CHAPT 05 Intestinal Absorption
CHAPT 05 Intestinal Absorption
CHAPT 05 Intestinal Absorption
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DIGESTION
1. General Principles
The purpose of digestion is to render large composite macromolecules in
food into smaller more manageable components. This is achieved by a group
of hydrolase enzymes that are present through out the digestive tract and
within the membranes of absorbing cells. There are three distinct stages in the
digestion process, (1) salivary, which involves amylases secreted from the
salivary gland that breakdown glycogen and starch, , (2) gastric, which
concerns mainly pepsin secreted from chief cells that attack proteins (3)
mucosal, which involves both trypsin and chymotrypsin synthesized in the
pancreas and released into the duodenum to digest proteins. The second
phase of mucosal digestion uses peptidase and glycosidase that are embedded
in the membranes of the absorbing mucosal cells as a final phase by attacking
smaller peptides and di-and trisaccharides allowing them to enter as individual
amino acids and monosaccharides. Incidental to the action of these enzymes
is the release of the minerals such as iron, calcium, magnesium that were in
the food matrix. Spared from the digestion are amino acids and
monosaccharides, which can function in aiding the solubility and absorbability
of minerals.
ABSORPTION
I. General Principles
Postdigestion processes in the absorbing region of the intestine expose
minerals to a whole new environment of cells. Cells that line the intestine are
basically columnar epithelialcells with a pronounced microvillus lining their
exposed surface. Passage into the system confronts first the microvilli on the
outer boundary which form the absorbing surface supported by a membrane
that regulates movement into the cytoplasmic interior. Absorption is not
complete until the passage from the entry portal release from the opposing
surface is completed. Once thought to be a simple oozing through a mucosal
barrier, minerals absorption in the small intestine is now regarded as a highly
complex, energy-driven process tuned to the prevailing mineral content within
the system. Understandably absorption is a key site for mineral-mineral
interactions, and mineral sequestering, which potentially can disrupt the
orderly flow of minerals into the system. It is at the intestinal stage that the
system is at its highest level of vigilance against excessive mineral intake. To
approach absorption we key on membrane transport systems that pass
minerals across intestinal cells. We also key on the energy factors driving
these processes as well as their regulation and mechanism. Intestinal
absorption and bioavailability are at the heart of nutritional need and both
decide the difference between a healthy outcome or a not- so-healthy mineral
deficiency.
bjectives:
create and then drive the exchange of Na+ for H+ thus maintaining
electroneutrality. The glucose- and amino acid cotransporters aptly
demonstrate the power of simple diffusion in intestinal absorption, which
accounts for about 50% of the Na+ taken in through the intestine;
electroneutral cotransport accounts for only about 20%. Both the sodiumglucose and the sodium-amino acid transporter systems are on the apical
Figure 5.2. Potassium channel in the membrane. The V-shaped funnel has the
cytoplasmic side facing down. A channel is formed by the interaction of 4
proteins with identical subunits.
3) Calcium
In the realm of the divalent cation transport, there is an increasing
propensity for dietary factors to be more influential in the absorption process.
One reason is because divalent as opposed to monovalent cations form stable
complexes with proteins and other factors in the diet. Thus, divalent cations
such as Ca2+, Mg2+ do not share the same high absorption efficiency as
monovalent ions. Researchers have attempted to elucidate the mechanism of
calcium absorption across the intestine with this thought in mind. Magnesium
predictably has some overlap with calcium. Calcium absorption, however,
unlike magnesium is clearly dependent on vitamin D, specifically the 1,25
dihydroxy derivative of the vitamin.
Calcium crosses the intestine by two major avenues; through the cell
barrier or around it. Through the cell (transcellular) accounts for most of the
calcium absorbed. Around the cell (paracellular) is mostly by diffusion and is
unregulated. Transcellular is a metabolically active,
Figure 5.3. A calcium channel protein in the membrane. The channel for calcium is formed by
a single polypeptide chain crossing the membrane in four different locations .
segments suggest that the proximal end of the intestine is most active in
transporting calcium. In the presence of 1,25 dihydroxy-D3 (the most active
form of vitamin D) calcium uptake is curvilinear with increasing dietary calcium
as seen in Figure 5.4. The response is suggestive of a saturable system,
suggesting a carrier. Without the vitamin, calcium still enters the cell but the
uptake is by diffusion and is no longer regulated.
In Figure 5.3, its can be seen that other than the duodenum, the jejunem is the
only other segment of the intestine that shows saturable uptake in the
presence of vitamin D. One may surmise that it is within these regions most of
the calcium is absorbed.
1) Calbindin as a mediator of calcium uptake
It could be argued from kinetic analysis that diffusion alone cannot
account for the rapidity with which calcium ions move across the intestine.
Instead, the data imply the existence of a rapidly moving carrier facilitating the
transfer. Efforts to identify the carrier led to the discovery of a small, 9
kilodalton protein that appeared to be specific for calcium. The protein was
given the name calbindin. Biochemical studies have since identified two high
affinity binding sites for calcium in calbindin, showing that a modest calcium
input can still lead to major calcium incorporation. Calbindin concentration in
cells can be as high as 0.2-0.4 mM, which suffices to augment calcium
movement under conditions prevailing in cells. Moreover, it now appears that
the enhancement of calcium transport correlates strongly with the level of
calbindin in the transporting cell. Recently, 1,25-dihydroxy-D3 has been shown
to control the synthesis of calbindin at the level of transcription and posttranscription, thus suggesting that calbindin is the agent that makes possible
vitamin D-dependent calcium transport. Linking vitamin D with calbindin has
thus help explain how vitamin D controls calcium uptake. It should also be
noted that calbindin null mice (those unable to make the protein because of the
inactivation of the calbindin gene) do not lose the ability to transport calcium,
which suggests other calcium transporters are present. Moreover, calbindin is
also expressed in a variety of tissues including uterus, kidney, pituitary gland,
and bone and thus may be regulated by other factors in a tissue-specific
manner.
Figure 5.6. Uptake of Calcium in the Presence of Magnesium and Phosphorous. Guinea pigs were
fed increasing amounts of magnesium in diets that were fixed in calcium and/or phosphorous. Daily
weight gain was determined for each amount.
It is hard to conclude that all three minerals vie for a common carrier, certainly
not an anion vying for a cation carrier or entry portal. The last argument for
magnesium and calcium having their own unique systems of entry comes with
the role of vitamin D on the two. Although there is some disagreement among
laboratories, the overwhelming opinion appears to be that neither vitamin D
nor any of its metabolites at physiological doses influence the 3.
MICROMINERAL ABSORPTION
Microminerals display a variety of transport systems for movement
across the intestine. Some recognize more then one mineral. All adapt to the
form of the mineral in the lumen and work closely with factors that allow
penetration on the apical surface and release on the basal surface of the
enterocyte. Because of the selectivity each micromineral must be discussed
separately.
IRON
Valance state and organic form are the two major determinants of iron
penetration into a mucosal cell. Organic iron in a food digest is present as
heme, a complex of iron with porphyrin and representing the most common
biochemical form of iron in the diet (Chapter 4). Inorganic iron, often referred
to as non-heme iron, is dependent on valence. As we noted in Chapter 2, iron
present as Fe2+ is more soluble that Fe3+ . The Fe2+ is generally the preferred
form for effective uptake, although oxygen in the water can readily oxidize Fe2+
the villae to the basolateral surface. In the ferrous pathway transport can only
occur if the iron is in the Fe2+ form. For this reason Vitamin C is capable of
facilitating iron uptake by converting iron to the ferrous form (Fe2+) which is the
more soluble form. This explains why vitamin C, a strong reductant, tends to
enhance iron uptake. As a consequence, a large percentage of iron taken in is
able to pass into the mucosal cells. Once inside the mucosal enterocyte, the
iron is subject to being trapped by mucosal ferritin which further delays its
movement into the system and forms the basis for only a small fraction of the
iron taken in diet ever reaching the blood. The DMT-1 transporter for ferrous
iron also recognizes other ions in the 2+ form. The latter include Cu2+, Mn2+,
Zn2+ and perhaps some macrominerals (Ca2+, Mg2+). This multi-recognition
property of DMT-1 form the basis for competition between these metals and
forms the foundation of metal ion antagonism.
Export stage of iron absorption
Passage out of the cells is the final stage of iron transmembrane
movement. Mobileferrin mentioned earlier in the uptake is also a component in
the release of iron from the cells. The major protein conducting the release is
ferroportin. The importance of ferroportin was shown in mice that carried a
disabled ferroportin gene (referred to a knockout mutant). The mice were
capable of absorbing iron into enterocytes but could not excrete iron from the
cells implicating and establishing ferroportin as indispensable for the release of
absorbed iron into the system. The discovery of ferroportin draws parallels to
the discovery of a protein called IREG (iron-regulatory protein) and MPT1 (metal
ion transport protein), which may be one in the same protein. Ferroportin,
however, has been shown to have functional and regulatory links to hepcidin,
which many investigators in iron absorption have considered to be the master
regulatory protein controlling iron absorption at the export stage.
ZINC
Because zinc transporters need recognize only one valence state, Zn2+,
the passage of zinc into the cell would appear to be less complex than multivalence state ions. This is not the case. The omni presence of zinc in tissues
and fluids and cell compartments dictates a need for many different
transporters that operate in a variety of cellular environments. Such is the
case with the zinc family of transporters, referred to as Zip1-5. Of these, Zip4
is involved in zinc uptake from the intestinal lumen. Most of the other Zip
family zinc transporters are located in tissues other than the intestine. Most
are designed to operate in environments that vary widely from cell to cell. As
an example consider zinc in the brain cells as compared to the zinc in the
intestine works in the environment of synaptic vesicles. Neurons with these
vesicles in certain brain regions must handle high amounts of zinc and
therefore be less sensitive than transporters that work in an extremely sparse
zinc environment, which typifies the intestine after a meal. We will discuss the
other Zip transports in the chapter on Zinc.
competition between CRIP and metallothionein for zinc is tuned to the zinc
status of the individual and the diet and is regulated at the level when zinc
enters the intestinal cell.
COPPER
Copper once again reintroduces the importance of valence state in the
movement across the intestine. Only about half of the dietary copper enters
the system. The lower valence state (Cu+) is the state that is least soluble and
could account for most of this loss. Like iron, however, there is a special
transporter that recognizes only one valence state of the ion, the Cu+ ion.
Although it is likely that some Cu2+ enters the enterocyte via DCT1, Cu+ is form
taken in through the uptake channel protein, CTR1 (copper transporter 1).
CTR1 that drives intestinal copper transport is present in the membrane as a
trimer (three identical subunits) that extends through the bilayer. The trimeric
protein forms a hole in the membrane through which copper ions move inside.
How copper ion move through the channel is unknown, but since Cu+ behaves
more like a closed shell ion, the driving force is likely to be provided by the
membrane potential.
Working in conjunction with CTR1 is a reductase enzyme that converts
Cu2+ to Cu+ preparatory to being taken in by CTR1. Once inside the enterocyte
the Cu+ ion can be sequestered by metal-binding proteins which either transfer
the copper to other regions or store the copper as metallothionein-bound
copper.
ATP7A
The counter part to the zip4 protein for zinc is a membrane-bound copper
transporting protein designated ATP7A. ATP7A is a member of large family of
membrane proteins, which as a class use the energy of ATP hydrolysis to drive
ions into and out of cells. ATP7A is a membrane bound enzyme that localizes
SELENIUM
Selenium in the diet is primarily present as selenocysteine and
selenomethionine. One can expect these seleno amino acids to use the same
carrier system that are for their sulfur counterparts. In addition, the system
can absorb inorganic selenium such as selenate and here the concern is with
the solubility.
SUMMARY