Alterations in the Establishment and Maintenance of Epithelial Cell Polarity As a Basis for Disease Processes

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Alterations in the Establishment and Maintenance of Epithelial Cell Polarity As a Basis for Disease Processes Alterations in the establishment and maintenance of epithelial cell polarity as a basis for disease processes. B A Molitoris, W J Nelson J Clin Invest. 1990;85(1):3-9. https://doi.org/10.1172/JCI114427. Research Article Find the latest version: https://jci.me/114427/pdf Perspectives Alterations in the Establishment and Maintenance of Epithelial Cell Polarity as a Basis for Disease Processes Bruce A. Molitons* and W. James Nelsont *Department ofMedicine, Veterans Administration Medical Center, University ofColorado School ofMedicine, Denver, Colorado 80220; and tInstitutefor Cancer Research, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111 Polarized epithelial cells play fundamental roles in the vecto- internal milieu and has a compliment of intrinsic and extrinsic rial movement of ions, water, and macromolecules between membrane proteins found over the entire surface membrane biological compartments. These vectorial processes include of nonpolarized cells. These basolateral membrane proteins absorption (enterocytes and renal proximal tubule cells), se- maintain the normal physiologic state of the cell and also par- cretion (hepatocytes, endocrine and exocrine cells), and ex- ticipate in signal recognition and transduction. The lipid com- change (alveolar cells and capillary endothelium). The ability position of apical and basolateral membranes also differs to conduct these vectorial processes is dependent on the struc- markedly (Table I; for review, see reference 3). This difference tural and functional organization of epithelial cells into: (a) is responsible for large physiochemical differences between the structurally, biochemically, and physiologically distinct apical two membrane domains (4) and influences the function of and basolateral plasma membrane domains that contain dif- numerous membrane proteins. The establishment and main- ferent ion channels, transport proteins, enzymes, and lipids; tenance of these specific apical and basolateral membrane and (b) cell-cell junctional complexes that integrate cells into a protein and lipid differences is essential for the efficient func- monolayer forming a cellular barrier between biological com- tioning of polarized epithelial cells. For example, sodium partments. reabsorption by renal proximal tubular cells is dependent on The establishment and maintenance of this specialized cel- the polarized localization of specific carrier proteins such as lular organization is a multistage process involving the forma- the Na+/H' antiporter and glucose, amino acid- and phos- tion of cell-cell and cell-substratum contacts, and the estab- phate Na'-dependent cotransporters to the apical membrane, lishment and maintenance of the polarized distributions of and the polarized distribution of Na',K+-ATPase to the baso- plasma membrane and cytoplasmic components. Aberrations lateral membrane. in any stage of this process could result in the development of Junctional complex. The lateral membrane domain pos- cell- and tissue-specific abnormalities, and ultimately a patho- sesses a specialized intercellular junctional complex composed logic state. of zonula occludens (tight junction), zonula adherens (inter- In this review we describe recent findings regarding basic mediate junction), desmosomes, gap junctions, and cell adhe- cellular mechanisms involved in the organization of polarized sion proteins (Fig. 1). The components of the junctional com- epithelial cells. These fundamental cellular concepts are then plex have four important functions: (a) regulating initial cell- used as a foundation for discussing potential alterations in- cell recognition and adhesion (cell adhesion proteins); (b) volved in disease processes in epithelial cells. maintaining the cohesive structural integrity of the epithelial monolayer (intermediate junctions and desmosomes); (c) al- Characteristics ofpolarized epithelial cells lowing for intercellular communication (gap junctions); and Distinct surface membrane domains. Polarized epithelial cells (d) (the tight junction) regulating the permeability of the para- have a characteristic cellular organization that includes a sur- cellular pathway ("gate" function) and maintaining the pro- face plasma membrane organized into distinct apical and ba- tein and lipid differences between apical and basolateral solateral domains. Within these surface membrane domains membrane domains ("fence" function) (5, 6). enzymes, transport proteins, hormone receptors, and lipids are The basal membrane contains specialized proteins that reg- localized in a polarized fashion (Table I; for review, see refer- ulate cell-substratum interactions. Cell attachment to the sub- ences 1 and 2). Apical membranes face the external compart- stratum occurs via specific receptors to type IV collagen, pro- ment and are composed of membrane proteins with special- teoglycan, and laminin (7, 8), is tissue specific, and is impor- ized properties related to the cell's primary function (e.g., ab- tant for epithelial morphogenesis, maintenance of the sorption). The basolateral membrane domain faces the differentiated state, and tissue-specific gene expression (7, 8). Cytoskeletal organization. The structural organization of epithelial cells is dependent on the polarized nature of the Address correspondence to Dr. Bruce A. Molitoris, Department of cytoskeleton and its interaction with the surface membrane Medicine (I 1 IC), V.A. Medical Center, 1055 Clermont St., Denver, (Fig. 1; 9-1 1). Actin microfilaments and their associated pro- CO 80220. teins interact with surface membrane proteins via direct or Received for publication 11 October 1989 and in revised form 16 October 1989. indirect linkages to fodrin (termed spectrin in erythrocytes), ankyrin, protein 4.1, vinculin, the ll0-kD protein (brush J. Clin. Invest. border myosin I) of the microvillus, and talin (1 1). For exam- © The American Society for Clinical Investigation, Inc. ple, ankyrin binds with high affinity to Na+,K+-ATPase (12), 0021-9738/90/01/0003/07 $2.00 and a complex containing Na+,K+-ATPase, ankyrin, and fo- Volume 85, January 1990, 3-9 drin has been detected in extracts of Madin-Darby canine kid- Epithelial Cell Polarity and Disease Processes 3 Table . Asymmetry of the Surface Membrane ofPolarized Subsequently, cells develop biochemically and physiologically Epithelial Cells distinct apical and basolateral membrane domains, and cyto- plasmic and cytoskeletal organization (2). In the mammalian Basolateral Characteristic Apical membrane membrane embryo, formation of a polarized epithelium (trophectoderm) occurs at the 8 cell stage (morula) during induction of exten- Proteins sive cell-cell contact (compaction) (17). Cell-cell and cell- Enzymes Leucine aminopeptidase Adenylate cyclase substratum contact also induces development of cell polarity Maltase in freshly isolated hepatocytes and MDCK cells previously GPI-linked proteins grown under suspension conditions. Before this cellular reor- (alkaline phosphatase) ganization, surface membrane proteins and lipids are ran- domly distributed over the entire surface membrane (18). Po- Receptors Insulin larization of the apical membrane follows either cell substra- Parathyroid tum attachment or cell-cell contact, but basolateral hormone membrane polarization requires extensive cell-substratum Epidermal and cell-cell contact ( 19). growth factor Cell-cell contact and the establishment of polarity. Cell- Laminin cell recognition and contact between individual cells is initi- ATPases H+-ATPase Na',K+-ATPase ated by cell adhesion molecules (CAMs). CAMs are cell sur- Mg2+-ATPase Ca2+-ATPase face membrane glycoproteins that are highly conserved, bind to each other in a homophilic manner and mediate calcium- Carriers Amiloride-sensitive Na' C1-/HCO3 dependent aggregation of epithelial cells (20-22). Cell-cell channel exchanger contact results in the rapid assembly of other components of Na'-dependent Na'-independent the junctional complex (e.g., tight junctions and desmosomes) cotransporters glucose carrier and the subsequent demarcation of apical and basolateral Na+/K+/Cl membrane domains. After cell-cell contact there is a redistri- cotransporter bution of surface membrane and cytoskeletal proteins to the Na+/H+ antiporter basolateral membrane. For example, after cell-cell and cell- Lipids substratum contact, Na',K+-ATPase, ankyrin, and fodrin, Cholesterol High Low which are distributed randomly over the entire surface mem- Sphingomyelin High Low brane, undergo a spatial reorganization resulting in the forma- Phosphatidylcholine Low High tion of metabolically stable, nonextractable cytoskeletal- Phosphatidylinositol Low High membrane protein complexes localized to the basolateral membrane (23, 24). Physical properties This process of recruitment and stabilization of surface Electrical resistance High Low membrane proteins may be initiated by cytoskeletal-CAM in- Membrane fluidity Low High teractions. As noted earlier, Na+,K+-ATPase forms a metaboli- cally stable detergent-insoluble complex with actin, fodrin, and ankyrin (12, 13; Fig. 1, inset). Uvomorulin (E-cadherin) may also form complexes with ankyrin and fodrin (25). Inter- ney (MDCK)' epithelial cells (13), demonstrating a direct link- estingly, deletion of part of the cytoplasmic domain of uvo- age of cytoskeletal proteins to a specific integral membrane morulin inhibits cell-cell binding in transfected fibroblasts protein. Cytokeratin intermediate filaments, composed of (26), perhaps because of loss of linkage to cytoplasmic proteins
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