Está bem estabelecido na literatura que o NHE3 é ativado, no intestino, pelo transporte de glicose mediado pelo SGLT1, e que esta ativação não dependente do metabolismo da glicose. Acredita-se que a co-ativação do NHE3 e do SGLT1 ocorra para maximizar a reabsorção de nutrientes no período pós-prandial. Porém, ainda não foi determinado se a captação de glicose através dos SGLTs é capaz de regular a atividade do NHE3 no túbulo proximal renal. Levando-se em conta que este segmento renal também expressa o SGLT2 e que os rins e intestinos apresentam significativas diferenças na disponibilidade de glicose ao longo do dia, o objetivo do presente trabalho foi o de determinar o efeito da glicose e da atividade dos SGLTs renais sobre a atividade do NHE3. Experimentos de microperfusão estacionária demonstraram que a perfusão luminal de glicose 5mM estimula o NHE3 via o metabolismo glicolítico. A perfusão de concentrações suprafisiológicas de glicose inibe o NHE3 por promover aumento de volume celular. A inibição farmacológica dos SGLTs, utilizando-se o inibidor inespecífico Florizina, ocasionou acentuada inibição do NHE3, mesmo na ausência de glicose. Além disso, experimentos de imunofluorescência determinaram que o NHE3 é co-expresso com o SGLT2, mas não com o SGLT1. Conclusão: os resultados deste trabalho demonstram que a glicose apresenta um efeito bimodal sobre o NHE3: em concentrações fisiológicas este açúcar estimula o NHE3, enquanto que em concentrações suprafisiológicas a glicose inibe o trocador. Além disso, a inibição farmacológica do transporte de glicose ocasiona acentuada inibição do NHE3 demonstrando que estes transportadores interagem funcionalmente no túbulo proximal. / It is well established that SGLT1-mediated glucose uptake leads to NHE3 activation in the intestine. This co-activation is thought to be important for postprandial nutrient uptake. However, it remains to be determined whether SGLT-mediated glucose uptake is capable of regulating NHE3-mediated NaHCO3 reabsorption in the renal proximal tubule. Considering that this nephron segment also expresses another SGLT isoform, SGLT2, and that the kidneys and intestine show significant variations in daily glucose availability, the goal of the present work was to determine the effect of SGLT-mediated glucose uptake on NHE3 activity in the renal proximal tubule. Stationary in vivo microperfusion experiments demonstrated that luminal perfusion with 5 mM glucose stimulates NHE3-mediated bicarbonate reabsorption. This stimulatory effect was mediated by glycolytic metabolism but not through ATP production. Conversely, luminal perfusion with 40 mM glucose inhibited NHE3 due to cell swelling. Interestingly, the pharmacological inhibition of SGLT activity by phlorizin produced a marked inhibition of NHE3, even in the absence of glucose. Furthermore, immunofluorescence experiments showed that NHE3 co-localizes with SGLT2, but not with SGLT1, in the rat renal proximal tubule. Collectively, the findings of this work demonstrate that glucose exerts a bimodal effect on NHE3. The physiological metabolism of glucose stimulates NHE3 transport activity, whereas supraphysiological glucose concentrations inhibit this exchanger. Additionally, phlorizin-sensitive SGLT transporters and NHE3 interact functionally in the proximal tubule.

Está bem estabelecido na literatura que o NHE3 é ativado, no intestino, pelo transporte de glicose mediado pelo SGLT1, e que esta ativação não dependente do metabolismo da glicose. Acredita-se que a co-ativação do NHE3 e do SGLT1 ocorra para maximizar a reabsorção de nutrientes no período pós-prandial. Porém, ainda não foi determinado se a captação de glicose através dos SGLTs é capaz de regular a atividade do NHE3 no túbulo proximal renal. Levando-se em conta que este segmento renal também expressa o SGLT2 e que os rins e intestinos apresentam significativas diferenças na disponibilidade de glicose ao longo do dia, o objetivo do presente trabalho foi o de determinar o efeito da glicose e da atividade dos SGLTs renais sobre a atividade do NHE3. Experimentos de microperfusão estacionária demonstraram que a perfusão luminal de glicose 5mM estimula o NHE3 via o metabolismo glicolítico. A perfusão de concentrações suprafisiológicas de glicose inibe o NHE3 por promover aumento de volume celular. A inibição farmacológica dos SGLTs, utilizando-se o inibidor inespecífico Florizina, ocasionou acentuada inibição do NHE3, mesmo na ausência de glicose. Além disso, experimentos de imunofluorescência determinaram que o NHE3 é co-expresso com o SGLT2, mas não com o SGLT1. Conclusão: os resultados deste trabalho demonstram que a glicose apresenta um efeito bimodal sobre o NHE3: em concentrações fisiológicas este açúcar estimula o NHE3, enquanto que em concentrações suprafisiológicas a glicose inibe o trocador. Além disso, a inibição farmacológica do transporte de glicose ocasiona acentuada inibição do NHE3 demonstrando que estes transportadores interagem funcionalmente no túbulo proximal. / It is well established that SGLT1-mediated glucose uptake leads to NHE3 activation in the intestine. This co-activation is thought to be important for postprandial nutrient uptake. However, it remains to be determined whether SGLT-mediated glucose uptake is capable of regulating NHE3-mediated NaHCO3 reabsorption in the renal proximal tubule. Considering that this nephron segment also expresses another SGLT isoform, SGLT2, and that the kidneys and intestine show significant variations in daily glucose availability, the goal of the present work was to determine the effect of SGLT-mediated glucose uptake on NHE3 activity in the renal proximal tubule. Stationary in vivo microperfusion experiments demonstrated that luminal perfusion with 5 mM glucose stimulates NHE3-mediated bicarbonate reabsorption. This stimulatory effect was mediated by glycolytic metabolism but not through ATP production. Conversely, luminal perfusion with 40 mM glucose inhibited NHE3 due to cell swelling. Interestingly, the pharmacological inhibition of SGLT activity by phlorizin produced a marked inhibition of NHE3, even in the absence of glucose. Furthermore, immunofluorescence experiments showed that NHE3 co-localizes with SGLT2, but not with SGLT1, in the rat renal proximal tubule. Collectively, the findings of this work demonstrate that glucose exerts a bimodal effect on NHE3. The physiological metabolism of glucose stimulates NHE3 transport activity, whereas supraphysiological glucose concentrations inhibit this exchanger. Additionally, phlorizin-sensitive SGLT transporters and NHE3 interact functionally in the proximal tubule.

O objetivo foi determinar se aldosterona e corticosterona agem sobre a acidificação do túbulo proximal e se esses efeitos são genômicos e/ou não-genômicos. A reabsorção de HCO3- foi avaliada por microperfusão estacionária. Aldosterona e corticosterona perfundidas na luz tubular causaram aumento significante do JHCO3-. Na presença de etanol, actinomicina D, cicloheximida ou espironolactona, o JHCO3- foi estatisticamente igual ao valor controle (2,84 ± 0,079 nmol.cm-2.s-1). RU486 sozinho inibiu o efeito estimulador da aldosterona e corticosterona. Losartan não alterou o JHCO3-. Concanomicina ou S3226 diminuiram o efeito estimulador da corticosterona. A aldosterona perfundida nos capilares peritubulares aumentou o JHCO3-. Assim, a aldosterona e corticosterona tem um efeito rápido, não-genômico, estimulante do JHCO3-, provavelmente com a participação do GR e pela ativação do NH3 e da H+-ATPase luminais. Além disto, a aldosterona e corticosterona endógenas estimulam o JHCO3- no túbulo proximal. / The purpose was to determine if aldosterone and corticosterone act on the acidification of proximal tubule and if these hormonal effects are genomic and/or nongenomic. Bicarbonate reabsorption was evaluated by microperfusion. Aldosterone and corticosterone caused a significant increase in JHCO3-. In the presence of ethanol, actinomycin D, cycloheximide or espironolactone, the JHCO3- was not different from the control value (2.84 ± 0.079 nmol.cm-2.s-1). However, in the presence of RU486 a decrease on JHCO3- was observed. Losartan inhibited the JHCO3-. Concanamicyn or S3226 decreased the stimulatory effect of corticosterone. Aldosterone perfused into peritubular capillaries also increased JHCO3-. Our results indicate that: aldosterone and corticosterone has a rapid, nongenomic, stimulatory effect on JHCO3-; probably, GR participates in this process and; this effect, probably, occurs by activation of luminal NH3 and H+-ATPase. Besides, endogenous aldosterone and corticosterone stimulate JHCO3-.

O objetivo foi determinar se aldosterona e corticosterona agem sobre a acidificação do túbulo proximal e se esses efeitos são genômicos e/ou não-genômicos. A reabsorção de HCO3- foi avaliada por microperfusão estacionária. Aldosterona e corticosterona perfundidas na luz tubular causaram aumento significante do JHCO3-. Na presença de etanol, actinomicina D, cicloheximida ou espironolactona, o JHCO3- foi estatisticamente igual ao valor controle (2,84 ± 0,079 nmol.cm-2.s-1). RU486 sozinho inibiu o efeito estimulador da aldosterona e corticosterona. Losartan não alterou o JHCO3-. Concanomicina ou S3226 diminuiram o efeito estimulador da corticosterona. A aldosterona perfundida nos capilares peritubulares aumentou o JHCO3-. Assim, a aldosterona e corticosterona tem um efeito rápido, não-genômico, estimulante do JHCO3-, provavelmente com a participação do GR e pela ativação do NH3 e da H+-ATPase luminais. Além disto, a aldosterona e corticosterona endógenas estimulam o JHCO3- no túbulo proximal. / The purpose was to determine if aldosterone and corticosterone act on the acidification of proximal tubule and if these hormonal effects are genomic and/or nongenomic. Bicarbonate reabsorption was evaluated by microperfusion. Aldosterone and corticosterone caused a significant increase in JHCO3-. In the presence of ethanol, actinomycin D, cycloheximide or espironolactone, the JHCO3- was not different from the control value (2.84 ± 0.079 nmol.cm-2.s-1). However, in the presence of RU486 a decrease on JHCO3- was observed. Losartan inhibited the JHCO3-. Concanamicyn or S3226 decreased the stimulatory effect of corticosterone. Aldosterone perfused into peritubular capillaries also increased JHCO3-. Our results indicate that: aldosterone and corticosterone has a rapid, nongenomic, stimulatory effect on JHCO3-; probably, GR participates in this process and; this effect, probably, occurs by activation of luminal NH3 and H+-ATPase. Besides, endogenous aldosterone and corticosterone stimulate JHCO3-.

Regulated cell death (RCD) is indispensable for homeostasis and plays a crucial role in the pathophysiology of numerous diseases. Adrenocortical carcinomas (ACCs) represent a rare and highly malignant type of cancer. Currently, the most common therapeutic options include the complete surgical removal of the adrenal gland and/or the administration of mitotane, a derivative of the pesticide DDT. Yet patient survival remains poor and the mechanism of action of mitotane remains elusive. In this thesis it is demonstrated that the human ACC cell line NCI-H295R is sensitive to mitotane-induced cell death. In the first part, the involvement of three different RCD pathways, namely apoptosis, necroptosis and ferroptosis, in mitotane induced necrosis was investigated. To this end, different inhibitors were used, which were not able to block mitotane-induced cell death. When the medium was supplemented with insulin, transferrin, sodium selenite and linoleic acid (ITS+1) no cell death of the ACC cells was observed. This phenomenon was attributed to the presence of linoleic acid, since ITS supplementation lacking this component was not able to reverse mitotane-induced necrosis. Identification of new drug targets for alternative options of ACC treatment led to the investigation of key molecules involved in the pathways of necroptosis and ferroptosis. The receptor-interacting protein kinase 1 and 3 (RIPK1 and 3) and the mixed lineage kinase domain-like protein (MLKL) were considered as interesting targets given their crucial role in the execution of necroptosis. A western blot analysis of those molecules revealed the presence only of RIPK1, suggesting that the necroptosis machinery is not present in the NCI-H295R cells. Of interest, evaluation of the expression levels of glutathione peroxidase four (GPX4), one of the main inhibitory molecules of ferroptosis, showed a much higher expression in the ACC cells compared to the standard cell line used for studying ferroptosis, the human fibrosarcoma HT1080 cells. A hypothesis that the NCI-H295R cells are susceptible to ferroptosis induction was formed based on this finding. Compounds representative of all the four classes of ferroptosis inducers (FINs) were tested. Direct inhibition of GPX4 using the small compound RSL3, a type II FIN, led to high necrotic populations. Co-treatment with the ferroptosis inhibitor ferrostatin-1 (Fer-1) completely reversed RSL3-induced ferroptosis. Type IV FIN FINO2, that causes indirect loss of the enzymatic activity of GPX4, lead also to high necrotic populations, while Fer-1 prevented FINO2-induced ferroptosis. Data from public databases concerning gene methylation or mutation status of ACC tissues and normal human adrenal tissues was used to investigate potential key players of ferroptosis that might be either mutated or silenced in ACCs. Of note, glutathione peroxidases 3 and 5 (GPX3 and 5) were highly methylated, while the enzyme cystathionine gamma-lyase (CSE) involved in the transsulfuration pathway via the break down of cystathionine into cysteine and α-ketobutyrate and ammonia was found to be highly mutated. Collectively, these data point towards a high sensitivity of ACCs to ferroptosis induction. This could provide a new chapter for the therapeutic approaches of ACCs. Additionally, these findings provide a better understanding of the biology of this type of cancer that highly mutates or silences ferroptosis-related genes. The second part of this thesis focuses on the involvement of RCD in spontaneous cell death in isolated murine tubules. Existing literature points towards an involvement of necroptosis and ferroptosis pathways in the kidney in models of acute kidney injury (AKI). Acute tubular necrosis (ATN) represents a hallmark of AKI. While the work in the Linkermann lab has shown that isolated tubules perfused with type I FIN erastin undergo cell death in a “wave-of-death” manner, no deeper insights into the propagation of tubular necrotic injury exist. A protocol for isolation of murine kidney tubules was established, providing an ex-vivo model for investigation of tubular death. The absence of potentially confounding blood cells as well as immune cells was ensured by extensive washing steps as well as the use of collagenase. Visual observation and staining of isolated tubules with the nucleic acid stain SYTOX green revealed a spontaneous cell death in a “wave-of-death” manner. This wave was running in parallel with a calcium concentration change, indicating its involvement in the spontaneous necrosis. To investigate the potential involvement of mitochondria in this process, electron microscopy images were obtained from parts of the tubules with different levels of damage which revealed highly damaged and ballooned mitochondria. These data provided with a phenotypic characterisation of the spontaneous tubular necrosis. Aiming to approach this type of death genetically, necroptosis and pyroptosis deficient mice (MLKL/GSDMDDKO) were used. Comparison of the LDH release, used as a measure of necrosis, from isolated kidney tubules of the MLKL/GSDMDDKO mice and wild type (WT) mice showed no difference. This indicated that neither necroptosis nor pyroptosis are involved in the tubular necrosis. Therefore, the next step was to investigate the effects of Fer-1 at the levels of LDH of isolated tubules from WT mice. A significantly lower LDH release was observed in tubules treated with Fer-1 compared to the ones treated with vehicle. However, this reduction in the LDH release was not complete, suggesting that ferroptosis is only partially responsible for the spontaneous death of isolated tubules. The difference of male and female mice towards AKI sensitivity has been noted in the literature in that female mice are less susceptible compared to the male mice. Therefore, the next step was to investigate whether this protection of females can be observed at the level of isolated tubules. Indeed, the LDH release from tubules isolated from female mice was significantly less compared to the LDH release of tubules isolated from male mice. Based on the data obtained from isolated tubules from WT male mice treated with Fer-1, a similar experiment was performed with tubules isolated from WT female mice. No difference in the LDH release was observed between the Fer-1-treated tubules and the vehicle-treated ones, indicating that another cell death pathway might be involved. The most obvious difference between male and female organisms is the sex hormones. Whether testosterone or β-estradiol are responsible for the higher susceptibility or protection against cell death has been a debate over the last years. To test this hypothesis, three different cell lines were utilised. A pre-treatment of 16 h with either testosterone or β-estradiol was performed. Treatment with either type I FIN erastin or type II FIN RSL3 followed, and cells were analysed via flow cytometry. Data revealed protective effects of β-estradiol against ferroptosis induction. Next, the effects of β-estradiol in a simultaneous treatment with RSL3 were investigated. Interestingly the protective effects of the hormone were still observed. Among the metabolites of β-estradiol, 2-hydroxyestradiol (2-OHE2) has been reported to exert antioxidant effects. Therefore, 2-OHE2 was used in a simultaneous treatment with RSL3, and the obtained data showed that it was a much more potent inhibitor of necrotic cell death than β-estradiol even at lower concentrations. Collectively these data indicate that the lower susceptibility of female organisms towards cell death might be explained by the presence of β-estradiol and its more potent antioxidant metabolites. Such findings could change the way the two sexes are approached scientifically, while providing new insights on different therapeutic strategies between male and female organisms.