International Journal of

Molecular Sciences

Review
Expression, Distribution and Role of Aquaporin
Water Channels in Human and Animal Stomach
and Intestines
Cui Zhu 1 , Zhuang Chen 1 and Zongyong Jiang 1,2, *
1 Agro-Biological Gene Research Center, Guangdong Academy of Agricultural Sciences,
Guangzhou 510640, China; [email protected] (C.Z.); [email protected] (Z.C.)
2 Institute of Animal Science, Guangdong Academy of Agricultural Sciences, Guangzhou 510640, China
* Correspondence: [email protected]; Tel.: +86-20-8759-6262; Fax: +86-20-8750-3358

Academic Editor: Kenichi Ishibashi

Received: 24 May 2016; Accepted: 22 August 2016; Published: 29 August 2016

Abstract: Stomach and intestines are involved in the secretion of gastrointestinal fluids and the
absorption of nutrients and fluids, which ensure normal gut functions. Aquaporin water channels
(AQPs) represent a major transcellular route for water transport in the gastrointestinal tract. Until now,
at least 11 AQPs (AQP1–11) have been found to be present in the stomach, small and large intestines.
These AQPs are distributed in different cell types in the stomach and intestines, including gastric
epithelial cells, gastric glands cells, absorptive epithelial cells (enterocytes), goblet cells and Paneth
cells. AQP1 is abundantly distributed in the endothelial cells of the gastrointestinal tract. AQP3 and
AQP4 are mainly distributed in the basolateral membrane of epithelial cells in the stomach and
intestines. AQP7, AQP8, AQP10 and AQP11 are distributed in the apical of enterocytes in the small
and large intestines. Although AQP-null mice displayed almost no phenotypes in gastrointestinal
tracts, the alterations of the expression and localization of these AQPs have been shown to be
associated with the pathology of gastrointestinal disorders, which suggests that AQPs play important
roles serving as potential therapeutic targets. Therefore, this review provides an overview of the
expression, localization and distribution of AQPs in the stomach, small and large intestine of human
and animals. Furthermore, this review emphasizes the potential roles of AQPs in the physiology and
pathophysiology of stomach and intestines.

Keywords: aquaporin; expression; distribution; stomach; intestine; physiology; pathology; cancer

1. Introduction
The gastrointestinal tract is the major organ for water transport and is only secondary to
kidneys [1]. This fast transepithelial fluid transport occurs either via transcellular pathways, which are
mediated by passive diffusion, aquaporin (AQP) water channels [2,3] and co-transporters [4,5], or via
paracellular pathways by tight junctions, or both [6,7]. Among these, the regulation of AQPs driven by
the osmotic forces [8] represent a major transcellular pathway for bidirectional water transport by the
epithelium of the digestive tract [9–11].
Currently, at least 13 isoforms of AQPs (AQP0–12) have been identified in mammals. Based on
their functional characteristics, they are divided into three groups. Specifically: (1) classical
AQPs (AQP0, AQP1, AQP2, AQP4, AQP5, AQP6 and AQP8) are selectively permeable to water;
(2) aquaglyceroporins (AQP3, AQP7, AQP9 and AQP10) are permeable to water, glycerol and urea;
and (3) non-classical AQPs (AQP11 and AQP12) [12]. It has been demonstrated that AQPs are
ubiquitously present in the digestive tract of mammals, including salivary gland, esophagus, stomach,
small and large intestines, liver, gallbladder, bile duct and pancreas [11,13]. Water can be secreted
as digestive juices and then be absorbed by the gastrointestinal epithelia [3,14], which are classified

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Int. J. Mol. Sci. 2016, 17, 1399 2 of 18

as leaky (small intestine), moderately tight (gastric antrum and colon) and tight (gastric fundus)
epithelia, respectively [15]. Thus, research regarding the specific expression, distribution and roles
of AQPs in stomach and intestines of human and animals has attracted much attention in the past
two decades [1,3,11,16,17].
Until now, 11 isoforms of AQPs (AQP1–11) have been found to be expressed in the stomach and
intestines of mammals. It is true that multiple isoforms of AQPs are commonly co-expressed in specific
digestive organs or cells, and no single AQP isoform is exclusively expressed at any single site along
the gastrointestinal tract [3]. In different digestive organs, AQPs have different water-transporting
capacities [11]. Among these, AQP3 and AQP4 are located highly in the stomach [3,11]; moreover,
AQP1, AQP3, AQP7, AQP10 and AQP11 are abundantly expressed in the small intestine, while AQP1,
AQP3, AQP4 and AQP8 are the predominant isoforms in the colon [3,11].
The functions of AQPs in the stomach and intestine physiology may involve water transfer,
gastric juice secretion, barrier function, as well as absorption and secretion of water and even
small solutes through the epithelium [1,3,11,13]. The absorption and secretion of transepithelial
fluids and solutes are closely related to gut physiology by maintaining water and electrolyte
balance [1]. This balance of gut fluid movement has been indicated to be regulated by a complex of
factors, including gastrointestinal hormones, intestinal contents, inflammatory factors and feeding
conditions [3,18,19]. These regulations may either affect the activation or inhibition of ion and solute
transport or alterations of AQPs’ expression and distribution, which may account for the changes
of water transport in the gastrointestinal tract [11]. Apart from the absorption of water and small
solutes, the abundant expression and localization of aquaglyceroporins (AQP3, AQP7, AQP9 and
AQP10) in the gastrointestinal tracts has also been indicated to be involved in the glycerol metabolism
in these tissues [20]. Previous studies have demonstrated that the alterations of AQPs expression and
distribution in the gastrointestinal tracts are associated with gut disorders and diseases [1,21,22]. Thus,
this review mainly summarizes recent advances in the expression, localization and distribution of
AQPs in the stomach and intestine of human and animals and emphasizes the potential roles of AQPs
in gut physiology and pathophysiology.

2. Expression, Distribution and Role of AQPs in the Stomach of Humans and Murine Rodents

2.1. Normal Physiological Conditions

2.1.1. Human Stomach

Stomach exhibits its major functions via the secretion of gastric acid, enzymes and hormones,
which are essential for nutrients’ digestive and absorptive processes [23]. The secretion of isotonic
hydrochloric acid (HCl) by parietal cells of gastric glands is usually accompanied by water transport
from the membrane [3]. Due to the relatively low permeability of gastric parietal cells to water and
small solutes [24], the paracellular pathway has been proposed as the major water transport route in
gastric juice production for years. However, the expression of AQPs in the stomach may indicate their
important roles in the regulation of stomach physiology.
Currently, at least ten isoforms of AQPs (including AQP1, AQP2, AQP3, AQP4, AQP5, AQP7,
AQP8, AQP9, AQP10 and AQP11) have been identified to be expressed in human stomach (Table 1).
Notably, the mRNAs of the AQP1, AQP3, AQP4, AQP5 and AQP11 isoforms are expressed in human
normal gastric tissues [25]. Additionally, AQP7, AQP8 and AQP10 mRNAs have been reported in
the body and pyloric antrum of healthy human stomach [3]. However, the mRNAs of other AQP
isoforms (AQP0, AQP6 and AQP12) were absent in different portions of human stomach [3,25].
Even though the presence of AQP1 protein expression was not confirmed in human stomach epithelia
and mucosa by immunohistochemistry, AQP1 was detected at a low expression level in the endothelial
barriers of the human gastrointestinal tract, including gastric antral and oxyntic mucosa using tissue
microarrays [26]. Moderate and low expression of AQP2 was found in human antral and oxyntic
gastric mucosa using tissue microarrays, respectively [27]; further immunohistochemistry analysis
Int. J. Mol. Sci. 2016, 17, 1399 3 of 18

showed that human AQP2 was localized to the gastric pits [27]. Moreover, AQP4 protein is mainly
localized to the basolateral membrane of parietal cells and chief cells in the normal human gastric
mucosa [25,28], indicating their possible roles in gastric acid and enzyme secretions. The AQP3 and
AQP5 localizations were also detected in the human gastric mucosa by immunofluorescence [25].
However, as mentioned above, despite the presence of AQP1, AQP7, AQP8, AQP10 and AQP11
mRNAs in human stomach [3,25,26], their protein expression and localization remains to be determined
(Table 2).

Table 1. Expression of aquaporins (AQPs) in the stomach of humans and rodents.

AQPs Species Distribution Method Reference

Human stomach
Gastric mucosal tissues; stomach body;
AQP1 Human RT-PCR [3,25,26]
pyloric antrum
AQP2 Human Antral and oxyntic gastric mucosa Tissue microarrays, IHC [27]
Gastric antral and oxyntic mucosa; stomach body; RT-PCR, WB,
AQP3 Human [3,25,27,29,30]
pyloric antrum; MKN45 cells tissue microarrays, IF
AQP4 Human Gastric mucosal tissues; stomach body; MKN45 cells RT-PCR, WB, IHC [3,25,28–30]
Gastric mucosal tissues; stomach body;
AQP5 Human RT-PCR, WB, IHC, IF [3,25,29]
pyloric antrum; MKN45 cells
AQP7 Human Stomach body; pyloric antrum RT-PCR [3]
AQP8 Human Stomach body RT-PCR [3]
AQP9 Human Gastric gland and smooth muscle cells IHC 1

AQP10 Human Stomach body RT-PCR [3]

AQP11 Human Gastric mucosal tissues; stomach antrum and body RT-PCR [3,25]
Murine stomach
AQP1 Rat Gastric mucosa ELISA, IHC [31]
AQP3 Rat Gastric gland RT-PCR, WB, IHC [32]
Rat, mouse, RT-PCR, ELISA, WB,
AQP4 Parietal cells; gastric mucosa; gastric gland [31,33–37]
guinea pig IHC, IF
AQP5 Rat Pyloric gland RT-PCR, WB, IHC, IF [18,38]
AQP6 Rat Gastric gland RT-PCR, WB, IHC, IS [19]
AQP8 Rat Gastric gland RT-PCR [32]
1 Data from the website (Available online: http://www.proteinatlas.org/ENSG00000103569-AQP9/tissue/stomach);

Abbreviations: IF, immunofluorescence; IHC, immunohistochemistry; IS, in situ hybridization; MKN45, human
gastric adenocarcinoma; NB, Northern blotting; RT-PCR, reverse transcription-polymerase chain reaction; WB,
Western blotting.

2.1.2. Murine Stomach

As shown in Table 1, at least six isoforms of AQPs (AQP1, AQP3, AQP4, AQP5, AQP6 and AQP8)
are present in the stomach mucosa of murine rodents, as demonstrated by the methods of reverse
transcription-polymerase chain reaction (RT-PCR), Western blotting, ELISA, in situ hybridization,
immunofluorescence and immunohistochemistry [18,19,31–38]. These AQPs are mainly present in the
gastric mucosa and glands, and they have been mostly reported in rats (Table 2). The presence of these
AQPs in glandular stomach may indicate their roles in gastric secretion. For example, AQP1 protein
was shown to be expressed in the mucosa surface of rat stomach [31]. By using immunohistochemistry,
AQP3 protein was detected in the basolateral membrane of glandular stomach [32]. Moreover, AQP4
expression has been demonstrated in the stomach of rats, mice and guinea pigs, but with different
distributed localizations [31,33–37]. In Sprague-Dawley rats, AQP4 protein is expressed not only
in gastric mucosa [31], but also in the basolateral membranes of mature parietal cells in specific
locations along the axis of the gastric glands [34]. In mice, AQP4-positive parietal cells are distributed
in the basal side of gastric fundic mucosa [35], especially in the basolateral membrane of parietal
cells [36,37]. AQP4 protein is expressed in parietal cells of the stomach in guinea pig [33]. However,
Int. J. Mol. Sci. 2016, 17, 1399 4 of 18

the gastric fluid secretion and gastric pH were not affected in the AQP4-knockout mice compared
to the wide-type mice [36]. Furthermore, the expression of AQP6 at both mRNA and protein levels
and its distribution were demonstrated in the rat stomach [19]. Using in situ hybridization, AQP6
mRNA was determined to be present in the isthmus, neck and basal region of the rat stomach;
AQP6 immunolabeling was confirmed in the isthmus, neck and some parietal cells of the rat
stomach using immunohistochemistry [19]. Neither AQP7 mRNA expression nor AQP7 protein
expression were detected in the rat stomach [14]. However, only a low mRNA level of AQP8 in the
forestomach and glandular stomach of rats was demonstrated by RT-PCR, while its protein expression
or immunolocalization could be not be detected [32].

Table 2. Cellular localization of aquaporins (AQPs) in different cell types in stomach and intestines.

Localization
Tissue Cell Types Reference
Apical Intracellular Basolateral
(1) Surface epithelial cells AQP5 – AQP3, AQP4 [3,13,31]
(2) Gastric gland cells
Stomach
Parietal cells AQP5 – AQP3, AQP4, AQP6 [11,13,19,33,36,37]
Chief cells AQP5 – AQP4 [11]
(3) Microvessels AQP1 – AQP1 [3,13]
AQP6, AQP7,
(1) Villi epithelial cells AQP8 AQP3 [3,11,19,20,39]
AQP10, AQP11 ?
Small (2) Crypt epithelial cells – – AQP3, AQP4 [3,11]
intestine
(3) Goblet cells AQP9, AQP10 – AQP3 [39,40]
(4) Paneth cells – – AQP3 [39]
(5) Microvessels AQP1, AQP10 – AQP1 [3,13,39]
AQP2, AQP3,
(1) Villi epithelial cells AQP7, AQP8, AQP8 AQP3, AQP4 [3,11,21,41–43]
Large AQP10, AQP11 ?
intestine AQP7,
(2) Crypt epithelial cells AQP7, AQP8 – [3,44]
AQP8
(3) Goblet cells AQP9 – – [40]
(4) Microvessels AQP1 – AQP1 [3,13]
–, not determined or not found; ?, unknown.

2.2. Pathological States

2.2.1. Chronic Gastritis

Chronic gastritis remains one of the most common serious pandemic infections affecting men and
women, which can lead to gastric ulcers and gastric cancers [45]. Several AQPs have been found in
chronic gastritis. For example, AQP3 mRNA is expressed in chronic atrophic and chronic superficial
gastritis patients [46]. There is a relationship between the altered human AQP3 and AQP4 mRNA
expression in the mucosa of upper stomach, and the degrees (severe, mild or normal control) of
spleen-stomach dampness-heat syndrome in human chronic superficial gastritis, with higher gene
expression of AQP3 and AQP4, were observed in the moderate and severe groups compared with
the other two groups [30]. In addition, a correlation between AQP3/AQP4 expression and gastritis
types was proposed [47]. A significantly higher expression of gastric mucosal AQP3 was detected in
patients with chronic superficial gastritis compared with patients with chronic atrophic gastritis [46].
Besides, AQP3 and other AQPs (AQP5, AQP7 and AQP11) were also upregulated at the mRNA level
in atrophic gastritis [3]. Bodis et al. (2001) have observed an increased expression of both AQP1 and
AQP4 in rats with gastritis, but without any macroscopically-detectable changes in the stomach [31].
Helicobacter pylori infection is the major cause for chronic gastritis. It has been proposed that
Helicobacter pylori are essential for the development of gastric tumorigenesis [48]. A recent study
Int. J. Mol. Sci. 2016, 17, 1399 5 of 18

has suggested that AQP3 is involved in Helicobacter pylori infection-related gastric carcinogenesis
since AQP3 expression was upregulated both in human gastric adenocarcinoma cells and in rat
gastric tissues [49]. However, in the Helicobacter pylori-infected mice, the ratio between AQP4 and
H+ /K+ ATPase mRNA expression was significantly decreased in histamine type 2 receptor knockout
mice [35]. Notably, the protective effect of calcitonin gene-related peptide on gastric mucosa injury in
rats was demonstrated to be involved in inhibition of AQP4 expression and mast cell degranulation
and in regulation of several hormone genes’ expression (such as gastrin and somatostatin) [50].
Additionally, another study suggested that both AQP1 and AQP4 were important for the maintenance
of mucosal integrity, and their expression in the stomach was increased inethanol-induced edema and
after gastric injury [31]. Collectively, these results indicate that the expression of several subtypes of
AQPs (AQP1, AQP3, AQP4, AQP5, AQP7 and AQP11) is upregulated by gastritis, and more studies are
essential to investigate their potentials as diagnostic biomarkers and drug targets for gastritis therapy.

2.2.2. Gastric Cancer

Gastric cancer is one of the most common cancers worldwide. It remains a major cause of mortality
and morbidity [51]. Evidence has shown that various types of ion channels, water channels and pH
regulators were expressed in gastric cancer cells and tissues, and changes in their expression and
activities may be involved in the pathology and development of gastric cancer [52,53]. The roles
of AQPs in gastrointestinal malignancies have been summarized in a recent review [52]. Evidently,
increasing studies have shown that AQPs behave more than just as water channels in the body, but
may be involved in migration, proliferation, adhesion and angiogenesis [54–56]. Several AQPs have
been reported to be expressed in gastric cancers, which indicated their potential involvement in human
gastric carcinogenesis. For example, the mRNAs of AQP1, AQP3, AQP4, AQP5 and AQP11 are
also found in human gastric cancers [25]. AQP1 has been demonstrated to play a crucial role in cell
migration of rat gastric epithelial cell line during wound healing [57]. The knock down of AQP1
by siRNA resulted in a marked delay of wound healing [57]. Moreover, Watanabe et al. (2009) has
reported that AQP5 protein is localized in the apical membrane of the human gastric cancer cells and
the human gastric adenocarcinoma cell line [29]. AQP5 promotes the proliferation and migration of
human gastric carcinoma cells, and its overexpression was correlated with enhanced lymph node
metastasis [58]. The increased expression of AQP5 may indicate its role in the cell differentiation
of human gastric adenocarcinomas [29]. In addition, AQP3, AQP4 and AQP5 exhibited differential
expression between human gastric carcinomas and corresponding normal tissues; AQP3 and AQP5
protein expression was detected as remarkably stronger in the human carcinoma tissues than that in
normal mucosa by immunofluorescence [25]. In contrast, AQP4 was found to be absent in human
carcinoma tissue in contrast with healthy tissue [25], indicating its downregulation during gastric
tumorigenesis. Interestingly, AQP9 facilitated water fluxes for epithelial wound healing based on its
involvement in the migration of monolayer epithelial cells [59].
Undoubtedly, AQP3 was best studied and was believed to be essential for gastric tumor growth
and spreading. AQP3 expression is higher in human gastric cancer tissue compared with that in
normal tissue, as well as in the human gastric carcinoma cell lines by Western blotting analysis [60].
The involvement of AQP3 in carcinogenesis and the progression of gastric carcinoma can be due to
upregulation of AQP3, which promotes the proliferation, migration and invasion of human gastric
carcinoma cells [56,61]. It seemed that both the ERK and PI3K/AKT signaling pathways were involved
in the upregulation of AQP3 expression, which was induced by hyperglycemia in human gastric
carcinoma [62]. Similarly, another study pointed out that c-Met could regulate the AQP3 expression
via the ERK signal pathway in human gastric carcinoma, which affected the metastasis and invasion of
human gastric carcinoma [63]. Huang et al. (2010) has also demonstrated that AQP3 played a critical
role in human epidermal growth factor (EGF)-induced migration of human gastric cancer cells via
ERK signal transduction pathways [60]. Additionally, a recent study has shown that AQP3 promotes
the tumorigenic potential of several gastric cancer cell lines by activating the Wnt/GSK-3β/β-catenin
Int. J. Mol. Sci. 2016, 17, 1399 6 of 18

pathway [56]. Moreover, in a recent study, AQP3 has been proposed as a potential biomarker for the
diagnosis of gastric intestinal metaplasia, which may finally transform into gastric cancer [64].
Collectively, AQPs-dependent cell migration has significant implications in tumor metastasis and
wound healing, since AQPs facilitate the cell shape changes and propel the cell forward by changing
the cell volume with water flow regulation [65]. Additional studies are required to determine whether
these AQPs can become potential therapeutic targets for gastric cancers.

3. Expression, Distribution and Role of AQPs in the Intestines of Humans and Murine Rodents

3.1. Normal Physiological States

3.1.1. Human Small Intestine

Small intestine (duodenum, jejunum and ileum) is the major site for digestion and absorption of
nutrients and water. For human, the daily fluid transport in small intestine is approximately 9 L, which
is composed of about 2 L of water intake and about 7 L of secretion of digestive juices [1]. The rapid
bidirectional movement of this large volume of water, which involves both absorptive and secretory
processes, largely depends on enterocytes [3]. The expression of AQPs in the human and murine small
intestine is summarized in Table 3. At least eight isoforms of AQPs (AQP1, AQP2, AQP3, AQP4, AQP7,
AQP8, AQP10 and AQP11) are present in human small intestine. A previous study has demonstrated
that AQP1, AQP3 and AQP4 mRNAs are expressed in human small intestine, without any detectable
mRNAs of AQP0, AQP2 and AQP5 [66]. However, another study by tissue microarrays has shown
the very weak expression of AQP2 in human small intestinal mucosa [27]. Moreover, AQP3 protein
expression was confirmed in human small intestine via Northern blotting [67]. In addition to AQP1 and
AQP3 as mentioned above, the AQP7 and AQP8 expression at both mRNA and protein levels was also
demonstrated in the mucosal epithelium of human ileum [21]. Moreover, abundant AQP11 mRNA has
been confirmed in the healthy human duodenum tissues [3]. Notably, the aforementioned AQPs are
mainly distributed in the villi and crypt of the enterocytes in human small intestine (Table 2). Evidently,
AQP1 protein is widely expressed in the human small intestinal capillary endothelia and erythrocytes,
but not in the mucosal epithelium [21,39]. However, the immunostaining of AQP3 and AQP8 was
strongly detected along the apical parts of the ileum surface epithelium (enterocytes), while AQP7
immunoreactivity was mainly found in the basolateral parts of surface epithelia in the human ileum
by immunofluorescence [21]. AQP3 was also found to be expressed highly in basolateral membranes
of villi epithelial cells and goblet cells, as well as Paneth cells and granule-containing cells in human
ileum crypts [39]. Besides, AQP10 was found to be expressed abundantly in the absorptive epithelial
cells of human small intestine [39,68,69], with much higher expression in duodenum and jejunum
than in ileum [68,69]. Moreover, AQP10 is expressed highly in the apical membrane of goblet cells
in human ileum villi [39]. These results suggest that AQP1, AQP3, AQP7, AQP8 and AQP10 are the
predominant AQPs in the human small intestine [21,39]. The expression of AQPs in the superficial villi
and the crypt of enterocytes otherwise indicates their roles in absorption and secretion, respectively [3].
Although the presence of AQP4 and AQP11 mRNAs was demonstrated as mentioned above, their
protein expression and localization in human small intestine remain to be investigated.

3.1.2. Murine Small Intestine

As shown in Table 3, there are at least nine isoforms of AQPs (AQP1, AQP3, AQP4, AQP5, AQP6,
AQP7, AQP8, AQP9 and AQP11) present in the small intestine of murine rodents, including rats,
mice and guinea pigs. A previous study has shown that the expression of AQP1, AQP3 and AQP4
was present in the small intestine of rats [70]. On the other hand, AQP1, AQP3, AQP7 and AQP11
mRNAs were demonstrated to be expressed in the enterocytes of jejunum and ileum of mice [71].
Both nonglycosylated and glycosylated forms of AQP1 were found to be localized in the apical and
basolateral membranes of cells of Brunner’s gland in the duodenum of rats [18]. Besides, AQP1, first
Int. J. Mol. Sci. 2016, 17, 1399 7 of 18

known as CHIP, has been shown to be abundantly expressed in the rat duodenal and ideal lacteals [72].
Notably, the AQP3 mRNA level is increased along the length of the intestine in rats, with abundant
expression in the distal ileum [73]. Using immunohistochemistry, AQP3 staining is confined to the
basolateral membrane of absorptive epithelial cells lining the lumen and to the neck of crypts [32].
The AQP3 and AQP8 proteins are localized to the basolateral membranes of rat ileum and to the
subapical compartment of epithelial cells of jejunum and ileum, respectively [32].

Table 3. Expression of aquaporins (AQPs) in the small intestine of human and murine rodents.

AQPs Species Distribution Method Reference

Human small intestine
AQP1 Human Duodenum, jejunum and ileum RT-PCR, IHC [21,66]
AQP2 Human Duodenum, jejunum and ileum Tissue microarrays, IHC [27]
AQP3 Human Duodenum, jejunum and ileum RT-PCR, tissue microarrays, IHC [21,27,66]
AQP4 Human Duodenum, jejunum and ileum RT-PCR [66]
AQP7 Human Ileum RT-PCR, IHC [21]
AQP8 Human Ileum RT-PCR, IHC [21]
AQP10 Human Duodenum, jejunum and ileum RT-PCR, IS, NB, WB, IHC, IEM [68,69]
AQP11 Human Duodenum RT-PCR [3]
Murine small intestine
AQP1 Rat, mouse Duodenum, jejunum and ileum RT-PCR, WB, IHC [18,38,71,74]
AQP3 Rat, mouse Jejunum and ileum RT-PCR, WB, IHC [32,71,73]
AQP4 Rat, guinea pig Jejunum and ileum WB, IF [33,73]
AQP5 Rat Duodenum RT-PCR, WB, IF [38]
AQP6 Rat Duodenum, jejunum and ileum RT-PCR, WB, IHC, IS [19]
AQP7 Mouse, rat Duodenum, jejunum and ileum RT-PCR, WB, IHC [14,71,75]
AQP8 Rat Duodenum, jejunum and ileum RT-PCR, WB, IHC [32,75]
AQP9 Mouse Duodenum, jejunum and ileum RT-PCR, IS, WB [40]
AQP11 Mouse Jejunum and ileum RT-PCR [71]
Abbreviations: IEM, immunoelectron microscopy; IF, immunofluorescence; IHC, immunohistochemistry;
IS, in situ hybridization; NB, Northern blotting; RT-PCR, reverse transcription-polymerase chain reaction;
WB, Western blotting.

Notably, AQP4 was expressed in both rats and guinea pigs, with its expression in the absorptive
and glandular epithelial cells of small and large intestine [33], as well as in the enteric glial cells
of guinea pig [33]. In addition to the AQP5 expression at both mRNA and protein levels, AQP5
localization was also demonstrated in the apical and lateral membranes of the pyloric gland of the
stomach, as well as in Brunner’s gland of duodenum in rats [18,38]. However, no AQP5 expression
was detected in the intestinal glands or cells in the villi of rat duodenum [76].
A previous study has demonstrated the distribution and expression of AQP6 along the rat small
intestine, at both mRNA and protein levels [19]. Specifically, the jejunal AQP6 mRNA expression was
increased after feeding, indicating its direct involvement in the absorption of water and anions [19].
The gastrointestinal fluid recirculation is significantly increased during a meal to facilitate proper
digestion and absorption of intestinal contents [11], which leads to possible alterations of AQPs’
expression thereafter.
The expression of AQP7 at both mRNA and protein levels has been found to be abundant in the rat
small intestine [14]. There is a much stronger expression in the surface epithelial cells of the duodenum,
jejunum and ileum when compared to the crypt cells at the basolateral side [14]. Further studies have
confirmed the mRNA and protein expression of AQP7 and AQP8 in the apical brush border membrane
of epithelial cells in the rat small intestine [75].
In addition, AQP8 has been shown to be present in the surface epithelial cells in the duodenum
and jejunum of rats [74]. Elkjaer et al. (2001) found that AQP8 mRNA was detected in the duodenum
and proximal jejunum [77]. Interestingly, AQP9 mRNA and protein expression, otherwise, has been
confirmed in the mucus-secreting goblet cells of mice duodenum, jejunum and ileum, which indicated
the potential role of AQP9 in mucus secretion for protecting the intestine from pathogen invasions [40].
Int. J. Mol. Sci. 2016, 17, 1399 8 of 18

3.1.3. Human Large Intestine

Large intestine, mainly referring to the colon, extracts water (approximately 2 L daily) and
electrolytes from the solid wastes to produce dehydrated feces [1]. Indeed, it has been proposed
that water movement in this site may be mediated mainly through AQPs expressed in the colon [3].
The expression of AQPs in the human and murine large intestine is summarized in Table 4. There are at
least eight isoforms of AQPs (AQP1, AQP2, AQP3, AQP4, AQP7, AQP8, AQP10 and AQP11) expressed
in human large intestine, and most have been reported to be in the colon [3,8,21,27,42,44]. As shown
previously, AQP1, AQP3, AQP7 and AQP8 are the predominant AQPs in the human colon [21]. Besides,
AQP2 was found to be expressed at a low level in the colonic mucosa by human tissue microarrays
and immunohistochemistry [27]. AQP3 is also expressed in the human intestinal epithelial cell line
(HT-29) [78]. For localization determination, AQP3 was found to be distributed in the apical membrane
of villus epithelial cells in the human colon [21,42]. In other studies, it has been indicated that AQP3
is selectively targeted to the basolateral membrane of the human colon [43]. AQP4 mRNA was also
detected at a very low level as shown by RT-PCR in human normal colons, but its specific staining
was not found by immunofluorescence [44]. Moreover, AQP7 immunoreactivity was detected in the
basolateral epithelia in the villi and crypt of human colon [21]. AQP8 is expressed in the apical sides
of the villus and crypt epithelial cells in human colon [8,21]. Another study has also shown that
both AQP7 and AQP8 are mainly expressed in the apical parts of human colonic tissues, with some
cytoplasmic and basolateral distributions [44]. Moreover, AQP10 mRNA is expressed at a very low
level in the ascending colon of human, while AQP11 mRNA is abundantly present in human ascending
colon [3].

Table 4. Expression of aquaporins (AQPs) in the large intestine of human and murine rodents.

AQPs Species Distribution Method Reference

Human large intestine
AQP1 Human Colon RT-PCR, WB, IF [21]
AQP2 Human Colon Tissue microarrays, IHC [27]
AQP3 Human Colon RT-PCR, WB, tissue microarrays, IHC [21,27,42]
AQP4 Human Colon RT-PCR [44]
AQP7 Human Colon RT-PCR, IHC [21,44]
AQP8 Human Colon RT-PCR, IHC, NB, IS [8,21,44]
AQP10 Human Colon RT-PCR [3]
AQP11 Human Colon RT-PCR [3]
Murine large intestine
AQP1 Mouse Colon RT-PCR [71]
AQP2 Rat Colon RT-PCR, WB, IS, IHC [41,79]
AQP3 Rat, mouse Colon and rectum RT-PCR, WB, IHC [32,78,80,81]
AQP4 Rat, mouse Colon RT-PCR, WB, IHC [33,44,71,81]
AQP6 Rat Colon and cecum RT-PCR, WB, IHC, IS [19]
AQP7 Mouse, rat Colon, cecum, and rectum WB, IHC [14,44]
AQP8 Rat, mouse Colon RT-PCR, WB, IHC [44,71,81]
AQP9 Mouse Colon IS [40]
AQP11 Mouse Colon RT-PCR [71]
Abbreviations: IF, immunofluorescence; IHC, immunohistochemistry; IS, in-situ hybridization; NB, Northern
blotting; RT-PCR, reverse transcription-polymerase chain reaction; WB, Western blotting.

3.1.4. Murine Large Intestine

As listed in Table 4, there are at least nine isoforms of AQPs (AQP1, AQP2, AQP3, AQP4,
AQP6, AQP7, AQP8, AQP9 and AQP11) that are expressed in the large intestine of murine rodents.
Specifically, AQP1, AQP4, AQP8 and AQP11 mRNAs were all detected in the mice colons [71].
Another study also demonstrated the mRNA and protein expression of AQP4, AQP7 and AQP8 in
mice colons [44]. Previous studies have shown that AQP3 was expressed in the basolateral membranes
of the epithelium in rats colons [32] and in mice [78]. However, the expression of AQP3 in the colon
Int. J. Mol. Sci. 2016, 17, 1399 9 of 18

and ileum was greater than in the stomach [80], and AQP3 has been believed to be a dominant AQP
subtype in the rat colon [82]. Additionally, using semi-quantitative RT-PCR and immunoblotting,
the AQP3, AQP4 and AQP8 expression was clearly shown in the apical membrane of superficial
colonocytes in rats [81]. Thus, AQP3 has been shown to be distributed in both the apical and lateral
colonocyte membranes in addition to staining a perinuclear region [83]. Gallardo et al. (2001) have
demonstrated that AQP2 is localized to the apical membrane of surface absorptive epithelial cells
in the rat distal colon, indicating the role of AQP2 in water absorption in the colon [41]. Moreover,
AQP4 is immunolocalized to the basolateral membrane of colonic surface epithelium of wide-type
mice, but not in AQP4 knockout mice [84]. The distribution and expression of AQP6 at both mRNA
and protein levels was demonstrated in rat colon and cecum, and its expression was higher in the
large intestine than the small intestine [19]. In contrast to the small intestine, AQP7 expression was
found to be weaker in the large intestine of rats [14]. Apart from the duodenum and jejunum, AQP8
was also present in the surface epithelial cells in the colon of rats [74]. AQP8 mRNA was detected in
the proximal colon and rectum of rats, with protein immunolocalization specifically in the absorptive
epithelial cells of these intestinal segments [77] and mainly localized to the subapical compartment of
intestinal epithelial cells [32], which indicated its possible roles in the secretion or absorption of water
at these sites [85]. The presence of AQP9 mRNA has also been demonstrated to be exclusively localized
in goblet cells at the bottom of crypts in the mouse colon, as determined using in situ hybridization [40].
Moreover, AQP1 was also demonstrated in the rat colon lymphatic lacteals [72], and AQP4 was found
to be expressed in the colonic enteric neurons of rats and mice [86].

3.2. Pathological States

3.2.1. Enteritis
Enteritis is characterized by abnormal electrolyte and water transport events that are accompanied
by intestinal inflammation and injury [44,87]. The reduced mRNA expression of several AQPs (AQP1,
AQP3, AQP7 and AQP8) in human intestinal mucosa has been demonstrated at the early stage of
inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis [21]. AQP4, AQP7
and AQP8 mRNAs were all detected in both normal colons and in the colons of patients with ulcerative
colitis, Crohn’s disease and infectious colitis [44]. In the trinitro-benzene-sulfonic acid-induced colitis of
rats, the mRNA and protein expressions of AQP3 and AQP8 were also downregulated in the ileum and
colon [87]. This suggests that AQP3 and AQP8 may play significant roles in the regulation of intestinal
fluid homeostasis and disorders in rats [32,87]. Indeed, the AQP3-null mice displayed impaired
enterocyte proliferation and developed severe colitis after dextran sulfate treatment, probably due
to the impaired glycerol-transporting function [88]. Moreover, the abnormal regulation of fluid and
electrolyte flux in IBD patients and in a murine colitis model may be associated with significant
reductions in AQP4 and AQP8 mRNA expression in the colon [44]. Accordingly, apical AQP8
immunolabeling was reduced in the colon of IBD patients, either in the surface epithelium or in
the crypts [21]. The inhibition of AQP8 expression by siRNA significantly decreased the osmotic
water permeability in isolated superficial colonocytes in the rat proximal colon [81]. These results may
suggest that the role of AQP8 in osmoregulation and mucosal fluid fluxes should be elucidated [77].
Notably, heat stroke has been shown to induce jejunum barrier damage and cell apoptosis via the
increased expression of AQP1, AQP3, AQP7, AQP8 and AQP11 mRNA [89]. These results collectively
indicated that enteritis, either in murine rodents or human, may be associated with alterations in
electrolyte and water transport mediated by a downregulation in AQPs’ expression, especially for
AQP3, AQP4 and AQP8. Moreover, it has been indicated that the structural changes of AQP3 and
AQP10 in human intestine may lead to fluid imbalance, thus facilitating the development of Crohn’s
disease and ulcerative colitis [43]. Notably, pro-inflammatory cytokine TNF-α has been shown to
decrease AQP5 protein and mRNA expression in a mouse lung epithelial cell line [90]. However, it
is still not clear whether the inflammatory cytokines released during intestinal inflammation would
Int. J. Mol. Sci. 2016, 17, 1399 10 of 18

exacerbate abnormal electrolytes and water transport due to the alterations of AQPs expression or
distribution. Thus, further experiments should be conducted.

3.2.2. Diarrhea
The defects and disorders of secretion and water absorption in the intestines are important
factors in the pathogenesis of diarrhea [71]. During infectious diarrhea, the rapid loss of fluids and
electrolytes is involved in this process due to increased intestinal secretion and/or decreased intestinal
absorption [91]. Water channel proteins may otherwise be involved in the normal dehydration of fecal
contents; thus, changes in the distribution of AQPs may play an important role in the development of
diarrhea [83].

Table 5. Changes in the aquaporins (AQPs) during diarrhea in humans and animals.

Species Cell Types AQPs Changes Level 1 Reference

Escherichia coli- and LPS-induced diarrhea
Human HT-29 cells LPS decreased AQP3 expression M, P [92]
Rat Colon Inhibition of AQP3 function caused diarrhea M, P [93]
AQP2 and AQP3 were mislocalized from cell membranes to the
Mouse Colon L [83]
cytoplasm under EHEC and EPEC diarrhea
Piglet Jejunum ETEC challenge reduced mucosa AQP8 expression M [94]
Piglet Jejunum LPS challenge decreased mucosa AQP8 expression M [95]
Cholera toxin-induced secretory diarrhea
Human Duodenum AQP10 expression was downregulated M [96]
Rat Small intestine Mucosal AQP8 expression was decreased M [97]
Allergy-induced diarrhea
AQP3, AQP7, AQP10 and AQP11 expression was decreased in
Human Colon M, P [3,22]
celiac disease patients
Mouse Proximal colon AQP4 and AQP8 were downregulation when there was an allergy M, P [98]
Drug-induced diarrhea
AQP1 and AQP11 expression was decreased in
Mouse Colon M [71]
5-fluorouracil-induced diarrhea
AQP4 and AQP8 expression was decreased in
Mouse Colon M, P [71]
5-fluorouracil-induced diarrhea
Rotavirus diarrhea
AQP1, AQP4 and AQP8 expression was downregulated in
Mouse Colon P [99]
rotavirus diarrhea
1 M, mRNA expression level; P, protein expression level; L, localization changes. Abbreviations: EHEC,
enterohemorrhagic Escherichia coli; EPEC, enteropathogenic Escherichia coli; ETEC, enterotoxigenic Escherichia coli;
HT-29, human colon epithelial cells; LPS, lipopolysaccharide.

Changes in the expression or distributions of AQPs in the development of several types of diarrhea
in human and animals are summarized in Table 5. Clearly, several AQPs have been demonstrated
to be downregulated under different types of diarrhea [22,71,93,95–98,100]. Moreover, the exposure
to mercury, which inhibits of AQPs, significantly downregulated gastric AQP3 and AQP4 mRNA
and their protein expression, as well as the AQP3 and AQP7 protein expression in the small and
large intestines of rats, thus leading to the accumulation of intestinal fluids and, finally, diarrhea [101].
These results suggested that these AQPs may be potential targets for the prevention and treatment of
diarrhea in human and animals. Increasing evidence has demonstrated that the anti-diarrhea effects of
some substances, including emodin [78] and berberine [102], and the laxative drugs magnesium sulfate
(MgSO4 ) [82,103], may involve the alteration of AQPs to regulate water transport and absorption
possibly, via the regulation of the cAMP-dependent PKA/p-CREB signal pathway [78,82,103]. A recent
study has also shown that the upregulation of AQP2 in the distal colon was found in cirrhotic rats
Int. J. Mol. Sci. 2016, 17, 1399 11 of 18

with ascites, and its expression is inhibited by Tolvaptan, which probably leads to decreased water
reabsorption and induces diarrhea in cirrhotic rats with ascites [79].
Notably, the importance and functions of AQP water channels in fluid transport were not
confirmed by AQP-null mice, and surprisingly, an apparent phenotypic abnormality is not associated
with the tissue-specific expression of AQPs [104]. For example, a previous study using AQP4 knockout
mice indicated that transcellular water transport through AQP4 facilitates transepithelial osmotic
water permeability, but it marginally affects colonic fluid secretion or fecal dehydration [84]. Moreover,
the AQP1-null mice displayed defective fat processing, which resulted in an increased stool fat content,
whereas AQP4 knockout mice exhibited defective fecal dehydration and colonic fluid absorption
compared to those of wild-type mice [1].

3.2.3. Colon Cancer and Rectal Cancer

Previous studies have shown that the alterations of the expression and localization of several
AQPs (such as AQP1, AQP3, AQP5 and AQP8) in the colon and rectum may imply their involvements
in the development of colon and rectal cancers [52], probably due to their roles in cell migration,
proliferation and angiogenesis, as mentioned above. Specially, AQP1, AQP3 and AQP5 expression has
been demonstrated in seven human colon and colorectal cancer cell lines, and they are associated with
an early stage of colorectal cancer development [105]. Additionally, human epidermal growth factor
significantly increased the expression of AQP3 and consequently the migration of human colorectal
carcinoma cells (HCT116) in a dose- and time-dependent manner [106]. These data suggested that the
overexpression of AQP3 may facilitate the migration of colorectal carcinoma cells [106]. Interestingly,
it has been shown that AQP3 may impair the intestinal barrier integrity [107], which is probably
mediated by miR-874 through targeting AQP3 following intestinal ischemic injury [108]. It is still
unknown if the regulation of AQP3 in intestinal barrier functions is associated with the progression of
intestinal cancers, and it requires further study. There was no expression of AQP8 in human colorectal
tumors, which indicated a downregulation of the AQP8 gene during tumorigenesis [8].

4. Expression and Distributions of AQPs in the Stomach and Intestines of Domestic Animals
In contrast to the findings in humans, rats and mice, there are limited reports regarding the
expression of water channel proteins in domestic animals. The water absorption along the large
intestines of pigs is lower than those of cattle and sheep, probably due to the difference in the
rates of passage of digesta among these species [109]. Previous studies have demonstrated the
expression and localization of AQP1, AQP4 and AQP5 in both the small intestine and large intestine of
colostrum-suckling buffalo calves [110–112]. Specifically, AQP1 immunoreactivity is abundant in the
endothelium and is moderate in the enterocytes of small and large intestines in newborn buffalo calves
after suckling colostrum for seven days [111]. AQP4 is mainly distributed along the endothelium and
enterocytes, whereas AQP5 is mainly in the endocrine cells of the large intestine [110,112]. Moreover,
the AQP3, AQP7 and AQP10 transcripts, together with the protein abundance of AQP3, AQP7 and
AQP8, have also been confirmed in ruminal papillae of lactating dairy cows [113]. Interestingly, AQP10
mRNA in the duodenum and jejunum of cattle could not be detected by RT-PCR due to the fact that
AQP10 is a pseudogene in cattle and in their relatives (sheep and goat) [114].
However, pigs are recognized as the best research model for humans due to their similarities
in gut structure and physiology. Importantly, AQP1 was found to be distributed extensively in the
epithelium and endothelium of the gastrointestinal system of pigs [115]; however, the role of AQP1 in
the fluid secretion, absorption and pathophysiology of the porcine gastrointestinal system remained
controversial [116]. The expression of AQP1 protein was also demonstrated in the enteric nervous
system of the ovine duodenum, with predominant distribution in the sensory submucosal neurons
instead of the myenteric neurons [117]. In a microarray analysis, AQP4 mRNA has been detected in
both the oxyntic and pyloric mucosa of weaned pigs, but with higher expression of AQP4 in the oxyntic
mucosa related to hydrochloric acid and secretion when compared to that of pyloric mucosa [118].
Int. J. Mol. Sci. 2016, 17, 1399 12 of 18

Additionally, the cellular localization of AQP4 is not only distributed in porcine enterocytes along the
villi and crypt in the small and large intestines, but also in its duodenal Brunner’s glands and enteric
neurons by immunohistochemistry [119]. Moreover, AQP8 mRNA is present in both the mucosa of
jejunum and ileum in weaned piglets [95]. However, the expression of water channel proteins in
different parts of the gastrointestinal tracts in domestic animals and their significance in gut physiology
and pathology has yet to be elucidated.

5. Conclusions
The gastrointestinal tract, mainly the stomach and intestine discussed herein, is the major digestive
and absorption site for nutrients and fluids that ensure normal gut functions. There is abundant water
and fluid transferred through the epithelial cell layer in the stomach and intestine. The transepithelial
fluid transport in the stomach and intestine may be mainly mediated by AQPs. Until now, at least
11 isoforms of AQPs (AQP1–11) have been shown to be present in the stomach, small intestine and
large intestine. The current available data have indicated that the alterations of the expression and
localization of these AQPs may be associated with the pathology of gastrointestinal disorders, such as
gastritis, gastric cancer, enteritis, diarrhea, as well as colon and rectal cancers. On the one hand, the
upregulation of the expression of AQP3 and AQP5 in the stomach indicates their important roles in
the development of gastritis and gastric cancers. On the other hand, the downregulated expression
of several AQPs (AQP1, AQP3, AQP4, AQP7, AQP8, AQP10 and AQP11) in the small and large
intestines has been observed in the process of either enteritis or diarrhea. Although AQPs have been
discovered for years, limited data could be found concerning the specific roles of each isoform in
the stomach and intestine. The current review summarized the possibilities of AQPs as potential
therapeutic targets in gastrointestinal disorders. Other important tissues in the gastrointestinal tract
(such as salivary glands, liver, pancreas and gallbladder) are also very vital for gut functioning, and
the roles of AQPs in these important tissues have been well summarized in recent reviews [17,120].
More investigations are required to elucidate the regulatory signal pathways for AQPs’ expression,
localization and distribution changes in gut physiology and pathology. New research approaches, such
as the CRISPR-Cas9 gene editing technique, the isotope labeling method and the Ussing chambers
technique, can be applied in future studies to elucidate the roles and mechanism of specific AQPs in
gut health and diseases.

Acknowledgments: This work was supported by the National Natural Science Foundation of China
(Nos. 31501967, 31472112), the Natural Science Foundation of Guangdong Province, China (No. 2015A030310332),
the Science and Technology Program of Guangdong Province, China (Nos. 2013B020306004, 2016B070701013,
201607020035), the Hundred Outstanding Talents Training Program at Guangdong Province, China, and the
Presidential Foundation of Guangdong Academy of Agricultural Sciences, China (No. 201612).
Author Contributions: Cui Zhu, Zhuang Chen and Zongyong Jiang contributed to the writing of the manuscript.
Conflicts of Interest: The authors declare no conflict of interest.

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