KCNJ10 (Kir4.1) potassium channel knockout abolishes endocochlear potential

Striavascularis of the cochlea generates the endocochlear potential andsecretes K⁺. K⁺ is the main charge carrier andthe endocochlear potential the main driving force for the sensorytransduction that leads to hearing. Stria vascularis consists of twobarriers, marginal cells that secrete potassium and basal cells thatare coupled via gap junctions to intermediate cells. Mice lacking theKCNJ10 (Kir4.1) K⁺ channel in strial intermediate cells didnot generate an endocochlear potential. Endolymph volume andK⁺ concentration ([K⁺]) were reduced. Thesestudies establish that the KCNJ10 K⁺ channel provides themolecular mechanism for generation of the endocochlear potential inconcert with other transport pathways that establish the[K⁺] difference across the channel. KCNJ10 is also alimiting pathway for K⁺ secretion.

     

Functional significance of channels and transporters expressed in the inner ear and kidney

A number of ion channels and transporters are expressed in both the inner ear and kidney. In the inner ear, K⁺ cycling and endolymphatic K⁺, Na⁺, Ca²⁺, and pH homeostasis are critical for normal organ function. Ion channels and transporters involved in K⁺ cycling include K⁺ channels, Na⁺-2Cl^–-K⁺ cotransporter, Na⁺/K⁺-ATPase, Cl^– channels, connexins, and K⁺/Cl^– cotransporters. Furthermore, endolymphatic Na⁺ and Ca²⁺ homeostasis depends on Ca²⁺-ATPase, Ca²⁺ channels, Na⁺ channels, and a purinergic receptor channel. Endolymphatic pH homeostasis involves H⁺-ATPase and Cl^–/HCO₃^– exchangers including pendrin. Defective connexins (GJB2 and GJB6), pendrin (SLC26A4), K⁺ channels (KCNJ10, KCNQ1, KCNE1, and KCNMA1), Na⁺-2Cl^–-K⁺ cotransporter (SLC12A2), K⁺/Cl^– cotransporters (KCC3 and KCC4), Cl^– channels (BSND and CLCNKA + CLCNKB), and H⁺-ATPase (ATP6V1B1 and ATPV0A4) cause hearing loss. All these channels and transporters are also expressed in the kidney and support renal tubular transport or signaling. The hearing loss may thus be paralleled by various renal phenotypes including a subtle decrease of proximal Na⁺-coupled transport (KCNE1/KCNQ1), impaired K⁺ secretion (KCNMA1), limited HCO₃^– elimination (SLC26A4), NaCl wasting (BSND and CLCNKB), renal tubular acidosis (ATP6V1B1, ATPV0A4, and KCC4), or impaired urinary concentration (CLCNKA). Thus, defects of channels and transporters expressed in the kidney and inner ear result in simultaneous dysfunctions of these seemingly unrelated organs. cochlea; vestibular labyrinth; stria vascularis; deafness; renal tubule     

Gastric type H+,K+-ATPase in the cochlear lateral wall is critically involved in formation of the endocochlear potential

Cochlear endolymph has a highly positive potential of approximately +80 mV known as the endocochlear potential (EP). The EP is essential for hearing and is maintained by K⁺ circulation from perilymph to endolymph through the cochlear lateral wall. Various K⁺ transport apparatuses such as the Na⁺,K⁺-ATPase, the Na⁺-K⁺-2Cl^– cotransporter, and the K⁺ channels Kir4.1 and KCNQ1/KCNE1 are expressed in the lateral wall and are known to play indispensable roles in cochlear K⁺ circulation. The gastric type of the H⁺,K⁺-ATPase was also shown to be expressed in the cochlear lateral wall (Lecain E, Robert JC, Thomas A, and Tran Ba Huy P. Hear Res 149: 147–154, 2000), but its functional role has not been well studied. In this study we examined the precise localization of H⁺,K⁺-ATPase in the cochlea and its involvement in formation of EP. RT-PCR analysis showed that the cochlea expressed mRNAs of gastric ₁-, but not colonic ₂-, and -subunits of H⁺,K⁺-ATPase. Immunolabeling of an antibody specific to the ₁ subunit was detected in type II, IV, and V fibrocytes distributed in the spiral ligament of the lateral wall and in the spiral limbus. Strong immunoreactivity was also found in the stria vascularis. Immunoelectron microscopic examination exhibited that the H⁺,K⁺-ATPase was localized exclusively at the basolateral site of strial marginal cells. Application of Sch-28080, a specific inhibitor of gastric H⁺,K⁺-ATPase, to the spiral ligament as well as to the stria vascularis caused prominent reduction of EP. These results may imply that the H⁺,K⁺-ATPase in the cochlear lateral wall is crucial for K⁺ circulation and thus plays a critical role in generation of EP. hydrogen, potassium-adenosine triphosphatase; stria vascularis; spiral ligament     

Ephrin-B2 governs morphogenesis of endolymphatic sac and duct epithelia in the mouse inner ear

Control over ionic composition and volume of the inner ear luminal fluid endolymph is essential for normal hearing and balance. Mice deficient in either the EphB2 receptor tyrosine kinase or the cognate transmembrane ligand ephrin-B2 (Efnb2) exhibit background strain-specific vestibular-behavioral dysfunction and signs of abnormal endolymph homeostasis. Using various loss-of-function mouse models, we found that Efnb2 is required for growth and morphogenesis of the embryonic endolymphatic epithelium, a precursor of the endolymphatic sac (ES) and duct (ED), which mediate endolymph homeostasis. Conditional inactivation of Efnb2 in early-stage embryonic ear tissues disrupted cell proliferation, cell survival, and epithelial folding at the origin of the endolymphatic epithelium. This correlated with apparent absence of an ED, mis-localization of ES ion transport cells relative to inner ear sensory organs, dysplasia of the endolymph fluid space, and abnormally formed otoconia (extracellular calcite-protein composites) at later stages of embryonic development. A comparison of Efnb2 and Notch signaling-deficient mutant phenotypes indicated that these two signaling systems have distinct and non-overlapping roles in ES/ED development. Homozygous deletion of the Efnb2 C-terminus caused abnormalities similar to those found in the conditional Efnb2 null homozygote. Analyses of fetal Efnb2 C-terminus deletion heterozygotes found mis-localized ES ion transport cells only in the genetic background exhibiting vestibular dysfunction. We propose that developmental dysplasias described here are a gene dose-sensitive cause of the vestibular dysfunction observed in EphB–Efnb2 signaling-deficient mice.     

Morphological aspects of potassium flow in the semicircular canal ampulla of the pigeon

Potassium ions are a prerequisite for the development and regulation of sensory cell stimulation in the inner ear. From the potassium-rich endolymph the ions flow into the sensory cells apically and are released basolaterally. After transport pathways of various lengths potassium is released again into the endolymph - in the cochlea by marginal cells of the stria vascularis, in the vestibular labyrinth by dark cells. While this long recycling pathway is relatively well-known in the cochlea, few studies have been conducted on the semicircular canal ampullae (SCCA) where its morphological basis is largely unknown. According to the present electron microscopic findings, potassium ions are initially released into the extracellular space during stimulation of the sensory cells and then absorbed by supporting and light cells. Finally they are transported transcellularly over numerous very long gap junctions into the region of the dark cells. From here they move to an extracellular compartment, which is more or less completely sealed off basally by basal plates of the light cells. Apically the intercellular space between light and dark cells is sealed by junctional complexes. This newly identified space in the SCCA corresponds to the extracellular compartment between the marginal and intermediate cells in the stria vascularis. At both sites, the cochlea and the SCCA, this probably serves as a regulatory valve, reservoir or storage space, particularly for potassium ions. It is likely that the different morphology of the ion transport pathways is related to the different flow levels of potassium ions expressed by the different levels of the so-called endocochlear potential and concomitant movement of other ions in the cochlea and SCCA.     

Activation of K+ channels induces apoptosis in vascular smooth muscle cells

Intracellular K⁺ playsan important role in controlling the cytoplasmic ion homeostasis formaintaining cell volume and inhibiting apoptotic enzymes in thecytosol and nucleus. Cytoplasmic K⁺ concentration is mainlyregulated by K⁺ uptake viaNa⁺-K⁺-ATPase and K⁺ efflux throughK⁺ channels in the plasma membrane. Carbonyl cyanidep-trifluoromethoxyphenylhydrazone (FCCP), a protonophorethat dissipates the H⁺ gradient across the inner membraneof mitochondria, induces apoptosis in many cell types. In ratand human pulmonary artery smooth muscle cells (PASMC), FCCP opened thelarge-conductance, voltage- and Ca²⁺-sensitiveK⁺ (maxi-K) channels, increased K⁺ currentsthrough maxi-K channels [I_K(Ca)], and inducedapoptosis. Tetraethylammonia (1 mM) and iberiotoxin (100 nM)decreased I_K(Ca) by blocking the sarcolemmalmaxi-K channels and inhibited the FCCP-induced apoptosis inPASMC cultured in media containing serum and growth factors.Furthermore, inhibition of K⁺ efflux by raisingextracellular K⁺ concentration from 5 to 40 mM alsoattenuated PASMC apoptosis induced by FCCP and theK⁺ ionophore valinomycin. These results suggest thatFCCP-mediated apoptosis in PASMC is partially due to anincrease of maxi-K channel activity. The resultant K⁺ lossthrough opened maxi-K channels may serve as a trigger for cellshrinkage and caspase activation, which are major characteristics ofapoptosis in pulmonary vascular smooth muscle cells.

     

Identification of a key residue in Kv7.1 potassium channel essential for sensing external potassium ions

K_v7.1 voltage-gated K⁺ (K_v) channels are present in the apical membranes of marginal cells of the stria vascularis of the inner ear, where they mediate K⁺ efflux into the scala media (cochlear duct) of the cochlea. As such, they are exposed to the K⁺-rich (∼150 mM of external K⁺ (K⁺_e)) environment of the endolymph. Previous studies have shown that K_v7.1 currents are substantially suppressed by high K⁺_e (independent of the effects of altering the electrochemical gradient). However, the molecular basis for this inhibition, which is believed to involve stabilization of an inactivated state, remains unclear. Using sequence alignment of S5-pore linkers of several K_v channels, we identified a key residue, E290, found in only a few K_v channels including K_v7.1. We used substituted cysteine accessibility methods and patch-clamp analysis to provide evidence that the ability of K_v7.1 to sense K⁺_e depends on E290, and that the charge at this position is essential for K_v7.1’s K⁺_e sensitivity. We propose that K_v7.1 may use this feedback mechanism to maintain the magnitude of the endocochlear potential, which boosts the driving force to generate the receptor potential of hair cells. The implications of our findings transcend the auditory system; mutations at this position also result in long QT syndrome in the heart.     

Mutations in PMCA2 and hereditary deafness: a molecular analysis of the pump defect

The inner ear converts sound waves into hearing signals through the mechanoelectrical transduction (MET) process. Deflection of the stereocilia bundle of hair cells causes the opening of channels that allow the entry of endolymph K⁺ and Ca²⁺. Ca²⁺ that enters is crucial to the hearing process and is exported to the endolymph by the plasma membrane Ca²⁺ pump (isoform PMCA2w/a): disturbances of the balance between Ca²⁺ penetration and ejection, e.g. by pump mutations, generate deafness. Hearing loss caused by PMCA defects is frequently exacerbated by mutations in cadherin 23, a single pass stereociliar Ca²⁺ binding protein that forms the tip links which permit the deflection of the stereocilia bundle and thus the opening of the MET channels. The PMCA2w/a pump ejects Ca²⁺ to the endolymph even in the absence of the natural activator calmodulin. This satisfies the special Ca²⁺ homeostasis requirements of the stereocilia/endolymph system. Here we have analyzed a mice and a human previously described pump mutant. The human mutant only exacerbated the deafness produced by a cadherin 23 mutation. The murine mutant overexpressed in model cells displayed an evident defect both in the basal activity of the pump and in the long range ejection of Ca²⁺, the human mutant instead failed to impair the Ca²⁺ ejection by the pump.     

Pathophysiology of mitochondrial volume homeostasis: Potassium transport and permeability transition

Regulation of mitochondrial volume is a key issue in cellular pathophysiology. Mitochondrial volume and shape changes can occur following regulated fission-fusion events, which are modulated by a complex network of cytosolic and mitochondrial proteins; and through regulation of ion transport across the inner membrane. In this review we will cover mitochondrial volume homeostasis that depends on (i) monovalent cation transport across the inner membrane, a regulated process that couples electrophoretic K⁺ influx on K⁺ channels to K⁺ extrusion through the K⁺-H⁺ exchanger; (ii) the permeability transition, a loss of inner membrane permeability that may be instrumental in triggering cell death. Specific emphasis will be placed on molecular advances on the nature of the transport protein(s) involved, and/or on diseases that depend on mitochondrial volume dysregulation.     

The endolymphatic sac: its roles in the inner ear

The endolymphatic sac is a non-sensory organ of the inner ear. It is connected to the endolymphatic compartment that is filled with endolymph, a potassium-rich fluid that bathes the apical side of inner ear sensory cells. The main functions ascribed to the endolymphatic sac are the regulation of the volume and pressure of endolymph, the immune response of the inner ear, and the elimination of endolymphatic waste products by phagocytosis. Functional alteration of these functions, leading to deficient endolymph homeostasis and/or altered inner ear immune response, may participate to the pathophysiology of Ménière's disease, an inner ear pathology that causes episodes of vertigo, sensorineural hearing loss and tinnitus, and is characterized by an increase in volume of the cochleo-vestibular endolymph (endolymphatic hydrops).     

Ionentransport und Taubheit

The identification of deafness genes helped to unravel the molecular mechanisms of ion movements that underlie the hearing process in the inner ear. Sound waves cause movements of the tympanic membrane that are transmitted as fluid movements to the inner ear by the middle ear bones. The sound-induced movements deflect hair cell stereocilia, which are bathed in endolymph. These movements cause the opening of mechanosensitive ion channels. Because of the high potassium concentration of the endolymph, potassium floods into the hair cells, which then depolarize. This results in transmitter release and the generation of postsynaptic electrical signals which are transmitted via the cochlear nerve. The unique ion gradient between hair cells and the endolymph is generated by a highly specialized epithelium in the lateral wall of the scala media, the stria vascularis.     

Characterization of inorganic phosphate transport in osteoclast-like cells

Osteoclasts possess inorganic phosphate (P_i) transport systems to take up external P_i during bone resorption. In the present study, we characterized P_i transport in mouse osteoclast-like cells that were obtained by differentiation of macrophage RAW264.7 cells with receptor activator of NF-B ligand (RANKL). In undifferentiated RAW264.7 cells, P_i transport into the cells was Na⁺ dependent, but after treatment with RANKL, Na⁺-independent P_i transport was significantly increased. In addition, compared with neutral pH, the activity of the Na⁺-independent P_i transport system in the osteoclast-like cells was markedly enhanced at pH 5.5. The Na⁺-independent system consisted of two components with K_m of 0.35 mM and 7.5 mM. The inhibitors of P_i transport, phosphonoformic acid, and arsenate substantially decreased P_i transport. The proton ionophores nigericin and carbonyl cyanide p-trifluoromethoxyphenylhydrazone as well as a K⁺ ionophore, valinomycin, significantly suppressed P_i transport activity. Analysis of BCECF fluorescence indicated that P_i transport in osteoclast-like cells is coupled to a proton transport system. In addition, elevation of extracellular K⁺ ion stimulated P_i transport, suggesting that membrane voltage is involved in the regulation of P_i transport activity. Finally, bone particles significantly increased Na⁺-independent P_i transport activity in osteoclast-like cells. Thus, osteoclast-like cells have a P_i transport system with characteristics that are different from those of other Na⁺-dependent P_i transporters. We conclude that stimulation of P_i transport at acidic pH is necessary for bone resorption or for production of the large amounts of energy necessary for acidification of the extracellular environment. Na⁺-dependent phosphate cotransporter; RAW264.7; phosphate uptake     

Mice lacking the basolateral Na-K-2Cl cotransporter have impaired epithelial chloride secretion and are profoundly deaf.

In chloride-secretory epithelia, the basolateral Na-K-2Cl cotransporter (NKCC1) is thought to play a major role in transepithelial Cl(-) and fluid transport. Similarly, in marginal cells of the inner ear, NKCC1 has been proposed as a component of the entry pathway for K(+) that is secreted into the endolymph, thus playing a critical role in hearing. To test these hypotheses, we generated and analyzed an NKCC1-deficient mouse. Homozygous mutant (Nkcc1(-/-)) mice exhibited growth retardation, a 28% incidence of death around the time of weaning, and mild difficulties in maintaining their balance. Mean arterial blood pressure was significantly reduced in both heterozygous and homozygous mutants, indicating an important function for NKCC1 in the maintenance of blood pressure. cAMP-induced short circuit currents, which are dependent on the CFTR Cl(-) channel, were reduced in jejunum, cecum, and trachea of Nkcc1(-/-) mice, indicating that NKCC1 contributes to cAMP-induced Cl(-) secretion. In contrast, secretion of gastric acid in adult Nkcc1(-/-) stomachs and enterotoxin-stimulated fluid secretion in the intestine of suckling Nkcc1(-/-) mice were normal. Finally, homozygous mutants were deaf, and histological analysis of the inner ear revealed a collapse of the membranous labyrinth, consistent with a critical role for NKCC1 in transepithelial K(+) movements involved in generation of the K(+)-rich endolymph and the endocochlear potential.     

Vacuolar Na/K Exchange, its Occurrence in Root Cells of Hordeum, Atriplex and Zea and its Significance for K/Na Discrimination in Roots

Using excised low-salt roots of barley and Atriplex hortenslsthe transport of endogenous potassium through the xylem vesselswas studied It was enhanced by nitrate and additionally by sodiumions which apparently replaced vacuolar potassium which wasthen available in the symplasm of root cells for transport tothe shoot Vacuolar Na/K exchange also has been investigatedby measurements of longitudinal ion profiles in single rootsof both species. In Atriplex roots a change in the externalsolution from K⁺ to Na⁺ induced an exchange of vacuolar K⁺ forNa⁺, in particular in the subapical root tissues and led toincreased K⁺ transport and loss of K⁺ from the cortex. In inverseexperiments a change from Na⁺ to K⁺ did not induce an exchangeof vacuolar Na⁺; merely in meristematic tissues Na⁺—apparentlyfrom the cytoplasm—was extruded in exchange for K⁺. Inroots of barley seedlings without caryopsis, as in excised roots,a massive exchange of K⁺ for Na⁺ was observed in the continuouspresence of external 1.0 mM Na and 0.2 mM K. This exchange alsowas attributed to the vacuole and was most pronounced in theyoung subapical tissues. It did not occur, however, in the correspondingtissues in roots of fully intact barley seedlings. In these,the young tissues retained a relatively high K/Na ratio alsoin their vacuoles. Similarly, contrasting results were obtainedwith intact and excised roots of Zea mays L. Based on theseresults a scheme of the events that lead to selective cationuptake in intact barley roots is proposed. In this scheme acrucial factor of selectivity is sufficient phloem recirculationof K⁺ by the aid of which K⁺ rich cortical cells are formednear the root tip. When matured these cells are suggested tomaintain a high cytoplasmic K/Na ratio due to K⁺ dependent sodiumextrusion at the plasmalemma and due to recovery of vacuolarK⁺ by Na/K exchange across the tonoplast. Key words: Potassium/Sodium selectivity, Vacuolar exchange, Xylem transport, Hordeum, Zea, Atriplex     

Diurnal Rb+ Transport from Roots to the Laminar Pulvinus in Phaseolus vulgaris L.

The primary leaves of kidney bean (Phaseolus vulgaris L.) openunder light and close in the dark by the deformation of thepulvinus resulting from diurnal distribution changes of K⁺,Cl^–, organic acid (or H⁺) and NO₃^–. When Rb⁺ was added as a tracer of K⁺ to the seedlings throughtheir roots, it was transported to the pulvinus cells duringthe light period but not during the dark period. Transpirationoccurred vigorously in the light but almost stopped in the dark.We concluded that Rb⁺ absorbed by the roots was carried to thepulvinus by the transpiration stream. Phaseolus vulgaris L., pulvinus, Rb⁺, diurnal transport transpiration stream     

Potassium Transport in Enteromorpha intestinalis (L.) Link: MEASUREMENT OF INTRACELLULAR K+, EXCHANGE FLUXES AND THERMODYNAMIC ANALYSIS

Potassium transport has been studied in the marine euryhalinealga, Enteromorpha intestimlis cultured in seawater and in low-salinitymedium (Artificial Cape Banks Spring Water, ACBSW; 25·5mol m^–3 Cl^–, 20·4 mol m^–3 Na⁺, 0·5mol m^–3 K⁺). K⁺ fluxes were measured using ⁴²K⁺ and ⁸⁶Rb⁺although ⁸⁶Rb⁺ does not act as an efficient K⁺ analogue in thisplant. ⁴²K⁺ experiments on seawater plants typically exhibiteda single protoplasmic exchange phase whereas ⁸⁶Rb⁺ exhibitedtwo exchange phases. Compartmental analysis of ⁸⁶Rb⁺ effluxexperiments on seawater-grown Enteromorpha plants were usedto deduce the intracellular partition of K⁺ between the cytoplasm(279±38 mMolal) and vacuole (405±68 mMolal). Theplasmalemma K⁺ flux in plants in seawater was greater in thelight than in the dark (563±108 nmol m^–2 s^–1versus 389±66·7 nmol m^–2 s^–1). Inlow-salinity plants, separate cytoplasmic and vacuolar exchangephases were apparent. Analysis of ⁴²K⁺ efflux experiments onlow-salinity plants yielded a cytoplasmic K⁺ of 222±38mMolal and a vacuolar K⁺ of 82±11 mMolal. The plasmalemmaand tonoplast flux was 23±4·5 nmol m^–2 s^–1. The Nernst equation showed that, although K⁺ was close to electrochemicalequilibrium, active accumulation of K⁺ across the plasmalemmaoccurred in plants in seawater and ACBSW both in the light anddark. K⁺ was also actively transported inwards across the tonoplastin low-salinity plants. The electrochemical potential for K⁺across the plasmalemma ranged from 2·41±0·60kJ mol^–1 in plants grown in seawater in the light to 5·79±0·87kJ mol^–1 for plants in ACBSW in the light. Although K⁺is close to electrochemical equilibrium, the flux of K⁺ in plantsin both seawater and ACBSW media is high, hence the power consumptionof K⁺ transport is high. The permeability of K⁺ (P_K⁺) was significantlyhigher in the light than in the dark in plants in seawater (about7·0 versus 2·5 nm s^–1) but in plants inlow-salinity (ACBSW) medium the permeability was independentof light (about 12 nm s^–1). The energy requirements ofactive K⁺ transport by ATP-dependent pumps is discussed. Key words: Enteromorpha, Potassium transport, Ionic relations, Saltwater, Low salinity, Thermodynamics     

EphB2 guides axons at the midline and is necessary for normal vestibular function

Mice lacking the EphB2 receptor tyrosine kinase display a cell-autonomous, strain-specific circling behavior that is associated with vestibular phenotypes. In mutant embryos, the contralateral inner ear efferent growth cones exhibit inappropriate pathway selection at the midline, while in mutant adults, the endolymph-filled lumen of the semicircular canals is severely reduced. EphB2 is expressed in the endolymph-producing dark cells in the inner ear epithelium, and these cells show ultrastructural defects in the mutants. A molecular link to fluid regulation is provided by demonstrating that PDZ domain-containing proteins that bind the C termini of EphB2 and B-ephrins can also recognize the cytoplasmic tails of anion exchangers and aquaporins. This suggests EphB2 may regulate ionic homeostasis and endolymph fluid production through macromolecular associations with membrane channels that transport chloride, bicarbonate, and water.     

Human pendrin expressed in Xenopus laevis oocytes mediates chloride/formate exchange

Pendred syndrome,characterized by congenital sensorineural hearing loss and goiter, isone of the most common forms of syndromic deafness. The gene causingPendred syndrome (PDS) encodes a protein designated pendrin,which is expressed in the thyroid, kidney, and fetal cochlea. Pendrinfunctions as an iodide and chloride transporter, but its role in thedevelopment of hearing loss and goiter is unknown. In this study, weexamined the mechanism of pendrin-mediated anion transport inXenopus laevis oocytes. Unlabeled formate added to the uptakemedium inhibited pendrin-mediated ³⁶Cl uptake in X. laevis oocytes. In addition, the uptake of[¹⁴C]formate was stimulated in oocytes injected with PDScRNA compared with water-injected controls. These results indicate thatformate is a substrate for pendrin. Furthermore, chloride stimulatedthe efflux of [¹⁴C]formate and formatestimulated the efflux of ³⁶Cl in oocytes expressingpendrin, results consistent with pendrin-mediated chloride/formateexchange. These data demonstrate that pendrin is functionally similarto the renal chloride/formate exchanger, which serves as an importantmechanism of chloride transport in the proximal tubule. A similarprocess could participate in the development of ion gradients withinthe inner ear.