of an amiloride-sensitive Na+-permeable nonselective cation channel. In our primary tracheal cells, terbutaline seems to affect transcription (effect after 30 min) rather than the open probability (effect within 10 min of exposure) of Na+ channels described by Baxendale-Cox (3) (Fig. 3A). Our data are in accordance with the finding from Minakata et al. (20), who found that alpha -ENaC mRNA expression in cultured alveolar type II cells was increased after 2 days exposure to 10-4 M terbutaline. About 80% of this transepithelial current was sensitive to amiloride. Different experimental protocols and/or concentrations applied could also account for various effects of terbutaline seen in different culture systems (15, 25). In epithelia from control animals, stimulation of Na+ transport by terbutaline under hypoxic conditions resulted in Isc values similar to those observed under control conditions. With respect to the underlying regulatory mechanisms, the channels in the alpha -ENaC-/-Tg+ mice seemed to respond similarly as those of wild-type cells (Fig. 4B). The reversal of a hypoxia-induced decrease of Isc by terbutaline fits with the findings from Vivona et al. (30). In hypoxic rats (FIO2 = 0.08), they reported a decrease in transepithelial Na+ and fluid transport that was reversible by intratracheal instillation of terbutaline (30). Indeed, the experimental findings match well with recent clinical studies in humans that showed that prophylactic inhalation of a beta -adrenergic agonist can reduce the risk of high-altitude pulmonary edema and that acute inhalation of beta -adrenergic agonist achieves therapeutic levels in the pulmonary edema fluid of ventilated patients with acute respiratory failure (1, 26). Terbutaline treatment might therefore represent a potential therapeutic strategy to decrease edema and improve gas exchange (for review, see Refs. 11, 31). Hypoxia has been shown to reduce Na+ transport in airway epithelia, and this effect is due at least in part to downregulation of ENaC in these cells (7, 22, 23). For this effect too, the channels of the alpha -ENaC-/-Tg+ mice seemed to respond similarly to those of wild-type cells (Fig. 4A). However, because the initial, baseline rate of transport was lower, the similar reduction resulted in a lower Na+ transport rate after hypoxia. This very low level of Na+ transport resulting from the combined effect of the low level of ENaC expression in alpha -ENaC-/-Tg+ animals and downregulation due to acute hypoxia might lead to a failure of airway fluid clearance and pulmonary edema.

The alpha -ENaC transgenic rescue mice present a model for renal salt-wasting syndrome PHA-1. ENaC channel activity derived from transgene expression in the alpha -ENaC-/-Tg+ mice provides a sufficient amount of Na+ absorptive function in the critical Na+ absorbing organs, like lung, kidney, and colon (13). Whereas young alpha -ENaC-/-Tg+ mice showed clinical features of severe PHA-1 with metabolic acidosis, urinary salt-wasting, growth retardation, and 50% mortality within the first 3 wk of life, adult transgenic rescue mice exhibited a compensated PHA-1 with normal acid/base and electrolyte values (13). Despite a diminished Na+ transport in all organs and a decreased lung liquid clearance, adult transgenic rescue mice showed near-normal liquid absorption under normoxia (10, 13). Our data suggest that diminished basal Na+ transport per se is not sufficient for edema formation but that an additional stress to the system is necessary for edema to develop. This stress might be a further reduction of the Na+ transport capacity, such as is the case in hypoxia, or an increase in fluid production, such as is the case of toxic or hydrostatic edema.

PHA-1 patients carrying ENaC mutations in all three subunits also have a reduced rate of liquid absorption from airway surface. The result is an increased volume of liquid in the airway that demonstrates that ENaC-mediated Na+ transport has an important role on adult airway surfaces (16, 24, 27). These patients are not known for spontaneous development of pulmonary edema. However, it is not known whether PHA-1 patients might be more prone to develop pulmonary edema when exposed to additional stress.

In conclusion, our observations show that, in our PHA-1 model that results from the knock out of the endogenous mouse alpha -ENaC gene and its partial replacement by rat alpha -ENaC, Na+ transport in the airway epithelia is globally reduced to ~40% of the wild-type level, but the responses to either pharmacological inhibitors or physiological regulation are preserved and are proportionally similar to those observed in tissues from wild-type animals. We propose that, under circumstances leading to downregulation of ENaC, the rate of Na+ transport becomes insufficient to maintain fluid balance, and lung edema may result. In other words, in addition to a lower basal Na+ transport, a further risk factor is necessary to generate lung edema in the in vivo models. Transgenic rescue mice with their ENaC dysfunction present a useful model to study the involvement of ENaC channels in the pathogenesis of pulmonary edema.


    ACKNOWLEDGEMENTS

We thank Friedrich Beermann for critically reading the manuscript and Hans-Peter Gaeggeler for excellent photographic work.


    FOOTNOTES

This work was supported by Swiss National Science Foundation Grant nos. 32-51157.97 (Tandem) (to U. Scherrer), 31-061966.00 (to B. C. Rossier), and 31-063801.00 (to E. Hummler).

Address for reprint requests and other correspondence: E. Hummler, Institut de Pharmacologie et de Toxicologie, Rue du Bugnon 27, CH-1005 Lausanne, Switzerland (E-mail: ehummler{at}pop-server.unil.ch).

The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

July 12, 2002;10.1152/japplphysiol.00413.2002

Received 10 May 2002; accepted in final form 9 July 2002.


    REFERENCES
TOP
ABSTRACT
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES

1.   Atabai, K, Ware L, Snider M, Koch P, Daniel B, Nuckton T, and Mattay M. Aerosolized beta 2-adrenergic agonists achieve therapeutic levels in the pulmonary edema fluid of ventilated patients with acute respiratory failure (Abstract). Am J Respir Crit Care Med 163: 618, 2001.

2.   Barker, PM, Gowen CW, Lawson EE, and Knowles MR. Decreased sodium ion absorption across nasal epithelium of very premature infants with respiratory distress syndrome. J Pediatr 130: 373-377, 1997[ISI][Medline].

3.   Baxendale-Cox, LM. Terbutaline increases open channel density of epithelial sodium channel (ENaC) in distal lung. Respir Physiol 116: 1-8, 1999[ISI][Medline].

4.   Bridges, RJ, Newton BB, Pilewski JM, Devor DC, Poll CT, and Hall RL. Na+ transport in normal and CR human bronchial epithelial cells is inhibited by BAY 39-9437. Am J Physiol Lung Cell Mol Physiol 281: L16-L23, 2001[Abstract/Free Full Text].

5.   Cheek, JM, Kim KJ, and Crandall ED. Tight monolayers of rat alveolar epithelial cells: bioelectric properties and active sodium transport. Am J Physiol Cell Physiol 256: C688-C693, 1989[Abstract/Free Full Text].

6.   Clarke, LL, Burns KA, Bayle JY, Boucher RC, and Van Scott MR. Sodium- and chloride-conductive pathways in cultured mouse tracheal epithelium. Am J Physiol Lung Cell Mol Physiol 263: L519-L525, 1992[Abstract/Free Full Text].

7.   Clerici, C, and Matthay MA. Hypoxia regulates gene expression of alveolar epithelial transport proteins. J Appl Physiol 88: 1890-1896, 2002[Abstract/Free Full Text].

8.   Donaldson, SH, Hirsh A, Li DC, Holloway G, Chao J, Boucher RC, and Gabriel SE. Regulation of the epithelial sodium channel by serine proteases in human airways. J Biol Chem 277: 8338-8345, 2002[Abstract/Free Full Text].

9.   Egli, M, Cook S, Hugli O, Hummler E, Nicod P, and Scherrer U. Delayed resolution of pulmonary edema in mice with defective sodium transport-dependent alveolar fluid clearance (Abstract). FASEB J 15: 860, 2001.

10.   Egli, M, Sartori C, Duplain H, Lepori M, Hummler E, Nicod P, Rossier BC, and Scherrer U. Impaired alveolar fluid clearance and augmented susceptibility to lung edema in mice with defective amiloride-sensitive sodium transport (Abstract). FASEB J 14: 127, 2000.

11.   Hardiman, KM, and Matalon S. Modification of sodium transport and alveolar fluid clearance by hypoxia. Am J Respir Cell Mol Biol 25: 538-541, 2001[Free Full Text].

12.   Hummler, E, Barker P, Gatzy J, Beermann F, Verdumo C, Schmidt A, Boucher R, and Rossier BC. Early death due to defective neonatal lung liquid clearance in alpha ENaC-deficient mice. Nat Genet 12: 325-328, 1996[ISI][Medline].

13.   Hummler, E, Barker P, Talbot C, Wang Q, Verdumo C, Grubb B, Gatzy J, Burnier M, Horisberger JD, Beermann F, Boucher R, and Rossier BC. A mouse model for the renal salt-wasting syndrome pseudohypoaldosteronism. Proc Natl Acad Sci USA 94: 11710-11715, 1997[Abstract/Free Full Text].

14.   Hummler, E, and Beermann F. Scnn1 sodium channel gene family in genetically engineered mice. J Am Soc Nephrol 11: S129-S134, 2000.

15.   Jain, L, Chen XJ, Ramosevac S, Brown LA, and Eaton DC. Expression of highly selective sodium channels in alveolar type II cells is determined by culture conditions. Am J Physiol Lung Cell Mol Physiol 280: L646-L658, 2001[Abstract/Free Full Text].

16.   Kerem, ETB, Hanukoglu A, Hofmann T, Zhou Z, Bennett W, MacLaughlin E, Barker P, Nash M, Quittell L, Boucher R, and Knowles MR. Pulmonary epithelial sodium-channel dysfunction and excess airway liquid in pseudohypoaldosteronism. N Engl J Med 341: 156-162, 1999[Abstract/Free Full Text].

17.   Lepori, M, Hummler E, Feihl F, Sartori C, Nicod P, Rossier BC, and Scherrer U. Amiloride-sensitive sodium transport dysfunction augments susceptibility to hypoxia-induced lung edema (Abstract). FASEB J 12: A39, 1998.

18.   Marunaka, Y, Niisato N, O'Brodovich H, and Eaton DC. Regulation of an amiloride-sensitive Na+-permeable channel by a beta 2-adrenergic agonist, cytosoloic Ca2+ and Cl- in fetal rat alveolar epithelium. J Physiol 515: 669-683, 1999[Abstract/Free Full Text].

19.   Matalon, S. Sodium channels in alveolar epithelial cells: molecular characterization, biophysical properties and physiological significance. Annu Rev Physiol 61: 627-661, 1999[ISI][Medline].

20.   Minakata, Y, Suzuki S, Grygorczyk C, Dagenais A, and Berthiaume Y. Impact of beta -adrenergic agonist on Na+ channel and Na+-K+-ATPase expression in alveolar type II cells. Am J Physiol Lung Cell Mol Physiol 275: L414-L422, 1998[Abstract/Free Full Text].

21.   O'Brodovich, HM. Respiratory distress syndrome: the importance of effective transport. J Pediatr 130: 342-344, 1997[ISI][Medline].

22.  Planès C, Escoubet B, Blot-Chabaud M, Friedlander G, Farman N, and Clerici C. Hypoxia downregulates expression and activity of epithelial sodium channels in rat alveolar type II cells. Am J Resp Cell Mol Biol. In press.

23.   Planès, C, Friedlander G, Loiseau A, Amiel C, and Clerici C. Inhibition of Na-K-ATPase activity after polonged hypoxia in an alveolar epithelial cell line. Am J Physiol Lung Cell Mol Physiol 271: L70-L78, 1996[Abstract/Free Full Text].

24.   Prince, LS, Launspach JL, Geller DS, Lifton RP, Pratt JH, Zabner J, and Welsh MJ. Absence of amiloride-sensitive sodium absorption in the airway of an infant with pseudohypoaldosteronism. J Pediatr 135: 786-789, 1999[ISI][Medline].

25.   Sakuma, T, Tuchihara C, Ishigaki M, Osanai K, Nambu Y, Toga H, Takahashi K, Ohya N, Inoue M, and Mattay MA. beta 1-adrenoceptor stimulation by high-dose terbutaline downregulates terbutaline-stimulated alveolar fluid clearance in ex vivo rat lung. Exp Lung Res 27: 453-468, 2001[ISI][Medline].

26.   Sartori, C, Allemann Y, Duplain H, Lepori M, Egli M, Lipp E, Hutter D, Turini P, Hugli O, Cook S, Nicod P, and Scherrer U. Salmeterol for the prevention of high-altitude pulmonary edema. N Engl J Med 346: 1631-1636, 2002[Abstract/Free Full Text].

27.   Schaedel, C, Marthinsen L, Kristoffersson AC, Kornfait R, Nilsson KO, Orlenius B, and Holmberg L. Lung symptoms in pseudohypoaldosteronism type 1 are associated with deficiency of the alpha subunit of the epithelial sodium channel. J Pediatr 135: 739-745, 1999[ISI][Medline].

28.   Scherrer, U, Sartori C, Lepori M, Allemann Y, Duplain H, Trueb L, and Nicod P. High altitude pulmonary edema: from exaggerated pulmonary hypertension to a defect in transepithelial sodium transport. Adv Exp Med Biol 474: 93-107, 2000.

29.   Vallet, V, Chraibi A, Gaeggeler HP, Horisberger JD, and Rossier BC. An epithelial serine protease activates the amiloride-sensitive sodium channel. Nature 389: 607-610, 1997[Medline].

30.   Vivona, ML, Matthay M, Chabaud MB, Friedlander G, and Clerici C. Hypoxia reduces alveolar epithelial sodium and fluid transport in rats. Reversal by beta -adrenergic agonist treatment. Am J Respir Cell Mol Biol 25: 554-561, 2001[Abstract/Free Full Text].

31.   Voelkel, N. High-altitude pulmonary edema. N Engl J Med 346: 1606-1607, 2002[Free Full Text].

32.   Vuagniaux, G, Vallet V, Jaeger-Fowler N, Bens M, Farman N, Courtois-Coutry N, Vandewalle A, Rossier BC, and Hummler E. Activation of the amiloride-sensitive epithelial sodium channel by the serine protease mCAP1 expressed in a mouse cortical collecting duct cell line. J Am Soc Nephrol 11: 828-834, 2000[Abstract/Free Full Text].

33.   Weymann, J, Swenson E, Gibbs S, Maggiorini M, Bärtsch P, and Mairbäurl H. Nasal epithelium Na- and Cl-conductance differences between controls and HAPE-susceptibles in normoxia and hypoxia (Abstract). Am J Respir Crit Care Med 161: 446, 2000.


J APPL PHYSIOL 93(5):1881-1887
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