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TRANSEPITHELIAL TRANSPORT OF AMINO ACIDS
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Epithelial cells in renal tubules and intestinal mucosa use several different transport systems to move amino acids through the luminal (apical) and the antiluminal (basolateral) membranes of the cell, using sodium-dependent symporters, proton-motive forces, and concentration gradients of other amino acids. Each transporter system prefers groups of amino acids with certain physicochemical properties, but most individual amino acids can use more than 1 transporter. The transport activities have been classified into 5 main groups: (1) the “basic system” for cystine and the structurally related dibasic cationic amino acids lysine, arginine, and ornithine; (2) the “neutral system” for neutral amino acids; (3) the “acidic system” for glutamate and aspartate; (4) the “iminoglycine system” for proline, hydroxyproline, and glycine; and (5) the “β-amino acid system.”
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Inherited defects in amino acid transport at the cell membrane (Fig. 139-1 and Table 139-1) are expressed as selective renal aminoaciduria (ie, the concentration of the affected amino acids is high in the urine while it is normal or low in plasma). Intestinal absorption of these amino acids is almost always impaired. The symptoms of these disorders result from an excess of certain amino acids in the urine or a lack of them in the tissues.
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