9. Intestinal Transport
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Questions and Answers

What is the primary mechanism driving peptide transport in the small intestine?

  • Sodium-coupled transport
  • Chloride-bicarbonate exchange
  • H+-coupled transport (correct)
  • Direct ATP hydrolysis
  • Approximately how many tripeptides can the transport system in the small intestine handle?

  • 8,000 (correct)
  • 40,000
  • 800,000
  • 400
  • Which of the following is NOT explicitly mentioned as being transported by the peptide transport system in the small intestine?

  • ACE inhibitors
  • Cephalosporin antibiotics
  • Dipeptides
  • Amino Acids (correct)
  • What is the role of $\text{Na}^+/\text{H}^+$ exchange in the context of peptide transport in small intestine?

    <p>It recycles $\text{H}^+$ that enters the cell during peptide transport. (B)</p> Signup and view all the answers

    What enzymes facilitate the breakdown of transported di- and tripeptides inside the intestinal cells?

    <p>Peptidases (C)</p> Signup and view all the answers

    What is the primary function of enteric enkephalinergic interneurons?

    <p>Inhibiting enteric effector neurons to permit increased fluid absorption. (C)</p> Signup and view all the answers

    At which location in the intestine do bacterial enterotoxins primarily stimulate fluid secretion?

    <p>Crypts (B)</p> Signup and view all the answers

    What is the net effect of bacterial enterotoxins on fluid dynamics in the gut lumen?

    <p>Net fluid accumulation. (B)</p> Signup and view all the answers

    How do bacterial enterotoxins impact fluid absorption at the villi and surface of the intestine?

    <p>Inhibit fluid absorption. (D)</p> Signup and view all the answers

    Which intracellular messenger is activated by VIP to stimulate chloride secretion?

    <p>Cyclic AMP (A)</p> Signup and view all the answers

    What is the classification of prostaglandins with respect to their mechanism of action in the intestine?

    <p>Paracrine (C)</p> Signup and view all the answers

    Which of the following bacterial toxins binds irreversibly to adenylate/guanylate cyclase?

    <p>Cholera toxin (B)</p> Signup and view all the answers

    What is the primary outcome of chloride secretion and decreased NaCl absorption due to bacterial enterotoxins?

    <p>Secretory diarrhea (C)</p> Signup and view all the answers

    Which of the following best describes the role of the $Na^+/H^+$ exchanger in $H^+$-coupled nutrient absorption?

    <p>It establishes a pH gradient by pumping $H^+$ out of the cell, making the cell surface more acidic. (C)</p> Signup and view all the answers

    What is the primary function of glucose in oral rehydration solutions like Pedialyte?

    <p>To enhance the absorption of $Na^+$, which then promotes water absorption. (A)</p> Signup and view all the answers

    What is the main characteristic of nutrient absorption controlled by little neuroendocrine influence?

    <p>It depends on the availability of specific cotransporters. (C)</p> Signup and view all the answers

    Which of the following substrates is NOT likely to be transported via SGLT1?

    <p>K+ (A)</p> Signup and view all the answers

    What is the effect of the absorption of the $Na^+$ during oral rehydration?

    <p>Increased $H_2O$ absorption due to osmotic gradient (A)</p> Signup and view all the answers

    What characteristic of a cell allows for $H^+$-coupled nutrient absorption?

    <p>A cell surface pH &lt; 7.0. (C)</p> Signup and view all the answers

    Which best describes the function of Pept1?

    <p>Transports digested peptides of 2- or 3- amino acid length. (B)</p> Signup and view all the answers

    What is the key driving force behind the activity of Pept1?

    <p>A $H^+$ gradient (A)</p> Signup and view all the answers

    Which of the following inhibits NaCl absorption in the context of healthy ECF (Euvolemia)?

    <p>Parasympathetic nervous system mediators (A)</p> Signup and view all the answers

    What is the primary effect of bacterial enterotoxins on NaCl absorption, as described in the text?

    <p>Increased cAMP and cGMP production, resulting in diarrhea (B)</p> Signup and view all the answers

    During hypovolemia, which mechanism promotes rapid NaCl and water absorption?

    <p>Blockage of digestive neuroendocrine control by the sympathetic nervous system (B)</p> Signup and view all the answers

    In the upper jejunum, what is the predominant activity of ion exchangers and their impact on luminal pH?

    <p>Na+/H+ exchangers dominate, neutralizing excess HCO3- from the pancreas (B)</p> Signup and view all the answers

    How does the ileum contribute to the buffering of volatile fatty acids (VFA) in the large intestine?

    <p>By secreting HCO3- to buffer VFAs in the large intestine (A)</p> Signup and view all the answers

    What is the primary function of Cl-/HCO3- exchangers in the ileum?

    <p>To alkalize the ileal effluent by secreting HCO3- (B)</p> Signup and view all the answers

    What is a distinctive characteristic of the proximal large intestine compared to the small intestine regarding ion transport?

    <p>The proximal large intestine employs the same transporters as the small intestine for electroneutral NaCl absorption. (A)</p> Signup and view all the answers

    How does the Cl-/HCO3 exchange activity differ between the healthy colon and the ileum?

    <p>The Cl-/HCO3 exchange is less in the healthy colon compared to the ileum, as the colon receives low [Cl-] from ileal effluent. (B)</p> Signup and view all the answers

    Which of the following is the primary role of CFTR in bicarbonate secretion?

    <p>It couples with $Cl^−/HCO_3^−$ exchangers to recycle $Cl^−$ and enhance bicarbonate secretion. (C)</p> Signup and view all the answers

    What gradient primarily drives water movement into the intestinal lumen during fluid secretion?

    <p>Osmotic gradient created by electrolyte secretion (B)</p> Signup and view all the answers

    In the context of intestinal fluid secretion, what characterizes euvolemia?

    <p>The balance of fluid and electrolyte levels maintained by hormonal and neural regulation. (A)</p> Signup and view all the answers

    How do bacterial enterotoxins induce secretory diarrhea?

    <p>By increasing cAMP or cGMP, leading to excessive fluid secretion (C)</p> Signup and view all the answers

    Which of the following is a consequence of CFTR mutation in cystic fibrosis?

    <p>Compromised composition and volume of secreted luminal fluid, leading to thick mucus (B)</p> Signup and view all the answers

    Which of the following describes the effect of parasympathetic nervous system stimulation on intestinal fluid transport?

    <p>Stimulates fluid secretion at the crypts and inhibits fluid absorption at the villi. (C)</p> Signup and view all the answers

    What is the role of carbonic anhydrase in intestinal fluid secretion?

    <p>Catalyzes a reaction essential for the production of bicarbonate ($HCO_3^−$). (B)</p> Signup and view all the answers

    How does ion secretion lead to water movement into the intestinal lumen?

    <p>Ion secretion creates an osmotic gradient, drawing water into the lumen. (D)</p> Signup and view all the answers

    In the distal large intestine, electrogenic $Na^+$ absorption generates a net charge across the epithelial barrier. Which of the following accurately describes the primary mechanism driving this process?

    <p>$Na^+$ absorption through $Na^+$ channels down its electrochemical gradient, coupled with $K^+$ secretion to maintain membrane potential. (B)</p> Signup and view all the answers

    What is the role of aldosterone in the distal large intestine?

    <p>It increases the expression of $ENaC$, increases $Na^+/K^+$ ATPase activity, and increases $K^+$ channels. (C)</p> Signup and view all the answers

    Which of the following best describes the 'Na+scavenging' process in the distal large intestine?

    <p>The absorption of $Na^+$ against a large concentration gradient via specific $Na^+$ channels. (C)</p> Signup and view all the answers

    In the distal large intestine, what is the primary role of $K^+$ secretion in relation to $Na^+$ absorption?

    <p>To maintain membrane potential, counterbalancing the electrogenic $Na^+$ absorption. (B)</p> Signup and view all the answers

    Which of the following is a difference between the distal tubule of the kidney and the distal large intestine?

    <p>They both contain the same processes involving electrogenic $Na^+$. (A)</p> Signup and view all the answers

    What happens after $Na^+$ is absorbed from the lumen in the distal large intestine?

    <p>$Cl^-$ follows the electrical gradient, and water follows the osmotic gradient. (D)</p> Signup and view all the answers

    Which of the following transport mechanisms is directly enhanced by aldosterone?

    <p>Sodium-potassium ATPase activity. (B)</p> Signup and view all the answers

    Suppose a patient has a condition causing chronically elevated aldosterone levels. Which of the following electrolyte imbalances would likely be observed?

    <p>Decreased fecal $Na^+$ and increased fecal $K^+$. (B)</p> Signup and view all the answers

    Flashcards

    H+-coupled nutrient transport

    Transport of nutrients in the small intestine that depends on H+ gradients.

    Na+/H+ exchange

    A mechanism in which sodium ions are exchanged for hydrogen ions in the small intestine.

    Pept1

    A transporter that facilitates the absorption of dipeptides and tripeptides.

    Peptidases

    Enzymes that break down peptides into smaller units for absorption.

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    Amino Acid Transport

    Process of moving amino acids from the intestinal lumen into the bloodstream.

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    Facilitated Diffusion

    A process where substances cross cell membranes with the help of carrier proteins.

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    SGLT1

    A transporter responsible for sodium-dependent glucose transport in the intestines.

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    Oral Rehydration Solutions

    Solutions containing electrolytes and glucose, used to prevent dehydration.

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    Glucose's Role in Na+ Absorption

    Glucose enhances sodium absorption through sodium-glucose transporters.

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    H+-Coupled Nutrient Absorption

    Absorption of nutrients driven by a gradient of protons (H+), such as through Pept1.

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    Electrical and Osmotic Gradients

    Forces that drive the movement of ions and water across membranes.

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    Distal Large Intestine Function

    Absorbs Na+ electrogenically, generating a net charge across its barrier.

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    Species-Specific Na+ Absorption

    The electrogenic Na+ absorption does not occur in rodents.

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    Na+ Scavenging Mechanism

    Na+ channels absorb Na+ against a large concentration gradient.

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    ENaC Role

    Epithelial Na+ channels (ENaC) absorb Na+ down to 5mM in the lumen.

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    Aldosterone Effects

    Increases ENaC expression and Na+/K+ ATPase activity, enhancing Na+ absorption.

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    K+ Secretion

    K+ secretion maintains the membrane potential in the distal large intestine.

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    Cl- Movement

    Cl- follows the electrical gradient during Na+ absorption.

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    Fluid Movement

    Water follows osmotic gradients related to Na+ and Cl- absorption.

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    Enteric enkephalinergic interneurons

    Neurons that inhibit enteric effector neurons to regulate fluid absorption and secretion.

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    Increased fluid absorption

    Absorption of more fluid at villi and surface, enhancing NaCl absorption.

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    Decreased fluid secretion

    Reduction of fluid secretion at crypts, decreasing CFTR activity.

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    Cyclic nucleotides

    Intracellular messengers that affect fluid secretion and absorption in the gut.

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    Bacterial enterotoxins

    Substances that stimulate fluid secretion at crypts and inhibit absorption at villi.

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    Cholera toxin

    A bacterial enterotoxin that irreversibly activates adenylate cyclase, causing fluid secretion.

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    Electroneutral NaCl absorption

    Absorption of sodium and chloride ions without creating electrical gradients.

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    Secretory diarrhea

    Diarrhea caused by excessive fluid secretion due to pathogens or toxins.

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    Euvolemia

    A healthy state of extracellular fluid (ECF) balance.

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    NaCl absorption during digestion

    NaCl absorption is inhibited while digesting; resumes afterwards to recover sodium and water.

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    Diarrhea and enterotoxins

    Bacterial enterotoxins increase cAMP and cGMP, leading to diarrhea.

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    Hypovolemia

    State where salt and water absorption is favored due to sympathetic nervous system activation.

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    Na/H and Cl/HCO3 exchangers

    Transporters that adjust luminal pH in specific intestinal regions through ion exchange.

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    Upper jejunum function

    Recovers bicarbonate (HCO3) while secreting H+ to neutralize excess juice from the pancreas.

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    Ileum's role

    The ileum uses Cl-/HCO3 exchange to alkalize effluent and buffer volatile fatty acids (VFA).

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    Absorption in Proximal Large Intestine

    Salt and water absorbed through the same transporters as the small intestine, especially low Cl-.

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    Carbonic Anhydrase

    An enzyme that helps to catalyze the conversion of carbon dioxide and water to bicarbonate and protons.

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    CFTR

    Cystic Fibrosis Transmembrane Conductance Regulator; a channel protein that transports chloride ions across epithelial cells.

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    Bicarbonate Secretion

    The release of bicarbonate ions into the pancreatic duct or intestine, aiding in digestion.

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    Cystic Fibrosis

    A genetic disorder caused by CFTR mutations leading to thick mucus build-up in various organs.

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    Parasympathetic Nervous System

    Part of the autonomic nervous system that promotes 'rest and digest' actions including stimulation of fluid secretion.

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    Sympathetic Nervous System

    Part of the autonomic nervous system that inhibits fluid absorption and prepares body for 'fight or flight.'

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    Study Notes

    Intestinal Transport of Electrolytes and Water

    • Enterosystemic fluid balance is the movement of electrolytes and water between the lumen of the gastrointestinal (GI) tract and the extracellular fluid (ECF).
    • Absorptive processes balance digestive secretions.
    • Most fluid entering the GI tract comes from endogenous secretions.
    • The small and large intestine recover 98% of the fluid in the GI tract.
    • Figure 32 shows the enterosystemic fluid balance in a 70 kg human, measured in ml /24 hr.
    • Oral intake, salivary glands, stomach, bile, pancreas, and intestine each contribute different volumes of fluids to the gastrointestinal tract.
    • The total fluid presented to the intestine is 7 liters
    • 98% of fluid is absorbed, with 0.2 liters lost in stool.

    Functional Morphology of the Intestine

    • Absorption:
      • Villus: Present in the small intestine, differentiated epithelium involved in digestion and absorption of nutrients, electrolytes, and water
      • Surface Epithelium: Present in the large intestine, involved in absorption
      • Crypt: Present in both small and large intestine, contains undifferentiated stem cells and transit-amplifying cells for proliferation and secretion of electrolytes and water.

    Small Intestine: Electrolyte and Water Absorption

    • Na+-coupled nutrient absorption:

      • Most nutrient transporters are specific (e.g., glucose) and driven by the Na+ gradient.
      • Na+ is absorbed with a nutrient substrate.
      • Little neuroendocrine control, and absorption depends on nutrient availability.
      • Oral rehydration solutions, such as Pedialyte, contain Na, K, Cl, Mg, citrate, and glucose. Glucose is included not for energy, but to increase the absorption rate of Na+ via Na+-coupled glucose transport. Cl- absorption follows the electrical gradient, and water absorption occurs via osmotic gradient.
    • H+-coupled nutrient absorption:

      • Driven by an outside-to-inside cell pH gradient.
      • Peptides are transported by H+-di-/tri-peptide transporters, Pept1.
      • Digested peptides (2-3 amino acid lengths) are transported; H+ is recycled by Na+/H+ exchange
      • H+-amino acid transporter, PAT1, transports specific amino acids (mainly proline).
    • Electroneutral NaCl absorption:

      • Coupling of Na+/H+ and Cl-/HCO3- exchangers.
      • NaCl is absorbed in exchange; Na+ and H+ or Cl- and HCO3- exchange.
      • Exchangers work together with carbonic anhydrase and hydration of CO2
      • Hydration of water follows osmotic gradient of NaCl
      • Euvolemia (healthy state of extracellular fluid) process is inhibited by parasympathetic nervous system and factors that act through intracellular messengers.

    Large Intestine: Salt and Water Absorption

    • Proximal Large Intestine: Same transporters as small intestine; low Cl- due to ileal Cl-/HCO3- exchange (less in healthy colon).

    • Site of fermentation, where Na+/H+ recycles protons for VFA absorption.

    • VFAs are the main anions in the colon (e.g., acetate, butyrate, propionate), and they are lipid-soluble.

    • Distal Large Intestine:

      • "Na+ scavenging" by Na+ channels: Same process as the distal tubule in kidney; Na+ is absorbed against large concentration gradients; Cl- follows the electrical gradient and water follows osmotic gradients; K+ secretion maintains membrane potential.
      • Regulated by plasma aldosterone concentration. Aldosterone causes an increase in Na+ transport activity and K+ channels.

    Intestinal Crypts: Salt and Water Secretion

    • Electrogenic Cl- and HCO3- secretion:
      • Crypts function in dilution, hydration of mucus, and buffering.
      • Cl- and HCO3- are secreted via anion channels (CFTR) and Cl-/HCO3- exchangers.
      • CFTR couples with Cl-/HCO3- exchangers to recycle Cl- and increase bicarbonate secretion.
      • Na+ and water follow between cells due to electrical and osmotic gradients.
      • Euvolemia is maintained via parasympathetic and endocrine systems that act via intracellular messengers like cyclic nucleotides and Ca2+.

    Neuroendocrine Regulation of Intestinal Fluid Secretion

    • Parasympathetic and enteric neural effector neurons stimulate fluid secretion at crypts; inhibit fluid absorption at villi/surface.
    • Sympathetic and enteric enkephalinergic interneurons inhibit enteric effector neurons to increase fluid absorption at villi, decrease secretion at crypts.

    Bacterial Enterotoxins

    • Activate intracellular cyclic nucleotides.
    • Stimulate fluid secretion at crypts, and inhibit fluid absorption at villi/surface.

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    Description

    This quiz explores the mechanisms of intestinal transport focusing on electrolyte and water balance in the gastrointestinal tract. It covers the absorptive processes, fluid contributions from various sources, and the efficiency of fluid recovery in humans. Test your knowledge on the functional morphology of the intestine and its role in digestion.

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