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Aldosterone producing adenoma

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https://www.readbyqxmd.com/read/29202495/disordered-cyp11b2-expression-in-primary-aldosteronism
#1
Celso E Gomez-Sanchez, Maniselvan Kuppusamy, Martin Reincke, Tracy Ann Williams
Primary aldosteronism is the most common type of secondary hypertension affecting 6-10% of patients with primary hypertension. PA is mainly caused by unilateral hyperaldosteronism due to an aldosterone-producing adenoma, unilateral hyperplasia with or without micronodules or bilateral zona glomerulosa hyperplasias with or without macro or micronodules. The development of antibodies against the terminal enzyme of aldosterone biosynthesis (CYP11B2) has permitted the further characterization of normal adrenals and resected adrenals from patients with primary aldosteronism...
December 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29202494/aldosterone-producing-cell-clusters-in-normal-and-pathological-states
#2
Kei Omata, Scott A Tomlins, William E Rainey
Primary aldosteronism (PA) significantly increases the risk of cardiovascular complications, and early diagnosis and targeted treatment based on its pathophysiology is warranted. Next-generation sequencing (NGS) has revealed recurrent somatic mutations in aldosterone-driving genes in aldosterone-producing adenoma (APA). By applying CYP11B2 (aldosterone synthase) immunohistochemistry and NGS to adrenal glands from normal subjects and PA patients, we and others have shown that CYP11B2-positive cells make small clusters, termed aldosterone-producing cell clusters (APCC), beneath the adrenal capsule, and that APCC harbor somatic mutations in genes mutated in APA...
December 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29202493/health-related-quality-of-life-and-mental-health-in-primary-aldosteronism-a-systematic-review
#3
Marieke S Velema, Aline H de Nooijer, Vivian W G Burgers, Ad R M M Hermus, Henri J L M Timmers, Jacques W M Lenders, Olga Husson, Jaap Deinum
The aim of this review was to determine the impact of primary aldosteronism on health-related quality of life (HRQoL) and mental health. We performed a systematic literature search up to July 2017 in six electronic databases. First, we screened the articles derived from this search based on title and abstract. Second, the selected studies were systematically reviewed and checked for our predefined inclusion criteria. The search yielded 753 articles, of which 15 studies met our inclusion criteria. Untreated patients with primary aldosteronism showed an impaired physical and mental HRQoL as compared to the general population...
December 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29202492/subtyping-of-patients-with-primary-aldosteronism-an-update
#4
Jacques W M Lenders, Graeme Eisenhofer, Martin Reincke
Primary aldosteronism (PA) comprises two main subtypes: unilateral aldosteronism, mainly caused by aldosterone-producing adenoma; and bilateral adrenal hyperplasia. Establishing the correct subtype in patients with PA is indispensible for choice of treatment. In addition to established methods, alternative tests are evolving for subtyping. Computed tomography (CT) and adrenal venous sampling (AVS) are currently recommended in the guidelines for the diagnostic work-up of patients with PA. CT cannot be used as a stand-alone test for subtyping because of its limited accuracy but may be used in combination with other tests such as AVS or functional imaging...
December 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29198769/subtyping-of-primary-aldosteronism-with-adrenal-vein-sampling-hormone-and-side-specific-effects-of-cosyntropin-and-metoclopramide
#5
Giacomo Rossitto, Giuseppe Maiolino, Livia Lenzini, Valeria Bisogni, Teresa Maria Seccia, Maurizio Cesari, Maurizio Iacobone, Gian Paolo Rossi
BACKGROUND: Cosyntropin and metoclopramide can affect the subtyping of primary aldosteronism when used with adrenal vein sampling by exerting hormone- and side-specific effects on cortisol and aldosterone secretion. We investigated how these stimuli affect the selectivity index, the relative aldosterone secretion index, and the lateralization index in consecutive primary aldosteronism patients submitted to adrenal vein sampling. METHODS: We recruited 171 patients; of these, 149 underwent adrenal vein sampling before and after stimulation with cosyntropin (250 µg intravenous bolus, n= 53, 73% with an aldosterone-producing adenoma) or with metoclopramide (10 mg intravenous bolus, n= 96, 65% aldosterone-producing adenoma), and 32 with an aldosterone-producing adenoma were investigated for the relative gene expression of dopamine, melanocortin 2, and 5-hydroxytryptamine (serotonin) 4 receptor with microarrays...
November 30, 2017: Surgery
https://www.readbyqxmd.com/read/29190995/predictors-of-hypertension-urgency-in-primary-aldosteronism-patients-during-the-first-24-hours-after-surgery
#6
Juping Zhao, Jun Dai, Wenlong Zhou, Haofei Wang, Wenbin Rui, Wei He, Zhe Zhu, Yu Zhu, Danfeng Xu, Fukang Sun
Study about blood pressure variation in the first 24 hours post-operation is limited in patients with adrenal aldosterone-producing adenoma. We aim to evaluate the potential predictors for postoperative hypertension urgency during the first 24 hours after laparoscopic adrenalectomy in patients with aldosterone-producing adenoma. Clinical data of 177 patients with aldosterone-producing adenoma were retrospectively collected from January 2009 to December 2015 and the potential factors that may influence postoperative blood pressure during the first 24 hours after surgery were analyzed...
November 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29165736/the-spartacus-trial-controversies-and-unresolved-issues
#7
Felix Beuschlein, Paolo Mulatero, Evelyn Asbach, Silvia Monticone, Cristiana Catena, Leonardo A Sechi, Michael Stowasser
Adrenal vein sampling (AVS) is considered the gold standard for the differential diagnosis in patients with primary aldosteronism (PA). The distinction between unilateral and bilateral disease dictates the targeted therapeutic approach with surgery for aldosterone producing adenomas and medical therapy for patients with bilateral hyperplasia. Thereby, this diagnostic step is crucial in clinical care. As AVS is an invasive, not well standardized procedure that is restricted to few specialized centers, several attempts have been made to simplify diagnostic algorithms...
December 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29165597/gsta1-expression-is-correlated-with-aldosterone-level-in-kcnj5-mutated-adrenal-aldosterone-producing-adenoma
#8
Xintao Li, Baojun Wang, Lu Tang, Yu Zhang, Luyao Chen, Liangyou Gu, Fan Zhang, Jinzhi Ouyang, Xu Zhang
Context: KCNJ5 mutation is a major cause of aldosterone-producing adenoma (APA). The development of APA apart from KCNJ5 mutation is less investigated. Objective: To investigate other mechanisms affecting aldosterone secretion apart from KCNJ5. Patients and Methods: Six pairs of KCNJ5-mutated, high and low aldosterone-secreting APAs, five non-KCNJ5-mutated APAs and four normal adrenal glands were assayed by Affymetrix Genechip Human Transcriptome Array 2...
November 20, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29164516/mineralocorticoid-receptor-antagonism-protects-the-aorta-from-vascular-smooth-muscle-cell-proliferation-and-collagen-deposition-in-a-rat-model-of-adrenal-aldosterone-producing-adenoma
#9
Yongji Yan, Chao Wang, Yiqin Lu, Huijie Gong, Zhun Wu, Xin Ma, Hongzhao Li, Baojun Wang, Xu Zhang
The number of patients with adrenal aldosterone-producing adenomas (APAs) has gradually increased. However, even after adenoma resection, some patients still suffer from high systolic blood pressure (SBP), which is possibly due to great arterial remodeling. Moreover, mineralocorticoid receptors (MRs) were found to be expressed in vascular smooth muscle cells (VSMCs). This study aims to determine whether MR antagonism protects the aorta from aldosterone-induced aortic remolding. Male rats were subcutaneously implanted with an osmotic minipumps and randomly divided into four groups: control; aldosterone (1 μg/h); aldosterone plus a specific MR antagonist, eplerenone (100 mg/kg/day); and aldosterone plus a vasodilator, hydralazine (25 mg/kg/day)...
November 21, 2017: Journal of Physiology and Biochemistry
https://www.readbyqxmd.com/read/29163738/a-case-of-moderate-sprue-like-enteropathy-associated-with-telmisartan
#10
Aurelio Negro, Loredana De Marco, Valentina Cesario, Rosaria Santi, Maria Chiara Boni, Magda Zanelli
Sprue-like enteropathy associated with olmesartan medoxomil use has been recently reported. Its clinical manifestations include diarrhea, weight loss and malabsorption. Duodenal biopsies show villous atrophy (VA) with or without intraepithelial lymphocytosis and inflammation of the lamina propria. Serology for celiac disease (CD) is negative and gluten-free diet does not result in clinical improvement. Symptoms resolve after olmesartan discontinuation. Follow-up biopsies show recovery/improvement of the duodenum...
December 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29141372/-role-of-adrenal-vein-sampling-in-differential-diagnosis-of-primary-aldosteronism-subtypes
#11
H Y Li, P Li, S M Shen, X B Zhang, W H Feng, H Huang, W Chen, D L Zhu
Objective: To investigate the role of adrenal vein sampling (AVS) in identifying the subtype of primary aldosteronism (PA). Methods: AVS was performed in 50 patients who were confirmed as PA between September 2010 and September 2016 in Nanjing Drum Tower Hospital. Clinical, biochemical and follow-up data were reviewed retrospectively. Bilaterally simultaneous catheterization without cosyntropin stimulation and contemporaneous cortisol measurement during AVS were used. Selectivity index (SI)≥1.5 suggested that the sample was from the adrenal vein...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29129575/cardiovascular-events-and-target-organ-damage-in-primary-aldosteronism-compared-with-essential-hypertension-a-systematic-review-and-meta-analysis
#12
Silvia Monticone, Fabrizio D'Ascenzo, Claudio Moretti, Tracy Ann Williams, Franco Veglio, Fiorenzo Gaita, Paolo Mulatero
BACKGROUND: There is conflicting evidence, relying on heterogeneous studies, as to whether aldosterone excess is responsible for an increased risk of cardiovascular and cerebrovascular complications in patients with primary aldosteronism. We aimed to assess the association between primary aldosteronism and adverse cardiac and cerebrovascular events, target organ damage, diabetes, and metabolic syndrome, compared with the association of essential hypertension and these cardiovascular and end organ events, by integrating results of previous studies...
November 9, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29109191/calneuron-1-increased-ca-2-in-the-endoplasmic-reticulum-and-aldosterone-production-in-aldosterone-producing-adenoma
#13
Kazuhiro Kobuke, Kenji Oki, Celso E Gomez-Sanchez, Elise P Gomez-Sanchez, Haruya Ohno, Kiyotaka Itcho, Yoko Yoshii, Masayasu Yoneda, Noboru Hattori
Aldosterone production is initiated by angiotensin II stimulation and activation of intracellular Ca(2+) signaling. In aldosterone-producing adenoma (APA) cells, the activation of intracellular Ca(2+) signaling is independent of the renin-angiotensin-aldosterone systems. The purpose of our study was to clarify molecular mechanisms of aldosterone production related to Ca(2+) signaling. Transcriptome analysis revealed that the CALN1 gene encoding calneuron 1 had the strongest correlation with CYP11B2 (aldosterone synthase) among genes encoding Ca(2+)-binding proteins in APA...
November 6, 2017: Hypertension
https://www.readbyqxmd.com/read/29100412/the-therapeutic-effect-of-bromocriptine-in-combination-with-spironolactone-in-patients-with-primary-aldosteronism-a-hypothesis-generating-pilot-study
#14
Vin-Cent Wu, Che-Hsiung Wu, Ya-Wen Yang, Kuo-How Huang, Chia-Hui Chang, Shao-Yu Yang, Yen-Hung Lin, Kwan-Dun Wu
Background: Dopamine D2-like receptors are attenuated in aldosterone producing adenoma, lead to overproduction of aldosterone in affected patients, and thus reported to serve as a potential treatment target for primary aldosteronism. The D2 dopamine receptor agonist bromocriptine has been used clinically for reducing tumor mass of pituitary adenomas of lactotroph origin. The aim of the present study was to assess the efficacy of adding bromocriptine to spironolactone in the biochemical control of primary aldosteronism...
September 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/29099925/quality-of-life-in-primary-aldosteronism-a-comparative-effectiveness-study-of-adrenalectomy-and-medical-treatment
#15
Marieke Velema, Tanja Dekkers, Ad Hermus, Henri Timmers, Jacques Lenders, Hans Groenewoud, Leo Schultze Kool, Johan Langenhuijsen, Aleksander Prejbisz, Gert-Jan van der Wilt, Jaap Deinum
Context: In primary aldosteronism (PA) two subtypes are distinguished: aldosterone-producing adenoma and bilateral adrenal hyperplasia. In general these are treated by adrenalectomy and mineralocorticoid receptor antagonists respectively. Objective: To compare the effects of surgical treatment and medical treatment on quality of life (QoL). Design: Post-hoc comparative effectiveness study within the SPARTACUS trial. Setting: Twelve Dutch hospitals and one Polish hospital...
November 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29069700/evaluation-of-cortisol-production-in-aldosterone-producing-adenoma
#16
Kosuke Inoue, Yuto Yamazaki, Yuya Tsurutani, Sachiko Suematsu, Chiho Sugisawa, Jun Saito, Masao Omura, Hironobu Sasano, Tetsuo Nishikawa
Aldosterone-producing adenoma (APA) is sometimes accompanied with subclinical hypercortisolism. We investigated the ability of cortisol production in APA, both clinically and pathologically. A retrospective cohort study was conducted at Yokohama Rosai Hospital from 2009 to 2016. Thirty patients with APA and serum cortisol levels during the 1 mg dexamethasone suppression test (F-DST)<3.0 μg/dl were included. We evaluated the 1) difference between pre-adrenalectomy F-DST (pre-F-DST) and post-adrenalectomy F-DST (ΔF-DST), 2) correlation between ∆F-DST and pre-F-DST, tumour size determined by CT, and type of adrenalectomy (total or partial), and 3) relationship between the ratio of F-DST divided by tumour size (ΔF-DST/pre-F-DST/mm) and immunoreactivity of CYP17A1, CYP11B1, and CYP11B2...
November 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29069360/mouse-models-of-primary-aldosteronism-from-physiology-to-pathophysiology
#17
Leticia Aragao-Santiago, Celso E Gomez-Sanchez, Paolo Mulatero, Ariadni Spyroglou, Martin Reincke, Tracy Ann Williams
Primary aldosteronism (PA) is a common form of endocrine hypertension that is characterized by the excessive production of aldosterone relative to suppressed plasma renin levels. PA is usually caused by either a unilateral aldosterone-producing adenoma or bilateral adrenal hyperplasia. Somatic mutations have been identified in several genes that encode ion pumps and channels that may explain the aldosterone excess in over half of aldosterone-producing adenomas, whereas the pathophysiology of bilateral adrenal hyperplasia is largely unknown...
October 23, 2017: Endocrinology
https://www.readbyqxmd.com/read/29065434/unanswered-questions-in-the-genetic-basis-of-primary-aldosteronism
#18
Ute I Scholl
Over the past six years, the genetic basis of a significant fraction of primary aldosteronism (PA) cases has been solved. Breakthrough discoveries include the role of somatic variants in the KCNJ5, CACNA1D, ATP1A1, and ATP2B3 genes as causes of aldosterone-producing adenomas (APAs), and the recognition of three novel hyperaldosteronism syndromes with germline variants in the KCNJ5, CACNA1D, and CACNA1H genes. The description of somatic variants in CACNA1D and ATP1A1 in aldosterone-producing cell clusters (APCCs) suggests that these clusters are precursors of some aldosterone-producing adenomas...
October 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29065433/primary-aldosteronism-the-next-five-years
#19
John W Funder
The management of primary aldosteronism is widely varied within various published guidelines, with very little in the way of data supporting the choice of one variation over others. Current estimates of prevalence are probably accurate for aldosterone producing adenoma, but fall very short of that for bilateral adrenal hyperplasia. Discovery at the level of basic science has proven illuminating over the past 6 years in terms of unilateral disease and both somatic and germline mutations, with much less focus on the much more common bilateral disease; Attempts at harmonization have begun - for example, criteria for complete/partial/absent cure after adrenalectomy for unilateral disease; again focus on bilateral disease is muted...
October 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29059354/inflammation-and-fibrosis-in-perirenal-adipose-tissue-of-patients-with-aldosterone-producing-adenoma
#20
Chunyan Wu, Huijian Zhang, Jiajun Zhang, Cuihua Xie, Cunxia Fan, Hongbin Zhang, Peng Wu, Qiang Wei, Wanlong Tan, Lingling Xu, Ling Wang, Yaoming Xue, Meiping Guan
The prevalence of primary aldosteronism is much higher than previously thought. Recent studies have shown that primary aldosteronism is related to a higher risk of cardiovascular events. However, the underlying mechanism is not yet clear. Here we investigate the characteristics, including inflammation, fibrosis and adipokine expression, of adipose tissues from different deposits in patients with aldosterone-producing adenoma (APA). Inflammation and fibrosis changes were evaluated in perirenal and subcutaneous adipose tissues obtained from patients with APA (n=16), normotension (NT; n=10) and essential hypertension (EH; n=5) undergoing laparoscopic surgery...
October 19, 2017: Endocrinology
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