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Impairment in renal medulla development underlies salt wasting in Clc-k2 channel deficiency
Meng-Hsuan Lin, Jen-Chi Chen, Xuejiao Tian, Chia-Ming Lee, I-Shing Yu, Yi-Fen Lo, Shinichi Uchida, Chou-Long Huang, Bi-Chang Chen, Chih-Jen Cheng
Meng-Hsuan Lin, Jen-Chi Chen, Xuejiao Tian, Chia-Ming Lee, I-Shing Yu, Yi-Fen Lo, Shinichi Uchida, Chou-Long Huang, Bi-Chang Chen, Chih-Jen Cheng
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Research Article Nephrology

Impairment in renal medulla development underlies salt wasting in Clc-k2 channel deficiency

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Abstract

The prevailing view is that the ClC-Ka chloride channel (mouse Clc-k1) functions in the thin ascending limb to control urine concentration, whereas the ClC-Kb channel (mouse Clc-k2) functions in the thick ascending limb (TAL) to control salt reabsorption. Mutations of ClC-Kb cause classic Bartter syndrome, characterized by renal salt wasting, with perinatal to adolescent onset. We studied the roles of Clc-k channels in perinatal mouse kidneys using constitutive or inducible kidney-specific gene ablation and 2D and advanced 3D imaging of optically cleared kidneys. We show that Clc-k1 and Clc-k2 were broadly expressed and colocalized in perinatal kidneys. Deletion of Clc-k1 and Clc-k2 revealed that both participated in NKCC2- and NCC-mediated NaCl reabsorption in neonatal kidneys. Embryonic deletion of Clc-k2 caused tubular injury and impaired renal medulla and TAL development. Inducible deletion of Clc-k2 beginning after medulla maturation produced mild salt wasting resulting from reduced NCC activity. Thus, both Clc-k1 and Clc-k2 contributed to salt reabsorption in TAL and distal convoluted tubule (DCT) in neonates, potentially explaining the less-severe phenotypes in classic Bartter syndrome. As opposed to the current understanding that salt wasting in adult patients with Bartter syndrome is due to Clc-k2 deficiency in adult TAL, our results suggest that it originates mainly from defects occurring in the medulla and TAL during development.

Authors

Meng-Hsuan Lin, Jen-Chi Chen, Xuejiao Tian, Chia-Ming Lee, I-Shing Yu, Yi-Fen Lo, Shinichi Uchida, Chou-Long Huang, Bi-Chang Chen, Chih-Jen Cheng

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Figure 3

Quantitative measurements of Clcnk1 and Clcnk2 mRNAs in each WT renal tubular segment and whole kidneys.

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Quantitative measurements of Clcnk1 and Clcnk2 mRNAs in each WT renal tu...
(A) Schematic representation of Clcnk1 and Clcnk2 exons shows the positions of primers (double-headed arrows) used for RT-PCR analysis of Clc-k1 and Clc-k2 in this study. The mouse Clcnk1 and Clcnk2 genes are closely adjacent to each other in the same chromosome (chromosome 4), with an approximately 5.6 kb genomic DNA fragment separating the 2 genes (B) Fixed amounts (10 pg, 100 pg, 1 ng) of mouse Clc-k1 and Clc-k2 plasmids were used to test the primers’ efficacy and specificity. The relative abundance of Clc-k1 or Clc-k2 was normalized to the mean of 3 replicas of 1 ng reaction. The measured threshold cycle was plotted against the log of the dilution. The results showed similar efficiencies (slope of the linear equation) of the Clc-k1 and Clc-k2 RT-PCR assays. (C) Tubule-specific markers (Slc12a1 to TAL, Slc12a3 to DCT, Aqp2 to CCD) were measured to confirm the purity of the dissected tubules. The average amount of target genes in the highest-expressed tubular segment (cortical TAL [cTAL] for Slc12a1, DCT for Slc12a3, CCD for Apq2) was set as 1. The renal tubules were isolated from WT mice 6~8 weeks of age (n ≥ 6 for each renal tubule segment). (D) Standardized mRNA levels of Clcnk1 and Clcnk2 in each tubular segment. Clcnk1 and Clcnk2 in each sample were standardized to the mRNA level of its own housekeeping Gapdh gene. The average amount of Clcnk1 in mTAL and Clcnk2 in cTAL was set as 1. The renal tubules were isolated from WT mice 6~8 weeks of age (n ≥ 6 for each renal tubule segment). (E) Standardized mRNA levels of Clcnk1 and Clcnk2 in 2- and 8-week-old mouse whole-kidney lysates. The mean of Clcnk1 mRNA level was set as 1 (n ≥ 6 for each group). The comparison between Clcnk1 and Clcnk2 was performed by unpaired t test. *P < 0.05 between Clc-k1 and Clc-k2. PT, proximal tubule; CNT, connecting tubule).

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