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Sweet talk: insights into the nature and importance of glucose transport in lung epithelium

Lookup NU author(s): Dr James Garnett, Erin Baker

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Abstract

For over 50 years, glucose has been recognised to cross the lung epithelial barrier and be transported by lung epithelial cells. However, until recently, research into these processes focused on their effects on lung liquid volume. Here, we consider a newly identified role for pulmonary glucose transport in maintaining low airway surface liquid (ASL) glucose concentrations and propose that this contributes to lung defence against infection. Glucose diffuses into ASL via paracellular pathways at a rate determined by paracellular permeability and the transepithelial glucose gradient. Glucose is removed from ASL in proximal airways via facilitative glucose transporters, down a concentration gradient generated by intracellular glucose metabolism. In the distal lung, glucose transport via sodium-coupled glucose transporters predominates. These processes vary between species but universally maintain ASL glucose at 3-20-fold lower concentrations than plasma. ASL glucose concentrations are increased in respiratory disease and by hyperglycaemia. Elevated ASL glucose in intensive care patients was associated with increased Staphylococcus aureus infection. Diabetic patients with and without chronic lung disease are at increased risk of respiratory infection. Understanding of mechanisms underlying lung glucose homeostasis could identify new therapeutic targets for control of ASL glucose and prevention and treatment of lung infection.


Publication metadata

Author(s): Garnett JP, Baker EH, Baines DL

Publication type: Review

Publication status: Published

Journal: European Respiratory Journal

Year: 2012

Volume: 40

Issue: 5

Pages: 1269-1276

Print publication date: 01/11/2012

Online publication date: 09/08/2012

Acceptance date: 19/07/2012

ISSN (print): 0903-1936

ISSN (electronic): 1399-3003

URL: http://dx.doi.org/10.1183/09031936.00052612

DOI: 10.1183/09031936.00052612

PubMed id: 22878875


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