Urate, a naturally occurring product of purine metabolism, is a scavenger of biological oxidants implicated in numerous disease processes, as demonstrated by its capacity of neuroprotection. It is present at higher levels in human blood (200 500 microM) than in other mammals, because humans have an effective renal urate reabsorption system, despite their evolutionary loss of hepatic uricase by mutational silencing. The molecular basis for urate handling in the human kidney remains unclear because of difficulties in understanding diverse urate transport systems and species differences. Here we identify the long-hypothesized urate transporter in the human kidney (URAT1, encoded by SLC22A12), a urate anion exchanger regulating blood urate levels and targeted by uricosuric and antiuricosuric agents (which affect excretion of uric acid). Moreover, we provide evidence that patients with idiopathic renal hypouricaemia (lack of blood uric acid) have defects in SLC22A12. Identification of URAT1 should provide insights into the nature of urate homeostasis, as well as lead to the development of better agents against hyperuricaemia, a disadvantage concomitant with human evolution.

Hyperuricemia is a significant factor in a variety of diseases, including gout and cardiovascular diseases. Although renal excretion largely determines plasma urate concentration, the molecular mechanism of renal urate handling remains elusive. Previously, we identified a major urate reabsorptive transporter, URAT1 (SLC22A12), on the apical side of the renal proximal tubular cells. However, it is not known how urate taken up by URAT1 exits from the tubular cell to the systemic circulation. Here, we report that a sugar transport facilitator family member protein GLUT9 (SLC2A9) functions as an efflux transporter of urate from the tubular cell. GLUT9-expressed Xenopus oocytes mediated saturable urate transport (K m : 365 ؎ 42 M). The transport was Na ؉ -independent and enhanced at high concentrations of extracellular potassium favoring negative to positive potential direction. Substrate specificity and pyrazinoate sensitivity of GLUT9 was distinct from those of URAT1. The in vivo role of GLUT9 is supported by the fact that a renal hypouricemia patient without any mutations in SLC22A12 was found to have a missense mutation in SLC2A9, which reduced urate transport activity in vitro. Based on these data, we propose a novel model of transcellular urate transport in the kidney; Remunurate is taken up via apically located URAT1 and exits the cell via basolaterally located GLUT9, which we suggest be renamed URATv1 (voltage-driven urate transporter 1).Urate (uric acid), an end product of purine metabolism in humans because of the genetic silencing of hepatic uricase, is now recognized as a natural antioxidant that has neuroprotective properties (1). Despite its beneficial role, elevation of the serum urate level is correlated with gout, hypertension, and cardiovascular and renal diseases (1, 2). The kidney plays a dominant role in maintaining plasma urate levels through the excretion process; it eliminates ϳ70% of the daily urate production (3). Therefore, it is important to understand the mechanism of renal urate handling because underexcretion of urate has been demonstrated in the majority of hyperuricemia patients (4).Since urate is a weak acid at physiological pH (pK a , 5.75), it hardly permeates the plasma membrane of cells in the absence of transport proteins (3). In 2002, we identified a long hypothesized urate-anion exchanger, URAT1, 2 encoded by SLC22A12, that localized on the apical side of the renal proximal tubule (5). Despite several potential candidate proteins for urate transport such as UAT (uric acid transporter), OAT1 (organic anionic transporter 1), OAT3, OAT4, OATv1/NPT1 (sodium phosphate transporter 1), MRP4 (multidrug resistance-associated protein), and OAT10 (6 -10), URAT1 is the sole transporter whose physiological role in renal urate reabsorption is established, based on the fact that lossof-function mutations in URAT1 cause renal hypouricemia (5). However, it is not known how urate taken up via URAT1 exits from the tubular cell (11). Moreover, there are patients with renal hypouricemia who had no...

Hartnup disorder, an autosomal recessive defect named after an English family described in 1956 (ref. 1), results from impaired transport of neutral amino acids across epithelial cells in renal proximal tubules and intestinal mucosa. Symptoms include transient manifestations of pellagra (rashes), cerebellar ataxia and psychosis 1,2 . Using homozygosity mapping in the original family in whom Hartnup disorder was discovered, we confirmed that the critical region for one causative gene was located on chromosome 5p15 (ref. 3). This region is homologous to the area of mouse chromosome 13 that encodes the sodium-dependent amino acid transporter B 0 AT1 (ref. 4). We isolated the human homolog of B 0 AT1, called SLC6A19, and determined its size and molecular organization. We then identified mutations in SLC6A19 in members of the original family in whom Hartnup disorder was discovered and of three Japanese families. The protein product of SLC6A19, the Hartnup transporter, is expressed primarily in intestine and renal proximal tubule and functions as a neutral amino acid transporter.Despite molecular characterization of other proximal tubule transporters, the neutral amino acid carrier defective in Hartnup disorder (OMIM 2345000) has resisted genetic identification 2 . We carried out homozygosity mapping and fine mapping in ten members of two consanguineous families (the siblings in whom Hartnup disorder was originally discovered 1 ; family A; Fig. 1a) and in siblings from the US 5 (family B; Fig. 1a). We found linkage of Hartnup disorder to 5p15 only in family A, with a maximum combined multipoint lod score of 2.31 at 11.24 cM (P ¼ 0.01). This confirmed our previous results showing linkage to chromosome 5p15 (ref.3). In family B, we obtained a maximum multipoint lod score of À2.40 at 15.81 cM.We simultaneously pursued two mouse monoamine transporterrelated orphan genes, Slc6a18 (also called Xtrp2; ref. 6) and Slc6a19 (encoding B 0 AT1; ref. 4). These members of the SLC6 family of transporters map to the mouse chromosomal region that is homologous to human chromosome 5p15. Both Slc6a18 and Slc6a19 showed abundant expression in mouse kidney, as assessed by real time RT-PCR (Fig. 2a). Immunohistochemistry confirmed expression of mouse B 0 AT1 at the brush border of small intestine (data not shown) and kidney proximal tubule cells (Fig. 2b).The human homolog, B 0 AT1, is encoded by the predicted locus SLC6A19, with a 2,022-bp open reading frame. PCR amplification using human kidney cDNA produced a 1,905-bp product with 100% identity to SLC6A19 sequence. We next determined the genomic organization of SLC6A19, which has a stop codon 28 bases before the ATG in the 5¢ untranslated region. SLC6A19 has 12 coding exons. The B 0 AT1 protein contains 634 amino acids and 12 predicted transmembrane regions (Fig. 1b). In a panel of human cDNAs, we detected robust expression of SLC6A19 in kidney and small intestine, with minimal expression in pancreas (Fig. 2c). SLC6A19 was also expressed in stomach, liver, duodenum and ileocecum (data n...

A cDNA that encodes a novel Na ؉ -independent neutral amino acid transporter was isolated from FLC4 human hepatocarcinoma cells by expression cloning. When expressed in Xenopus oocytes, the encoded protein designated LAT3 (L-type amino acid transporter 3) transported neutral amino acids such as L-leucine, L-isoleucine, L-valine, and L-phenylalanine. The LAT3-mediated transport was Na ؉ -independent and inhibited by 2-aminobicyclo[2.2.1]heptane-2-carboxylic acid, consistent with the properties of system L. Distinct from already known system L transporters LAT1 and LAT2, which form heterodimeric complex with 4F2 heavy chain, LAT3 was functional by itself in Xenopus oocytes. The deduced amino acid sequence of LAT3 was identical to the gene product of POV1 reported as a prostate cancer-upregulated gene whose function was not determined, whereas it did not exhibit significant similarity to already identified transporters. The Eadie-Hofstee plots of LAT3-mediated transport were curvilinear, whereas the low affinity component is predominant at physiological plasma amino acid concentration. In addition to amino acid substrates, LAT3 recognized amino acid alcohols. The transport of L-leucine was electroneutral and mediated by a facilitated diffusion. In contrast, L-leucinol, Lvalinol, and L-phenylalaninol, which have a net positive charge induced inward currents under voltage clamp, suggesting these compounds are transported by LAT3. LAT3-mediated transport was inhibited by the pretreatment with N-ethylmaleimide, consistent with the property of system L2 originally characterized in hepatocyte primary culture. Based on the substrate selectivity, affinity, and N-ethylmaleimide sensitivity, LAT3 is proposed to be a transporter subserving system L2. LAT3 should denote a new family of organic solute transporters.

Abstract. Human organic anion transporter OAT4 is expressed in the kidney and placenta and mediates high-affinity transport of estrone-3-sulfate (E 1 S). Because a previous study demonstrated no trans-stimulatory effects by E 1 S, the mode of organic anion transport via OAT4 remains still unclear. In the present study, we examined the driving force of OAT4 using mouse proximal tubular cells stably expressing OAT4 (S 2 OAT4). OAT4-mediated E 1 S uptake was inhibited by glutarate (GA) (IC 50 : 1.25 mM) and [14 C]GA uptake via S 2 OAT4 was significantly trans-stimulated by unlabeled GA (5 mM) (P<0.001).[3 H]E 1 S uptake via S 2 OAT4 was significantly trans-stimulated by preloaded GA (P<0.001) and its [ 14 C]GA efflux was significantly trans-stimulated by unlabeled E 1 S in the medium (P<0.05). In additon, both the uptake and efflux of [14 C]p-aminohippuric acid (PAH) and [14 C]GA via S 2 OAT4 were significantly trans-stimulated by unlabeled GA or PAH. The immunoreactivities of OAT4 were observed in the apical membrane of proximal tubules along with those of basolateral organic anion / dicarboxylate exchangers such as hOAT1 and hOAT3 in the same tubular population. These results indicate that OAT4 is an apical organic anion / dicarboxylate exchanger and mainly functions as an apical pathway for the reabsorption of some organic anions in renal proximal tubules driven by an outwardly directed dicarboxylate gradient.

The tubular secretion of diuretics in the proximal tubule has been shown to be critical for the action of drugs. To elucidate the molecular mechanisms for the tubular excretion of diuretics, we have elucidated the interactions of human organic anion transporters (hOATs) with diuretics using cells stably expressing hOATs. Diuretics tested were thiazides, including chlorothiazide, cyclothiazide, hydrochlorothiazide, and trichlormethiazide; loop diuretics, including bumetanide, ethacrynic acid, and furosemide; and carbonic anhydrase inhibitors, including acetazolamide and methazolamide. These diuretics inhibited organic anion uptake mediated by hOAT1, hOAT2, hOAT3, and hOAT4 in a competitive manner. hOAT1 exhibited the highest affinity interactions for thiazides, whereas hOAT3 did those for loop diuretics. hOAT1, hOAT3, and hOAT4 but not hOAT2, mediated the uptake of bumetanide. hOAT3 and hOAT4, but not hOAT1 mediated the efflux of bumetanide. hOAT1 and hOAT3, but not hOAT2 and hOAT4 mediated the uptake of furosemide. In conclusion, it was suggested that hOAT1 may play an important role in the basolateral uptake of thiazides, and hOAT3 in the uptake of loop diuretics. In addition, it was also suggested that bumetanide taken up by hOAT3 and/or hOAT1 is excreted into the urine by hOAT4.

Activation of T cells accompanies remarkable enhancement of metabolism. Sufficient and continuous nutrient supply is therefore important to support immune reaction in T cells. However, the mechanism of the promotion of nutrient incorporation in activated T cells has not been elucidated. In this study, we show that L-type amino acid transporter 1 (LAT1) is a major transporter for essential amino acids into activated human T cells. CD3/CD28 stimulation in primary human T cells triggered dramatic induction of LAT1 expression mediated by NF-κB and AP-1. Functional disturbance of LAT1 by a specific inhibitor and by small interfering RNA in human T cells suppressed essential amino acid uptake and induced a stress response mediated by DNA damage–inducible transcript 3 to attenuate cytokine production via inhibition of NF-κB and NFAT activities. These results uncover the previously unknown mechanism by which T cells accelerate essential amino acid uptake upon activation and adapt to essential amino acid starvation. Our results also raise the possibility for application of an LAT1 inhibitor as a new drug for therapy of disease caused by exaggerated immune response.

The evolutionary loss of hepatic urate oxidase (uricase) has resulted in humans with elevated serum uric acid (urate). Uricase loss may have been beneficial to early primate survival. However, an elevated serum urate has predisposed man to hyperuricemia, a metabolic disturbance leading to gout, hypertension, and various cardiovascular diseases. Human serum urate levels are largely determined by urate reabsorption and secretion in the kidney. Renal urate reabsorption is controlled via two proximal tubular urate transporters: apical URAT1 (SLC22A12) and basolateral URATv1/GLUT9 (SLC2A9). In contrast, the molecular mechanism(s) for renal urate secretion remain unknown. In this report, we demonstrate that an orphan transporter hNPT4 (human sodium phosphate transporter 4; SLC17A3) was a multispecific organic anion efflux transporter expressed in the kidneys and liver. hNPT4 was localized at the apical side of renal tubules and functioned as a voltage-driven urate transporter. Furthermore, loop diuretics, such as furosemide and bumetanide, substantially interacted with hNPT4. Thus, this protein is likely to act as a common secretion route for both drugs and may play an important role in diuretics-induced hyperuricemia. The in vivo role of hNPT4 was suggested by two hyperuricemia patients with missense mutations in SLC17A3. These mutated versions of hNPT4 exhibited reduced urate efflux when they were expressed in Xenopus oocytes. Our findings will complete a model of urate secretion in the renal tubular cell, where intracellular urate taken up via OAT1 and/or OAT3 from the blood exits from the cell into the lumen via hNPT4.Urate is the end product of purine metabolism in humans and certain primates as a result of uricase genetic loss (urate oxidase degrades urate to allantoin) (1). Two independent nonsense mutations in this gene, found in human, chimpanzee, and orangutan but not in the gibbon, indicate that this loss had evolutionary advantages for early primates (2). Because urate has powerful antioxidant properties, uricase loss resulting in elevated serum urate may have been beneficial to early primate survival (1). In addition, Watanabe et al. (3) hypothesized that elevated serum urate levels provided a survival advantage by helping to maintain blood pressure under the low salt dietary conditions that prevailed during the middle to late Miocene period. Despite its beneficial role and given the fact that more than half of uricase-deficient mice die from urate nephropathy within 4 weeks of age, elevation in serum urate level produces a burden on the body (4). To circumvent this problem, the human body had to develop a urate excretion system.The kidney plays a dominant role in maintaining serum urate levels (1, 5). Renal urate excretion is a function of the balance between reabsorption and secretion. Recently it was demonstrated that luminal urate is taken up by a urate-anion exchanger (URAT1; SLC22A12) 3 (6) into the renal proximal tubular cell and that intracellular urate exits the cell into the interstitium/blood ...