Expression and function of renal and hepatic organic anion transporters in extrahepatic cholestasis

World J Gastroenterol. 2012 Nov 28;18(44):6387-97. doi: 10.3748/wjg.v18.i44.6387.


Obstructive jaundice occurs in patients suffering from cholelithiasis and from neoplasms affecting the pancreas and the common bile duct. The absorption, distribution and elimination of drugs are impaired during this pathology. Prolonged cholestasis may alter both liver and kidney function. Lactam antibiotics, diuretics, non-steroidal anti-inflammatory drugs, several antiviral drugs as well as endogenous compounds are classified as organic anions. The hepatic and renal organic anion transport pathways play a key role in the pharmacokinetics of these compounds. It has been demonstrated that acute extrahepatic cholestasis is associated with increased renal elimination of organic anions. The present work describes the molecular mechanisms involved in the regulation of the expression and function of the renal and hepatic organic anion transporters in extrahepatic cholestasis, such as multidrug resistance-associated protein 2, organic anion transporting polypeptide 1, organic anion transporter 3, bilitranslocase, bromosulfophthalein/bilirubin binding protein, organic anion transporter 1 and sodium dependent bile salt transporter. The modulation in the expression of renal organic anion transporters constitutes a compensatory mechanism to overcome the hepatic dysfunction in the elimination of organic anions.

Keywords: Bilitranslocase; Bromosulfophthalein/bilirubin binding protein; Kidney; Liver; Multidrug resistance-associated protein 2; Organic anion transporter 1; Organic anion transporter 3; Organic anion transporting polypeptide 1; Organic anions; Sodium dependent bile salt transporter.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adaptation, Physiological
  • Animals
  • Bile Acids and Salts / metabolism*
  • Biological Transport
  • Cholestasis, Extrahepatic / metabolism*
  • Humans
  • Jaundice, Obstructive / metabolism*
  • Kidney / metabolism*
  • Liver / metabolism*
  • Organic Anion Transporters / metabolism*
  • Pharmaceutical Preparations / metabolism
  • Pharmacokinetics


  • Bile Acids and Salts
  • Organic Anion Transporters
  • Pharmaceutical Preparations