Cotransporters, WNKs and hypertension: an update

Peter W Flatman1

  • 1Centre for Integrative Physiology, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK. peter.flatman@ed.ac.uk

Abstract

Insights

The With No Lysine (WNK) signalling cascade regulates blood pressure by controlling sodium transport. Aberrant WNK signalling increases sodium retention and vascular resistance, contributing to hypertension.

Area of Science:

  • Nephrology
  • Cardiovascular Physiology
  • Molecular Biology

Background:

  • The With No Lysine (WNK) signalling cascade is crucial for blood pressure regulation.
  • Dysregulation of this cascade is implicated in essential hypertension.
  • Key components include WNK kinases, SPAK/OSR1, and Cation-Chloride Cotransporters (CCCs).

Purpose of the Study:

  • To review the molecular interactions within the WNK-SPAK/OSR1-CCC signalling cascade.
  • To elucidate the role of this cascade in sodium homeostasis and hypertension pathogenesis.
  • To explore the impact of WNK mutations on blood pressure regulation.

Main Methods:

  • Review of studies involving transgenic animals and gene knockins.
  • Analysis of functional studies on WNK1 phosphorylation and activity.
  • Examination of structural data on SPAK/OSR1 interactions.

Main Results:

  • Mutant WNK4 increases kidney sodium-chloride cotransporter (NCC) expression and activity.
  • WNK1 phosphorylation regulates its activity and interaction with SPAK/OSR1.
  • The structural basis for SPAK/OSR1 target interactions has been elucidated.

Conclusions:

  • WNKs activate SPAK/OSR1, which phosphorylates and activates NCCs and Na-K-Cl cotransporters (NKCCs).
  • This leads to increased sodium retention and vascular resistance, contributing to hypertension.
  • Hypertension-associated WNK mutants enhance renal tubular NKCC2 and NCC activity, though their full role requires further investigation.

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