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Aldosterone producing adenoma

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https://www.readbyqxmd.com/read/29436482/the-angiotensin-type-2-receptor-in-%C3%A2-human-adrenocortical-zona-glomerulosa-and-in-aldosterone-producing-adenoma-low-expression-and-no-functional-role
#1
Paul Emmanuel Vanderriele, Brasilina Caroccia, Teresa Maria Seccia, Maria Piazza, Livia Lenzini, Francesca Torresan, Maurizio Iacobone, Thomas Unger, Gian Paolo Rossi
The angiotensin II type 2 receptor (AT2R) and the angiotensin-(1-7) receptor (MasR) play a cardiovascular protective role by counter-regulating angiotensin II type 1 receptor (AT1R)-mediated effects, but whether this involves blunting of adrenocortical hormone secretion is unknown. We investigated the presence of AT1R, AT2R and MasR in aldosterone-producing adenoma (APA), a condition featuring hyperaldosteronism, and in APA-adjacent tissue. The effect of C21, an AT2R agonist, on CYP11B1 (cortisol synthase) and CYP11B2 (aldosterone synthase) gene expression in NCI-H295R and HAC15 cell lines, and in APA and APA-adjacent tissue was also assessed using the AT1R antagonist irbesartan to ascertain the specificity of C21 effect...
February 7, 2018: Clinical Science (1979-)
https://www.readbyqxmd.com/read/29432258/overview-of-aldosterone-related-genetic-syndromes-and-recent-advances
#2
Maria-Christina Zennaro, Fabio L Fernandes-Rosa, Sheerazed Boulkroun
PURPOSE OF REVIEW: Primary aldosteronism is the most common form of secondary hypertension. Early diagnosis and treatment are key to cure of hypertension and prevention of cardiovascular complications. Recent genetic discoveries have improved our understanding on the pathophysiology of aldosterone production and triggered the development of new diagnostic procedures and targeted treatments for primary aldosteronism. RECENT FINDINGS: Different inherited genetic abnormalities distinguish specific forms of familial hyperaldosteronism...
February 8, 2018: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/29409357/macrolides-for-kcnj5-mutated-aldosterone-producing-adenoma-mapa-design-of-a-study-for-personalized-diagnosis-of-primary-aldosteronism
#3
Giuseppe Maiolino, Giulio Ceolotto, Michele Battistel, Giulio Barbiero, Maurizio Cesari, Laurence Amar, Brasilina Caroccia, Roberto Padrini, Michel Azizi, Gian Paolo Rossi
PURPOSE: Aldosterone-producing adenoma (APA) is the main curable cause of endocrine hypertension cause of primary aldosteronism (PA) and it is in up to 66% of all cases investigated with adrenal vein sampling (AVS). Mutations in the KCNJ5 potassium channel involve up to 70% of APA and cause the most florid PA phenotypes. The recent finding that macrolide antibiotics specifically inhibit in vitro the altered function of mutated KCNJ5 channels has opened new horizons for the diagnosis and treatment of APA with KCNJ5 mutations in that it can allow identification and target treatment of PA patients harbouring a mutated APA...
February 6, 2018: Blood Pressure
https://www.readbyqxmd.com/read/29348428/evaluation-of-quantitative-parameters-for-distinguishing-pheochromocytoma-from-other-adrenal-tumors
#4
Youichi Ohno, Masakatsu Sone, Daisuke Taura, Toshinari Yamasaki, Katsutoshi Kojima, Kyoko Honda-Kohmo, Yorihide Fukuda, Koji Matsuo, Toshihito Fujii, Akihiro Yasoda, Osamu Ogawa, Nobuya Inagaki
Adrenal tumors are increasingly found incidentally during imaging examinations. It is important to distinguish pheochromocytomas from other adrenal tumors because of the risk of hypertensive crisis. Although catecholamines and their metabolites are generally used to diagnose pheochromocytoma, false-positive test results are common. An effective screening method to distinguish pheochromocytoma from adrenal incidentalomas is needed. We analyzed 297 consecutive patients with adrenal incidentalomas. Our findings included 162 non-functioning tumors, 47 aldosterone-producing adenomas, 26 metastases, 22 cases of subclinical Cushing's syndrome, 21 pheochromocytomas, 12 cases of Cushing's syndrome, and 7 adrenocortical cancers...
January 18, 2018: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/29348113/genetics-in-endocrinology-the-expanding-genetic-horizon-of-primary-aldosteronism
#5
Silvia Monticone, Fabrizio Buffolo, Martina Tetti, Franco Veglio, Barbara Pasini, Paolo Mulatero
Aldosterone is the main mineralocorticoid hormone in humans and plays a key role in maintaining water and electrolyte homeostasis. Primary aldosteronism (PA), characterized by autonomous aldosterone overproduction by the adrenal glands, affects 6% of the general hypertensive population and can be either sporadic or familial. Aldosterone producing adenoma (APA) and bilateral adrenal hyperplasia (BAH) are the two most frequent subtypes of sporadic PA, and 4 forms of familial hyperaldosteronism (FH-I to FH-IV) have been identified...
January 18, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29287775/regulation-of-aldosterone-production-by-ion-channels-from-basal-secretion-to-primary-aldosteronism
#6
Tingting Yang, Min He, Changlong Hu
Aldosterone is produced by zona glomerulosa (ZG) cells of the adrenal cortex and plays a key role in balancing water and electrolytes levels. Autonomous overproduction of aldosterone leads to primary aldosteronism (PA), which is the most common form of secondary endocrine hypertension. Recently, significant progress has been made towards understanding the genetic basis of PA, where increasing clinical evidence suggests that mutations in ion channels appear to be the major cause of aldosterone-producing adenomas...
December 26, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29279316/targeting-cxcr4-cxc-chemokine-receptor-type-4-for-molecular-imaging-of-aldosterone-producing-adenoma
#7
Britta Heinze, Carmina T Fuss, Paolo Mulatero, Felix Beuschlein, Martin Reincke, Mona Mustafa, Andreas Schirbel, Timo Deutschbein, Tracy Ann Williams, Yara Rhayem, Marcus Quinkler, Nada Rayes, Silvia Monticone, Vanessa Wild, Celso E Gomez-Sanchez, Anna-Carinna Reis, Stephan Petersenn, Hans-Juergen Wester, Saskia Kropf, Martin Fassnacht, Katharina Lang, Ken Herrmann, Andreas K Buck, Christina Bluemel, Stefanie Hahner
Primary aldosteronism is the most frequent cause of secondary hypertension and is associated with increased morbidity and mortality compared with hypertensive controls. The central diagnostic challenge is the differentiation between bilateral and unilateral disease, which determines treatment options. Bilateral adrenal venous sampling, currently recommended for differential diagnosis, is an invasive procedure with several drawbacks, making it desirable to develop novel noninvasive diagnostic tools. When investigating the expression pattern of chemokine receptors by quantitative real-time polymerase chain reaction and immunohistochemistry, we observed high expression of CXCR4 (CXC chemokine receptor type 4) in aldosterone-producing tissue in normal adrenals, adjacent adrenal cortex from adrenocortical adenomas, and in aldosterone-producing adenomas (APA), correlating strongly with the expression of CYP11B2 (aldosterone synthase)...
December 26, 2017: Hypertension
https://www.readbyqxmd.com/read/29202495/disordered-cyp11b2-expression-in-primary-aldosteronism
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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