Chloride

Introduction
Most abundant anion in extracellular fluid
88% found extracellularly 12% found intracellulary

Often associated with sodium Total body content: 0.15% of body weight
105 g in 70 kg human

Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009.

Nomenclature and Forms

Diatomic molecule chlorine (Cl2) when in natural form Exists as an ion (Cl-) when inside the body Forms various salts and compounds via covalent bonding

History
1774: Gaseous element first produced by Carl Wilhelm Scheele 1807: Sir Humphry Davy correctly identified Scheeles discovery as a new element, chlorine

Royal Society of Chemistry. Visual Elements Periodic Table. Accessed from http://www.rsc.org/periodic-table. 2013.

Unit of Measure
In serum: mEq/ L chloride In foods: mg

Whitney E, Rolfes SR. Understanding nutrition, 10th ed. California: Thomson Learning, Inc. 2005.

Food Sources
Average consumption: 50 200 mEq Cl/ day Primary source: salt in food (60% chloride) Other sources:
Soy sauce Fresh meats, seafood, milk, eggs Large amounts in processed foods

Claudio VS, Dirige OV, Ruiz AJ. Basic nutrition for Filipinos, 5th ed. Manila: Merriam & Webster Bookstore, Inc. 2004. Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009. Thompson JL, Manore MM, Vaughan LA. The science of nutrition. Illinois: Pearson Education, Inc. 2008. Whitney E, Rolfes SR. Understanding nutrition, 10th ed. California: Thomson Learning, Inc. 2005.

Digestion, Absorption, Transport, and Excretion

Majority of dietary chloride is absorbed in the small intestine Regulated by the kidneys
Conserved by reabsorption in renal tubules Enhanced by aldosterone

Claudio VS, Dirige OV, Ruiz AJ. Basic nutrition for Filipinos, 5th ed. Manila: Merriam & Webster Bookstore, Inc. 2004. Thompson JL, Manore MM, Vaughan LA. The science of nutrition. Illinois: Pearson Education, Inc. 2008.

Digestion, Absorption, Transport, and Excretion

Absorption closely follows that of sodium but with different mechanisms
Cl passively follows Na through paracellular (tight junction) pathway Absorbed Na creates electrical gradient that provides energy for inward diffusion of Cl

Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009.

Digestion, Absorption, Transport, and Excretion

Stipanuk MH. Biochemical, physiological, and molecular aspects of human nutrition, 2nd ed. Missouri: Saunders Elsevier. 2006.

Digestion, Absorption, Transport, and Excretion

Excreted through three primary routes
Gastrointestinal tract Skin Kidneys

Losses closely reflect those of sodium

Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009.

Digestion, Absorption, Transport, and Excretion

Stipanuk MH. Biochemical, physiological, and molecular aspects of human nutrition, 2nd ed. Missouri: Saunders Elsevier. 2006.

Digestion, Absorption, Transport, and Excretion

Major secretory product of stomach Mechanism: electrogenic chlorine secretion
Only ion actively secreted by epithelium Cells take up Cl from blood across basolateral membrane via Na+/K+/Cl- cotransport pathway Gradient set up by Na+/K+-ATPase pump Cl accumulating in cells exit through brush border membrane into lumen (using Cl channels)
Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009.

Digestion, Absorption, Transport, and Excretion

Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009.

Functions and Mechanisms of Action

Major anion of extracellular fluid
Mostly in association with sodium Associates with potassium inside cells Maintains fluid and electrolyte balance

Aids in preparing food for digestion (as HCl)

Maintain acid-base balance Activation of pepsinogen to pepsin Breakdown of protein
Claudio VS, Dirige OV, Ruiz AJ. Basic nutrition for Filipinos, 5th ed. Manila: Merriam & Webster Bookstore, Inc. 2004. Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009. Thompson JL, Manore MM, Vaughan LA. The science of nutrition. Illinois: Pearson Education, Inc. 2008. Whitney E, Rolfes SR. Understanding nutrition, 10th ed. California: Thomson Learning, Inc. 2005.

Functions and Mechanisms of Action

Helps kill bacteria
Released by white blood cells during phagocytosis

Assists in transmission of nerve impulses Role in enzyme inactivation Interactions with macroions
Surfaces are modified by counterion atmosphere enriched with oppositely charged small ions

Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009. Thompson JL, Manore MM, Vaughan LA. The science of nutrition. Illinois: Pearson Education, Inc. 2008. Stipanuk MH. Biochemical, physiological, and molecular aspects of human nutrition, 2nd ed. Missouri: Saunders Elsevier. 2006.

Functions and Mechanisms of Action

Acts as exchange anion for HCO3- in red blood cells (chloride shift)
Requires protein transporter that moves Cl and HCO3 ions in opposite directions Allow transport of tissue-derived CO2 back to lungs in the form of plasma HCO3 Waste CO2 from tissue is converted to HCO3- by carbonic anhydrase

Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009.

Interactions with Other Nutrients

Sodium
Maintains osmolarity and balances in fluid, electrolytes, and acid-base interactions Negative charge of Cl neutralizes positive charge of Na Use similar pathways for absorption and transport (electrochemical gradient from Na is needed)

Potassium
Associates when inside cells
Claudio VS, Dirige OV, Ruiz AJ. Basic nutrition for Filipinos, 5th ed. Manila: Merriam & Webster Bookstore, Inc. 2004. Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009. Stipanuk MH. Biochemical, physiological, and molecular aspects of human nutrition, 2nd ed. Missouri: Saunders Elsevier. 2006.

Recommended Nutrient Intakes

Age Month 05 6 - 11 Year 4.5 8.9 180 300 Weight (kg) Chloride (mg)

1 25 69 10 18 > 18

11 16 25 50 70

350 500 600 750 750

Food and Nutrition Research Institute. Recommended energy and nutrient intakes: Philippines, 2002 edition. Bicutan: Department of Science and Technolgy. 2002.

Assessment of Nutriture
Usual serum concentration: 101-111 mEq/ L Concentration depends on body water status Two techniques widely used:
Ion-selective electrode potentiometry Coulometric titration with silver ions

Claudio VS, Dirige OV, Ruiz AJ. Basic nutrition for Filipinos, 5th ed. Manila: Merriam & Webster Bookstore, Inc. 2004. Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009.

Deficiency
Diets rarely lack chloride Occurs chiefly through gastrointestinal tract disturbance
Heavy sweating Chronic diarrhea Prolonged vomiting Severe dehydration

Claudio VS, Dirige OV, Ruiz AJ. Basic nutrition for Filipinos, 5th ed. Manila: Merriam & Webster Bookstore, Inc. 2004. Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009. Whitney E, Rolfes SR. Understanding nutrition, 10th ed. California: Thomson Learning, Inc. 2005.

Deficiency
Can lead to alkalosis
Excessive loss of chloride ions from gastric secretion During continued vomiting, diarrhea, or tube drain Concentration of bicarbonate ions in plasma are increased Main symptom: muscle convulsions

Claudio VS, Dirige OV, Ruiz AJ. Basic nutrition for Filipinos, 5th ed. Manila: Merriam & Webster Bookstore, Inc. 2004. Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009. Whitney E, Rolfes SR. Understanding nutrition, 10th ed. California: Thomson Learning, Inc. 2005.

Toxicity
No known toxicity symptoms for chloride alone
Vomiting Hypertension (for salt-sensitive individuals)

High blood chloride concentration can be caused by dehydration due to water deficiency

Thompson JL, Manore MM, Vaughan LA. The science of nutrition. Illinois: Pearson Education, Inc. 2008. Whitney E, Rolfes SR. Understanding nutrition, 10th ed. California: Thomson Learning, Inc. 2005.