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the cell surface and transport activity are reduced. The prolonged PKC/Nedd4‐2 activation results in enhanced OAT internalization from the cell surface to the intracellular endosomes and subsequent degradation in proteolytic systems. Overexpression of Nedd4‐2/C821A, a ligase‐dead mutant of Nedd4‐2, or the knockdown of endogenous Nedd4‐2 with Nedd4‐2‐specific siRNA evaded the PKC‐induced change in OAT ubiquitination, trafficking, and function in cultured cells [82, 91, 93]. On the other hand, serum and glucocorticoid‐regulated kinase 1 (Sgk1) phosphorylated Nedd4‐2 on Ser327 in cultured cells, which weakened the interaction between OATs and Nedd4‐2 and decreased OAT ubiquitination, leading to increased OAT transport activity [94]. Sgk2, an isoform of Sgk1, impaired the binding between OATs and Nedd4‐2 and decreased OAT ubiquitination, leading to elevated OAT cell surface expression and transport activity in cultured cells [95, 96]. In summary, PKC (negative regulation) and Sgk1/2 (positive regulation) exert opposite effects on OAT trafficking to the cell membrane and transport activity through phosphorylation of Nedd4‐2 at distinct sites. Nedd4‐2 serves as a central switch in these regulations.

      During the past few years, positive and negative crosstalk between different PTMs has been explored. Positive crosstalk is when one PTM serves as a signal for the modification of a second PTM, whereas negative crosstalk is when one PTM directly competes with another PTM or indirectly masks the recognition site for another PTM. The interplay between the PTMs that occur on the same type of amino acid residue(s) has attracted research attention because of its potential to regulate a wide array of cellular functions. One key example of negative crosstalk occurs between ubiquitination and SUMOylation, in which both ubiquitin and small ubiquitin‐like modifier (SUMO) are covalently attached to the lysine residue(s) of the target protein. Ubiquitin and SUMO can either conjugate to the same lysine residue(s) in the substrate protein in a competitive manner or conjugate to different lysine residues in the target protein. Under both circumstances, SUMOylation may preclude the ubiquitin‐mediated trafficking of the target protein [107]. It has been reported that the enhanced OAT SUMOylation induced by PKA activation occurs in parallel with a decrease in OAT ubiquitination, leading to an increased rate of OAT recycling and decreased rate of OAT degradation, without affecting the internalization rate of OATs. Therefore, SUMOylation and ubiquitination may coordinately regulate OAT trafficking and transport activity through negative crosstalk [108].

Schematic illustration of post-translational modifications of OATs.

      Several hormones and chemicals have been shown to regulate OAT trafficking through the protein kinases/Nedd4‐2 signaling pathway. Angiotensin II, an endogenous hormone, activated PKC/Nedd4‐2 pathway, which led to an increased rate of OAT internalization and therefore a reduction in OAT transport activity [109, 110]. AG490, a specific inhibitor of the Janus tyrosine kinase 2 (JAK2), reduced Nedd4‐2 phosphorylation at tyrosine residue(s), resulting in enhanced interaction between OAT and Nedd4‐2 and enhanced OAT ubiquitination, which led to a reduction in OAT cell surface expression and transport activity in cultured cells. Moreover, AG490 also increased the degradation rate of OATs. On the other hand, the inhibition effect of AG490 on OATs was diminished by knocking down the endogenous Nedd4‐2 using Nedd4‐2‐specific siRNA [111]. Dexamethasone, an upstream hormone of Sgk1, increased Nedd4‐2 phosphorylation, leading to stimulated OAT expression and transport activity in cultured cells [112]. Insulin, an endogenous hormone, phosphorylated Nedd4‐2 on Ser327 and impaired the interaction between OAT and Nedd4‐2, resulting in the upregulation of OAT expression and transport activity. Knocking down the endogenous Nedd4‐2 with Nedd4‐2‐specific siRNA diminished the upregulation on OATs induced by insulin [113].

      4.4.1 Substrates

      Multiple reviews describe the OAT substrates in great detail [23, 24, 114]. Here, we provide some general information. OATs handle a remarkably chemically diverse set of small molecule organic anions, including important and commonly prescribed pharmaceuticals (e.g., penicillins, cephalosporins, antiretrovirals, antihypertensives, antineoplastics, and diuretics), endogenous metabolites (e.g., cortisol and estrone‐3‐sulfate), and hormones, as well as environmental contaminants and toxicants (e.g., conjugates of organic mercury, perfluoroctanoic acid, ochratoxin A, and aristocholic acid), among others [24]. Because of the broad spectrum nature of the substrates, there are several substrates that are commonly used as tracers in published studies mostly performed in vitro assays. Some of the tracer/substrates include glutarate, PAH (para‐aminohippurate, a synthetic molecule), estrone sulfate, and more recently fluorescent compounds of fluorescein, 6‐carboxyfluorecein, and 5‐carboxyfluorecein.

      4.4.2 Substrate Specificity

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Compound