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Physiol Rev
83: 1183–1221, 2003; 10.1152/physrev.00010.2003.
Regulation and Modulation of pH in the Brain
MITCHELL CHESLER
Department of Physiology and Neuroscience, Department of Neurosurgery, New York University
School of Medicine, New York, New York
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I. Introduction
II. Buffering Power
III. Regulation of Intracellular pH in Vertebrate Neurons
A. Neurons from hippocampus
B. Neurons from cerebral cortex
C. Neurons from cerebellum
D. Neurons from spinal cord
E. Medullary neurons
F. Retinal neurons and photoreceptors
G. Sympathetic neurons
H. Neoplastic neural cells
I. Synaptosomes
IV. Regulation of Intracellular pH in Glial Cells
A. pH regulation in nonmammalian glial cells
B. pH regulation in mammalian astrocytes
C. pH regulation in oligodendroglia
D. pH regulation in Schwann cells
E. pH regulation in glial tumor cells
F. pH regulation and volume control in glia
V. Molecular Identification of Brain Acid Transporters
A. Na⫹/H⫹ exchangers in brain
B. HCO⫺
3 transporters in brain
VI. Modulation of Intracellular pH by Neuronal Activity
A. Modulation of pHi in neurons
B. Modulation of pHi in glial cells
VII. Regulation and Modulation of Brain Extracellular pH
A. The pH of interstitial fluid
B. Changes in interstitial pH caused by neural activity
VIII. Effects of Activity-Dependent pH Shifts on Neural Function
A. Modulation of function by extracellular alkaline shifts
B. Modulation of function by activity-dependent acid shifts
IX. Conclusion
Chesler, Mitchell. Regulation and Modulation of pH in the Brain. Physiol Rev 83: 1183–1221, 2003; 10.1152/
physrev.00010.2003.—The regulation of pH is a vital homeostatic function shared by all tissues. Mechanisms that govern
H⫹ in the intracellular and extracellular fluid are especially important in the brain, because electrical activity can elicit
rapid pH changes in both compartments. These acid-base transients may in turn influence neural activity by affecting a
variety of ion channels. The mechanisms responsible for the regulation of intracellular pH in brain are similar to those of
⫺
⫹
other tissues and are comprised principally of forms of Na⫹/H⫹ exchange, Na⫹-driven Cl⫺/HCO⫺
3 exchange, Na -HCO3
⫺
⫺
cotransport, and passive Cl /HCO3 exchange. Differences in the expression or efficacy of these mechanisms have been
noted among the functionally and morphologically diverse neurons and glial cells that have been studied. Molecular
identification of transporter isoforms has revealed heterogeneity among brain regions and cell types. Neural activity gives
rise to an assortment of extracellular and intracellular pH shifts that originate from a variety of mechanisms. Intracellular
pH shifts in neurons and glia have been linked to Ca2⫹ transport, activation of acid extrusion systems, and the
accumulation of metabolic products. Extracellular pH shifts can occur within milliseconds of neural activity, arise from
an assortment of mechanisms, and are governed by the activity of extracellular carbonic anhydrase. The functional
significance of these compartmental, activity-dependent pH shifts is discussed.
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0031-9333/03 $15.00 Copyright © 2003 the American Physiological Society
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MITCHELL CHESLER
I. INTRODUCTION
II. BUFFERING POWER
The study of pH regulation requires the establishment of fundamental concepts of pH buffering and a
Physiol Rev • VOL
␤⫽⫺
dA
dpH
(1)
or
␤⫽
dB
dpH
(2)
where A and B are the concentrations of strong acid or
base, respectively. Accordingly, the buffering power (or
buffering capacity) has units of concentration.
If one could analyze cytosol in the absence of organellar or metabolic influences, the buffering capacity
would be determined by the summed contributions of the
separate buffer species. In physiological studies, it is convenient to divide the total intracellular buffering capacity
into the bicarbonate-dependent component and the nonbicarbonate or “intrinsic” buffering capacity, given the
symbols ␤b and ␤i, respectively. The total intracellular
buffering capacity (␤T) is simply the sum of ␤b and ␤i.
The contribution to buffering provided by the CO2HCO⫺
3 equilibria (␤b) can be approximated as
␤b ⫽ 2.3 ⫻ [HCO3⫺]i
(3)
⫺
where [HCO⫺
3 ]i is the intracellular HCO3 concentration.
The derivation of this formula assumes that cytosolic CO2
is constant, due to its equilibration with extracellular CO2,
which serves as a fixed, infinite source. Such a system is
said to be “open” with respect to CO2. If one knows the
system PCO2 and the intracellular pH (pHi), then [HCO⫺
3 ]i
and ␤b can be calculated from rearrangement of the Henderson-Hasselbalch equation as
␤b ⫽ 2.3[HCO3⫺] ⫽
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2.3 ⫻ S ⫻ PCO2
⫻ 10pH
K
10P
a
(4)
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The importance of pH regulation to the viability of cells
is widely recognized. The production of intracellular acid is
a normal consequence of respiration and, if unchecked, can
lead to a marked fall in intracellular pH, compromising vital
functions. In this broad respect, the cells of the central
nervous system (CNS) do not differ from those found in
other tissues. Indeed, many of the mechanisms responsible
for long-term “housekeeping” of hydrogen ions are similar.
The cellular diversity of the CNS is unique, however,
and significant differences can be found in the complement of acid transport mechanisms expressed among
subtypes of neurons and glial cells. This has been made
apparent by physiological experiments on particular cells
and by molecular studies that have revealed regional diversity in the expression of transporter subtypes.
The study of pH in the CNS is also distinguished by
the occurrence of rapid increases or decreases in H⫹ that
arise from electrical activity. These changes take place in
time frames from milliseconds to minutes, involve neurons as well as glia, and occur in both the intracellular and
extracellular compartments. Given numerous enzymes
and ion channels that can be influenced by pH, a possible
modulatory role of these pH transients has often been
considered, particularly in relation to membrane potential
and excitability. In this respect, the mechanisms that
generate and regulate these pH changes are of considerable neurobiological interest.
The regulation of brain pH, the generation of activitydependent pH changes, and their functional consequences have been the subject of earlier reviews (76, 80,
94). A comprehensive treatment of pH and brain function
has also appeared in an excellent volume edited by Kaila
and Ransom (152). The present contribution aims to provide an accessible, updated summary of this field and is
consequently more circumscribed. To maintain reasonable limits, certain subjects have not received full coverage. Historical aspects and methodological issues have
been described elsewhere (76, 149). The effect of pH on
numerous enzymes and channels is an extensive subject
that is also beyond the scope of this summary. With the
exception of particularly notable studies, the reader is
directed to various reviews of this topic (22, 211, 288, 298,
307, 319). Important pioneering work on pH regulation in
the nervous system of invertebrates has been covered by
several earlier contributions (76, 94, 259, 303). This review
emphasizes pH studies in the mammalian CNS and ventures into invertebrate studies only when they are particularly relevant to the topic at hand.
consistent nomenclature. The definition and measurement of pH, the mechanisms of extracellular and intracellular buffering, and the chemical equilibria involved have
been the subject of previous comprehensive reviews (55,
76, 259, 303). The purpose of this section is to highlight
the basic concepts of buffering power relevant to physiological studies of pH, before addressing the means of
intracellular and extracellular pH regulation in the nervous system.
The buffering power of aqueous solutions can be
defined in a number of ways (157, 259). The most extensively used definition comes from the early work of Koppel and Spiro (172) and Van Slyke (323), where buffering
power (␤) is conceptualized as the concentration of
added strong acid (or base) divided by the resulting
change in pH. Thus
pH REGULATION IN THE BRAIN
J ⫽ ␤T ⫻
dpHi
dt
(5)
where J may be expressed as mM H⫹ extruded per unit
time. A common mistake in studies of pH regulation is to
compare values of dpHi/dt instead of calculating J from
Physiol Rev • VOL
Equation 5. For example, if the rate of pHi recovery from
an acid load were the same in the presence and absence
⫺
of CO2-HCO⫺
3 , one could not assert that HCO3 -dependent
acid extrusion played no role. On the contrary, since ␤T is
greater in the CO2-HCO⫺
3 -buffered media, one should conclude that the acid efflux rate (J) had increased and that
HCO⫺
3 -dependent acid extrusion was indeed present. In
such studies, comparisons of J are best performed at the
same baseline pHi, since ␤b rises, and ␤i typically falls
with elevation of pHi.
III. REGULATION OF INTRACELLULAR pH
IN VERTEBRATE NEURONS
The plasma membrane transport systems responsible
for neuronal pHi regulation were first investigated in large
invertebrate cells. The modern period of this work was
initiated by Roos, Boron, and Thomas, who have reviewed
their classic studies (259, 303). The essential features of
acid transport systems described in invertebrate neurons
can also be found in vertebrate nerve cells. In the first
investigation of a vertebrate neuron, the giant reticulospinal cells of the lamprey were found to eliminate acid loads
by an amiloride-sensitive Na⫹/H⫹ exchanger and an Na⫹-,
⫺
HCO⫺
3 -, and Cl -dependent acid extruder (75, 83). In subsequent studies of mammalian neurons, Na⫹/H⫹ exchange and Na⫹-dependent bicarbonate transport were
frequently noted. In addition, some nerve cells were found
to express a passive Cl⫺/HCO⫺
3 exchanger, which served
as an acid-loading mechanism during recovery from cytosolic alkalization. Significant differences in the function,
expression, and pharmacological sensitivity of these
transporters have been noted in the investigation of mammalian neurons. Details of these studies are provided
below and are summarized in Tables 1 and 2.
A. Neurons From Hippocampus
Neurons derived from the hippocampus have been
the subject of the most extensive studies of intracellular
pH (pHi) regulation in the mammalian nervous system.
Cultured, fetal, rat hippocampal neurons were investigated by Raley-Susman et al. (250). A key finding was the
presence of an Na⫹/H⫹ exchanger insensitive to amiloride
and its derivatives. This transporter was the principal
mechanism for maintenance of resting pHi and for recovery from acid loads. Evidence for Na⫹/H⫹ exchange in
these cells was based on the ion dependence of pHi
regulation in HCO⫺
3 -free media. Thus an acidification was
noted upon removal of external Na⫹, and acid extrusion
was blocked in the absence of Na⫹, but could be supported by Li⫹. In HCO⫺
3 -containing solutions, pHi recovery from acid loads was slightly inhibited by the stilbene
derivative DIDS and was Na⫹ dependent, suggesting that
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where PCO2 is expressed in Torr and S is the solubility
coefficient of CO2 in mM/torr. It should be noted that the
value of ␤b increases steeply as pHi rises, being 2.5-fold
greater at pHi 7.4 versus 7.0.
In one study of cultured mammalian neurons, intracellular HCO⫺
3 , while present in significant concentration,
was found to contribute little to ␤T (7). The basis of this
observation was not clear. Faced with a rapid acid-base
challenge, the rate of CO2-HCO⫺
3 buffering would depend
on the presence of carbonic anhydrase (see sect. VIIB,
1–3). It is plausible that insufficient activity of this enzyme limited the contribution of ␤b under these circumstances.
The major components of ␤i are associated with the
buffering contribution of imidazole residues and phosphate (55). Determination of ␤i for a cell is not always
straightforward. To measure ␤i, one might apply a known
concentration of acid or base (in the absence of CO2 and
HCO⫺
3 ) and measure the resulting change in pHi. This
procedure, however, would rarely give an accurate value,
since the imposed pHi change would be countered by
plasma membrane acid transport in addition to cytosolic
chemical buffering. Acid or base challenges are therefore
typically made under conditions in which these transporters are inactive (e.g., under pharmacological blockade or
ion substitution) or are minimally active (e.g., using a
series of small base challenges). Under these conditions,
the ratio of the acid (or base) load to the ⌬pHi (Eq. 1 or
2) is then considered to be a measure of ␤i. Although
values of ␤i obtained with such methods are useful in
analyzing pH regulatory processes, they should be considered as no better than convenient operational measures, since they ignore the probable contributions of
metabolism and organellar transport to the cytosolic H⫹
balance. ␤i has been operationally determined in this way
for a number of neurons and glial cells and tends to falls
in a range from 5 to 30 mM (76, 159), but may be as high
as 40 –50 mM in cells of neonatal brain (256). The value of
␤i can vary with pHi and typically increases as pHi falls
(for examples, see Refs. 26, 35, 159).
Determination of the intracellular buffering capacity
becomes critical when analyzing acid-base transport
across the plasma membrane. The rate at which pHi is
changed by a transporter has quantitative relevance only
in view of the buffering capacity that opposes the pH
change. The molar rate of acid efflux from a cell (J) would
therefore be given by
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TABLE
MITCHELL CHESLER
1. Acid regulatory mechanisms identified in neurons of brain and spinal cord
Hippocampal
Rat cultured fetal
Acutely isolated
Rat neonatal
Rat neonatal/mature
Mouse neonatal
Cerebral cortical (fetal)
Rat cultured fetal
Na⫹-Driven HCO⫺
3
Cl⫺/HCO⫺
3 Exchange
⫹*
⫹*
⫹
⫹
⫺
⫹
⫹*
⫹*
⫹
⫹
H⫹ Pump
250, 251
20
⫹
⫹
⫹
Reference Nos.
⫹
273
24
251
358
⫹
⫹
⫹
⫺?
⫹
⫹
⫹
236
8
245
⫹
⫹
⫺
⫹
⫹
⫹
113
248
⫹
⫹
⫹
46
⫹
⫹
⫺
⫺
⫹
⫺
256, 257
256
⫹
⫺?
⫹
146, 216, 265, 268
⫺
Rows designate evidence for (⫹) or against (⫺) the presence of Na⫹/H⫹ exchange, Na⫹-driven HCO⫺
3 transport (both Cl -dependent and
⫹
-independent forms), Cl⫺/HCO⫺
exchange,
and
an
ATP-driven
H
pump.
VLM,
vasolateral
medulla;
IO,
inferior
olive;
HYP,
hypoglossal
nucleus; NTS,
3
nucleus tractus solitarius. *Insensitivity to amiloride or its derivatives.
a form of Na⫹-linked HCO⫺
3 influx also contributed to net
acid extrusion. Whether this mechanism was Cl⫺ dependent was not addressed.
Baseline pHi of the fetal hippocampal neurons was
not affected by removal of Cl⫺ or by application of DIDS,
indicating that the fetal cells did not utilize a passive
Cl⫺/HCO⫺
exchanger as an acid-loading mechanism
3
(250). This feature was confirmed in a later study of
acutely isolated, fetal hippocampal neurons (251). In contrast, acutely isolated adult hippocampal neurons exhibited a pronounced alkalization upon removal of external
Cl⫺. In situ hybridization studies targeting the brain isoform of the Cl⫺/HCO⫺
3 exchanger (see sect. VB3) were in
agreement with these findings. Although the message
could be identified in fetal brain (171, 251), there was a
greater predominance in mature tissue (251).
TABLE
Later studies of the acid extrusion mechanisms in
fetal hippocampal neurons were undertaken by Baxter
and Church (20). An Na⫹/H⫹ exchanger insensitive to
ethylisopropylamiloride (EIPA) was noted, consistent
with earlier data (250). However, in contrast to the previous studies, removal of Cl⫺ produced a DIDS-sensitive,
Na⫹-independent alkalization, suggesting the presence of
a passive Cl⫺/HCO⫺
3 exchanger in the fetal-derived neuronal culture. Transition from HCO⫺
3 -free (i.e., HEPESbuffered) to HCO⫺
3 -containing solution induced a robust
alkalization that was Na⫹ dependent and was blocked by
DIDS, or by depletion of internal Cl⫺. These observations
suggested that fetal hippocampal neurons can extrude
acid using both Na⫹/H⫹ exchange and an Na⫹-driven,
Cl⫺/HCO⫺
3 exchanger. The latter process appeared to play
a greater role in pHi regulation at room temperature. Thus
2. Acid regulatory mechanisms identified in neurons outside brain and spinal cord
Retina
Toad photoreceptors
Frog, salamander rods
Skate horizontal cells
Sympathetic neurons
Rat cultured
Neoplastic neurons
Neuroblastoma
Pheochromocytoma
Na⫹/H⫹ Exchange
Na⫹-Driven HCO⫺
3
Cl⫺/HCO⫺
3 Exchange
⫹
⫹
⫹
⫹
⫹
⫹
⫺
⫹
⫹?
⫹
⫹
⫹
H⫹ Pump
Reference Nos.
160, 231
155, 264
135
306
⫹
⫹
21, 212
100
100
⫺
Rows designate evidence for (⫹) or against (⫺) the presence of Na⫹/H⫹ exchange, Na⫹-driven HCO⫺
3 transport (both Cl -dependent and
⫹
-independent forms), Cl⫺/HCO⫺
exchange,
and
an
ATP-driven
H
pump.
3
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Mouse cultured fetal
Cerebellar (fetal)
Rat cultured Purkinje
Rat cultured granule
Spinal cord (embryonic)
Rat cultured ventral
Medullary (in slices)
VLM, IO, HYP
NTS
Synaptosomes
Na⫹/H⫹ Exchange
pH REGULATION IN THE BRAIN
Physiol Rev • VOL
with low sensitivity to amiloride distinguishes hippocampal neurons from the great majority of cells. The nature of
this amiloride resistance and its relationship to transporter isoforms remains unclear (see sect. VA). It is notable that acutely isolated CA1 neurons from mice displayed
an Na⫹/H⫹ exchanger inhibited by the agent HOE 694
(358). However, the Na⫹/H⫹ exchanger of cultured fetal
hippocampal neurons was insensitive to this drug (20).
B. Neurons From Cerebral Cortex
The regulation of pHi in cortical neurons has been
studied in cultured fetal cells obtained from rat (236) and
mouse (245). In cultured fetal rat neurons, recovery from
intracellular acid loads was partially inhibited by amiloride (or 5-N-methyl-N-isobutylamiloride) and was dependent on external Na⫹, indicating the operation of an
Na⫹/H⫹ exchanger (236) [inhibition of acid extrusion by
amiloride was also noted by Amos and Richards (8) in
cultures of rat neocortical neurons]. Ou-Yang et al. (236)
suggested the absence of HCO⫺
3 -dependent acid extrusion
in fetal neurons, based on the following: 1) the similarity
⫺
of acid extrusion rates in HCO⫺
3 -free and HCO3 -contain⫺
ing solutions, 2) the failure of DIDS or Cl removal to
inhibit recovery from acid loading, and 3) similar acid
extrusion rates in the presence of amiloride versus amiloride plus DIDS. In contrast, recovery from alkaline loads
was inhibited by DIDS and by the absence of Cl⫺, suggesting the presence of a passive Cl⫺/HCO⫺
3 exchanger.
The putative absence of HCO⫺
-dependent
acid extru3
sion in the cortical neurons studied by Ou-yang et al. (236)
warrants comment. Although calculated acid efflux rates
were similar in the presence and absence of HCO⫺
3 , analysis was highly dependent on accurate determination of
the ␤i. It should also be noted that the method of acid
loading in these studies was unorthodox, consisting of a
transition from 5 to 15% CO2 with compensatory increases
⫺
in solution HCO⫺
3 (and decrease in Cl ) to maintain a
constant bath pH. Given the presence of a Cl⫺/HCO⫺
3
⫺
exchanger in these cells, the changes in HCO⫺
3 and Cl
could have confounded interpretation of the pHi recoveries. This study also reported that addition of DIDS to
amiloride-containing solution did not further reduce acid
extrusion. How this experiment was carried out is uncertain, as a precipitate commonly forms when DIDS is
combined with amiloride or one of its derivatives (unpublished observation). It is worth noting that like hippocampal neurons (273), the steady-state pHi of the cultured
cortical cells was higher in HCO⫺
3 -containing media,
which would be consistent with the presence of a HCO⫺
3dependent acid extrusion mechanism.
In a later study of cultured fetal neurons from mouse
cortex, it was suggested that cells utilized both Na⫹/H⫹
exchange and an HCO⫺
3 -dependent acid extruder (245).
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transition from HEPES to HCO⫺
3 buffer induced an alkalization, or speeded recovery from acid loading, only at
18 –22°C, and application of DIDS caused a fall in pHi at
this low temperature, but not at 37°C. At the warmer,
physiological temperature, acid extrusion appeared to be
dominated by Na⫹/H⫹ exchange.
Noncultured hippocampal neurons were investigated
by Schwiening and Boron (273). These studies utilized a
specific population of pyramidal neurons, acutely isolated
from the hippocampal CA1 region of 4- to 14-day-old rats.
In the absence of HCO⫺
3 , the cells exhibited a low baseline
pHi (a mean of 6.81) and sluggish recovery from acid
loads. In agreement with previous studies of fetal, hippocampal neurons (250), this pHi recovery was inhibited
by removal of Na⫹ (suggesting the presence of Na⫹/H⫹
exchange) and showed little sensitivity to amiloride. Unlike fetal hippocampal cultures, where Na⫹/H⫹ exchange
was predominant (20), this mechanism played a minor
role in acutely dissociated pyramidal neurons (in both the
establishment of baseline pHi and the extrusion of acid at
37°C). With addition of external HCO⫺
3 , a marked increase
in baseline pHi occurred. This HCO⫺
3 -dependent acid extrusion required external Na⫹ as well as internal Cl⫺ and
was sensitive to DIDS, indicating the operation of an
Na⫹-driven Cl⫺/HCO⫺
3 exchanger. It was notable that the
demonstration of Cl⫺ dependence could not be achieved
by incubation in Cl⫺-free media for up to 3 h. To adequately deplete intracellular Cl⫺, repeated activation of
the transporter in Cl⫺-free solution was required. These
observations urge caution in the interpretation of experiments in which exposure to Cl⫺-free solution fails to
alter pHi regulation.
A study of pHi regulation in both postnatal immature
and mature CA1 neurons from rat was undertaken by
Bevensee et al. (24). The basic properties of pHi regulation were similar in the two age groups and featured an
EIPA-insensitive Na⫹/H⫹ exchanger and a robust stimu⫹
lation of acid extrusion by HCO⫺
3 , attributed to Na ⫺
⫺
driven Cl /HCO3 exchange. A fraction of neurons exhibited a slow recovery from acid loads in the absence of
external Na⫹, suggesting the presence of an H⫹ pump.
Similar Na⫹-independent pHi recovery was later noted in
CA1 neurons acutely isolated from mouse (358). The principal difference between immature and mature CA1 neurons was related to the distribution of baseline pHi.
Acutely dissociated neurons derived from both age
groups were found to have a wide range of initial pHi
values (6.3–7.7) in HCO⫺
3 -free, HEPES-buffered media.
Mature neurons displayed a bimodal distribution, falling
into low pHi (mean of 6.68) and high pHi (mean of 7.32)
categories. For high pHi neurons, the relationship between pHi and the acid extrusion rate was shifted in the
alkaline direction and had a greater slope, both in the
absence and presence of HCO⫺
3.
The presence of a predominant Na⫹/H⫹ exchanger
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MITCHELL CHESLER
C. Neurons From Cerebellum
Two studies of nerve cells cultured from rat cerebellum have been performed. Gaillard and Dupont (113)
investigated Purkinje cells from neonatal (P0 –P1) rats
after 6 –7 days in culture. In HCO⫺
3 -free media, recovery
from acid loading was abolished by withdrawal of external Na⫹ or by exposure to amiloride, indicating the operation of an Na⫹/H⫹ exchanger. In media containing
HCO⫺
3 , recovery from acid loading was also completely
blocked by amiloride, which suggested the absence of
HCO⫺
3 -dependent acid extrusion. The presence of passive
Cl⫺/HCO⫺
3 exchange was indicated by the presence of a
DIDS-sensitive, Na⫹-independent alkalization upon removal of external Cl⫺. The steady-state pHi of these cells
was consistent with this complement of transporters. Unlike hippocampal (273) and cortical neurons (236), the
steady-state pHi of the cultured Purkinje cells was lower
⫺
in HCO⫺
3 -containing (7.06) versus HCO3 -free media
(7.40). This finding is consistent with steady-state acid
loading via Cl⫺/HCO⫺
3 exchange and the absence of
HCO⫺
-dependent
acid
extrusion.
3
Studies of rat cerebellar granule cells (cultured from
7-day-old pups) revealed a similar behavior of steadystate pHi (248). In HCO⫺
3 -containing solution, pHi was
lower (7.27) compared with HCO⫺
3 -free media (7.49). Although completely dependent on external Na⫹, the recovery of pHi from acid loads was only partially blocked by
amiloride. In roughly half the cells, this recovery exhibited a dependence on HCO⫺
3 (but was not blocked by
stilbenes). Recovery from acid loading persisted after
prolonged exposure to Cl⫺-free media, suggesting the
possible operation of Na⫹-HCO⫺
3 cotransport in these
cells. However, as noted by Schwiening and Boron (273),
Physiol Rev • VOL
internal Cl⫺ is not readily depleted from neurons and may
require repetitive acid loading in Cl⫺-free solution to be
sufficiently eliminated from the cytoplasm. The presence
of a passive Cl⫺/HCO⫺
3 exchanger in a fraction of the
granule cells was suggested by the observation of a reversible alkalization upon withdrawal of external Cl⫺
(however, this effect was not blocked by stilbenes). The
lower steady-state pHi noted in HCO⫺
3 media was consistent with the presence of a Cl⫺/HCO⫺
3 exchanger that
contributed to steady-state acid loading.
D. Neurons From Spinal Cord
Recently, pHi regulation was studied in neurons cultured from ventral spinal cord of 14- to 15-day rat embryos
(46). In HCO⫺
3 -free media, acid extrusion was mediated by
amiloride-sensitive Na⫹/H⫹ exchange. In the presence of
HCO⫺
3 , recovery from acid loading was also significantly
slowed by 1 mM amiloride (but was not blocked by 40 ␮M
EIPA). Steady-state pHi was reduced by DIDS, suggesting
that a HCO⫺
3 -dependent acid extruder contributed to the
maintenance of baseline pHi. Recovery from acid loads in
HCO⫺
3 -containing media was slowed by DIDS and abolished in Na⫹-free solutions. It was suggested that this
recovery was mediated by an electrogenic Na⫹-HCO⫺
3
cotransporter, since a reversible alkalization was observed when external K⫹ was raised to 30 mM. Whether
this alkalization was dependent on Na⫹ or HCO⫺
3 or could
be evoked by other means of depolarization was not
addressed, however. Thus experiments to more fully distinguish between Na⫹-driven Cl⫺/HCO⫺
3 exchange and
electrogenic Na⫹-HCO⫺
cotransport
appear
warranted.
3
Removal of external Cl⫺ was found to elicit a reversible
alkaline shift in the spinal cord neurons, suggesting the
operation of a passive Cl⫺/HCO⫺
3 exchanger. Baseline pHi
was lower in HCO⫺
-containing
media compared with
3
HCO⫺
-free,
HEPES-buffered
solution,
consistent with
3
steady-state acid loading via this mechanism.
E. Medullary Neurons
The neurons of the medulla oblongata are heterogeneous in form and function. Of particular interest in this
region are the cells of the chemosensitive areas, which
depolarize and fire in response to elevation of CO2 or H⫹.
The degree to which this response is triggered by a fall in
pHi, a fall in extracellular pH (pHo), or elevation of CO2
per se has been the subject of debate (218). Several recent
studies have suggested that a fall in pHi is the principal
trigger for the chemosensitive response (110a, 342, 348).
For such cells, therefore, the control of pHi is a subject of
great interest. The regulation of pHi in chemosensitive
neurons has recently been reviewed (249).
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After acid loading with the NH⫹
4 prepulse method (38) in
HCO⫺
-containing
media,
the
pH
3
i recovery was markedly
reduced by EIPA, indicating the operation of an Na⫹/H⫹
exchanger. The rates of pHi recovery in the presence and
absence of HCO⫺
3 (and during exposure to DIDS) were
consistent with a HCO⫺
3 -dependent component of acid
efflux. However, the dpHi/dt values were not converted to
acid extrusion rates (Eq. 5), and therefore the relative
contribution of Na⫹/H⫹ exchange versus HCO⫺
3 -dependent processes remained unclear. The authors suggested
that recovery from alkaline loads occurred by a DIDSinsensitive Cl⫺/HCO⫺
3 exchanger. In addition, a passive
H⫹ influx through voltage-gated H⫹ channels was proposed, since exposure to 1 mM Zn2⫹ slowed the recovery
from alkaline loads. Such channels, however, would not
be open near the resting membrane potential, as they
typically activate near 0 mV. Moreover, there is no compelling evidence for their presence in vertebrate neurons
(92).
pH REGULATION IN THE BRAIN
F. Retinal Neurons and Photoreceptors
Early evidence for acid extrusion via Na⫹/H⫹ exchange was provided by Oakley and colleagues (160, 231)
in studies of rod photoreceptors from toad. A characterization of pHi regulatory mechanisms was later carried
out in rods from frog (155) and salamander retina (264).
Both amphibian rods utilized an amiloride-sensitive
Na⫹/H⫹ exchanger. In addition, Na⫹-dependent acid extrusion was accelerated by HCO⫺
3 and inhibited by DIDS,
suggesting the presence of an Na⫹-driven HCO⫺
3 transporter. Whether this mechanism was linked to Cl⫺ was
not clear. Evidence for passive Cl⫺/HCO⫺
3 exchange was
found in both frog and salamander rods, as the withdrawal of Cl⫺ produced a rise in pHi, which persisted in
the absence of external Na⫹ in the case of frog rods (155).
A study of retinal horizontal neurons from the skate also
demonstrated the presence of amiloride-sensitive Na⫹/H⫹
exchange, and apparent HCO⫺
3 -dependent acid extrusion,
based on the inhibition of acid extrusion by DIDS (135).
Physiol Rev • VOL
Removal of external Cl⫺ had no effect on pHi in the
horizontal cells, suggesting that these neurons did not
possess a passive Cl⫺/HCO⫺
3 exchanger.
G. Sympathetic Neurons
One of the first studies of pHi regulation in mammalian nerve cells utilized cultured rat sympathetic neurons
(306). Acid extrusion was dependent on external Na⫹ and
was inhibited by amiloride, providing clear evidence for
Na⫹/H⫹ exchange. The role of HCO⫺
3 -dependent acid extrusion in these cultured neurons was less certain. While
addition of stilbenes did not affect recovery from acid
loads, in some cases, pHi recovery was stimulated by
addition of 5–10 mM HCO⫺
3.
H. Neoplastic Neural Cells
Neuroblastoma cells were among the first neural
preparations in which Na⫹/H⫹ exchange was identified
(21, 212). Acid extrusion via Na⫹/H⫹ exchange was subsequently reported in other studies of neural tumor cells
(111, 204). Dickens et al. (100), studying neuroblastoma
and pheochromocytoma (PC12) cells, noted the presence
of Na⫹/H⫹ as well as Cl⫺/HCO⫺
3 exchange. This paper
also reported regional heterogeneity of pHi, as the tips of
extending neurites were more alkaline (by 0.2– 0.3 pH
units) than the cell body.
I. Synaptosomes
There is wide consensus that acid extrusion from
brain synaptosomes is mediated by amiloride-sensitive
Na⫹/H⫹ exchange (146, 216, 265, 268). It has been reported that there is no HCO⫺
3 -dependent acid extrusion in
synaptosomes (216, 265). This finding was based on similar rates of recovery from acidosis in the presence and
absence of HCO⫺
3 and lack of sensitivity to stilbene derivatives. However, an identical dpH/dt in the presence of
HCO⫺
3 would imply a greater rate of acid efflux, since
intracellular buffering capacity should be elevated in the
presence of CO2 and HCO⫺
3 . Therefore, the possibility of
HCO⫺
-dependent
acid
extrusion
in these preparations
3
cannot be excluded. A rise in pHi was noted in synaptosomes exposed to elevated external K⫹ (265) [although in
an earlier study (254), elevated external K⫹ did not produce a similar rise in pHi]. This apparent depolarizationinduced alkalization (DIA) persisted in the absence of
⫹
HCO⫺
3 and Na , suggesting that it was not attributable to
electrogenic Na⫹-HCO⫺
3 cotransport. The cause of the
DIA was not elucidated.
Synaptosomal acid transport linked to a Cl⫺ flux was
suggested by one study in which withdrawal of external
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Putnam and colleagues (256 –258) imaged pHi from
neurons of rat neonatal, medullary brain slices which had
been incubated in BCECF. Neurons from two chemosensitive areas, nucleus of the solitary tract (NTS) and ventrolateral medulla (VLM), were compared with cells from
the nonchemosensitive inferior olive (IO) and hypoglossal
nucleus (HYP). In all cells, recovery from acid loading
was completely abolished by amiloride but was insensitive to DIDS, suggesting that brain stem neurons utilize
Na⫹/H⫹ exchange but not HCO⫺
3 -dependent acid extrusion (257). In chemosensitive neurons, elevation of CO2
induced a fall in pHi that recovered only when bath pH
was maintained at 7.48 (by simultaneous elevation of
external HCO⫺
3 to 52 mM). In contrast, neurons from
nonchemosensitive areas recovered when CO2 was elevated, despite a fall in bath pH to 7.15 (at constant bath
HCO⫺
3 of 26 mM). This difference was attributed to an
Na⫹/H⫹ exchange mechanism in the chemosensitive neurons that was more readily inhibited by external H⫹ (256).
Immunocytochemical and pharmacological data from
chemosensitive neurons in organotypic culture have implicated the type 3 Na⫹/H⫹ exchanger isoform in these
cells (348) (i.e., NHE-3; see sect. VA).
The presence of Cl⫺/HCO⫺
3 exchange was suggested
in VLM, HYP, and IO neurons, as a DIDS-sensitive alkalization was noted upon withdrawal of external Cl⫺. This
exchanger could mediate recovery from alkaline loads in
neurons from all three of these regions; however, the
Cl⫺/HCO⫺
3 exchanger in VLM cells was inhibited by high
bath pH (7.9), unlike the nonchemosensitive cells. In contrast, there was no apparent Cl⫺/HCO⫺
3 exchanger in the
chemosensitive NTS neurons, which accordingly, could
not recover from alkaline loading (256).
1189
1190
MITCHELL CHESLER
Cl⫺ caused a DIDS-sensitive rise in pHi. This alkalization,
however, was not dependent on HCO⫺
3 , suggesting the
presence of a Cl⫺-H⫹ cotransport mechanism (195). A
similar putative Cl⫺-H⫹ cotransporter (or equivalently, a
Cl⫺/OH⫺ exchanger) has been noted in cardiac myocytes
(183).
these cells (294). Evidence for Na⫹/H⫹ exchange (11) and
electrogenic Na⫹-HCO⫺
3 cotransport (12) was also reported for glial cells of the mudpuppy optic nerve. This
work is well covered by the review of Deitmer and Rose
(94).
B. pH Regulation in Mammalian Astrocytes
IV. REGULATION OF INTRACELLULAR pH
IN GLIAL CELLS
1. Principal acid extrusion mechanisms
in mammalian astrocytes
A. pH Regulation in Nonmammalian Glial Cells
The first detailed investigations of glial pHi were
conducted on invertebrate cells which could withstand
long-term penetration with pH-sensitive microelectrodes.
Pioneering work on the giant glial cells of the leech
demonstrated the presence of at least three acid extrusion
mechanisms: an Na⫹/H⫹ exchanger, an Na⫹-driven Cl⫺/
⫹
⫺
HCO⫺
3 exchanger, and an electrogenic Na -HCO3 cotransporter (95, 96, 98, 293). Later work indicated the
additional presence of a passive Cl⫺/HCO⫺
3 exchanger in
TABLE
3. Acid regulatory mechanisms identified in glia
Glia
Amphibian glia
Na⫹/H⫹ exchange
Na⫹-HCO⫺
3 cotransport
Astrocytes
⫹
⫹
Na /H exchange
Na⫹-HCO⫺
3 cotransport
Na⫹-driven Cl⫺/HCO⫺
3 exchange
H⫹ pump
Cl⫺/HCO⫺
3 exchange
Oligodendroglia
Na⫹/H⫹ exchange
Na⫹-HCO⫺
3 cotransport
Cl⫺/HCO⫺
3 exchange
Schwann cells
Na⫹/H⫹ exchange
Cl⫺/HCO⫺
3 exchange
Glioma cells
Na⫹/H⫹ exchange
Na⫹-driven Cl⫺/HCO⫺
3 exchange
H⫹ pump
Reference Nos.
11
12, 221, 222, 224
26, 53, 87, 163, 166, 205, 247, 277
23, 26, 50, 53, 87, 128, 129, 167,
221–224, 232, 240, 277
203, 167, 277
239, 246, 353
53, 163, 203
41, 42, 162
41, 42, 162
41, 138
217, 267
217
111, 199, 277
277
246, 331
Evidence for particular transport mechanisms for a given cell type
is listed. See text for differences in expression that have been noted
within a cell category.
Physiol Rev • VOL
The presence of Na⫹/H⫹ exchange in mammalian
astrocytes is well established and uniformly supported.
Kimelberg and colleagues (163, 166) provided early evidence for Na⫹/H⫹ exchange in primary astrocyte cultures
based on detection of Na⫹-dependent extracellular pH
shifts. The use of amiloride or its derivatives to acidify
baseline pHi or inhibit pHi recovery from acid loads
served as the principal evidence for Na⫹/H⫹ exchange in
later astrocyte studies (26, 53, 87, 205, 247, 277). The
presence of an Na⫹/H⫹ exchanger in mammalian astrocytes has also been confirmed by immunocytochemical
studies which revealed the presence of the amiloridesensitive NHE-1 isoform of this transporter (247) (see
sect. VA).
In some studies, the amiloride analog EIPA appeared
ineffective against the astrocyte Na⫹/H⫹ exchanger (44)
or caused a paradoxical increase in pHi (45, 247). Bevensee et al. (26) reported that while amiloride and EIPA
could inhibit acid extrusion with similar efficacy at low
pHi, EIPA appeared less effective near baseline pHi. Moreover, a fall in pHi was consistently produced by amiloride
but not by EIPA. The basis of these observations remains
unclear.
Inhibition of Na⫹/H⫹ exchange by low external pH
was described by Aronson et al. (10) in their studies of the
renal transporter. A similar property was noted by Mellergard and Siesjo (205) who found that cultured astrocytes failed to extrude acid in bicarbonate-free media
when the external pH was ⬍6.9. This feature has significant implications for the role of astrocyte Na⫹/H⫹ exchange in normal versus pathological settings. While culture studies show a significant contribution of this transporter when astrocyte pHi approaches 6.0 (26), such a low
cytosolic pH would probably only arise in vivo under
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The pH regulatory mechanisms of glial cells are comprised of transport systems very similar to those found in
neurons. Physiological studies suggest that glia differ
from neurons and from one another in their expression of
Na⫹-linked bicarbonate transporters. Electrogenic Na⫹HCO⫺
3 cotransporters appear to be especially prevalent
among glial cells. Details elaborated below are summarized for glial cells according to cell type in Table 3.
Studies of intracellular pH in mammalian glia have
focused mainly on astrocytes. With a few exceptions,
these studies have made use of pH-sensitive fluorescent
dyes rather than pH microelectrodes. Almost all investigations have been performed on cultured astrocytes. Generally, the mechanisms of acid transport appear similar to
those found in the invertebrate glia; however, some notable differences exist among mammalian astrocyte studies.
1191
pH REGULATION IN THE BRAIN
exception of one study (203), its expression in mammalian astrocytes is agreed upon. Among glia, the presence
of this transporter was first reported in invertebrates,
where Na⫹-HCO⫺
3 -dependent, electrogenic acid extrusion
(13, 96), and a membrane potential-driven shifts in pHi
were described (98).
The first clue to the presence of this transporter in
mammalian astrocytes came from the observation of a
depolarization-induced alkalization (DIA) in rat cortical
astrocytes studied in vivo. During stimulation of surrounding cortex, a rapid rise in astrocyte pHi was correlated with a depolarization of the astrocyte membrane,
attributed to elevation of extracellular K⫹ concentration
([K⫹]o) (81). Addition of Ba2⫹ prevented both the activityevoked depolarization (17) and the cytosolic alkalization,
despite a similar evoked rise in [K⫹]o (82).
Data consistent with electrogenic Na⫹-HCO⫺
3 cotransport was subsequently reported in cultured astrocytes (23, 50, 53, 232, 277), reactive astrocytes in gliotic
brain slices (128, 129), and acutely isolated astrocytes
from retina (221, 223, 224). This body of evidence is
formed by two related observations. The first is the occurrence of a hyperpolarization (or an outward current)
upon transition from bicarbonate-free to bicarbonate-containing media, which may be inhibited by DIDS or related
stilbene derivatives (53, 221, 224, 232). A potential difficulty with this criterion is that the presence of a bicarbonate conductance could give rise to a similar shift in
membrane potential (or membrane current under voltage
clamp). In a novel, alternative approach, Bevensee et al.
(23) withdrew external sodium to reverse the transporter
and demonstrated a stilbene-inhibited depolarization.
The second observation favoring electrogenic Na⫹HCO⫺
3 cotransport has been the presence of a DIA in
astrocytes. This rise in pHi is typically Na⫹ and HCO⫺
3
dependent and is often blocked by stilbenes (50, 129, 222,
223, 240). In gliotic brain slices, however, an Na⫹-independent component of the DIA and an insensitivity to
stilbenes were noted in reactive astrocytes (129).
The dependence of the transport direction upon voltage is governed by the difference between membrane
potential and the equilibrium potential for a Na⫹-HCO⫺
3
cotransporter (ENBC). The general relation for ENBC is
given by
E NBC ⫽
2. The astrocyte Na⫹-HCO3⫺ cotransporter
The Na⫹-HCO⫺
3 cotransporter of astrocytes has received considerable attention due to its electrogenic character and the resulting dependence on membrane potential. A form of this transport mechanism was first described in renal proximal tubule (37), and with the
Physiol Rev • VOL
关Na⫹兴o关HCO3⫺兴on
⫺ RT
ln
F共n ⫺ 1兲
关Na⫹兴i关HCO3⫺兴ni
(6)
⫹
where n is the net HCO⫺
3 -Na transport ratio (37, 96). The
preponderance of evidence suggests that the astrocyte
mechanism has a stoichiometry of 2:1 (23, 50, 232) and
that the net change in transport elicited by membrane
depolarization is an influx of Na⫹ and HCO⫺
3.
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ischemic conditions, where it would be accompanied by a
prominent fall in pHo, in the range of 6.2– 6.9 (174 –176,
215, 220, 332). Given the inhibition of this transporter by
external H⫹, it seems that the astrocyte Na⫹/H⫹ exchanger would never operate within the pHi range that
caused its maximum activation in tissue culture. In fact,
under conditions which simulated the external ion shifts,
acidosis and hypoxia of ischemic brain, the pHi of cultured astrocytes fell to 6.7– 6.8 and exhibited little or no
recovery of pHi over a 20- to 30-min period (28).
Virtually all studies agree on the presence of Na⫹and HCO⫺
3 -linked acid transport in astrocytes. Differences
exist regarding the role of Na⫹-driven Cl⫺/HCO⫺
3 exchange and electrogenic Na⫹-HCO⫺
cotransport.
Using
3
mouse cortical astrocytes, Chow et al. (87) reported that
recovery from acid loads was not Cl⫺ dependent, and
therefore suggested that a form of Na⫹-HCO⫺
3 cotransport
was involved. In contrast, Mellergard et al. (203) noted
diminished acid extrusion after withdrawal of Cl⫺ and
suggested that their cultured rat cortical astrocytes uti⫹
⫺
lized Na⫹-driven Cl⫺/HCO⫺
3 exchange, but not Na -HCO3
cotransport. Curiously, they reported a DIA, a phenomenon typically associated with an electrogenic Na⫹-HCO⫺
3
cotransporter (see below). Shrode and Putnam (277) provided strong support for both Na⫹-driven Cl⫺/HCO⫺
3 exchange and electrogenic Na⫹-HCO⫺
cotransport
in
their
3
cultured rat cortical astrocytes. A later study of cultured
cerebellar astrocytes also found evidence for both exchangers (167). A detailed examination of pHi regulation
in cultured rat hippocampal astrocytes was conducted by
Bevensee et al. (23, 26). Using a fluorescent Cl⫺-sensitive
dye to confirm the depletion of cytosolic Cl⫺, these authors were able to convincingly demonstrate that HCO⫺
3linked acid extrusion did not depend upon Cl⫺ and, accordingly, was attributed to Na⫹-HCO⫺
3 cotransport.
Differences in the identification of acid extrusion
mechanisms among astrocytes could be attributed to a
number of factors. Discrepancies may arise due to use of
low Cl⫺ media to test for Cl⫺-dependent transport. Unless
depletion of internal Cl⫺ can be assured, failure to inhibit
acid transport after Cl⫺ removal cannot be considered
convincing (whereas inhibition of transport after Cl⫺
withdrawal clearly supports Cl⫺ dependence) (277). Differences in data may also originate from altered expression of transporters, arising from varied culture conditions, species of origin (e.g., mouse vs. rat) or brain region
(e.g., cortex, vs. cerebellum vs. hippocampus).
1192
MITCHELL CHESLER
3. Na⫹-independent acid extrusion in astrocytes
While the ability of astrocytes to extrude acid loads
appears to be mainly due to a combination of Na⫹/H⫹
exchange and Na⫹-linked HCO⫺
3 transport, reports of
Physiol Rev • VOL
Na⫹-independent transport have appeared. Recording
with pH microelectrodes from cultured mouse astrocytes
in HCO⫺
3 -free media, Walz (353) noted a recovery from
acute acid loads that was unaffected by either amiloride
or withdrawal of external Na⫹. This result stands in
marked contrast to a large body of evidence indicating
that amiloride-sensitive Na⫹/H⫹ exchange is the principal
acid extrusion mechanism of astrocytes in the absence of
HCO⫺
3 (see above). However, it may be noted that penetration of the mouse astrocytes with microelectrodes was
made possible after rounding the cells by several hours of
exposure to 1 mM dibutyryl cAMP (339). In response to
this treatment, it is plausible that changes in transporter
expression occurred. Downregulation of the Na⫹/H⫹
exchanger and the expression of a plasmalemmal H⫹ATPase could account for these results.
Pappas and Ransom (239) were able to uncover a
plasmalemmal vacuolar H⫹-ATPase in cultured rat hippocampal astrocytes that made a small contribution to
acid extrusion. This transporter was identified in HCO⫺
3free media by a small, bafilomycin-sensitive component of
acid extrusion that remained in the absence of external
Na⫹ or the presence of amiloride. In agreement with these
findings, V-type ATPase mRNA has been isolated from
cultured astrocytes (246). However, in view of the small
component of acid extrusion attributed to this mechanism, its normal function is unclear. In the hippocampal
astrocyte study, addition of bafilomycin caused a small
intracellular acidification, suggesting a role in the maintenance of steady-state pHi (239). In cultured cortical
astrocytes, however, the H⫹-ATPase inhibitors bafilomycin and concanamycin did not affect baseline pHi (5).
4. Cl⫺/HCO3⫺ exchange in astrocytes
The presence of a Cl⫺/HCO⫺
3 exchanger in astrocytes
was suggested in early studies of astrocyte Cl⫺ fluxes by
Kimelberg et al. (163). In most subsequent reports, the
expression of this transporter was noted by the observation of a cytosolic alkalization upon removal of external
Cl⫺. This alkalosis was reported in cerebellar (53) and
cortical astrocytes (203), where it was inhibited by DIDS.
In contrast, in hippocampal astrocytes, withdrawal of Cl⫺
did not alter pHi notably, and it was suggested that this
transporter was not prominent in these cells (23). Shrode
and Putnam (277) cautioned that alkalization upon withdrawal of external Cl⫺ could be mediated by reversal of a
Na⫹-coupled Cl⫺/HCO⫺
3 exchanger. To convincingly demonstrate the presence of passive Cl⫺/HCO⫺
3 exchange in
cortical astrocytes, these investigators showed that removal of external Cl⫺ produced a DIDS-sensitive intracellular alkalization that persisted in the absence of Na⫹.
This process appeared to be active only at an elevated
baseline pHi, suggesting a role in the recovery from alkaline loads.
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For most astrocytes, values of ENBC would be on the
order of ⫺80 mV (76), and given a membrane potential of
similar magnitude, the transporter would normally be
close to equilibrium. Some astrocytes have membrane
potentials of ⫺50 mV or less, however (32, 287). For these
cells, the energetics of transport may favor a large, steadystate influx of Na⫹ and HCO⫺
3 (provided ENBC was maintained at a more negative value). However, little is known
about how ENBC or transporter stoichiometry varies
among astrocyte subtypes.
A notable exception comes from the work of Newman (221, 222, 224) who investigated Na⫹-HCO⫺
3 transport in acutely dissociated Muller cells of the salamander
retina. These specialized glia are sometimes considered to
be astrocyte variants due to their expression of glial fibrillary acidic protein (27). Muller cells were found to have a
transporter with a reversal potential near 0 mV, consistent
with a stoichiometry of one Na⫹ per three HCO⫺
3 . As such,
the energetics would favor the efflux of these ions at
normal negative membrane potentials. Physiological studies found the transporter predominantly localized to the
distal end foot process which normally abuts the vitreous
humor. This led to the suggestion that the transporter is
specialized to shuttle metabolically produced CO2/HCO⫺
3
out of the retina (221). In later studies, evidence for
Na⫹-HCO⫺
3 cotransport was also found in Muller cells and
astrocytes of rat retina (223).
Numerous questions about localization, function, and
role of astrocytic Na⫹-HCO⫺
3 cotransporters remain unsettled. One issue is whether a DIA can always be completely attributed to this mechanism, since this alkalizing
response, albeit diminished, can sometimes occur in
HCO⫺
3 -free media (42, 44, 50, 98, 204, 239). These observations might be explained by a mechanism with a high
affinity for HCO⫺
3 , capable of utilizing the small concentrations of this ion generated from metabolically derived
CO2 (97). Whether this carrier actually utilizes HCO⫺
3 or
CO2⫺
in
the
transport
mechanism
has
not
been
settled,
3
however (see sect. VIIB6).
From the functional standpoint, Na⫹-HCO⫺
3 cotransport appears capable of net acid extrusion in response to
cytosolic acidification, as well as the modulation of transmembrane pH, in response to changes in membrane potential. The latter property may be a normal and unique
feature of astrocytes, since neural activity rapidly depolarizes glial cells as a result of [K⫹]o elevation (132, 161,
234, 253, 284). The astrocyte Na⫹-HCO⫺
3 cotransporter
may therefore play a role in the modulation of both intracellular and interstitial pH (see sects. VIB and VIIB6).
pH REGULATION IN THE BRAIN
C. pH Regulation in Oligodendroglia
D. pH Regulation in Schwann Cells
Primary cultures of Schwann cells from rat sciatic
nerve were studied by Nakhoul et al. (217). In addition to
a classic, amiloride-sensitive Na⫹/H⫹ exchanger, these
Physiol Rev • VOL
cells exhibited a passive Cl⫺/HCO⫺
3 exchanger, revealed
by the presence of an Na⫹-independent alkalization upon
removal of external Cl⫺. The Cl⫺/HCO⫺
3 exchanger of the
Schwann cells was unaffected by DIDS. These experiments did not address whether an Na⫹-linked HCO⫺
3dependent acid extrusion mechanism was present.
A role for pHi in the proliferation of Schwann cells
was suggested in an early study in which mitogenic stimulation resulted in an apparent rise in pHi (267). This
alkaline shift was associated with the Na⫹/H⫹ exchanger.
Inhibition of Na⫹/H⫹ exchange after addition of a mitogen
significantly reduced the degree of subsequent mitosis.
E. pH Regulation in Glial Tumor Cells
The regulation of pHi was studied in C6 glioma cells
by Shrode and Putnam (277) in conjunction with their
investigation of rat cortical astrocytes. The glioma cells
shared two acid extrusion mechanisms with the astrocytes: a conventional, amiloride-sensitive Na⫹/H⫹ exchanger and a DIDS-sensitive, Na⫹-driven Cl⫺/HCO⫺
3 exchanger. Unlike the astrocytes, the glioma cells did not
have an electrogenic Na⫹-HCO⫺
3 cotransporter, as they
displayed no depolarization-induced alkalization upon elevation of external K⫹. A second study of C6 glioma cells
(utilizing NMR spectroscopy) also presented evidence for
Na⫹/H⫹ exchange and HCO⫺
3 transport (111). A comparison of pHi regulation in glioma cell lines (C6 and human
U-251, U-118, and U-87) versus primary cortical astrocyte
cultures (199) reported a higher steady-state pHi in the
gliomas (also noted by Shrode and Putnam for C6 cells)
(277) and a higher rate of recovery from acid loads. These
effects were attributed to enhanced activity of the
Na⫹/H⫹ exchanger in the glioma cell lines, which was not
attributed to genetic alterations. Disparity in the efficacy
or expression of the HCO⫺
3 -dependent acid transporters
was also noted, as the astrocytes rapidly alkalinized upon
introduction of CO2-HCO⫺
3 , whereas the glioma cells underwent a marked acidification.
A study by Volk et al. (331) provided evidence for a
vacuolar H⫹-ATPase in C6 glioma cells, based on a fall in
pHi observed after application of H⫹-ATPase inhibitors. A
voltage-clamp study of bafilomycin-sensitive currents
from C6 glioma cells provided additional data supporting the presence of an electrogenic plasmalemmal H⫹ATPase in these cells (246). In a comparison of vacuolar
ATPase mRNA in C6 cells, primary astrocyte cultures, and
immortalized astrocytes, no differences in levels were
noted (246). However, an equivalence in H⫹-ATPase message may not imply similar activity of the transporter in
glioma cells and astrocytes. Indeed, significant differences between these cells have been noted in this regard.
For example, in the study of Volk et al. (331), the pronounced fall in the steady-state pHi during application of
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A detailed study of pHi regulation in oligodendrocytes from mouse spinal cord was conducted by Kettenmann and Schlue (162). These cells displayed a high
baseline pHi, ranging from 7.2–7.9 in HCO⫺
3 -containing
media of pH 7.4. In the absence of HCO⫺
3 , pHi was lower,
and recovery from acid loading occurred via a typical
amiloride-sensitive Na⫹/H⫹ exchange mechanism. In
HCO⫺
3 -containing media, an additional acid extruder was
identified that was Na⫹ dependent and apparently not
linked to Cl⫺. The observation of a DIA (upon elevation of
[K⫹]o) suggested that this mechanism could be an electrogenic Na⫹-HCO⫺
3 cotransporter; however, this process
was unaffected by stilbenes or furosemide. The presence
of a Cl⫺/HCO⫺
3 exchanger in these oligodendrocytes was
uncertain. Removal of external Cl⫺ resulted in a higher
baseline pHi, consistent with passive Cl⫺/HCO⫺
3 exchange; however, the removal of HCO⫺
3 had no complementary effect on Cl⫺ transport (138).
Further studies of oligodendroglia were carried out
by Gaillard and colleagues (41, 42) using cultured cerebellar cells. In mature oligodendrocytes, baseline pHi was
7.04 in HCO⫺
3 -containing media (a value considerably
lower than that of cultured spinal oligodendrocytes) and
was unaffected by stilbenes or Cl⫺ removal, suggesting
the absence of a Cl⫺/HCO⫺
3 exchanger. In oligodendrocyte precursors, however, a DIDS-sensitive, passive Cl⫺/
HCO⫺
3 exchanger was identified. Steady-state acid loading
by Cl⫺/HCO⫺
3 exchange accounted for a lower baseline
pHi of the precursor cells, which averaged 6.88 (41). The
differences in pHi noted during oligodendrocyte development may be related to the events leading to termination
of cell division, as has been suggested for rat astrocytes
(241).
In HCO⫺
3 -free media, both mature cerebellar oligodendrocytes and precursor cells extruded acid via an
amiloride-sensitive Na⫹/H⫹ exchanger (41, 42). In the
⫹
⫺
presence of HCO⫺
3 , an electrogenic Na -HCO3 cotransporter was also identified. This transporter was unaffected by DIDS as was noted earlier for spinal cord oligodendrocytes (162). Analysis of the rate of alkalization
and the calculated HCO⫺
3 influx induced by graded elevations of external K⫹ suggested a reversal potential close
to ⫺60 mV, consistent with an Na⫹-HCO⫺
3 transport stoichiometry of 1:3 (42). Since the resting potential of these
cells was also near ⫺60 mV, it was suggested that this
transporter was normally close to equilibrium.
1193
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MITCHELL CHESLER
H⫹-ATPase inhibitors suggested a particularly prominent
role for this mechanism in C6 cells. In contrast, H⫹ATPase inhibitors had little or no effect on baseline pHi in
cultured astrocytes (5, 239).
F. pH Regulation and Volume Control in Glia
V. MOLECULAR IDENTIFICATION OF BRAIN
ACID TRANSPORTERS
Molecular correlates of several acid transport mechanisms have been identified in the mammalian CNS. Functional characterization in expression systems has served
to confirm the physiological identity of these transporters.
Localization of particular mRNAs and immunostaining of
specific proteins have provided insights into possible regional functions of these molecules. Details provided below are summarized in Table 4.
A. Naⴙ/Hⴙ Exchangers in Brain
The gene family of Na⫹/H⫹ exchangers identified in
vertebrate tissues consists of at least seven members,
TABLE
4. Localization of acid transport isoforms in brain
Exchangers/Cotransporters
Na⫹/H⫹ exchangers
NHE1
NHE2
NHE3
NHE4
NHE5
Cl⫺/HCO⫺
3 exchangers
AE3
Na⫹-HCO⫺
3 cotransporters
“NBC”
Na⫹-driven Cl⫺-HCO⫺
3 exchange
NDCBE1?
Localization
Reference Nos.
High in cortex, hippocampus, cerebellum
Cerebral cortex, brain stem
Cerebellum (Purkinje cells)
Hippocampus, cortex, brain stem-diencephalon
High in hippocampal dentate gyrus, low in CA1 fields and cerebral cortex
191, 235
105, 191
191
30
14
Widespread in CNS
171, 168, 251
Widespread in CNS with glial and neuronal subtypes (see text)
25, 105, 120, 270
Widespread in CNS
340
For differences in results and methodologies, and discussion of NHE-6, see text. CNS, central nervous system.
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The activation of acid transport mechanisms can lead
to a net transmembrane flux of osmoles, resulting in
changes in cell volume. Linkages between volume regulation of glial cells and the regulation of cytosolic pH can
therefore be anticipated. For example, activation of
Na⫹/H⫹ exchange can lead to glial swelling, owing to the
accumulation of Na⫹ (143a). In addition, the regulatory
response to changes in osmolarity involving taurine transport can have immediate, direct effects on pHi (234a). Due
to the role of glial swelling in clinical brain edema, this
subject has received considerable attention in literature
beyond the scope of the present review. For an overview
of this topic, the contribution of Kempski et al. (161a) may
be consulted.
commonly denoted NHE-1 through NHE-7. Deduced
amino acid sequences have indicated similarity in membrane-spanning domains and distinct putative regulatory
domains in the cytosolic regions (54, 226, 336). The first
member cloned was the human growth factor-activated
NHE-1 (266), an abundant isoform thought to play a
housekeeping role in maintenance of steady-state pHi.
NHE-1 mRNA is widespread in the mammalian CNS
(191, 235). Immunocytochemical analysis has also identified the protein in assays of whole tissue (105, 247) and
astrocyte cultures (247). Transcripts, localized by Northern analysis and in situ hybridization, revealed a marked
presence in hippocampus, periamygdaloid cortex, and
cerebellum (191). A general increase in message (191) and
protein (105) was noted in postnatal cortex. This observation may account for the lower resting pHi and the
slower recovery from acid loading reported in fetal versus
adult hippocampal neurons (24). However, NHE-1 is typically sensitive to amiloride (or its analogs) (226), a feature at odds with its predominance in hippocampus,
where neuronal Na⫹/H⫹ exchange has little or no sensitivity to these agents (250, 273). It is undetermined
whether this characteristic of CA1 pyramidal neurons is
due to cell-specific alterations of NHE-1 or the presence
of an alternative NHE isoform.
mRNA for other NHE isoforms has been reported in
the mammalian CNS. NHE-2 message was noted in whole
brain (343), and later localized to cerebral cortex and
brain stem (105, 191), where the mRNA level was apparently one-tenth that of NHE-1 (191). Message for NHE-3,
however, was limited to Purkinje cells of the cerebellum
(191) (but has been noted in medullary chemosensitive
neurons in organotypic cultures, Ref. 348).
An in situ hybridization study of NHE-4 reported a
predominance of this isoform in hippocampus (30). Compared with NHE-1, -2 and -3, the sensitivity of NHE-4 to
amiloride was low. NHE-4 may therefore appear to be a
candidate for the neuronal transporter in hippocampus.
However, concentrations of amiloride that had no effect
pH REGULATION IN THE BRAIN
Physiol Rev • VOL
pears likely in the case of NHE-6 (47, 209, 230) and NHE-7
(229a).
B. HCO3ⴚ Transporters in Brain
The transport processes that regulate pHi through the
transmembrane flux of bicarbonate fall within the bicarbonate transporter superfamily. Identified and cloned species correspond to the physiologically well-characterized
⫹
⫺
categories of Cl⫺/HCO⫺
3 exchange, Na -HCO3 cotrans⫹
⫺
⫺
port, and Na -driven Cl /HCO3 exchange. Subspecies of
all three transporter classes have been identified in the
CNS.
1. The Cl⫺/HCO3⫺ exchanger in the CNS
This transporter falls within the anion exchanger
(AE) gene family, which consists of at least four members
(170). AE3 is expressed in both brain and heart (171), with
polypeptide subtypes that differ in their NH2-terminal
sequences (185). The AE3 transporter has been localized
to CNS neurons (171, 251), and two polypeptide isoforms
of the AE3 gene have been separately localized to Muller
cells and horizontal neurons within retina (168). While
AE3 mRNA was found in both fetal and adult hippocampal neurons, physiological Cl⫺/HCO⫺
3 exchange appeared
nearly absent in the younger cells (251). This suggests
that inferences regarding AE3 function made on the basis
of message localization should be regarded with caution.
In one study, AE3 expression was altered in response to
environmental changes. Experiments on cultured hippocampal neurons demonstrated increased AE3 immunoreactivity in response to exposure to ammonia (142). This
effect may be related to the depolarizing shift in the
GABAA receptor equilibrium potential that has been associated with long-term exposure to ammonium ions
(188, 190).
2. Na⫹-HCO3⫺ cotransporters in the CNS
Studies of the Na⫹-HCO⫺
3 cotransporter (NBC) in
mammalian brain have indicated a wide distribution in
the CNS and the presence of more than one isoform.
Using nucleotide probes derived from the electrogenic
Na⫹-HCO⫺
3 cotransporter of rat kidney, in situ hybridization revealed NBC mRNA in olfactory bulb, hippocampal
dentate gyrus, and cerebellum, with localization to both
glial cells and neurons (270). Immunostaining with polyclonal antibodies indicated that NBC protein was distributed diffusely in cell bodies and processes, as well as in
epithelial cells of the choroid plexus, ependyma, and meninges. Colocalization with glial fibrillary acidic protein,
microtubule-associated protein, or 2⬘,3⬘-cyclic mononucleotide 3⬘-phosphodiesterase demonstrated expression
in particular subpopulations of astrocytes, neurons, and
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on acid extrusion in hippocampal neurons (250, 273)
could inhibit NHE-4 activity by 50 – 60% when expressed
in fibroblasts (30). Moreover, NHE-4 could not be activated by acid loading under isosmolar conditions. An
increase in acid extrusion required hyperosmolar media,
suggesting its activation was linked to changes in cytoskeletal elements brought about by cell shrinkage (31).
If NHE-4 displayed similar properties in hippocampal neurons, it could not be responsible for the normal extrusion
of H⫹ by these cells. Later studies raise additional questions about the role of NHE-4 in hippocampus, as it was
found to be principally located in cerebral cortex and
brain stem-diencephalon (105, 191).
Cloning and expression of the NHE-5 isoform in
PS120 cells revealed a functional Na⫹/H⫹ exchanger with
a sensitivity to EIPA. In situ hybridization demonstrated
strong localization to the hippocampal dentate gyrus, with
lower levels noted in the CA1 fields and cerebral cortex
(14). In separate studies, cloning of NHE-5 and expression
in fibroblasts (15), or Chinese hamster ovary cells (292),
also yielded a functional Na⫹/H⫹ exchanger. Less specific
localization to hippocampus and other regions was noted
by Northern analysis (15).
The NHE-6 isoform has a high degree of sequence
identity to a mitochondrial Na⫹/H⫹ exchanger of yeast,
termed NHA2. Its abundant expression in mitochondriarich tissues, including brain, increased suspicion that it
also was a mitochondrial Na⫹/H⫹ exchanger (230). Recent studies have not confirmed a mitochondrial localization, however, and have provided evidence that the transporter is targeted to endoplasmic reticulum (209), or endosomes (47). NHE-7 is also in organelles, localized to the
trans-Golgi network (229a).
The function of individual NHE isoforms in brain is
unclear, with the possible exception of NHE-1. It is likely
that the principal role of NHE-1 in the CNS is the maintenance of steady-state pHi and the recovery from cytosolic acid loads. This is supported by recent studies of a
spontaneous slow-wave epilepsy mutant mouse (89, 358).
The autosomal recessive defect of these animals arises
from a null allele of NHE-1 localized to chromosome four
and is associated with ataxic gait, absence and tonicclonic seizures, and selective neuronal death in brain
stem and cerebellum (89). In a study of pHi regulation in
HEPES-buffered media, acutely dissociated CA1 pyramidal neurons from mutant mice displayed a more acidic
state pHi and a lower rate of acid extrusion compared
with cells from wild-type animals. In some instances,
recovery from acid loading was virtually absent in the
neurons from mutant animals (358).
The roles of NHE-2 through NHE-7 are more subject
to conjecture. Given the well-established utilization of
Na⫹/H⫹ exchange in cell volume regulation (336), this
function appears plausible, particularly for NHE-4 (30).
Regulation of pH within organellar compartments ap-
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MITCHELL CHESLER
3. Na⫹-driven Cl⫺/HCO3⫺ exchange in the CNS
The Na⫹-driven Cl⫺/HCO⫺
3 exchanger (NDCBE) was
the first acid extrusion mechanism identified in early studies of snail neurons and squid axon (259, 303). In hippocampal neurons, where mammalian neuronal pHi regulation was extensively dissected, NDCBE played a major
role in the extrusion of acid (273). An NDCBE cloned
from the insulin-secreting cell line MIN6 cDNA library
was found to have high mRNA levels in brain, and when
expressed in oocytes, it mediated an Na⫹-HCO⫺
3 influx in
exchange for internal Cl⫺ (340). This isoform is likely
related to the NDCBE1 cloned and extensively characterized by Grichtchenko et al. (131). Northern blots revealed
robust presence of the isoform in all major regions of
human brain. When expressed in oocytes, it mediated an
Na⫹-dependent, DIDS-sensitive increase in pHi associated
with a rise in [Na⫹]i with a 1:2 stoichiometry of Na⫹ to
⫺
HCO⫺
3 . In addition, isotopic Cl efflux from oocytes was
⫹
⫺
Na and HCO3 dependent, blocked by DIDS, and required external Cl⫺ to run in reverse mode.
VI. MODULATION OF INTRACELLULAR pH
BY NEURONAL ACTIVITY
Both neurons and glia cells can undergo substantial
shifts in pHi in response to electrical stimulation or application of specific membrane ligands. For both classes
of cells, these pH changes can occur within seconds, in
either the acidifying or alkalizing direction, and can attain
magnitudes of several tenths of a pH unit.
Physiol Rev • VOL
A. Modulation of pHi in Neurons
1. pHi shifts associated with depolarizing stimuli
A number of investigators have demonstrated a fall in
neuronal pHi associated with membrane depolarization or
repetitive spike activity. Many of these studies were first
performed on large invertebrate cells. In barnacle photoreceptors, a fall in pHi was correlated with the depolarizing receptor potential (51). Repetitive firing was associated with a cytosolic acidification in molluscan (1) and
leech (261) neurons. In the former study it was found that
the acidification induced by repetitive spike activity was
dependent on the entry of Ca2⫹. Depolarization of snail
neurons also elicited a Ca2⫹-dependent acidification
(202). Meech and Thomas (200, 201) had reported that
injection of Ca2⫹ into snail neurons caused cytosolic acidification and found that this response was partly mediated
by mitochondrial Ca2⫹/H⫹ exchange, but was largely unexplained. It was later demonstrated that the Ca2⫹-linked
acidification of snail neurons was sensitive to vanadate.
This finding implicated the Ca2⫹/H⫹ exchange property of
the plasmalemmal Ca2⫹-H⫹-ATPase (reviewed in Refs. 61,
62) in the origin of the intracellular acid shift (274). It
should be mentioned that snail neurons can also generate
transmembrane H⫹ fluxes though a specific voltage-gated
H⫹ conductance (57, 305). Because this conductive pathway activates at potentials positive to the H⫹ equilibrium
potential, and exhibits pronounced outward rectification,
its main role appears to be the extrusion of H⫹ (reviewed
in Ref. 92).
Depolarizing stimuli have also been associated with a
fall in pHi in vertebrate neurons. In studies of lamprey
reticulospinal cells (74) and frog motoneurons (107), intracellular acidosis was associated with depolarization,
due to elevation of [K⫹]o or exposure to excitatory amino
acids, respectively. In catfish horizontal cells, application
of glutamate elicited a fall in pHi that was responsible for
suppression of voltage-gated Ca2⫹ channels (102). Cultured mammalian neurons have also been found to acidify
in response to excitatory amino acids, and these intracellular acid shifts were linked to entry of Ca2⫹ (60, 134, 143,
341, 346). In a brain stem slice preparation, acid shifts in
vagal neurons were noted in response to spike activity or
depolarization under voltage clamp. These acid shifts appeared to have a dependence on Ca2⫹ entry as they were
blocked by Cd2⫹ and Ni2⫹ but persisted in the presence of
tetrodotoxin or HCO⫺
3 -free saline (316). In addition, activity-dependent, Ni2⫹-sensitive intracellular acid shifts have
been reported in rat thalamic neurons (207).
In contrast, in hippocampal CA1 neurons studied in
acute slices, depolarizing agents [including N-methyl-Daspartate (NMDA)] evoked intracellular acidifications
that displayed a minor dependence on Ca2⫹ and were
largely attributed to production of metabolic acid (361).
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oligodendrocytes, respectively. Screening of cDNA libraries resulted in the cloning of two rat brain NBC isoforms,
rb1NBC and rb2NBC, which were identical except for a
unique 61-amino acid COOH terminus of the latter (25).
Generation of polyclonal antibodies to distinguish between the carboxy ends of the isoforms revealed predominant rb1NBC protein in astrocytes compared with neurons, whereas rb2NBC antibody revealed the opposite
pattern. When expressed in oocytes, rb2NBC was found
to mediate Cl⫺-independent, DIDS-sensitive, electrogenic
Na⫹-HCO⫺
3 cotransport. An NBC isoform cloned by
Giffard et al. (120) was similarly found to generate DIDSsensitive, HCO⫺
3 -dependent currents when expressed in
oocytes, and in situ hybridization showed widespread
presence in rat CNS, and colocalization with glial acidic
fibrillary protein. NBC mRNA was detected in brain at P0
with an increase at P15 and persistence into adulthood. In
spinal cord, in contrast, expression was noted by embryonic day 17. Western blots from microsomal preparations
of rat brain indicated NBC protein expression as early as
embryonic day 16 in cortex and brain stem-diencephalon
(105).
pH REGULATION IN THE BRAIN
Physiol Rev • VOL
surface pH from a single cell, or as interstitial pH, when
studying responses from a tissue.
Although depolarizing stimuli are most often associated with a fall in pHi, alkaline responses have occasionally been noted. Gaillard et al. (114) found that elevation
of [K⫹]o elicited a Cd2⫹-sensitive alkalization of cultured
cerebellar Purkinje cells, consistent with Ca2⫹ dependence (however, depolarization evoked only acid responses in Purkinje cells studied in acute slices) (349).
Recording pHi from the CA1 pyramidal cell layer of hippocampal slices, Zhan et al. (362) found that application
of NMDA caused an initial intracellular alkalization followed by an acid shift. The alkaline response was inhibited in low Ca2⫹ media, while the late acid shift appeared
to have a metabolic origin. An alkalization of spinal cord
neurons was reported in response to elevation of external
K⫹ and was speculated to arise via an electogenic Na⫹HCO⫺
3 cotransporter (46).
With prolonged neural activity, cytosolic acidification
may occur due to an increase in the production of metabolic acids such as CO2 and lactate. These products could
be generated from the energetic demands associated with
the influx of Ca2⫹ (341), but could also arise from a host
of metabolic needs including the ATP requirements of the
Na⫹-K⫹ pump (186). Metabolic processes are likely to
underlie the considerable acidosis associated with seizure
and spreading depression. Because a metabolically derived acidosis is expected to lower both intracellular and
interstitial pH, the acid changes associated with prolonged stimulation, seizure, and spreading depression are
considered further below, in context with extracellular
acid shifts (see sects. VIIB6 and VIII).
2. pHi shifts associated with GABAA
and glycine receptors
In characterizing the properties of GABAA receptors,
Bormann et al. (34) noted a significant permeability to
bicarbonate ions. The equilibrium potential for HCO⫺
3
(which is the same as that of H⫹) typically lies between 0
and ⫺20 mV. Thus, at more negative membrane potentials, the opening of a GABAA anion channel will result in
an HCO⫺
3 efflux, leading to intracellular acidification and
extracellular alkalization. This was first reported by Kaila
and Voipio (154), who demonstrated that the opening of
GABAA receptors on crayfish muscle produced a bicarbonate-dependent, intracellular acidification accompanied by a surface alkalization. Kaila and colleagues also
demonstrated a GABAA receptor-mediated acidosis in
crayfish stretch receptors (330), cultured astrocytes
(151), and acutely isolated hippocampal CA1 pyramidal
neurons (244). In situ evidence for similar intracellular
acid shifts was provided by Ballanyi and colleagues (316),
who demonstrated an HCO⫺
3 -dependent, bicuculline-sensitive fall in pHi in vagal neurons that was evoked by
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An interesting, rapidly spreading acidification of cerebellar cortex (in vivo) was reported by Ebner and colleagues (66, 67), using neutral red as an epifluorescent pHi
indicator. These responses were elicited by synaptic activation of the cerebellar Purkinje cells through stimulation of the parallel fibers (66, 67). The basis of these acid
responses is unclear. They may be related to a recently
reported, rapid, activity-linked, Ca2⫹-related acidification
of Purkinje cell dendrites studied in acute cerebellar
slices (349).
The causes of Ca2⫹-dependent cytosolic acidosis
may be multiple. Intracellular acidosis arising from elevated [K⫹]o or glutamate has been linked to the generation of metabolic acid (341) as well as mitochondrial
Ca2⫹/H⫹ exchange (346). In a voltage-clamp study of
hippocampal CA1 pyramidal cells (317), Ca2⫹ entry
through voltage-gated channels caused a cytosolic acid
shift that appeared unrelated to mitochondrial Ca2⫹ transport, as it was not significantly reduced when ruthenium
red was included in the patch pipettes. The acid shifts
were significantly smaller when the electrodes contained
1–5 mM vanadate, or 100 ␮M eosin. These data were
consistent with cytosolic acidification mediated by the
Ca2⫹/H⫹ exchange property of the plasmalemmal Ca2⫹ATPase, as was noted for snail neurons (274).
In evaluating data from such studies it should be
borne in mind that the available tools are still rather poor.
The use of BCECF to measure acid shifts may confuse the
quantitative interpretation of results, as this agent is itself
an inhibitor of the plasma membrane Ca2⫹-ATPase (115).
For the human erythrocyte pump, the inhibition constant
(Ki) of BCECF is 100 ␮M (115), and only 30 ␮M BCECF
was able to cause half-inhibition of the plasmalemmal
Ca2⫹-ATPase in snail neurons (275).
Qualitative difficulties in interpretation can also arise
because of the poor specificity of the transport inhibitors.
In addition to blocking the plasmalemmal Ca2⫹-ATPase,
vanadate has been reported to inhibit mitochondrial
Ca2⫹/H⫹ exchange (with a Ki of 0.6 mM) (173) and is
well-established as a blocker of sarcoplasmic/endoplasmic reticulum Ca2⫹ (SERCA) pumps (233). SERCA pumps
are also inhibited by low concentrations of eosin (with a
reported Ki of 0.8 ␮M) (173). Moreover, like the plasmalemmal Ca2⫹-ATPase, the SERCA pumps exchange Ca2⫹
for H⫹ (85, 359). Thus the effects of eosin and vanadate
on pHi may not be solely attributable to their inhibition of
the plasmalemmal transporter.
These considerations underscore the challenges
faced when seeking to establish the basis of an intracellular acid shift. Cytosolic acidosis may arise from a wide
variety of organellar and metabolic sources in addition to
the movement of acid equivalents across the plasma membrane. To distinguish transmembrane movements of acid,
it is therefore advantageous if associated pH transients
can be recorded in the extracellular domain, either as
1197
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MITCHELL CHESLER
GABA. Brain stem medullary neurons also exhibited a
GABAergic acidosis. In addition, these cells could be
acidified by activation of strychnine-sensitive glycine receptors (189), which have an HCO⫺
3 permeability comparable to that of GABAA receptors (34).
3. Additional modulators of neuronal pHi
B. Modulation of pHi in Glial Cells
Neuronal activity has long been associated with depolarizing responses of astrocytes, which have been
mainly attributed to the transient elevation of [K⫹]o (132,
234, 253, 284). A consequence of astrocyte depolarization
is the activation of electrogenic Na⫹-HCO⫺
3 cotransport,
which causes a rapid cytosolic alkaline shift. In the great
majority of studies, these alkaline responses were evoked
in vitro by the elevation of [K⫹]o (44, 50, 129). The recording of similar alkalizations which followed the elevation
and fall of [K⫹]o was reported for cortical astrocytes in
vivo by Chesler and Kraig (81, 82) using double-barreled
pH microelectrodes. Stimulation of the cortical surface
elicited typical slow depolarizing responses that were
accompanied by a rapid rise in pHi of several tenths of a
unit pH. After tetanic stimulation, the pHi recovered and
was sometimes followed by a prolonged intracellular acidosis. During passage of a cortical spreading depression,
the alkaline-acid sequence was repeated but was exaggerated in amplitude, with some alkaline transients apPhysiol Rev • VOL
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A variety of endogenous agents have been found
capable of altering cytosolic pH. Connor and Hockberger
(88) injected molluscan neurons with cAMP or cGMP and
noted either a slow acidification or a biphasic alkalineacid response. In cultured mammalian neurons, an acid
shift was elicited by activation of type I metabotropic
glutamate receptors (6). The mechanisms underlying
these pHi changes have not been determined.
An interesting alkalization of acutely isolated hippocampal CA1 neurons was reported by Church and colleagues (280). Norepinephrine, acting through ␤-adrenergic receptors, elicited a concentration-dependent, sustained rise in steady-state pHi and increased the rate of
pHi recovery from imposed acid loads. This alkalosis was
Na⫹ linked, but was not dependent on HCO⫺
3 or the
elevation of [Ca2⫹]i, and appeared to be mediated by
increased activity of the amiloride-insensitive Na⫹/H⫹ exchanger. The effect was linked to G protein-coupled stimulation of adenylate cyclase with subsequent activation of
the cAMP-dependent protein kinase. These observations
suggest a means by which pHi could vary as a function of
the metabolic and electrophysiological history of a set of
neurons. In this regard it may be noted that CA1 pyramidal cells have been found to fall into distinct populations
with relatively low or high baseline pHi values (24).
proaching 0.8 pH units. In recordings from medullary glial
cells in vivo, Ballanyi et al. (18) reported similar intracellular alkaline shifts evoked by stimulation of spinal pathways.
Intracellular alkaline shifts in response to neural activity have also been reported in the giant glial cells of the
leech (an annelid worm) (94). It therefore appears that
this glial property has been conserved through evolution.
An activity-dependent alkalization of glial cells may have
functional significance in several respects. A rise in cytosolic pH can elevate glycolytic rate (321), increase gap
junctional conductance (289), and favor the uptake of
glutamate (43), or the formation of glutamine (48). On the
other hand, when viewed from an extracellular perspective, the Na⫹-HCO⫺
3 cotransporter would appear to function as an acid secretory mechanism, as discussed in
section VIIB6.
Another form of astrocyte alkalization has been associated with activation of metabotropic glutamate receptors. Amos and colleagues (5, 6) described a group I
mGluR-mediated rise in pHi of cultured cortical and cerebellar astrocytes. The response was independent of Na⫹
but required HCO⫺
3 (5). The alkaline shift was apparently
Ca2⫹ dependent, as it could be triggered by caffeine and
ionomycin (5), and was mitigated by intracellular BAPTA
(6). Elevation of [Ca2⫹]i appeared to be dependent on its
release from intracellular stores, as the response persisted in the absence of external Ca2⫹. Acutely dissociated astrocytes also exhibited an mGluR-mediated alkalization, suggesting that similar responses might occur in
vivo (5).
As discussed for neurons, glial cell acidosis may be
expected to arise from a variety of sources, which include
transmembrane acid transport, organellar acid fluxes, and
metabolic production of CO2 and lactic acid. Late acidifications of astroctyes studied in vivo were noted by
Chesler and Kraig following repetitive neural activity (81,
82). Application of excitatory amino acids was also found
to acidify astrocytes in a number of studies (49, 52, 263).
Acidosis of glial cells induced by glutamate has been
largely attributed to its inward transport (52, 263), as the
uptake of this amino acid is coupled to the influx of H⫹
(43, 344, 360). Accordingly, superfusion of hippocampal
slices with transportable glutamate analogs was found to
cause a fall in tissue pHi (3).
Acidification of astrocytes has also been noted in
response to the excitatory amino acid kainate, which is
not taken up by the glutamate carrier (165). In CO2/HCO⫺
3containing media, Rose and Ransom (263) found that the
kainate-evoked acidification of hippocampal astrocytes
was preceded by an alkaline shift. It was proposed that
these pHi shifts were governed by the Na⫹-HCO⫺
3 cotransporter responding to sequential depolarization and hyperpolarization of the membrane. In support of this contention, they found little or no kainate-induced acidification
pH REGULATION IN THE BRAIN
in CO2/HCO⫺
3 -free media. In contrast, in cerebellar astrocytes, kainate-evoked acid shifts were prominent in the
absence of CO2 and HCO⫺
3 (52), suggesting an alternate
mechanism. The kainate responses of the cerebellar astrocytes did not require external Ca2⫹, unlike acidifications evoked by excitatory amino acid receptors in neurons (60, 134, 143, 341, 346).
VII. REGULATION AND MODULATION
OF BRAIN EXTRACELLULAR pH
A. The pH of Interstitial Fluid
Physiol Rev • VOL
shifts in blood flow remain plausible, however, and evidence for slow extracellular alkaline shifts arising from
postactivity hyperemia has been published recently by
Venton et al. (325a).
B. Changes in Interstitial pH Caused
by Neural Activity
Synchronous activation of nerve cells has been
shown to cause changes of interstitial pH in a variety of
preparations. Reports of activity-dependent pHo shifts go
back over 60 years. Many of the earlier measurements are
suspect, as extracellular potential shifts were not subtracted from the pH recordings, and the spatial and temporal resolutions were poor (76). The first reliable recordings of pHo transients following synchronous cortical activity were performed in vivo, using pH microelectrodes
in combination with an extracellular reference microelectrode to enable subtraction of interstitial potential
changes. Stimulated activity, seizure, or spreading depression were associated with an initial interstitial alkaline
shift followed by an acidosis that could persist for minutes. This pattern was first noted in cortex (65, 322) and
cerebellum (174, 253a) and has been commonly found
throughout the CNS. In some instances, however, neural
activity has been associated with predominant early acid
shifts (see sect. VIIB6).
The processes responsible for the generation of activity-dependent pHo shifts have not been fully elucidated.
In principle, a large number of transport mechanisms
could contribute to the dynamic H⫹ balance of the brain
interstitial space. To understand whether a flux of given
magnitude can account for an observed pHo transient,
however, one must have a quantitative appreciation of the
interstitial buffering capacity. Therefore, before addressing the origin of the activity-dependent pHo transients, the
nature of pH buffering in the brain interstitial space will
be considered.
1. Buffering of brain interstitial fluid
The acid-base status of extracellular fluid is governed
by the chemical buffering properties of the solution and
by the transmembrane flux of acid equivalents. In the
adoption of nomenclature, it is formally correct as well as
heuristically useful to distinguish between these components. Buffering is a term best reserved for the chemical
equilibria within the interstitial fluid which act to mitigate
the change in pH arising from an imposed acid or base
load. Transmembrane fluxes, in contrast, constitute the
source of acid-base loads imposed upon the interstitial
fluid. In some instances, a pHo shift caused by one transmembrane flux may be masked by a second flux of opposite direction. The term pH muffling has sometimes been
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pH microelectrode studies have indicated that brain
interstitial fluid is slightly more acidic than blood, with a
pH of ⬃7.3 (90, 145, 174). In brain slices, however, the
interstitial pH is usually lower, despite the flow of saline
buffered to pH 7.4. At the center of a brain slice, baseline
pHo values of 7.1–7.2 have been reported (16, 71, 144, 180,
338). Low pHo has also been noted in other isolated CNS
preparations including lamprey brain stem (75), frog spinal cord (107), and turtle cerebellum (139).
The cause of baseline acidosis in hippocampal slices
was studied by Voipio and Kaila (328) using a unique, dual
CO2-pH microelectrode. It was demonstrated that the low
pH of the interstitial fluid was entirely due to elevation of
tissue PCO2. In their interface-style recording chamber, the
slice PCO2 ranged from 40 to 50 Torr. In a later study, PCO2
was calculated in submerged hippocampal slices using pH
and CO2⫺
3 -sensitive microelectrodes (78). The submerged
slices had a considerably higher baseline CO2 (⬃75 Torr),
which again accounted entirely for the difference in pH
between bath and interstitial fluid. The high concentration
of CO2 in brain slices is likely due to its generation by
aerobic metabolism, and poor clearance, owing to lack of
blood flow. In a slice, the egress of CO2 would be reliant
on diffusion across the tissue and its unstirred layer of
surface fluid. CO2 clearance can therefore be expected to
be greater (and thus the PCO2 lower) in an interface chamber, where CO2 is able to diffuse across both the upper
and lower surfaces (225).
In vivo, CO2 is cleared by blood flow, and accordingly, large steady-state accumulation of CO2 is not expected. With a physiological rise in perfusion, due to
elevated neural activity, increased clearance of CO2 and
local increases in brain pH could arise, in principle. Indeed, observations of rapid, activity-dependent increases
in brain interstitial pH were at first attributed to augmented blood flow (322). The identification of similar pH
shifts in numerous in vitro studies (where blood flow was
absent) indicated that alternate mechanisms must account for these rapid pH changes. Candidate processes
are the subject of detailed discussion in the sections
which follow. Alterations in brain pH due to physiological
1199
1200
MITCHELL CHESLER
CA
CO 2 ⫹ H 2 O |
0 H 2 CO 3 |
0 HCO 3⫺ ⫹ H ⫹
(7)
Within the physiological time frame, formation of
⫹
HCO⫺
3 and H from H2CO3 occurs virtually instantly. The
hydration of CO2 to form carbonic acid (H2CO3) and its
dehydration back to CO2 and water are extremely slow,
however, with time constants on the order of 20 s and 1 s,
respectively (192). Accordingly, the attainment of equilibrium following an acid or base challenge can require
minutes. Biological systems typically overcome these
slow kinetics using various forms of the enzyme carbonic
anhydrase (CA), which catalyzes both the hydration and
dehydration steps. In the brain interstitial space, CA activity is the principal regulatory factor governing the manifestation of pH transients. Indeed, the characterization of
Physiol Rev • VOL
activity-dependent pHo shifts and the function of interstitial CA are inseparable issues and therefore will be considered together.
2. Interstitial pH transients and CA
The first evidence that CA played a role in the regulation of interstitial pH came from the work of Kraig et al.
(174). These investigators reported alkaline-acid pHo transients in rat cerebellum in response to stimulation of the
parallel fibers, or the passage of a spreading depression.
When the cerebellar cortex was superfused with 5 mM
acetazolamide, the amplitude of the alkaline and acid
shifts increased two- to threefold. Enhancement of
evoked alkaline shifts by millimolar concentrations of
acetazolamide was also noted in rat cortex (215) and in
brain slices (63, 338). Comparable effects, however, could
be obtained in hippocampal slices using as little as 1 ␮M
acetazolamide (71).
At the time of the earliest studies of pHo transients, it
was known that brain CA resided in glia (119, 164, 228),
within both oligodendrocytes (58) and astrocytes (59). In
view of the permeability of cell membranes to acetazolamide (192), and the high concentrations used in the
initial experiments, it appeared likely that glial CA would
have been inhibited. However, the means by which inhibition of glial intracellular CA could so profoundly affect
rapid pHo transients was not obvious, and Kraig et al.
(174) were careful to stress that the site of action of
acetazolamide was uncertain.
Clarification came from a series of experiments using
CA inhibitors that do not readily cross cell membranes.
Activity-dependent pHo shifts were profoundly affected
by these agents. It was therefore reasoned that the site of
enzyme activity had to reside in the extracellular space
(71, 72, 150). These CA inhibitors included benzolamide,
which is relatively impermeant due to its low pKa (318),
as well as a set of similarly potent sulfonamides conjugated to high-molecular-weight dextrans (117, 156).
In one series of experiments alkaline shifts were
evoked in area CA1 of hippocampal slices by either stimulation of the Schaffer collaterals, or by local microejection of glutamate (71, 72). Superfusion of benzolamide
(71) or a dextran-conjugated sulfonamide (72) increased
the amplitude of these transients severalfold. This increase in the amplitude of an alkaline transient is expected to occur when the pHo shift is generated by the
loss of protons from (or addition of OH⫺ to) the interstitial compartment (Fig. 1A). Since CO2-HCO⫺
3 is the principal extracellular buffer, the ability to replenish extracellular H⫹ hinges on the CA-dependent rate of CO2 hydration. With inhibition of interstitial CA, the generation of
H⫹ is reliant on the slow, uncatalyzed hydration of CO2,
which leads to a poorly buffered, or “amplified” alkalosis.
CA inhibitors will similarly amplify alkaline shifts elicited
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used to distinguish such a process from the ever-present
chemical buffering (304).
The buffering capacity of a fluid at equilibrium is
governed by the concentrations of the individual buffers
and their respective pKa values. In brain interstitial fluid,
the principal buffer is CO2/HCO⫺
3 with a total combined
concentration of ⬃27 mM. In comparison, the contributions of other buffers appear negligible (109).
Quantification of the CO2/HCO⫺
3 buffering capacity in
the physiological setting typically relies on two assumptions. First, the buffer components are considered to be at
equilibrium, and second, the system is treated as “open”
with respect to CO2 (i.e., the PCO2 is constant). When
these conditions are met, then the extracellular buffering
capacity (␤e) is reliant solely on bicarbonate concentration, and is given by Equation 3. Thus, for an [HCO⫺
3 ]o of
26 mM, ␤e would be 60 mM. However, as discussed below,
neither fixed PCO2 nor its equilibrium with HCO⫺
3 appear
to occur under all conditions in which activity-dependent
pHo shifts are generated. Accordingly, the effective buffering capacity can be considerably less than 60 mM.
In rat hippocampal slices it has been shown that
synchronous neuronal activity can cause interstitial PCO2
to rise by 20 –30 Torr, accounting entirely for the prolonged extracellular acidosis (328). Since the PCO2 is not
fixed, interstitial buffering would be less than maximal
during these pHo transients. Acid shifts also occur after
synchronous activity in vivo (174, 278, 285), but unlike the
slice preparation, blood flow is intact and the contribution
of CO2 to these phenomena is therefore likely to be less.
Over periods of minutes, PCO2 in vivo is governed by the
blood flow and pulmonary ventilation, and long-term buffering can be considered to occur at a roughly fixed PCO2.
A second important constraint on CO2/HCO⫺
3 -dependent buffering arises from the kinetics of the carbonic
acid reactions
pH REGULATION IN THE BRAIN
1201
by any extracellular “proton sink” including alkalizations
imposed by local microejection of NaOH (72). Properties
of this activity-evoked, HCO⫺
3 -independent alkalosis are
detailed in section VIIB4.
In another set of experiments, inhibitors of extracellular CA were used to study extracellular alkaline shifts
evoked by activation of GABAA receptors (71, 150, 153,
154). Work on crayfish muscle demonstrated that the
efflux of HCO⫺
3 across GABAA anion channels gives rise
to a surface alkalosis (153, 154). In this circumstance,
rather than reduce an alkalosis, CA was required to generate the alkaline shift, since the fall in surface H⫹ required the rapid dehydration of H2CO3 (Fig. 1B). Thus,
when CA on the surface of the muscle was inhibited with
Physiol Rev • VOL
benzolamide, the dehydration of H2CO3 was slowed, and
the GABA-evoked surface alkalosis was prevented (153).
Similar effects were later noted when benzolamide and
dextran-conjugated inhibitors of CA were used to study
GABAA receptor-mediated extracellular alkalosis in the
CA1 region of hippocampal slices (71, 150). Studies of this
HCO⫺
3 -dependent alkalosis are detailed in section VIIB5.
The contrasting effects of CA inhibitors on alkaline
transients demonstrated that there are two classes of
interstitial alkalization that may accompany normal sequences of excitation and inhibition. Excitation appears
to generate a rapid proton sink. Because glial cells secrete
acid into the interstitial space, and undergo an intracellular alkalization during neural activity, it has been specu-
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FIG. 1. Effect of extracellular carbonic anhydrase (CA) inhibition on activity-dependent alkaline shifts. A, left:
extracellular alkalosis generated by an H⫹ sink (or equivalently an efflux of OH⫺) would be buffered via the CA-catalyzed
hydration of CO2. Right: inhibition of extracellular CA by benzolamide would diminish the rate of hydration, permitting
the development of a larger alkalosis. B, left: extracellular alkalosis generated by an HCO⫺
3 source is generated by the
CA-catalyzed dehydration of H2CO3. Right: inhibition of extracellular CA by benzolamide slows the dehydration step,
thereby limiting development of the alkalosis.
1202
MITCHELL CHESLER
3. Nature of interstitial CA activity in brain
Extracellular CA activity has been found in tissues
outside the CNS associated with the membrane-tethered
isoform CA IV (64). Examples include the luminal brush
border of renal tubules (350), the surface of muscle fibers
(335), and the luminal endothelial surface in lung (334). In
the nervous system, in contrast, there has been little
morphological evidence of extracellular CA. Histochemical studies suggested the presence of interstitial CA in
dorsal root ganglia (106); however, such methods did not
allow definitive extracellular localization. The physiological demonstration of extracellular CA in hippocampal
slices (71, 72, 150) nearly coincided with immunocytochemical studies of brain using antibodies against CA type
IV. In the latter study, CA IV was found on the luminal
membrane of brain endothelial cells, but CA IV staining
was not observed in brain tissue proper (118). More recently, immunostaining for CA IV was described on scattered glial cells and neurons in mammalian brain (342).
The consistency of the physiological evidence for
extracellular CA is at apparent odds with the variability of
the morphological studies. This might be explained if
interstitial CA activity detected by physiological means in
brain slices was an artifact of cellular injury. Indeed,
because CA is abundant in glial cells (58, 59, 119, 164,
221a, 228), and there is physiological (207, 244) and morphological evidence (2, 158, 227, 229, 351, 352) for its
presence in neurons, it is reasonable to assume that release of intracellular CA would occur when tissue is cut in
the preparation of brain slices. Yet, amplification of alkaline transients by acetazolamide (174) and benzolamide
(140) was also noted in vivo, suggesting that damage due
to slicing was not a primary factor. Indeed, because exogenous CA was found to readily diffuse to and from the
interstitial space of brain slices (140), the enzyme would
Physiol Rev • VOL
be expected to rapidly wash out of the tissue when released from injured cells.
Additional evidence that simple spillage of the enzyme could not account for interstitial CA came from a
study of hippocampal slices prepared from mutant mice
lacking CA II. In a comparison of mutant versus wild-type
animals, activity-dependent interstitial alkaline shifts
were comparable in amplitude and were amplified in a
similar manner by benzolamide (311). Moreover, histochemical studies in brains of CA II-deficient mice detected
the presence of membrane-associated CA (255) near neuronal processes.
The inability to detect interstitial CA with antisera
against CA IV could have several explanations. Extracellular isoforms other than CA IV may account for brain
interstitial CA activity. Alternatively, the concentration of
CA IV in the interstitial space could be below the detection limit of the immunocytochemical assay. This would
not be unprecedented, as early immunocytochemical
studies did not detect the CA II isoform in astrocytes (58).
These possibilities are not mutually exclusive, and evidence now exists for both a low concentration of interstitial CA IV and the presence of an additional extracellular CA isoform.
A suggestion that interstitial CA was present in low
concentration came from experiments in which pHo,
[HCO⫺
3 ]o, and PCO2 were monitored during repetitive stimulation of rat hippocampal slices. The rise in [HCO⫺
3 ]o
associated with the extracellular alkaline transient was
sometimes less than the value predicted by the Henderson-Hasselbalch equation, suggesting lack of equilibrium
⫹
between CO2, HCO⫺
(79). This result is consis3 , and H
tent with an insufficient rate of CO2 hydration owing to
low enzyme activity (Fig. 1A). In a later study, addition of
exogenous bovine CA to physiological saline decreased
evoked alkaline shifts in rat cortical slices by two- to
threefold (140). A similar increase in interstitial buffering
capacity was also noted when exogenous CA was superfused over rat cortex in vivo (140). The augmentation of
buffering occurred when the exogenous CA concentration was ⬃300 nM but was not observed at 30 nM. After
addition of 300 nM enzyme, increasing its level to 3,000
nM had no additional effect on the pH transients. Assuming a molar activity comparable to the added CA, these
data were consistent with an overall interstitial CA concentration on the order of 30 –300 nM.
Tong et al. (310) provided evidence that interstitial
CA activity in brain is attributable to CA IV. The type IV
CA isoform is tethered to the extracellular face of membranes by a phosphatidylinositol-glycan linkage. Accordingly, treatment with phosphatidlyinositol-specific phospholipase C (PIPLC) can liberate the enzyme and enable
its washout (335, 364). When hippocampal slices were
incubated with PIPLC, interstitial alkaline shifts were increased markedly compared with controls, and the am-
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lated that this proton sink is not a glial response, but
rather, represents the movement of H⫹ equivalents into a
neuronal compartment (76, 94, 252). Possible mechanisms for the proton sink are considered in section VIIB4.
GABAA receptor-mediated inhibition, on the other hand,
appears to generate a local, extracellular “bicarbonate
source.”
A second implication of these studies was that a form
of CA was present in the interstitial space of the brain
slice preparation. Given the similar effects of acetazolamide in vivo (174, 215), it appeared likely that this extracellular CA activity was also present in the intact brain.
This was confirmed when benzolamide was found to amplify AMPA-evoked alkaline shifts in vivo (140). Similar
amplification of interstitial alkaline transients was later
reported in nonmammalian preparations exposed to CA
inhibitors, including isolated turtle cerebellum (121) and
leech segmental ganglia (262).
pH REGULATION IN THE BRAIN
4. Bicarbonate-independent alkaline shifts
Although its features have been studied in some detail, the mechanism underlying the activity-evoked, bicarbonate-independent, “net proton sink” (Fig. 1A) has not
been established. This alkalosis has been extensively
characterized in rat hippocampal slices (63, 71, 72, 124,
130, 144, 177, 237, 238, 282, 283, 329, 338). In this preparation, optical recordings of interstitial pH performed
with phenol red (177) or dextran-conjugated fluorescein
(124) revealed an onset within 10 ms. Significant characterization of this alkalosis has also been performed in
turtle cerebellum (69, 77, 84) and rat lateral geniculate
Physiol Rev • VOL
nucleus (312), where the basic features appeared similar
to the hippocampal response.
Differentiation from the GABAA receptor-mediated
alkaline shift became apparent in early experiments, since
the response persisted in HEPES-buffered Ringer solution
(77, 84, 122) and in the presence of picrotoxin (69, 71).
These results also indicated that an increase of interstitial
HCO⫺
3 concentration, presumed to arise from activitydependent shrinkage of the extracellular space (101),
could not be responsible for the alkalosis (174). Amplification of the responses by extracellular CA inhibitors
(Fig. 2A) provided a further means of differentiation from
the GABAergic response (71, 72) (discussed in sect.
VIIB2).
A) IS THE ACTIVITY-DEPENDENT PROTON SINK DUE TO GLUTAMATE UPTAKE? In principle, a number of transport mechanisms could provide a pathway for an HCO⫺
3 -independent,
net proton sink, but might not generate an interstitial base
load of sufficient magnitude to account for the observed
extracellular pH change. One example is glutamate transport, where the electrogenic, Na⫹-coupled uptake of this
amino acid is coupled to an HCO⫺
3 -independent, influx of
H⫹ (43, 344, 360). Under conditions of low extracellular
buffering capacity, this mechanism can generate a surface
alkalosis on retinal glial cells (43). The carrier can also
cause a prolonged intracellular acidosis of brain slices
when transported amino acids are superfused over the
tissue (3). Yet, glutamate uptake does not appear to be
responsible for the Schaffer collateral-evoked interstitial
alkaline shift in hippocampal slices. This contention is
supported by the fact that the synaptically evoked alkalosis can be blocked by 6-cyano-7-nitroquinoxaline-2,3dione (CNQX) and DL-2-amino-5-phosphonovalerate
(APV). In the presence of these ionotropic glutamate
receptor antagonists, postsynaptic currents are abolished;
however, the presynaptic release of glutamate and its
subsequent uptake should be unaffected (70). It is also
notable that a similar interstitial alkalosis can be evoked
by antidromic activation of the CA1 pyramidal neurons in
the presence of CNQX, APV, and picrotoxin (70, 130, 237).
These data suggest that in the hippocampal CA1 region,
postsynaptic electrical activity is responsible for generation of the extracellular proton sink (see below).
Given the influx of an acid equivalent linked to glutamate uptake, this process should contribute in some
measure to the interstitial alkalosis during excitatory synaptic transmission. Yet, when transportable glutamate analogs (e.g., D-aspartate) were injected into hippocampal
slices, extracellular alkaline shifts could not be detected
unless the buffering capacity was reduced with benzolamide (281). Thus, under normal buffering conditions,
alkaline shifts generated by glutamate transport do not
have a measurable impact on the broad interstitial space
in which the carriers reside. It is plausible, however, that
pH shifts associated with glutamate uptake attain a sig-
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plifying effect of benzolamide was largely occluded. The
incubation fluid from PIPLC-treated slices contained a
low concentration of CA that was insensitive to SDS, a
property consistent with CA IV (197, 347). Western blots
confirmed the presence of CA IV in this fluid. The immunocytochemical detection of CA IV required the pooled
samples from several slices, consistent with a low interstitial CA IV activity. Based on the liberated SDS-insensitive CA IV activity, the interstitial concentration was estimated to be on the order of 100 nM, a figure consistent
with the earlier estimate of 30 –300 nM (140).
It is notable that treatment with PIPLC never eliminated all interstitial CA activity in hippocampal slices,
since addition of benzolamide always caused some enhancement of alkaline transients (310). Incomplete cleavage of phosphatidylinositol-glycan linkages may explain
this result. Alternatively, an additional membrane-associated CA could account for the persistence of CA activity.
One candidate would be the CA XIV isoform, a membrane-spanning protein with an apparent extracellular
catalytic domain. Transcripts of CA XIV have been detected in brain Northern blots (112, 213), and immunocytochemical studies have indicated its presence in medulla,
pons, hippocampus, cerebellar granular layer, and major
white matter tracts (242). The extent to which CA XIV
catalyzes interstitial buffering is not known.
Interstitial CA in brain is likely due to surface enzyme
located on both glial cells and neurons. An association
with glia was noted in two early reports. Physiological
studies demonstrated interstitial CA activity in gliotic hippocampal slices, where neuronal elements were virtually
absent (128) (see Fig. 5A and sect. VIIB6). Surface CA
activity on individual, acutely isolated retinal Muller cells
(astrocyte variants) was also detected by Newman (222)
(see sect. VIIB6). In a recent study, the reliance of lactate
influx on surface CA was used to demonstrate the presence of this enzyme on both astrocytes and neurons
(289a). The type of surface CA on the astrocytes and
neurons cells was not addressed; however, the immunocytochemical study of CA XIV has suggested that neurons
specifically express this isoform (242).
1203
1204
MITCHELL CHESLER
nificant magnitude in microdomains close to the sites of
transport.
The ability of ionotropic glutamate antagonists to
prevent the synaptic generation of the proton sink in
cerebellum (77) and hippocampus (70) suggested that the
response was triggered by excitation of the postsynaptic
elements. Indeed, in turtle cerebellum, direct activation of
glutamate receptors induced an alkaline shift that persisted after synaptic transmission was blocked by Mn2⫹
or Cd2⫹ (84). In hippocampus, confirmation of the
postsynaptic origin came from experiments in which picrotoxin-resistant alkaline shifts were elicited by repetitive
antidromic activation of the CA1 pyramidal neurons (70,
237). The antidromically induced alkalization was far
smaller than that evoked by orthodromic trains of identical frequency and duration (70). Large alkaline responses
could be elicited only by high-frequency antidromic stimulus trains of 50 –200 Hz (130, 237). Curiously, in experiments using phenol red as an extracellular pH indicator,
antidromic stimulation of hippocampal CA1 or dentate
neurons did not produce any detectable pHo change
Physiol Rev • VOL
(177). An insufficient rate or duration of antidromic stimulation may account for this result.
B) IS THE ACTIVITY-DEPENDENT PROTON SINK DUE TO THE
2⫹
PLASMALEMMAL CA -ATPASE? A mechanism consistent with a
postsynaptic origin was suggested by Schwiening et al.
(274) in their studies of surface pH on snail neurons.
Calcium entry (elicited by voltage-clamp depolarization)
triggered a rise in surface pH that was blocked by vanadate, an inhibitor of the plasmalemmal Ca2⫹-ATPase. This
transporter is activated by elevation of cytosolic Ca2⫹ and
extrudes this ion in exchange for extracellular H⫹ (61,
62). Accordingly, vanadate also slowed the recovery of
the cytosolic Ca2⫹ transients.
These experiments demonstrated the ability of the
plasmalemmal Ca2⫹-ATPase to elicit a surface alkalosis,
but it remained unclear whether this transporter was
responsible for the activity-dependent proton sink in the
vertebrate CNS. Preliminary support for this hypothesis
came from experiments in which alkaline shifts were
found to be dependent on external Ca2⫹. In the CA1
region of hippocampal slices, alkalizations evoked by
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FIG. 2. Extracellular alkalosis generated
by proton sinks and bicarbonate sources in rat
hippocampal slices. A: alternate microejection
of GABA or glutamate elicited interstitial alkaline shifts of comparable amplitude and time
course. Superfusion of increasing concentrations of benzolamide caused inhibition of the
GABA response (revealing an acid shift) and
amplification of the glutamate response, consistent with generation of the alkalosis via an
HCO⫺
3 efflux and a proton sink, respectively.
[From Chen and Chesler (71).] B: in a rat
hippocampal slice, block of excitatory synaptic transmission (with CNQX and APV) permitted selective, high-frequency stimulation of
GABAergic inhibitory interneurons. The resulting rapid alkaline transient was largely
blocked in the presence of benzolamide. pHo,
extracellular pH. [From Kaila et al. (150).]
pH REGULATION IN THE BRAIN
Physiol Rev • VOL
cytosolic Ca2⫹ load is handled by the plasmalemmal Ca2⫹ATPase, a far lower extracellular buffering capacity
would be required in order for Ca2⫹/H⫹ exchange to
plausibly account for the extracellular proton sink.
C) IS THE ACTIVITY-DEPENDENT PROTON SINK DUE TO A CHAN⫹
NEL-MEDIATED H FLUX? In principle, an extracellular proton
sink could be generated by a conductive pathway for H⫹
or OH⫺, since the electrochemical gradients for these ions
are inward and outward, respectively (76, 259). Voltagegated proton conductances were first characterized in
snail neurons (57, 305). While they have also been described in vertebrate cells, there is no evidence for such a
conductance in vertebrate neurons. Moreover, voltagegated H⫹ channels typically activate at membrane potentials close to zero, where the electrochemical gradient for
H⫹ is outward (reviewed in Ref. 92). This feature is consistent with their presumed role as a rapid H⫹ extrusion
mechanism.
Channels that are permeant to other ions may conduct H⫹ (or OH⫺) to a limited degree (92). However,
several observations make it doubtful that alkaline shifts
arise from nonspecific H⫹ conductances of this sort. A
variety of channel blockers do not inhibit alkaline shifts
(evoked by either glutamate agonists or electrical stimulation), including tetrodotoxin (73), amiloride (77), Ba2⫹
(130), and stilbene derivatives (215, 338). Ca2⫹ channel
antagonists have sometimes inhibited alkaline shifts (130,
237), but in many instances the alkalosis was unaffected
or only partially reduced by these agents (84, 282). It has
been argued that the low activity of H⫹ and OH⫺ (on the
order of 10⫺7 M) is inconsistent with a large, channelmediated flux of these ions, unless the channels involved
are present in exceptionally high density, as has been
suggested for cells that exhibit specific proton conductances (92).
D) BICARBONATE-INDEPENDENT ALKALINE SHIFTS IN RETINA.
The forms of alkalosis discussed above are considered to
arise from mechanisms that remove acid or add base to
the interstitial fluid. In the retina, a different form of
interstitial alkalization can occur in response to light. In
this tissue, the high metabolic rate in the dark leads to a
sustained interstitial acidosis (33, 357), which varies in a
circadian rhythm (103, 104). When the photoreceptor
dark current is transiently turned off during light stimulation, a slow, transient increase in pHo occurs, owing to
a decrease in metabolic rate. These slow alkaline shifts
have been noted in frog (33) and cat (357) and are most
prominent in the proximal retina adjacent to the rods.
5. Bicarbonate-dependent alkaline shifts
The means by which the efflux of HCO⫺
3 generates an
external alkalosis is well established. The ability of CO2 to
rapidly equilibrate across cell membranes results in an
identical equilibrium potential for H⫹ and HCO⫺
3 which is
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ionotropic glutamate agonists (238, 283), or by antidromic
stimulation (130, 237), were blocked in media containing
0 Ca2⫹ and EGTA. However, subsequent studies revealed
that sizable interstitial alkaline shifts could often be obtained in the nominal absence of external Ca2⫹ following
interstitial AMPA ejection (282), or during the onset of
spreading depression (206). In addition, when alkaline
shifts were reduced or abolished in 0 Ca2⫹, addition of
Ba2⫹ restored the responses (130, 282, 312). While Ba2⫹
can substitute for Ca2⫹ in carrying charge across voltagegated Ca2⫹ channels (137), the Ca2⫹-ATPase is not known
to utilize Ba2⫹ effectively (181, 363).
Additional arguments against the Ca2⫹-ATPase
mechanism have come from the use of inhibitors. Cd2⫹ is
a potent blocker of the plasmalemmal Ca2⫹-ATPase with
a Ki near 2 nM (326, 327). At an external concentration of
100 ␮M, Cd2⫹ did not affect the glutamate-evoked alkaline
shift in turtle cerebellum (84), and caused just a partial
block of the AMPA-induced alkalosis in rat hippocampal
slices (282). Carboxyeosin, with a Ki of 20 nM (115), is a
more widely used inhibitor of the plasmalemmal Ca2⫹ATPase (86, 110, 126, 276). Instead of blocking this alkalosis, carboxyeosin augmented the interstitial alkaline
shifts elicited by antidromic stimulation in hippocampal
slices (133).
To date, the reduction of the alkaline shift in zero
Ca2⫹ solutions is the best evidence favoring the Ca2⫹ATPase hypothesis. In view of the myriad processes influenced by a Ca2⫹ influx, however, a specific link to this
Ca2⫹ transporter cannot yet be claimed. Nevertheless,
because the plasmalemmal Ca2⫹-ATPse is an obligatory
Ca2⫹/H⫹ exchanger, it must contribute to interstitial alkalosis to some degree. Such a ubiquitous mechanism
might account for the small extracellular alkaline transients associated with electrical activity in muscle (116)
and isolated nerve (91, 108). In the CNS, however, it
remains unclear whether the H⫹ flux contributed by this
process is sufficient to account for large, rapid, stimulusevoked alkaline shifts. In this regard, it is notable that in
cortical pyramidal cells (193), and cerebellar Purkinje
neurons (110), cytosolic Ca2⫹ loads are handled mainly by
uptake into endoplasmic reticulum and mitochondria, and
the fraction of Ca2⫹ entry extruded by the plasmalemmal
Ca2⫹-ATPase is accordingly small.
These observations, coupled with quantitative consideration of the extracellular alkalosis, place significant
restrictions on the Ca2⫹-ATPase hypothesis. For example,
if an activity-dependent fall in [Ca2⫹]o was on the order of
200 ␮M (248a) and the entire Ca2⫹ load was rapidly
extruded by the plasmalemmal Ca2⫹-ATPase (with a
Ca2⫹/H⫹ exchange ratio of 1:2), then the interstitial space
would be subjected to a base load of 400 ␮M. To produce
an alkaline shift of 0.05– 0.1 pH units, the extracellular
buffering capacity would have to be very small, on the
order of 4 – 8 mM. Because only a small fraction of the
1205
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MITCHELL CHESLER
Physiol Rev • VOL
ulus train to the Schaffer collaterals. The speed of this
early GABAergic response remains unclear, however. Although the ligand-gated activation of the HCO⫺
3 conductance would suggest rapid generation of the alkalosis, the
rate-limiting step in the generation of this response is the
catalyzed dehydration of carbonic acid (Fig. 1B) (71, 150),
rather than channel gating.
Since the GABAA receptor and the strychnine-sensitive glycine receptor have a similar permeability to HCO⫺
3
(34), it is plausible that glycinergic inhibitory transmission is also associated with HCO⫺
3 -dependent alkaline pHo
shifts. Accordingly, the glycinergic fall in pHi noted in
brain stem medullary neurons (189) might be accompanied by a concomitant external alkalosis. This topic remains largely unexplored, however. In the dorsal horn of
neonatal rat spinal cord, Sykova and colleagues (147)
noted a small glycine-evoked alkaline shift; however, this
response persisted in the HEPES-buffered media, suggesting it was not mediated by an HCO⫺
3 efflux.
6. Mechanisms of activity-dependent acid shifts
A) LATE ACID SHIFTS: EVIDENCE FOR A METABOLIC ORIGIN.
Slow, activity-dependent acid shifts were noted in the
earliest pH microelectrode studies (65, 322). Kraig et al.
(174) made the first attempt to elucidate the cause of
these phenomena. In the in vivo rat cerebellum, stimulation of the parallel fibers, or induction of spreading depression, elicited a small, brief alkaline transient, followed by a pronounced acidification lasting minutes. In
the presence of acetazolamide, the acid shift was increased in size. This observation suggests that the acidosis was due to extrusion of H⫹ rather than the generation
of CO2. A persistent acidification was also induced by
elevation of [K⫹]o, which could be abolished by fluoride
(a glycolytic inhibitor). A similar acidosis was noted in
vivo following spreading depression (174, 215) and could
be correlated with an increase in brain lactate (215, 269).
Taken together, these observations argue that the metabolic production of acid and its subsequent extrusion
were responsible for these interstitial acid shifts.
Although brain cells express a lactic acid transporter
(219), there is no evidence that this mechanism directly
contributes to interstitial acidosis. Indeed, in hippocampal slices, lactate transport inhibitors did not affect the
extracellular acidosis induced by hypoxia (180), or by
elevated K⫹ (128). Given the ability of lactate to serve as
an energy source in brain (272), it has been suggested that
lactic acid efflux from glial cells is followed by uptake and
utilization by neurons (245a, 271, 345). As such, there may
be no net effect on interstitial pH. Assuming that prolonged stimulation, spreading depression, and hypoxia
cause a fall in pHi, it seems likely that classic acid extrusion mechanisms would be activated, (e.g., Na⫹/H⫹ exchange, Na⫹-driven Cl⫺/HCO⫺
3 exchange, or electrogenic
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typically close to ⫺20 mV in vertebrate neurons and glia
(76). Thus, at normal negative membrane potentials, there
exists an outward electrochemical gradient for HCO⫺
3 that
can drive the efflux of this base to generate an external
alkaline shift. A likely pathway for such an efflux became
evident when Bormann et al. (34) demonstrated that
GABAA and glycine receptor channels had a significant
permeability to HCO⫺
3 . Subsequently, Kaila and Voipio
(154) showed that agonist gating of GABAA receptors on
crayfish muscle led to an HCO⫺
3 -dependent alkalization of
the surface membrane. This external alkalosis had the
features expected of a pH shift generated by an HCO⫺
3
efflux as it was blocked when surface CA was inhibited by
benzolamide (153) and could be mimicked by formate
(196), an anion that can also pass the GABAA receptor
channel (34).
In the vertebrate CNS, extracellular alkaline shifts
generated by GABAA receptors were first noted in turtle
cerebellum. Superfusion of GABA or GABAA agonists produced a rapid increase in pHo. This alkalosis was HCO⫺
3
dependent (68, 69), mimicked by formate (69), and inhibited by benzolamide (125). A similar interstitial alkalosis
mediated by GABAA receptor agonists was noted in the
CA1 stratum pyramidale of rat hippocampal slices (71,
150). Pressure ejection of GABA resulted in a picrotoxinsensitive, bicarbonate-dependent alkalosis that was
blocked by extracellular CA inhibitors (Fig. 2A). A more
physiological demonstration was provided by Kaila et al.
(150) who showed that selective activation of inhibitory
interneurons produced an alkaline shift in stratum pyramidale (Fig. 2B) that was augmented by pentobarbital,
blocked by picrotoxin, and inhibited by an extracellular,
dextran-conjugated CA inhibitor.
These studies indicated that the activation of interneurons can give rise to extracellular alkaline shifts localized around GABAA receptors. The significance of
these pHo shifts remains to be determined, and the size
and speed of these responses during typical sequences of
synaptic excitation and inhibition are still unclear. Kaila
and colleagues (295) proposed that with prolonged, repetitive stimulation of the Schaffer collaterals, early fatigue
of the GABAergic synaptic transmission will limit the
contribution of the HCO⫺
3 efflux to the net alkalosis.
Accordingly, alkaline shifts elicited in this manner were
amplified by benzolamide (295), signifying prevalence of
the excitation-associated proton sink through most of the
stimulus train. However, it was noted that high-frequency,
short-duration stimulus trains elicited alkaline shifts that
were amplified modestly by benzolamide (when compared with the amplification of alkaline transients evoked
by low-frequency trains containing the same number of
stimuli). Moreover, the alkalosis produced by sufficiently
short, high-frequency trains could be inhibited by benzolamide (295). These data suggested that the GABAergic,
HCO⫺
3 -dependent alkalosis is predominant early in a stim-
pH REGULATION IN THE BRAIN
anisms. In contrast, in isolated neonatal spinal cord, a
prominent early alkalosis occurred, which could be elicited with as little as a single shock to the dorsal root (148).
Over the first two postnatal weeks, this response converted to a rapid acid shift that increased in prominence
over the next three months (Fig. 3A). A similar developmental shift from stimulus-evoked alkaline to acid shift
was noted in rat optic nerve (91) (Fig. 3B) and in the CA3
region of hippocampal slices (356). It was suggested that
the alkaline to acid transformation had a glial origin, as
the time course of the change roughly paralleled glial cell
development (91, 148).
The idea that glial cells actively secrete acid in response to neural activity has been proposed on many
occasions. The observation of a rapid, activity-dependent
rise in the cytosolic pH of astrocytes suggested that these
cells extrude acid in response to membrane depolarization (81, 82). This hypothesis was tested using Ba2⫹ to
inhibit the astrocyte K⫹ conductance and thereby prevent
the depolarization that normally results from elevation of
[K⫹]o (17). When rat cortex was superfused with Ba2⫹,
the stimulus-evoked depolarization and the cytosolic alkalization of astrocytes were both blocked (82). In the
cortical interstitial space, Ba2⫹ unmasked or amplified an
early stimulus-evoked alkalosis, consistent with the loss
of a rapid acid source (82). In neonatal rat spinal cord,
Ba2⫹ had a similar effect. After the developmental shift
from stimulus-evoked alkalosis to acidosis (148), addition
of Ba2⫹ appeared to inhibit the acidification and unmask
the underlying alkaline response (290). Moreover, in the
spinal cord of irradiated animals, where astrocyte devel-
FIG. 3. Developmental onset of rapid,
stimulus-evoked acid shifts. A: repetitive
stimulation of the dorsal roots elicited an
alkaline-acid sequence of pHo transients in
the dorsal horn of 4-day-old rats. In older
animals, identical dorsal root stimulation
elicited a predominant acid shift. [From
Sykova et al. (290), copyright 1992, with permission from Elsevier.] B: repetitive stimulation of optic nerve from a 1-day-old rat elicited an initial, small alkalinization, followed
by a modest, slow acid shift. In older animals,
pure acid shifts were observed. [From Davis
et al. (91), copyright 1987, with permission
from Elsevier.]
Physiol Rev • VOL
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Na⫹-HCO⫺
3 cotransport), which could be responsible for
the ensuing extracellular acidification. Inhibition of activity-dependent acidosis by amiloride has implicated
Na⫹/H⫹ exchange in this regard (338, 262); however, effects of this drug on excitability (301) could not be ruled
out.
In hippocampal slices there is strong evidence that
CO2 generation, rather than acid extrusion, is responsible
for slow activity-dependent acid shifts. Voipio and Kaila
(328) demonstrated that repetitive activation of the Schaffer collaterals was associated with a slow rise of tissue
PCO2 that fully accounted for a concomitant delayed interstitial acidosis. The late acid shift of spreading depression was similarly attributed to CO2 generation in hippocampal slices (297). The hippocampal acid shifts were
reduced by benzolamide (328), consistent with a CO2generated acidosis. These results seem to differ from the
observations in vivo, where cerebellar (174) and cortical
(215) acid shifts were increased by acetazolamide. The
ability of blood flow to rapidly clear CO2 in vivo may
partly explain these differences.
B) EARLY ACID SHIFTS: EVIDENCE FOR A GLIAL ORIGIN. In some
instances, neural activity induces a rapid interstitial acidification that can precede or preclude early alkaline transients. For example, initial acid shifts have sometimes
been noted at the onset of spreading depression (215,
314). Sykova and Svoboda (291) reported robust, early
acid shifts in the dorsal horn of the adult rat spinal cord
following peripheral nerve stimulation. These acidifications were inhibited by stilbenes and amiloride, consistent with the involvement of several acid extrusion mech-
1207
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MITCHELL CHESLER
evoked alkalosis in this preparation was normally masked
by the action of the glial electrogenic Na⫹-HCO⫺
3 cotransporter.
The study of extracellular acid shifts evoked by glial
cells has led to further insights into the nature of their
Na⫹-HCO⫺
3 cotransporter. In gliotic slices, and in retinal
Muller cells, depolarization-induced external acidification
was increased after inhibition of extracellular CA (128,
222; Fig. 5A). This suggested that the mechanism of acidification was not solely dependent on the uptake of
HCO⫺
3 , since an acid shift involving loss of interstitial
HCO⫺
3 alone should have been diminished when external
CA was blocked (128) (Fig. 5B). It has been suggested that
⫺
CO2⫺
3 is the ion species utilized to accomplish net HCO3
⫹
⫺
flux by the renal Na -HCO3 cotransporter as well as
other HCO⫺
3 carriers (36, 39, 40, 283a). Such a mechanism
could explain the effects of CA inhibitors on the extracellular acid shifts produced by glial cell depolarization.
Grichtchenko and Chesler (128) proposed that the uptake
of Na⫹ and CO2⫺
by astrocytes (thermodynamically
3
equivalent to 1:2 Na⫹-HCO⫺
3 cotransport) would acidify
the extracellular compartment by driving the dissociation
⫹
of HCO⫺
and replenishing CO2⫺
3 , thereby producing H
3
(Fig. 5C). The fractional increase in [H⫹]o would be
greater than the fractional fall in [HCO⫺
3 ]o, driving the
dehydration of H2CO3, and thereby buffering the increase
in H⫹. If external CA were blocked, the rate of buffering
would be reduced, leading to a greater acid shift (128).
Additional evidence consistent with this idea was provided in a study of the surface pH of oocytes expressing
both an Na⫹-HCO⫺
3 cotransporter and extracellular CA IV.
Voltage-clamp depolarization produced a surface acidification that was amplified following inhibition of the CA,
consistent with the uptake of carbonate ions (127).
It should be noted, however, that the same results
FIG. 4. Extracellular pH transients in
leech ganglion regulated by glial cell membrane potential (Em). Left traces: afferent
stimulation evoked a slow glial depolarization and an extracellular acid transient under current (Im) clamp. Middle traces: afferent stimulation during voltage clamp of glial
cell unmasked a rapid extracellular alkaline
shift. Right traces: an acid shift was again
elicited upon return to afferent stimulation
under current clamp. [From Rose and Deitmer (260).]
Physiol Rev • VOL
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opment was prevented, the early stimulus-evoked acid
shift did not develop, and addition of Ba2⫹ had no effect
on the prevailing early alkalosis (290).
Taken together, these observations suggest that the
effect of Ba2⫹ on activity-dependent pHo transients is due
to the arrest of glial acid secretion. Nonspecific actions of
Ba2⫹ cannot be discounted, however, particularly when
this ion is superfused over a complex preparation. Use of
simpler preparations to study glial acid secretion has
reduced some of these concerns. Direct evidence for
depolarization-induced acid secretion of astrocytes came
from studies of gliotic hippocampal slices in which the
CA3 neuronal population was replaced by a dense proliferation of reactive astrocytes (128, 129). K⫹-evoked depolarization of the astrocyte population elicited an intracellular alkaline shift (129), and a corresponding interstitial acidosis (128), that were both blocked in the presence
of Ba2⫹. The acidosis was dependent on external Na⫹ and
⫹
HCO⫺
3 , consistent with the operation of electrogenic Na ⫺
⫹
HCO3 cotransport. Similar characteristics of K -evoked
intracellular and surface pH shifts were noted in studies
of retinal Muller cells from mudpuppy retina (222). External acidification was recorded with a novel method in
which the fluorescent pH indicator BCECF was fixed to a
coverslip and imaged below the cell. The external acidification was localized mainly to the end foot process and
was reduced in HCO⫺
3 -free media or by addition of DIDS.
The best evidence that glial cells actively secrete acid
(via inward electrogenic Na⫹-HCO⫺
3 cotransport) has
come from studies of the leech, where the extracellular
fluid of a ganglion is controlled by a single giant glial cell
(Fig. 4). Preventing activity-dependent depolarization of
the cell under voltage clamp turned the stimulus-induced
pHo shift from an acid to an alkaline response (260). This
result convincingly demonstrated that the stimulus-
pH REGULATION IN THE BRAIN
1209
would be anticipated in the above studies, if a Na⫹-HCO⫺
3
pair was taken up in exchange for H⫹, as this would result
in similar fractional changes in the interstitial ion concentrations. Thus, while the data of the above studies indicate
that HCO⫺
3 is not the sole acid equivalent carried by the
Na⫹-HCO⫺
3 cotransporter, the results can be explained
with or without the transport of CO2⫺
3 .
It has been suggested that glial acid secretion is a
means of regulating interstitial pH at the onset of neural
activity, and serves to “muffle” activity-dependent alkaline
shifts (76, 94, 252). Because activity-evoked alkalosis can
arise within 10 ms (124, 177), glial acid secretion might be
expected to occur with similar speed. The rate of this
process is not clear, however. In spinal cord, where early
acid shifts are presumed to have a glial origin, pH microPhysiol Rev • VOL
electrodes demonstrated an onset within seconds of stimulation (148, 290, 291). Faster changes could not have
been detected, however, as the best response time of pH
microelectrodes is on the order of 1 s. Studies of glial acid
secretion would accordingly benefit from the use of optical recording methods.
C) DO SYNAPTIC VESICLE CONTENTS CONTRIBUTE TO EXTRACELLULAR ACIDIFICATION? Extremely rapid, apparent acid transients were reported in hippocampal slices after stimulation of the Schaffer collaterals (177). These changes, detected by phenol red absorbance, peaked ⬃10 ms after an
orthodromic stimulus and were followed by slower transients that corresponded to typical alkaline-acid shifts. It
was suggested that such an early acidification could be
due to release of the acidic contents of synaptic vesicles
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FIG. 5. Acid shifts evoked by glial acid secretion modified by inhibition of extracellular carbonic anhydrase. A:
extracellular acid shifts elicited by depolarization (elevation of [K⫹]o) in a gliotic hippocampal slice were reversibly
amplified by benzolamide. [From Grichtchenko and Chesler (127), copyright 1994, with permission from Elsevier.] B:
⫹
uptake of Na⫹ and two HCO⫺
via the hydration of CO2 (left). Addition of benzolamide would
3 would elicit a rise in H
⫹
be expected to reduce the acid transient (right). C: uptake of Na⫹ and CO2⫺
3 would elicit a rise in H via the dissociation
⫺
2⫺
⫹
⫹
of HCO3 into CO3 and H . The elevation of H would be buffered by the dehydration of H2CO3, and addition of
benzolamide would therefore be expected to increase the acid transient.
1210
MITCHELL CHESLER
VIII. EFFECTS OF ACTIVITY-DEPENDENT pH
SHIFTS ON NEURAL FUNCTION
Processes that could be modulated by activity-dependent pH shifts would be expected to have a steep sensitivity to H⫹ near its physiological range. In this category
fall a number of membrane conductances including those
associated with NMDA receptors (300, 320, 333), GABAA
receptors (243, 279, 299), voltage-gated Ca2⫹ channels
(19, 141, 308, 309) and proton-gated channels (169, 178;
reviewed in Refs. 22, 307, 319, 337).
Although channels may have appropriate sensitivities
to changes in pH, in most experiments, pH shifts have
been elicited by application of neurotransmitters or by
artificial, synchronous activation of thousands of neurons. One may therefore question whether these responses are relevant to the in vivo setting. Synchronous
or repetitive neural activity, however, is a normal feature
of brain function. In hippocampus, for example, large
populations of neurons fire together during the theta
rhythm at frequencies close to 10 Hz (reviewed in Ref. 56).
Stimulation of hippocampal afferents at comparable rates
can elicit extracellular alkaline transients on the order of
0.1– 0.2 pH units (63, 71, 144, 295, 355). While pHo shifts
have not been recorded in association with normal hippocampal or cortical rhythms, they are known to accompany aberrant neural activity associated with seizure. In
vivo, seizure activity has been associated with pronounced interstitial acid shifts (278, 285). In addition,
sizable alkaline shifts have been noted at the onset of
Physiol Rev • VOL
spontaneous epileptiform bursts in isolated guinea pig
brain (93) and hippocampal slices (355). Interstitial pH
transients have also been noted in response to physiological stimuli. In the dorsal horn of the rat spinal cord,
Sykova and Svoboda (291) reported a prolonged fall in
pHo (of 0.05– 0.10 pH units) in response to noxious stimulation of the skin.
A. Modulation of Function by Extracellular
Alkaline Shifts
The speculation that channel function is modulated
by activity-dependent alkaline pHo shifts has received
some experimental support. Enhanced excitability has
long been associated with a rise in pHo, while acidosis has
been observed to diminish neural activity (9, 16, 144, 182,
194, 324) (for review, see Ref. 286). NMDA receptors were
implicated in these effects when the increased excitability
of hippocampal slices induced by alkaline saline was
prevented by specific antagonists (9). A likely biophysical
basis for this observation was provided when it was discovered that NMDA receptors are blocked by external
protons, with a steep sensitivity in the physiological range
of extracellular pH (300, 320, 333).
To implicate a pHo shift in the modulation of a channel, one can alter the buffering capacity and note whether
shifts in the amplitude of the pH change elicit expected
changes in channel behavior. This may be done by adding
or removing major buffers such as sodium bicarbonate or
HEPES; however, this approach necessarily entails large
changes in the concentration of these substances, which
could have numerous unanticipated effects. Inhibition of
the interstitial CA with benzolamide is an attractive alternate means of reducing extracellular buffering power,
since only micromolar amounts can markedly amplify
HCO⫺
3 -independent, interstitial alkaline shifts. Similar
concentrations of benzolamide can also be used to reduce
alkaline transients that are generated by a GABAA receptor-mediated HCO⫺
3 efflux (153). Because this agent can
have this dual effect, it is essential to understand the
nature of the pH change one is attempting to modulate. In
addition, possible nonspecific effects of CA inhibitors
should be considered when conducting such experiments.
For example, in neonatal hippocampal CA1 neurons, benzolamide partially inhibited low-threshold Ca2⫹ channels
(123), which could diminish excitability. Therefore, to
correctly interpret data, it is best that both pHo transients
and excitability be monitored in such experiments.
Taira et al. (296) first attempted to modify excitability
using benzolamide in hippocampal slices. An increase in
the amplitude (but no change in time course) of Schaffer
collateral-evoked excitatory postsynaptic field potentials
was noted, which began 5 min after exposure to benzolamide and progressed over the next 35 min. This enhance-
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(187, 198, 208). These putative fast acid responses were
not altered by acetazolamide, however, and were not
otherwise confirmed to be pH changes by manipulation of
the buffering power. In a study using a fluorescein-dextran probe to record Schaffer collateral evoked pHo shifts,
only an early alkaline shift was detected within this time
frame (124), and these fluorescent responses were amplified by addition of the CA inhibitor benzolamide (315).
The release of vesicular contents into the synaptic
cleft should nonetheless alter the pH in this microdomain.
DeVries (99) has recently provided evidence that acid
vesicular contents released from mammalian cone photoreceptors produce a significant local pH change that has a
feedback inhibitory action on the cone calcium channels.
The onset of inward cone calcium currents was interrupted by a transient outward current that decayed with a
1- to 2-ms time constant. This brief suppression of the
Ca2⫹ current was correlated with the onset of transmitter
release, and the effect was diminished when the extracellular buffering power was augmented with HEPES. These
data are the best evidence to date that a physiologically
relevant acid transient may occur in the synaptic cleft due
to release of acidic vesicular contents.
pH REGULATION IN THE BRAIN
Physiol Rev • VOL
fied by benzolamide, but the propagation of spreading
depression was no longer enhanced (313, 314).
Although these data suggest that endogenous alkaline shifts can have a neuromodulatory role, several caveats remain. Assuming the effects of benzolamide on
synaptic transmission and spreading depression were due
to the pH sensitivity of NMDA receptors, it still remains
unclear whether smaller alkaline shifts, elicited under
normal buffering conditions (i.e., in the absence of benzolamide), would have a significant modulatory effect. In
addition, while benzolamide did not appear to directly
affect NMDA receptors, alternative actions of this drug on
pre- or postsynaptic processes remain possible.
Similar putative modulation of other channels by
endogenous alkaline shifts has not been demonstrated.
Enhancement of voltage-gated Ca2⫹ conductances by an
alkaline transient appears plausible, particularly for highthreshold channels (307). The GABAA receptor-evoked
alkalosis, being mediated by a channel-gated HCO⫺
3 efflux, may be particularly suited to influence GABAA receptors in a feedback manner (243). The nature of this
modulation is unlikely to be uniform, however, since the
pHo dependence of GABAA receptors varies with subunit
composition (319). Moreover, because generation of this
alkalosis relies on interstitial CA, the localization of this
enzyme with respect to GABAA receptors may be a critical
factor.
B. Modulation of Function by Activity-Dependent
Acid Shifts
Given the decrease in excitability associated with an
imposed acidosis, endogenous interstitial acid shifts
could be expected to reduce neural activity. However,
unlike an extrinsically imposed acidosis, which is unlocalized and slow, endogenous acid shifts show regional
differences and can display a range of onset and decay
times. Intracellular acid shifts generated by transmembrane H⫹ fluxes may be rapid and localized to a given cell,
whereas metabolic acidosis is likely to affect intracellular
and extracellular pH across a wide region. Potential effects of these pH changes are therefore considered according to their time course and location.
The fastest extracellular acid shifts may be those
speculated to occur following the release of the acidic
contents of synaptic vesicles (177). The strongest evidence for such modulation comes from a study of retinal
cones in which depolarization-evoked Ca2⫹ currents underwent a brief inhibition, coincident with the expected
release of synaptic vesicles from these cells (99). Detection of pH transients of appropriate time course, localized
to the synaptic cleft, is still awaited.
Acid secretion by the astrocyte Na⫹-HCO⫺
3 cotransporter would be expected to operate on a somewhat
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ment was not seen in the presence of APV, indicating the
involvement of NMDA receptors. In the presence of
CNQX and the absence of external Mg2⫹, benzolamide
caused a 20 –30% increase in the amplitude of the NMDA
receptor-mediated field potential, which did not occur in
the presence of APV and Mg2⫹ (without CNQX). Although
the pHo transients were not recorded, and GABAA receptors were not blocked, these observations implicated
NMDA receptors in a benzolamide-mediated enhancement of excitability and suggested a buffering-mediated
effect of the drug. If it were assumed that benzolamide
amplified the stimulus-evoked alkaline transients, the results would be consistent with an associated augmentation of NMDA receptor currents, leading perhaps to an
enhancement of AMPA receptor-mediated synaptic field
potentials through long-term potentiation.
In a subsequent study, the effect of benzolamide on
NMDA receptor-mediated synaptic transmission was resolved in conjunction with pHo recordings (122). Excitatory postsynaptic currents (EPSCs) were recorded from
CA1 pyramidal neurons under whole cell voltage clamp
during single shocks to the Schaffer collaterals, while
corresponding interstitial alkaline shifts were monitored
with a nearby pH microelectrode. Application of benzolamide (in the presence of picrotoxin) increased the alkaline transients, as expected for a net proton sink (72).
Benzolamide caused no significant change in the mean
amplitude of the EPSCs. However, the duration of the
EPSCs was markedly prolonged, and the onset of this
effect coincided with the first observed amplification of
the alkaline transient. This prolongation was not seen
when benzolamide was added in the presence of APV
(although the alkaline transients were still amplified),
indicating that the effect was mediated via NMDA receptors. Because neither the prolongation of the synaptic
response nor the increase in the alkaline transient occurred in HEPES-buffered media, the synaptic enhancement was not due to a direct action of benzolamide on
these receptors. It is notable that when optical recordings
of Schaffer collateral-evoked alkaline shifts were made
under comparable conditions (with picrotoxin and benzolamide), the alkalosis peaked in 20 –200 ms (124). These
synaptically evoked alkaline shifts therefore appear welltimed to modulate the decay of the NMDA receptor-mediated synaptic responses, which occur within a similar
period (136).
Augmentation of NMDA receptors by benzolamide
has also been demonstrated in a pathological setting.
Spreading depression is associated with a large alkaline
transient that is increased by CA inhibitors (174, 215). In
hippocampal slices, the latency and propagation velocity
of spreading depression were increased by benzolamide,
in conjunction with an amplification of the initial alkalosis. When APV was present, the alkalosis was still ampli-
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MITCHELL CHESLER
Physiol Rev • VOL
for the antiepileptic action of this drug (184). However,
acetazolamide may have complex and diverse effects on
baseline pH in the brain as it has been reported to alkalinize the interstitial space in vivo (174), acidify the interstitial space in brain slices (71, 338), and alkalinize the
cytoplasm of thalamic neurons (214).
Although acidosis has typically been linked to a fall in
excitability, under particular circumstances, a fall in pH
may have the opposite effect. Velisek et al. (325) noted
that microinfusions with fluid of pH 6.7 had proconvulsant effects in the posterior substantia nigra pars reticulata of rats, but no such effect in the anterior part of the
nucleus. Differentiation between extracellular and intracellular sites of action could be difficult in such cases,
since application of an acidic fluid is likely to reduce both
pHo and pHi. An intracellular acidosis could increase
excitability if membrane resistance were increased. This
was the case in crayfish muscle where Moody (210) was
able to attribute acid-induced hyperexcitability to block
of an inward rectifying K⫹ conductance. Augmentation of
inward currents by acidosis can also occur in the case of
proton-gated channels. As these responses inactivate with
sustained acidosis, extracellular acid shifts of sufficient
size and speed would be required to increase excitability
through this mechanism (22, 179, 337).
IX. CONCLUSION
A great deal has been learned about the regulation of
pHi in cells derived from the vertebrate CNS. The majority
of studies have been performed in tissue culture. From
the experimental perspective, culture systems are practical, and doubtless will continue to provide important
clues to transporter function, particularly as studies focus
on molecular sites responsible for the modulation of
transporter activity. Issues concerning the biological relevance of culture systems should not be overlooked, however. The degree to which a cultured neuron or glial cell
will express its in situ complement of transporters is not
always known. Studies using brain slices or acutely dissociated cells, while more technically challenging, have
appeal in this regard.
Many of the mechanisms responsible for activitydependent modulation of brain pH remain unclear. The
study of intracellular pH shifts can benefit from in vitro
studies in tissue culture where individual cells are amenable to manipulation. The development of better pharmacological tools to more selectively target H⫹ and Ca2⫹
transport mechanisms would be beneficial for such studies. The adequate stimulus for the generation of a pHi shift
in culture may not be biologically relevant, however. In
situ studies may be particularly useful in determining how
changes in neural activity modulate acid transport systems and how normal shifts in the composition of the
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slower time scale, commensurate with the time course of
membrane depolarization. The onset of external acidification may also rely on the activity of interstitial CA (128).
It has often been speculated that this process serves to
mask or supercede endogenous, activity-dependent alkaline shifts. Because extracellular alkalization may be expected to increase neural activity, muffling of the alkalosis by glial acid secretion may serve to stabilize neuronal
excitability (76, 94, 252) (see sect. VIIB6).
Rapid intracellular acidifications, beginning within a
second of repetitive spike activity, have recently been
reported in somata and dendrites of cerebellar Purkinje
cells (349). In addition to their speed, these phenomenon
are notable because they can be generated by the repetitive activity of a single neuron and are therefore likely to
occur in vivo. The basis of these phenomena remains to
be established. Given the inhibitory effect of internal acid
on Ca2⫹ channel activity (307), and the preponderance of
dendritic Ca2⫹ spikes in Purkinje neurons (302), one may
speculate that these cytosolic acid transients act to diminish dendritic electroresponsiveness.
Delayed interstitial acid shifts can last for minutes
following persistent, synchronous neural activity. These
phenomena are the likely result of respiratory by-products such as CO2 and lactic acid (see sect. VIIB6). The
association of such responses with in vivo seizure activity
(278), and the fall in excitability often associated with
external acidosis (9, 16, 144, 182, 194), leads to the obvious speculation that epileptiform events become inhibited, and are possibly terminated, as a result of accruing
interstitial acid. Thus, in hippocampal slices, low Mg2⫹induced seizures in hippocampal slices were suppressed
by superfusion with Ringer solution of low pH (324).
NMDA receptors are an obvious focus of interest in this
context, given their inhibition by external H⫹ (300, 320,
333). However, it should be noted that if these forms of
acidosis are metabolic in origin, they would be associated
with a fall in intracellular as well as interstitial pH. In
addition, most experimental manipulations that sought to
reduce pHo would be likely to acidify the intracellular
compartment as well. Concomitant intracellular acidosis
may be expected to limit excitability through actions on a
variety of channels (211, 288, 298, 307). It can therefore be
difficult to pinpoint the manner in which an observed or
imposed extracellular acidosis affects excitability.
A number of studies have provided evidence that a
fall in intracellular, rather than extracellular, pH is important in arresting seizure activity. Use of weak acids to
lower pHi of hippocampal slices was able to suppress
epileptiform events (29, 354), and the spontaneous termination of seizure was correlated with intracellular acidosis (354). The use of acetazolamide as an antiepileptic
agent may be similarly related to its effects on brain pH.
A fall in pHi in hippocampal neurons was noted after
application of acetazolamide and was proposed as a basis
pH REGULATION IN THE BRAIN
Address for reprint requests and other correspondence: M.
Chesler, Dept. of Physiology & Neuroscience, NYU School of
Medicine, 550 First Ave., New York, NY 10016 (E-mail:
[email protected]).
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