title: Acute saline infusion induces extracellular acidification and activation of the Na+/H+ exchanger in man.
abstract: The effect of acute expansion of the extracellular fluid volume (ECV) with isotonic (0.9%) saline on the activity of the lymphocyte Na+/H+ antiport (NHE) was studied in a total of 18 healthy volunteers. Saline was infused at a constant rate so that 4 mmol kg-1 b.w. was administered over 2 h. NHE activity was measured by quantifying cytosolic pH (pHi) recovery following acidification of the cells with propionic acid and by pH clamping at various pHi values between 7.2 and 5.8 using nigericin. Both methods demonstrate NHE activation associated with intravenous saline infusion, the kinetic difference being a marked decrease in the Hill coefficient n from 3.28 +/- 0.21 (SEM) to 2.22 +/- 0.11 in the absence of changes in baseline pHi (7.14 +/- 0.02 vs. 7.08 +/- 0.02; P = 0.15), Vmax (42.8 +/- 2.7 vs. 48.1 +/- 2.8 mmol L-1 min-1; P = 0.08) and pK (6.32 +/- 0.04 vs. 6.35 +/- 0.02). NHE activation was associated with significant decreases in serum chloride (P = 0.016), calcium (P = 0.008), total cholesterol (P = 0.008), low-density lipoproteins (P = 0.016) and high-density lipoproteins (P = 0.008). Moreover, saline infusion induced extracellular acidification with a decrease in pH from 7.39 +/- 0.01 to 7.37 +/- 0.01 (P = 0.016), HCO3- from 23.3 +/- 0.43 mmol L-1 to 21.3 +/- 0.25 mmol L-1 (P = 0.008) and base excess from -1.03 +/- 0.38 mmol L-1 to -3.00 +/- 0.31 mmol L-1 (P = 0.008). Our results show for the first time that acute ECV expansion with isotonic saline is followed by an activation of the lymphocyte NHE. The underlying mechanism(s) remain to be investigated. However, the demonstration in our study of marked changes in acid-base balance induced by acute saline points to a possible inter-relationship of antiporter activation and extracellular acidification.
authors.affiliation: Medizinische Universitäts-Poliklinik, Bonn, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Kessler
authors.forename: S
authors.initials: S
authors.lastname: Leibhammer
authors.forename: O
authors.initials: O
authors.lastname: Laue
authors.forename: A
authors.initials: A
authors.lastname: Sachinidis
authors.forename: W
authors.initials: W
authors.lastname: Siffert
authors.forename: H
authors.initials: H
authors.lastname: Hols
authors.forename: H
authors.initials: H
authors.lastname: Vetter
authors.forename: R
authors.initials: R
authors.lastname: Düsing
mesh_terms: D000136:Acid-Base Equilibrium / Q000187:drug effects; D000328:Adult; D001784:Blood Gas Analysis; D002784:Cholesterol / Q000097:blood; D004573:Electrolytes / Q000097:blood; D005110:Extracellular Space / Q000187:drug effects* / Q000378:metabolism; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007262:Infusions, Intravenous; D015640:Ion Channel Gating; D008297:Male; D011422:Propionates / Q000097:blood / Q000378:metabolism; D012965:Sodium Chloride / Q000008:administration & dosage*; D017923:Sodium-Hydrogen Exchangers / Q000187:drug effects / Q000378:metabolism*; D014527:Uric Acid / Q000097:blood
chemical_list: D004573:Electrolytes; D011422:Propionates; D017923:Sodium-Hydrogen Exchangers; D014527:Uric Acid; D012965:Sodium Chloride; D002784:Cholesterol; C029658:propionic acid