Mediation of cimetidine secretion by P-glycoprotein and a novel H(+)-coupled mechanism in cultured renal epithelial monolayers of LLC-PK1 cells.

1. Previous studies have shown that the weak base, cimetidine, is actively secreted by the renal proximal tubule. In this study we have examined the transport of cimetidine by renal LLC-PK1 epithelial cell monolayers. 2. In LLC-PK1 cell monolayers the basal-to-apical flux of cimetidine was significantly greater than the apical-to basal flux, consistent with net secretion of cimetidine in a basal-to-apical direction. 3. Net secretion of cimetidine was significantly (70%) reduced by the addition of either 100 microM verapamil or 100 microM nifedipine to the apical membrane. The reduction in net secretion was the result of an inhibition of basal-to-apical flux; these agents had no effect upon flux in the apical-to-basal direction. These results suggest that cimetidine secretion is mediated primarily by P-glycoprotein located in the apical membrane. In addition we found no evidence of a role for organic cation antiport in the secretion of cimetidine. 4. In the presence of an inwardly directed proton gradient across the apical membrane (pH 6.0), cimetidine secretion was significantly reduced compared to that measured at an apical pH of 7.4. The reduction in net secretion at pH 6.0 was the result of a stimulation of cimetidine uptake across the apical membrane. This pH-dependent uptake mechanism was sensitive to inhibition by DIDS (100 microM). 5. Experiments with BCECF (2',7'-bis(2-carboxyethyl)-5(6)-carboxyfluorescein) loaded monolayers demonstrated that cimetidine influx across the apical membrane was associated with proton flow into the cell and was sensitive to inhibition by DIDS. 6. These results suggest that net secretion of cimetidine across the apical membrane is a function of the relative magnitudes of cimetidine secretion mediated by P-glycoprotein and cimetidine absorption mediated by a novel proton-coupled, DIDS-sensitive transport mechanism.