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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 2

Localization of Clcnk1 and Clcnk2 mRNA transcripts in embryonic and adult kidneys.

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Localization of Clcnk1 and Clcnk2 mRNA transcripts in embryonic and adul...
(A) In situ hybridization revealed mRNA signals of Clcnk1 and Clcnk2 in E18 embryonic kidneys. Both Clcnk1 and Clcnk2 mRNA were detected in the renal cortex and medulla, including TAL, where Clcnk mRNA signals encircled the green fluorescence of Nkcc2, suggesting the colocalization between Clc-k1 and Clc-k2 in the developing loop of Henle. (B and C) Superimposed Nkcc2 IFC staining and in situ hybridization of Clcnk1 and Clcnk2 mRNAs depict the distribution of Clc-k1 and Clc-k2 along the Nkcc2-positive TAL in 8-week-old adult mouse kidneys. Areas inside the white squares were magnified (a, cortex; b, outer medulla; c, boundary between outer and inner medulla). Scale bars: 50 μm, insets 200 μm (A); 50 μm, insets 100 μm (B and C).

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