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Physiological Reviews, Vol. 82, No. 1, January 2002, pp. 245-289; 10.1152/physrev.00026.2001.
Copyright ©2002 by the American Physiological Society
Department of Physiology and Pharmacology, University of Queensland, St. Lucia, Queensland, Brisbane, Australia; and Universitäts-Kinderklinik, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany
Kunzelmann, Karl and
Marcus Mall.
Electrolyte Transport in the Mammalian Colon: Mechanisms and Implications for Disease. Physiol. Rev. 82: 245-289, 2002.
The colonic epithelium has both absorptive
and secretory functions. The transport is characterized by a net
absorption of NaCl, short-chain fatty acids (SCFA), and water,
allowing extrusion of a feces with very little water and salt content.
In addition, the epithelium does secret mucus, bicarbonate, and KCl.
Polarized distribution of transport proteins in both luminal and
basolateral membranes enables efficient salt transport in both
directions, probably even within an individual cell. Meanwhile, most of
the participating transport proteins have been identified, and their function has been studied in detail. Absorption of NaCl is a rather steady process that is controlled by steroid hormones regulating the
expression of epithelial Na+ channels (ENaC), the
Na+-K+-ATPase, and additional modulating
factors such as the serum- and glucocorticoid-regulated kinase SGK.
Acute regulation of absorption may occur by a Na+ feedback
mechanism and the cystic fibrosis transmembrane conductance regulator
(CFTR). Cl
secretion in the adult colon relies on luminal
CFTR, which is a cAMP-regulated Cl channel and a
regulator of other transport proteins. As a consequence, mutations in
CFTR result in both impaired Cl secretion and enhanced
Na+ absorption in the colon of cystic fibrosis (CF)
patients. Ca2+- and cAMP-activated basolateral
K+ channels support both secretion and absorption of
electrolytes and work in concert with additional regulatory proteins,
which determine their functional and pharmacological profile. Knowledge of the mechanisms of electrolyte transport in the colon enables the
development of new strategies for the treatment of CF and secretory
diarrhea. It will also lead to a better understanding of the
pathophysiological events during inflammatory bowel disease and
development of colonic carcinoma.
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