The present observations suggest that the two receptors cubilin and megalin are both involved in the endocytic uptake of albumin in renal proximal tubule cells.

Receptor‐mediated endocytosis is an important mechanism for transport of macromolecules and regulation of cell‐surface receptor expression. In renal proximal tubules, receptor‐mediated endocytosis mediates the reabsorption of filtered albumin. Acidification of the endocytic compartments is essential because it interferes with ligand‐receptor dissociation, vesicle trafficking, fusion events and coat formation. Here we show that the activity of Na+‐H+ exchanger isoform 3 (NHE3) is important for proper receptor‐mediated endocytosis of albumin and endosomal pH homeostasis in a renal proximal tubular cell line (opossum kidney cells) which expresses NHE3 only. Depending on their inhibitory potency with respect to NHE3 and their lipophilicity, the NHE inhibitors EIPA, amiloride and HOE694 differentially reduced albumin endocytosis. The hydrophilic inhibitor HOE642 had no effect. Inhibition of NHE3 led to an alkalinization of early endosomes and to an acidification of the cytoplasm, indicating that Na+‐H+ exchange contributes to the acidification of the early endosomal compartment due to the existence of a sufficient Na+ gradient across the endosomal membrane. Exclusive acidification of the cytoplasm with propionic acid or by removal of Na+ induced a significantly smaller reduction in endocytosis than that induced by inhibition of Na+‐H+ exchange. Analysis of the inhibitory profiles indicates that in early endosomes and endocytic vesicles NHE3 is of major importance, whereas plasma membrane NHE3 plays a minor role. Thus, NHE3‐mediated acidification along the first part of the endocytic pathway plays an important role in receptor‐mediated endocytosis. Furthermore, the involvement of NHE3 offers new ways to explain the regulation of receptor‐mediated endocytosis.

Albumin, glycated albumin, fatty acid-free albumin, or globulins led to an increase of secreted collagen (types I, III, and IV) in OK and LLC-PK1 cells. In cells with low protein uptake activity, albumin exposure inhibited collagen secretion. Western blot analysis showed an increase of cellular collagen. MMP activity was significantly decreased by albumin exposure. Furthermore, albumin exposure led to activation of the NF-kappa B-, AP1-, NFAT-, SRE-, and CRE-pathways. Inhibition of NF-kappa B, PKC, or PKA partially reversed the effects of albumin. In addition, inhibition of albumin endocytosis reduced collagen secretion and activation of the signaling pathways. Discussion. The data show that endocytic uptake of proteins disturbs collagen homeostasis in proximal tubular cells. This disturbed matrix homeostasis probably supports the progression of interstitial fibrosis, which is of importance for the development of renal insufficiency.

The steroid hormone aldosterone is a major regulator of extracellular volume and blood pressure. Aldosterone effectors are for example the epithelial Na+ channel (ENaC), the Na+-K+-ATPase and the proximal tubule Na+/H+ exchanger isoform 3 (NHE3). The aim of this study was to investigate whether aldosterone acts directly on proximal tubule cells to stimulate NHE3 and if so whether the EGF-receptor (EGFR) is involved. For this purpose, primary human renal proximal tubule cells were exposed to aldosterone. NHE3 activity was determined from Na+- dependent pH-recovery, NHE3 surface expression was determined by biotinylation and immunoblotting. EGFR-expression was assessed by ELISA. pHi- measurements revealed an aldosterone-induced increase in NHE3 activity, which was inhibited by the mineralocorticoid receptor blocker spironolactone and by the EGFR-kinase inhibitor AG1478. Immunoprecipitation and immunoblot analysis showed an aldosterone-induced increase in NHE3 surface expression, which was also inhibited by spironolactone and AG1478. Furthermore, aldosterone enhanced EGFR-expression. In conclusion, aldosterone stimulates NHE3 in human proximal tubule cells. The underlying mechanisms include AG1478 inhibitable kinase and are paralleled by enhanced EGFR expression, which could be compatible with EGF-receptor-pathway-dependent surface expression and activity of NHE3 in human primary renal proximal tubule epithelial cells.

Receptor-mediated, clathrin-dependent endocytosis (RME) is important for macromolecular transport and regulation of cell-surface protein expression. Pharmacological studies have shown that the plasma membrane transport protein Na(+)/H(+) exchanger 3 (NHE3), which shuttles between the plasma membrane and the early endosomal compartment by means of clathrin-mediated endocytosis, contributes to endosomal pH homeostasis and endocytic fusion events. Furthermore, it is known that NHE3 is phosphorylated and inhibited by cAMP-dependent kinase (protein kinase A). Here, we show, in a cellular knockout/retransfection approach, that NHE3 supports RME and confers cAMP sensitivity to RME, using megalin/cubilin-mediated albumin uptake in opossum kidney cells. RME, but not fluid-phase endocytosis, was dependent on NHE3 activity and expression. Furthermore, NHE3 deficiency or inhibition reduced the relative surface expression of megalin without altering total expression. In wild-type cells, cAMP inhibits NHE3 activity, leads to endosomal alkalinization, and reduces RME. In NHE3-deficient cells, endosomal pH is not sensitive to NHE3 inhibition, and cAMP does not affect endosomal pH or RME. NHE3 transfection into deficient cells restores RME and the effects of cAMP. Thus our data show that NHE3 is important for cAMP sensitivity of clathrin-dependent RME.