Electrolyte transport in the mammalian colon: mechanisms and implications for disease

Kunzelmann, Karl; Mall, Marcus

doi:10.1152/physrev.00026.2001

Cited by 655Ion Transport and Channel RegulationCystic Fibrosis Research AdvancesGastrointestinal motility and disorders

Electrolyte transport in the mammalian colon: mechanisms and implications for disease

Kunzelmann, Karl, Mall, Marcus·2002·Physiological Reviews

DOI 10.1152/physrev.00026.2001

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Abstract

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. Ca(2+)- 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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Intestinal epithelial cells allow selective penetration of nutrients, water, and electrolytes while simultaneously excluding microbial pathogen-associated molecular pattern, toxins, and foreign antigens.
“Intestinal epithelial cells (IECs) allow for selective penetration of nutrients, water, and electrolytes while simultaneously excluding microbial pathogen-associated molecular pattern, toxins, and foreign antigens.30”
From Regulation of Intestinal Barrier Function by Microbial Metabolites (2021) · cites this paper as [30]
In mammals, K+ is absorbed in the small intestine and to a lesser extent in the colon, by passive diffusion through a paracellular pathway, and by active transcellular transport, mediated by the apical H+/K+-ATPases and the basolateral NKCC1.
“In mammals, K + is absorbed in the small intestine and to a lesser extent in the colon, by passive diffusion through a paracellular pathway, and by active transcellular transport, mediated by the apical H + /K + -ATPases [ 140 – 142 ], and the basolateral NKCC1 [ 142 , 143 ].”
From Sex differences in potassium regulation: evidence, molecular mechanisms and clinical implications (2026) · cites this paper as [141]

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Authors: Kunzelmann, K., & Mall, M.
Affiliations: University of Freiburg (DE)
ORCID: Kunzelmann, Karl
Mall, Marcus
Venue: Physiological Reviews
Publisher: American Physiological Society
Published: 2002-01-01
Volume: 82
Issue: 1
Pages: 245-289
ISSN: 0031-9333 (ISSN-L)
1522-1210
DOI: 10.1152/physrev.00026.2001
OpenAlex: W2144603992
Cited by: 655
References: 683
Citations by year: 2026: 9 · 2025: 13 · 2024: 17 · 2023: 23 · 2022: 23 · 2021: 21 · 2020: 18 · 2019: 21 · 2018: 33 · 2017: 23 · 2016: 20 · 2015: 34 · 2014: 31 · 2013: 35 · 2012: 30
FWCI: 2.77
Type: journal article
Language: en
Open access: closed
Locations: Physiological Reviews (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Ion Transport and Channel Regulation
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Keywords: colonic epithelium, NaCl absorption, short-chain fatty acids, water uptake (human physiology), epithelial Na+ channel, Na+/K+-ATPase, SGK, CFTR, cystic fibrosis, chloride secretion, cAMP signaling, secretory diarrhea, inflammatory bowel disease, colon cancer
MeSH terms: Animals, Biological Transport, Colon, Cystic Fibrosis, Electrolytes, Humans, Intestinal Diseases

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