Mechanisms of ENaC regulation and clinical implications

J Am Soc Nephrol. 2008 Oct;19(10):1845-54. doi: 10.1681/ASN.2008020225. Epub 2008 Aug 27.


The epithelial Na+ channel (ENaC) transports Na+ across tight epithelia, including the distal nephron. Different paradigms of ENaC regulation include extrinsic and intrinsic factors that affect the expression, single-channel properties, and intracellular trafficking of the channel. In particular, recent discoveries highlight new findings regarding proteolytic processing, ubiquitination, and recycling of the channel. Understanding the regulation of this channel is critical to the understanding of various clinical phenomena, including normal physiology and several diseases of kidney and lung epithelia, such as blood pressure (BP) control, edema, and airway fluid clearance. Significant progress has been achieved in this active field of research. Although ENaC is classically thought to be a mediator of BP and volume status through Na+ reabsorption in the distal nephron, several studies in animal models highlight important roles for ENaC in lung pathophysiology, including in cystic fibrosis. The purpose of this review is to highlight the various modes and mechanisms of ENaC regulation, with a focus on more recent studies and their clinical implications.

Publication types

  • Review

MeSH terms

  • Biological Transport, Active / physiology
  • Blood Pressure / physiology
  • Epithelial Sodium Channels / physiology*
  • Gastrointestinal Diseases / etiology
  • Humans
  • Kidney Diseases / etiology*
  • Kidney Diseases / metabolism
  • Kidney Diseases / physiopathology
  • Lung Diseases / etiology
  • Water-Electrolyte Balance / physiology


  • Epithelial Sodium Channels