There are two classes of glucose transporters involved in glucose homeostasis in the body, the facilitated transporters or uniporters (GLUTs) and the active transporters or symporters (SGLTs). The energy for active glucose transport is provided by the sodium gradient across the cell membrane, the Na(+) glucose cotransport hypothesis first proposed in 1960 by Crane. Since the cloning of SGLT1 in 1987, there have been advances in the genetics, molecular biology, biochemistry, biophysics, and structure of SGLTs. There are 12 members of the human SGLT (SLC5) gene family, including cotransporters for sugars, anions, vitamins, and short-chain fatty acids. Here we give a personal review of these advances. The SGLTs belong to a structural class of membrane proteins from unrelated gene families of antiporters and Na(+) and H(+) symporters. This class shares a common atomic architecture and a common transport mechanism. SGLTs also function as water and urea channels, glucose sensors, and coupled-water and urea transporters. We also discuss the physiology and pathophysiology of SGLTs, e.g., glucose galactose malabsorption and familial renal glycosuria, and briefly report on targeting of SGLTs for new therapies for diabetes.

Membrane transporters that use energy stored in sodium gradients to drive nutrients into cells constitute a major class of proteins. We report the crystal structure of a member of the solute sodium symporters (SSS), the Vibrio parahaemolyticus sodium/galactose symporter (vSGLT). The ~3.0Å structure contains 14 transmembrane helices in an inward facing conformation with a core structure of inverted repeats of 5 TM helices (TM2-TM6 and TM7-TM11). Galactose is bound in the center of the core, occluded from the outside solutions by hydrophobic residues. Surprisingly, the architecture of the core is similar to the leucine transporter (LeuT) from a different gene family. Modeling the outward-facing conformation based on the LeuT structure, in conjunction with biophysical data, provides insight into structural rearrangements for active transport.

In humans, the kidneys filter approximately 180 g of D-glucose from plasma each day, and this is normally reabsorbed in the proximal tubules. Although the mechanism of reabsorption is well understood, Na(+)-glucose cotransport across the brush-border membrane and facilitated diffusion across the basolateral membrane, questions remain about the identity of the genes responsible for cotransport across the brush border. Genetic studies suggest that two different genes regulate Na(+)-glucose cotransport, and there is evidence from animal studies to suggest that the major bulk of sugar is reabsorbed in the convoluted proximal tubule by a low-affinity, high-capacity transporter and that the remainder is absorbed in the straight proximal tubule by a high-affinity, low-capacity transporter. There are at least three different candidates for these human renal Na(+)-glucose cotransporters. This review will focus on the structure-function relationships of these three transporters, SGLT1, SGLT2, and SGLT3.

Secondary active glucose transport occurs by at least four members of the SLC5 gene family. This review considers the structure and function of two premier members, SGLT1 and SGLT2, and their role in intestinal glucose absorption and renal glucose reabsorption. Genetics disorders of SGLTs include GlucoseGalactose Malabsorption, and Familial Renal Glucosuria. SGLT1 plays a central role in Oral Rehydration Therapy used so effectively to treat secretory diarrhoea such as cholera. Increasing attention is being focused on SGLTs as drug targets for the therapy of diabetes.

Organic substrates (sugars, amino acids, carboxylic acids and neutrotransmitters) are actively transported into eukaryotic cells by Na+ co-transport. Some of the transport proteins have been identified--for example, intestinal brush border Na+/glucose and Na+/proline transporters and the brain Na+/CI-/GABA transporter--and progress has been made in locating their active sites and probing their conformational states. The archetypical Na+-driven transporter is the intestinal brush border Na+/glucose co-transporter (see ref. 8), and a defect in the co-transporter is the origin of the congenital glucose-galactose malabsorption syndrome. Here we describe cloning of this co-transporter by a method new to membrane proteins. We have sequenced the cloned DNA and have found no homology between the Na+/glucose co-transporter and either the mammalian facilitated glucose carrier or the bacterial sugar transport proteins. This suggests that the mammalian Na+-driven transporter has no evolutionary relationship to the other sugar transporters.

An important class of integral membrane proteins, cotransporters, couple solute transport to electrochemical potential gradients; e.g., the Na+/glucose cotransporter uses the Na+ electrochemical potential gradient to accumulate sugar in ceils. So far, kinetic analysis of cotransporters has mostly been limited to steady-state parameters. In this study, we have examined pre-steady-state kinetics of Na+/glucose cotransport. The cloned human transporter (hSGLT1) was expressed in Xenopus oocytes, and voltageclamp techniques were used to monitor current transients after step changes in membrane potential. Transients exhibited a voltage-dependent time constant (Xr) ranging between 2 and 10 ms. The charge movement Q was fitted to a Boltzmann relation with mamal charge Q. of =20 nC, apparent valence z of 1, and potential Vo.s of -39 mV for 50% Q.. Lowering external Na+ from 100 to 10 mM reduced Q.,. 40%, shifted Vo.s from -39 to -70 mV, had no effect on z, and reduced the voltage dependence of T. Q. was independent of, but was dependent on, temperature (a 10°C increase increased X by a factor of ""2.5 at -50 mV). Addition ofsugar or phlorizin reduced Q",. Analyses of hSGLT1 pre-steady-state kinetics indicate that charge transfer upon a step of membrane potential in the absence of sugar is due to two steps in the reaction cycle: Na+ binding/dissociation (30%) and reorientation of the protein in the membrane field (70%). The rate-limiting step appears to be Na+ binding/dissociation. Qm. provides a measure of transporter density (=104/pm2). Charge transfer measurements give insight into the partdal reactions of the Na+/glucose cotransporter, and, combined with genetic engineering of the protein, provide a powerful tool for studying transport mechCotransporters are membrane transport proteins widely expressed in bacterial, plant, and animal cells (1, 2) which couple the transport of sugars, amino acids, neurotransmitters, osmolytes, and ions into cells to electrochemical potential gradients (Na+, H+, Cl-). An important example is the Na+/glucose cotransporter, which is responsible for the "active" accumulation of sugars in epithelial cells of the intestine.In recent electrophysiological experiments designed to measure steady-state kinetic properties of the cloned Na+/ glucose cotransporter (SGLT1) expressed in Xenopus oocytes we observed pre-steady-state currents (3, 4). These pre-steady-state currents were central in formulating a detailed quantitative nonrapid equilibrium six-state kinetic model of Na+/glucose transport (5). This model (see Fig. 4A (Fig. 4A).Here we have isolated the SGLT1 pre-steady-state currents, using a fast two-electrode voltage clamp, and have determined their kinetics as a function of voltage and Na+ and sugar concentrations. The results enable us to estimate the number of transporters in the membrane, the apparent valence of the voltage sensor, and rates for the voltagedependent steps in the transport reaction cycle (see Fig. 4A). Analysis ofpre-steady-state currents, therefore, represents ...

Membrane co-transport proteins that utilize a 5-helix inverted repeat motif have recently emerged as one of the largest structural class of secondary active transporters1,2. However, despite many structural advances there is no clear evidence as to how ion and substrate transport are coupled. Here, we report a comprehensive study of the Sodium-Galactose Transporter from Vibrio parahaemolyticus (vSGLT) consisting of molecular dynamics simulations, biochemical characterization, and a new crystal structure of the inward-open conformation at 2.7 Å resolution. Our data show that sodium exit causes a reorientation of transmembrane helix 1 (TM1) opening an inner gate required for substrate exit, while also triggering minor rigid body movements in two sets of transmembrane helical bundles. This cascade of events, initiated by sodium release, ensures proper timing of ion and substrate release. Once set in motion, these molecular changes weaken substrate binding to the transporter and allow galactose to readily enter the intracellular space. Additionally, we identify an allosteric pathway between the sodium binding sites, the unwound portion of TM1, and the substrate binding site that is essential in the coupling of co-transport.

Basic to the function of cell membranes is the ability to select between closely similar ions and molecules, such as potassium and sodium, calcium and magnesium, alcohols and aldehydes, and esters and acids. An under standing of the principles underlying selectivity is relevant to the study of neurophysiology, active transport, passive permeation, enzyme activation, and membrane structure. The present chapter has a twofold purpose : to summarize experimental evidence concerning the distinctive and consistent selectivity patterns exhibited by biol o gical membranes; and to review recent developments that have made it possible to account in large part for the main features of these patterns in terms of intermolecular and interatomic forces. Analyses of selectivity must begin by trying to explain as many phenomena as possible in terms of elementary physical concepts such as free energy, and in terms of the simplest principles governing the interactions of ions, such as Coulomb's law, or the simplest principles governing the interactions of non electrolytes, such as hydrogen bonding and van der Waals forces. While consideration of additional forces may prove necessary to interpret some more complex phenomena, explanations that do not take account even of the simplest forces cannot provide an adequate starting point. The first half of this chapter is devoted to ion selectivity, while the second half deals with nonelectrolyte selectivity.