Solute transporters and aquaporins impaired celiac disease - dehydration malnutrition

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This looks like it could explain our dehydration and malnutrition problems ... what do you think ?

http://www.ncbi.nlm.nih.gov/pubmed/20415666

2010 May 26;102(8):457-67.
Solute transporters and aquaporins are impaired in celiac disease.

Laforenza U, Miceli E, Gastaldi G, Scaffino MF, Ventura U, Fontana JM, Orsenigo MN, Corazza GR.

Source

Department of Physiology, University of Pavia, Pavia, Italy. lumberto@unipv.it

Abstract

BACKGROUND INFORMATION:

Celiac disease is a chronic inflammatory disorder of the small bowel induced in genetically susceptible subjects by gluten ingestion. Diarrhoea, weight loss and malabsorption represent the major clinical presentation of the disease.

Here we examined the possible alteration in the expression and localization of water channels [AQPs (aquaporins)] and some solute transporters in duodenal mucosa of celiac disease patients. Duodenal biopsies from untreated celiacs, treated celiacs, healthy controls and disease controls were considered in the present study.

The expressions of some AQPs and transporter mRNAs in human duodenal biopsies were determined by semi-quantitative RT-PCR (reverse transcription PCR) and real-time RT-PCR. The localization of AQPs 3, 7 and 10 and of SGLT1 (Na+/glucose co-transporter 1), PEPT1 (H+/oligopeptide transporter 1) and NHE3 (Na+/H+ exchanger 3) was evaluated by immunohistochemistry.
RESULTS:

AQPs 3, 7, 10 and 11, SGLT, PEPT and NHE, CFTR (cystic fibrosis transmembrane conductance regulator) and NKCC (Na-K-2Cl co-transporter) mRNAs were expressed in duodenal biopsies of healthy controls, treated celiac patients and disease controls.

The expression of transcripts was virtually absent in duodenal biopsies of untreated celiac disease patients except for CFTR and NKCC. In healthy controls, immunohistochemistry revealed a labelling in the apical membrane of surface epithelial cells of the duodenum.

The immunolabelling was heavily reduced or absent in untreated celiac patients, while it was normal in patients consuming a gluten-free diet for at least 12 months.

CONCLUSIONS:

Our results indicate that the main routes for water and solute absorption are deficient in celiac disease and may play a role in the onset of malabsorption symptoms.

PMID: 20415666 [PubMed - indexed for MEDLINE]

I was googling celaic sodium glucose when I found that article. I was looking for it because when we were discussing individual rehydration techniques this article came up ...

http://en.wikipedia.org/wiki/Oral_rehydration_therapy

Oral rehydration therapy


From Wikipedia, the free encyclopedia

Oral rehydration therapy (ORT) is a simple treatment for dehydration associated with diarrhea, particularly gastroenteritis or gastroenteropathy, such as that caused by cholera or rotavirus. ORT consists of a solution of salts and sugars which is taken by mouth. It is used around the world, but is most important in the developing world, where it saves millions of children a year from death due to diarrhea, the second leading cause of death (after pneumonia) in children under five.[1]


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Physiological basis


Fluid from the body is normally pumped into the intestinal lumen during digestion. This fluid is typically isosmotic with blood because it contains a high concentration of sodium (approx. 142 mEq/L). A healthy individual will secrete 20-30 grams of sodium per day via intestinal secretions. Nearly all of this is reabsorbed by the intestine, helping to maintain constant sodium levels in the body (homeostasis).[44]


Because there is so much sodium secreted by the intestine, without intervention, heavy continuous diarrhea can be a very dangerous and potentially life-threatening condition within hours. This is because liquid secreted into the intestinal lumen during diarrhea passes through the gut so quickly that very little sodium is reabsorbed, leading to very low sodium levels in the body (severe hyponatremia).[44] This is the motivation for sodium and water replenishment via ORT.




Sodium absorption via the intestine occurs in two stages. The first is at the outermost cells (intestinal epithelial cells) at the surface of the intestinal lumen. Sodium passes into these outermost cells by co-transport facilitated diffusion (symport diffusion) via the SGLT1 protein.[44] From there, sodium is pumped out of the cells (basal side) and into the extracellular space by active transport via the sodium potassium pump.[45][46]


The co-transport of sodium into the epithelial cells via the SGLT1 protein requires glucose or galactose. Two sodium ions and one molecule of glucose/galactose are transported together across the cell membrane through the SGLT1 protein. Without glucose or galactose present, intestinal sodium will not be absorbed.[44] This is the reason glucose is included in ORSs. For each cycle of the transport, hundreds of water molecules move into the epithelial cell, and this brings about the rehydration

Please keep in mind that the definition of celiac disease has changed over the years and this article doesn't reflect that ... The first 8 pages in this article by the FDA reflect the changes that I'm aware of ...

http://www.fda.gov/downloads/Food/S.../RiskAssessmentSafetyAssessment/UCM264152.pdf

tc ... x

 

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