Sodium-glucose transport proteins explained

solute carrier family 5 (sodium/glucose cotransporter), member 1
Hgncid:11036
Symbol:SLC5A1
Altsymbols:SGLT1
Entrezgene:6523
Omim:182380
Refseq:NM_000343
Uniprot:P13866
Chromosome:22
Arm:q
Band:13.1
solute carrier family 5 (sodium/glucose cotransporter), member 2
Hgncid:11037
Symbol:SLC5A2
Altsymbols:SGLT2
Entrezgene:6524
Omim:182381
Refseq:NM_003041
Uniprot:P31639
Chromosome:16
Arm:p
Band:11.2
solute carrier family 5 (low affinity glucose cotransporter), member four
Hgncid:11039
Symbol:SLC5A4
Altsymbols:SGLT3, SAAT1, DJ90G24.4
Entrezgene:6527
Refseq:NM_014227
Uniprot:Q9NY91
Chromosome:22
Arm:q
Band:12.1-12.3

Sodium-dependent glucose cotransporters (or sodium-glucose linked transporter, SGLT) are a family of glucose transporter found in the intestinal mucosa (enterocytes) of the small intestine (SGLT1) and the proximal tubule of the nephron (SGLT2 in PCT and SGLT1 in PST). They contribute to renal glucose reabsorption. In the kidneys, 100% of the filtered glucose in the glomerulus has to be reabsorbed along the nephron (98% in PCT, via SGLT2). If the plasma glucose concentration is too high (hyperglycemia), glucose passes into the urine (glucosuria) because SGLT are saturated with the filtered glucose.

Types

The two most well known members of SGLT family are SGLT1 and SGLT2, which are members of the SLC5A gene family. In addition to SGLT1 and SGLT2, there are 10 other members in the human protein family SLC5A.[1] Of these, SLC5A4/SGLT3 (SAAT1) is a low-affinity transporter for glucose, but seems to have more of an electric function.[2]

Gene Protein Acronym Tissue distribution
in proximal tubule[3]
Na+:Glucose
Co-transport ratio
Contribution to glucose
reabsorption (%)[4]
- SLC5A1 Sodium/GLucose
coTransporter 1
SGLT1 S3 segment 2:1 10 - SLC5A2 Sodium/GLucose
coTransporter 2
SGLT2 predominantly in the
S1 and S2 segments
1:1 90

The other SLC5 proteins transport mannose, myo-inositol, choline, iodide, vitamins, and short-chain fatty acids.[2]

SGLT2 inhibitors for diabetes

See main article: Gliflozin. SGLT2 inhibitors, also called gliflozins,[5] are used in the treatment of type 2 diabetes. SGLT2 is only found in kidney tubules and in conjunction with SGLT1 resorbs glucose into the blood from the forming urine. By inhibiting SGLT2, and not targeting SGLT1, glucose is excreted which in turn lowers blood glucose levels. Examples include dapagliflozin (Farxiga in US, Forxiga in EU), canagliflozin (Invokana) and empagliflozin (Jardiance). Certain SGLT2 inhibitors have shown to reduce mortality in type 2 diabetes.[6] The safety and efficacy of SGLT2 inhibitors have not been established in patients with type 1 diabetes, and FDA has not approved them for use in these patients.[7]

Function

Firstly, an Na+/K+ ATPase on the basolateral membrane of the proximal tubule cell uses ATP molecules to move 3 sodium ions outward into the blood, while bringing in 2 potassium ions. This action creates a downhill sodium ion gradient from the outside to the inside of the proximal tubule cell (that is, in comparison to both the blood and the tubule itself).

The SGLT proteins use the energy from this downhill sodium ion gradient created by the ATPase pump to transport glucose across the apical membrane, against an uphill glucose gradient. These co-transporters are an example of secondary active transport. Members of the GLUT family of glucose uniporters then transport the glucose across the basolateral membrane, and into the peritubular capillaries. Because sodium and glucose are moved in the same direction across the membrane, SGLT1 and SGLT2 are known as symporters. Of course, sodium can deplete, so Sodium–hydrogen antiporter gets sodium into the cell to begin with. Therefore, glucose actually moved with net protons being pushed out of cell, sodium being the intermediate.

History

In August 1960, in Prague, Robert K. Crane presented for the first time his discovery of the sodium-glucose cotransport as the mechanism for intestinal glucose absorption.[8]

Crane's discovery of cotransport was the first-ever proposal of flux coupling in biology.[9] [10]

See also

Notes and References

  1. http://www.ensembl.org/Homo_sapiens/familyview?family=ENSF00000000509 Ensembl release 48: Homo sapiens Ensembl protein family ENSF00000000509
  2. Gyimesi . Gergely . Pujol-Giménez . Jonai . Kanai . Yoshikatsu . Hediger . Matthias A. . Sodium-coupled glucose transport, the SLC5 family, and therapeutically relevant inhibitors: from molecular discovery to clinical application . Pflügers Archiv: European Journal of Physiology . September 2020 . 472 . 9 . 1177–1206 . 10.1007/s00424-020-02433-x. 32767111 . 7462921 . free .
  3. Wright EM, Hirayama BA, Loo DF . Active sugar transport in health and disease . Journal of Internal Medicine . 261 . 1 . 32–43 . January 2007 . 17222166 . 10.1111/j.1365-2796.2006.01746.x . 44399123 .
  4. Wright EM . Renal Na(+)-glucose cotransporters . American Journal of Physiology. Renal Physiology . 280 . 1 . F10–8 . January 2001 . 11133510 . 10.1152/ajprenal.2001.280.1.F10 .
  5. Web site: SGLT2 Inhibitors (Gliflozins). Diabetes.co.uk. 2015-05-19.
  6. Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, Mattheus M, Devins T, Johansen OE, Woerle HJ, Broedl UC, Inzucchi SE . 6 . Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes . The New England Journal of Medicine . 373 . 22 . 2117–28 . November 2015 . 26378978 . 10.1056/NEJMoa1504720 . 11573/894529 . 205098095 . free .
  7. Research. Center for Drug Evaluation and. 2018-12-28. Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors. FDA. en.
  8. Book: Membrane Transport and Metabolism. Proceedings of a Symposium held in Prague, August 22–27, 1960. Kleinzeller A. Kotyk A. Czech Academy of Sciences & Academic Press. The restrictions on possible mechanisms of intestinal transport of sugars. Miller D, Bihler I . 439–449 . 1961 .
  9. Wright EM, Turk E . The sodium/glucose cotransport family SLC5 . Pflügers Archiv . 447 . 5 . 510–8 . February 2004 . 12748858 . 10.1007/s00424-003-1063-6 . 41985805 . Crane in 1961 was the first to formulate the cotransport concept to explain active transport [7]. Specifically, he proposed that the accumulation of glucose in the intestinal epithelium across the brush border membrane was [is] coupled to downhill Na+ transport cross the brush border. This hypothesis was rapidly tested, refined, and extended [to] encompass the active transport of a diverse range of molecules and ions into virtually every cell type. .
  10. Boyd CA . Facts, fantasies and fun in epithelial physiology . Experimental Physiology . 93 . 3 . 303–14 . March 2008 . 18192340 . 10.1113/expphysiol.2007.037523 . 41086034 . p. 304. “the insight from this time that remains in all current text books is the notion of Robert Crane published originally as an appendix to a symposium paper published in 1960 (Crane et al. 1960). The key point here was 'flux coupling', the cotransport of sodium and glucose in the apical membrane of the small intestinal epithelial cell. Half a century later this idea has turned into one of the most studied of all transporter proteins (SGLT1), the sodium–glucose cotransporter. . free .