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Aldosterone producing adenoma

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https://www.readbyqxmd.com/read/27917596/plasma-adrenocorticotropic-hormone-but-not-aldosterone-is-correlated-with-blood-pressure-in-patients-with-aldosterone-producing-adenomas
#1
Hiroki Kobayashi, Akira Haketa, Ueno Takahiro, Hiromasa Otsuka, Sho Tanaka, Yoshinari Hatanaka, Yukihiro Ikeda, Masanori Abe, Noboru Fukuda, Masayoshi Soma
Although plasma aldosterone concentration (PAC) varies depending on primary aldosteronism (PA) subtypes, patients with different subtypes may have similar blood pressure (BP). The authors hypothesized that hormones other than aldosterone might influence BP in PA patients. A total of 73 PA cases, including 30 cases of aldosterone-producing adenomas (APAs), 29 cases of bilateral hyperaldosteronism, and 24 control cases of essential hypertension were enrolled retrospectively. The authors examined the levels of aldosterone, cortisol, renin, and adrenocorticotropic hormone (ACTH) measured at 12 am, 6 am, 12 pm, and 6 pm and BP in the early morning (6 am to 7 am), late morning (9 am to 11 am), and early evening (5 pm to 7 pm)...
December 5, 2016: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/27864864/genetics-of-adrenocortical-tumours
#2
T Åkerström, T Carling, F Beuschlein, P Hellman
The recently available genomic sequencing techniques have led to breakthroughs in understanding of the underlying genetic mechanisms in adrenocortical tumours. Disease-causing mutations have been described for aldosterone-producing adenomas, cortisol-producing adenomas and adrenocortical carcinomas. Further, knowledge gained from transcriptome analyses and methylation arrays has provided new insights into the development of these tumours. Elucidation of the genomic landscape of adrenocortical tumours and improved techniques may in the future be useful for early diagnosis through the detection of mutated DNA in the circulation...
December 2016: Journal of Internal Medicine
https://www.readbyqxmd.com/read/27862984/of-channels-and-pumps-different-ways-to-boost-the-aldosterone
#3
REVIEW
Sascha Bandulik
The mineralocorticoid aldosterone is a major factor controlling the salt and water balance and thereby also the arterial blood pressure. Accordingly, primary aldosteronism characterized by an inappropiately high aldosterone secretion is the most common form of secondary hypertension. The physiological stimulation of aldosterone synthesis in adrenocortical glomerulosa cells by angiotensin II and an increased plasma K(+) concentration depends on a membrane depolarization and an increase of the cytosolic Ca(2+) activity...
November 15, 2016: Acta Physiologica
https://www.readbyqxmd.com/read/27862274/risk-of-fracture-in-primary-aldosteronism-a-population-based-cohort-study
#4
Vin-Cent Wu, Chia-Hui Chang, Cheng-Yi Wang, Yen-Hung Lin, Tze-Wah Kao, Po-Chih Lin, Tzong-Shinn Chu, Yuan-Shian Chang, Likwang Chen, Kwan-Dun Wu, Shih-Chieh Jeff Chueh
Primary aldosteronism (PA) is associated with increased urinary calcium excretion and osteoporosis prevalence. We studied the long-term effect of hyperaldosterone on fracture risk and possible risk mitigation via treatments, by comparing PA patients and their essential hypertension (EH) counterparts extracted by propensity score match. We used a longitudinal population database from the Taiwan National Health Insurance, and used a validated algorithm to identify PA patients diagnosed in 1997-2010. Our sample included 2533 PA patients, including 921 patients with aldosterone-producing adenoma (APA)...
November 10, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/27853054/expression-of-cyp11b2-in-aldosterone-producing-adrenocortical-adenoma-regulatory-mechanisms-and-clinical-significance
#5
Yasuhiro Nakamura, Yuto Yamazaki, Yuta Tezuka, Fumitoshi Satoh, Hironobu Sasano
Aldosterone-producing adrenocortical adenoma (APA) is responsible for the majority of cases clinically diagnosed as primary aldosteronism. Aldosterone synthase (CYP11B2) is one of the enzymes that play essential roles in aldosterone synthesis and is involved in the pathogenesis of APA. Recent studies have demonstrated that various factors and regulators influence the expression and function of CYP11B2 in APA. In particular, somatic mutations, such as gain-of-function and loss-of-function mutations, have been identified in several genes, each of which encodes a pivotal protein that affects the calcium signaling pathway, the expression of CYP11B2, and aldosterone production...
2016: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/27834080/cardiac-dysfunction-in-association-with-increased-inflammatory-markers-in-primary-aldosteronism
#6
Jung Soo Lim, Sungha Park, Sung Il Park, Young Taik Oh, Eunhee Choi, Jang Young Kim, Yumie Rhee
BACKGROUND: Oxidative stress in primary aldosteronism (PA) is thought to worsen aldosterone-induced damage by activating proinflammatory processes. Therefore, we investigated whether inflammatory markers associated with oxidative stress is increased with negative impacts on heart function as evaluated by echocardiography in patients with PA. METHODS: Thirty-two subjects (mean age, 50.3±11.0 years; 14 males, 18 females) whose aldosterone-renin ratio was more than 30 among patients who visited Severance Hospital since 2010 were enrolled...
November 3, 2016: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27777363/transcriptome-pathway-analysis-of-pathological-and-physiological-aldosterone-producing-human-tissues
#7
Junhua Zhou, Brian Lam, Sudeshna G Neogi, Giles S H Yeo, Elena A B Azizan, Morris J Brown
Primary aldosteronism is present in ≈10% of hypertensives. We previously performed a microarray assay on aldosterone-producing adenomas and their paired zona glomerulosa and fasciculata. Confirmation of top genes validated the study design and functional experiments of zona glomerulosa selective genes established the role of the encoded proteins in aldosterone regulation. In this study, we further analyzed our microarray data using AmiGO 2 for gene ontology enrichment and Ingenuity Pathway Analysis to identify potential biological processes and canonical pathways involved in pathological and physiological aldosterone regulation...
October 24, 2016: Hypertension
https://www.readbyqxmd.com/read/27776721/primary-aldosteronism-diagnosis-and-management
#8
REVIEW
Geeta Gyamlani, Carol M Headley, Adnan Naseer, Ganpat S Valaulikar, Stephen A Geraci
Primary aldosteronism (PA) is an important and commonly unrecognized cause of secondary hypertension. Idiopathic hyperaldosteronism and aldosterone-producing adenomas account for more than 95% of PA and are characterized, respectively, by bilateral or unilateral involvement of the adrenal glands. When there is suspicion for the presence of PA, a plasma aldosterone to renin ratio should be obtained initially. Localization to determine adrenal gland involvement is done by imaging, with computerized tomography or magnetic resonance imaging...
October 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27759849/long-term-results-after-ct-guided-percutaneous-ethanol-ablation-for-the-treatment-of-hyperfunctioning-adrenal-disorders
#9
Nathan Elie Frenk, Fernando Sebastianes, Antonio Marcondes Lerario, Maria Candida Barisson Villares Fragoso, Berenice Bilharinho Mendonca, Marcos Roberto de Menezes
OBJECTIVES: To evaluate the safety and long-term efficacy of computed tomography-guided percutaneous ethanol ablation for benign primary and secondary hyperfunctioning adrenal disorders. METHOD: We retrospectively evaluated the long-term results of nine patients treated with computed tomography-guided percutaneous ethanol ablation: eight subjects who presented with primary adrenal disorders, such as pheochromocytoma, primary macronodular adrenal hyperplasia and aldosterone-producing adenoma, and one subject with Cushing disease refractory to conventional treatment...
October 1, 2016: Clinics
https://www.readbyqxmd.com/read/27754862/hypomethylation-of-cyp11b2-in-aldosterone-producing-adenoma
#10
Yoko Yoshii, Kenji Oki, Celso E Gomez-Sanchez, Haruya Ohno, Kiyotaka Itcho, Kazuhiro Kobuke, Masayasu Yoneda
The purpose of this study was to evaluate the DNA methylation levels of steroidogenic enzyme genes in aldosterone-producing adenoma (APA) and the effects of gene mutations in APA on the DNA methylation levels. DNA methylation array analysis was conducted using nonfunctioning adrenocortical adenoma (n=12) and APA (n=35) samples, including some with a KCNJ5 mutation (n=21), an ATP1A1 mutation (n=5), and without the known mutations (n=9). The quantitative polymerase chain reaction assay was performed for the detection of CYP11B2 and CYP11B1 expression levels in nonfunctioning adrenocortical adenoma and APA...
October 17, 2016: Hypertension
https://www.readbyqxmd.com/read/27754305/lbos-02-06-histopathological-specific-mutation-spectrum-of-aldosterone-producing-adenomas
#11
Elena Azizan, Norlela Sukor, Nor Azmi Kamaruddin, A Rahman A Jamal, Jiri Ceral, Miroslav Solar, Isa Mohamed Rose, Geok Chin Tan
OBJECTIVE: Aldosterone-producing adenoma (APA) is a common curable cause of hypertension. Somatic mutations in five genes (KCNJ5, ATP1A1, ATP2B3, CACNA1D, and CTNNB1) have been found to cause the excess aldosterone production of two thirds of APAs [1-4]. KCNJ5 mutant APAs, the most common and largest, had explicit genotype-phenotype relationship - a low protein expression of KCNJ5 relative to their peritumoural zona glomerulosa (ZG) and a zona fasciculata-like composition [5-6]. Conversely for the other genes, controversy arises on whether they have the opposite cell phenotype [4,7-8]...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754249/os-35-09-long-term-outcome-of-surgically-and-medically-treated-patients-of-the-primary-aldosteronism-prevalence-in-hypertensives-papy-study
#12
Giuseppe Maiolino, Alberto Flego, Gian Paolo Rossi
OBJECTIVE: PA causes excess cardiovascular (CV) damage, but whether it worsens prognosis remained uncertain as there are no prospective studies. To compare long-term outcome of the 1125 patients recruited in the PAPY study. DESIGN AND METHOD: 11.2% of the PAPY study patients had PA: 6.4% idiopathic hyperaldosteronism (IHA) received medical therapy; 4,8% aldosterone-producing adenoma (APA) required adrenalectomy. Endpoints were total and CV mortality, major adverse cardiovascular events (MACE) and total CV events...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754230/os-33-06-in-patients-with-primary-aldosteronism-obstructive-sleep-apnoea-improves-with-treatment-by-adrenalectomy-or-medical-therapy
#13
Martin Wolley, Diane Cowley, Ashraf Ahmed, Richard Gordon, Michael Stowasser
OBJECTIVE: Obstructive sleep apnoea (OSA) is known to commonly co-exist with primary aldosteronism (PA), but it is unknown if treatment via mineralocorticoid receptor blockade or adrenalectomy (for aldosterone producing adenoma, APA), improves sleep apnoea parameters in these patients. We therefore aimed to determine if specific medical or surgical treatment of PA improves OSA, as measured by the apnoea hypopnoea index (AHI). DESIGN AND METHOD: Patients undergoing diagnostic workup for PA were recruited if they had symptoms suggestive of OSA...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754085/os-19-08-the-activated-intrarenal-renin-angiotensin-systems-and-oxidative-stress-in-tubular-can-be-the-original-mechanism-of-renal-damage-in-primary-aldosteronism
#14
Yoshitsugu Iwakura, Ryo Morimoto, Kumi Kikuchi, Yoshikiyo Ono, Yuta Tezuka, Yasuko Tsukada, Masahiro Nezu, Yasuhiro Igarashi, Masataka Kudo, Akira Nishiyama, Sadayoshi Ito, Fumitoshi Satoh
OBJECTIVE: High prevalence of renal damage has been demonstrated in patients with primary aldosteronism (PA). However, the original mechanism and onset still be elucidated. The purpose of this study is to investigate the possible original mechanisms of renal damages in PA. DESIGN AND METHOD: Consecutive 72 patients with aldosterone producing adenoma (APA) and 70 patients with essential hypertension (EH) participated. No patients had renal damages defined as eGFR (based on Cystatin C) < 60 ml/min/1...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753883/ish-ada-04-transcriptome-pathway-analysis-of-autonomous-and-physiological-aldosterone-producing-human-tissue
#15
Junhua Zhou, Brian Lam, Sudeshna Neogi, Giles Yeo, Elena Azizan, Morris Brown
OBJECTIVE: Primary aldosteronism (PA) is the most common type of secondary hypertension occurring in ∼10% of hypertensive patients. Up to 50% of PA is caused by aldosterone-producing adenomas (APA). This study is to identify the potential biological processes and canonical pathways involved with aldosterone regulation, APA formation, or APA and ZG cell functions. DESIGN AND METHOD: Gene ontology (GO) and pathway analyses were performed on genes differentially expressed in APAs when compared to ZG and on genes differentially expressed in ZG when compared to ZF...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753830/sy-03-3-overview-of-somatic-mutations-and-epigenetic-regulation-of-aldosterone-producing-adenoma-apa
#16
Satoshi Umemura
Primary aldosteronism (PA) is a heterogeneous group of disorders including both sporadic and familial forms (familial hyperaldosteronism type I, II and III). PA is the most frequent endocrine cause of secondary hypertension and associated with a higher rate of cardiovascular complications, compared with essential hypertension.Here I review the recent progress in understanding of the genetic and molecular mechanisms leading to autonomous aldosterone production in PA.Systematic screening detects primary aldosteronism in 5 to 10% of all patients with hypertension and in approximately 20% of patients with resistant hypertension...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27751767/immunohistochemistry-of-aldosterone-synthase-leads-the-way-to-the-pathogenesis-of-primary-aldosteronism
#17
Koshiro Nishimoto, Minae Koga, Tsugio Seki, Kenji Oki, Elise P Gomez-Sanchez, Celso E Gomez-Sanchez, Mitsuhide Naruse, Tomokazu Sakaguchi, Shinya Morita, Takeo Kosaka, Mototsugu Oya, Tadashi Ogishima, Masanori Yasuda, Makoto Suematsu, Yasuaki Kabe, Masao Omura, Tetsuo Nishikawa, Kuniaki Mukai
Our group previously purified human and rat aldosterone synthase (CYP11B2 and Cyp11b2, respectively) from their adrenals and verified that it is distinct from steroid 11β-hydroxylase (CYP11B1 or Cyp11b1), the cortisol- or corticosterone-synthesizing enzyme. We now describe their distributions immunohistochemically with specific antibodies. In rats, there is layered functional zonation with the Cyp11b2-positive zona glomerulosa (ZG), Cyp11b1-positive zona fasciculata (ZF), and Cyp11b2/Cyp11b1-negative undifferentiated zone between the ZG and ZF...
October 14, 2016: Molecular and Cellular Endocrinology
https://www.readbyqxmd.com/read/27748964/volumetric-and-densitometric-evaluation-of-the-adrenal-glands-in-patients-with-primary-aldosteronism
#18
Christoph Degenhart, Julia Schneller, Andrea Osswald, Anna Pallauf, Anna Riester, Maximilian F Reiser, Martin Reincke, Felix Beuschlein
OBJECTIVE: To evaluate volumetric and densitometric properties of the adrenal glands in patients with unilateral and bilateral disease in comparison to normal controls. DESIGN: 77 patients (56 male and 21 female) diagnosed with primary aldosteronism (PA) with a mean age of 53±10 years were prospectively enrolled. Unenhanced and contrast enhanced CT scans were analyzed for adrenal volumes and mean densities. f These values were compared with normal controls and between PA subtypes...
October 17, 2016: Clinical Endocrinology
https://www.readbyqxmd.com/read/27729216/cacna1h-mutations-are-associated-with-different-forms-of-primary-aldosteronism
#19
Georgios Daniil, Fabio L Fernandes-Rosa, Jean Chemin, Iulia Blesneac, Jacques Beltrand, Michel Polak, Xavier Jeunemaitre, Sheerazed Boulkroun, Laurence Amar, Tim M Strom, Philippe Lory, Maria-Christina Zennaro
Primary aldosteronism (PA) is the most common form of secondary hypertension. Mutations in KCNJ5, ATP1A1, ATP2B3 and CACNA1D are found in aldosterone producing adenoma (APA) and familial hyperaldosteronism (FH). A recurrent mutation in CACNA1H (coding for Cav3.2) was identified in a familial form of early onset PA. Here we performed whole exome sequencing (WES) in patients with different types of PA to identify new susceptibility genes. Four different heterozygous germline CACNA1H variants were identified. A de novo Cav3...
October 4, 2016: EBioMedicine
https://www.readbyqxmd.com/read/27725373/acth-stimulation-test-and-computed-tomography-are-useful-for-differentiating-the-subtype-of-primary-aldosteronism
#20
Ayako Moriya, Masaaki Yamamoto, Shunsuke Kobayashi, Tomoko Nagamine, Naomi Takeichi-Hattori, Mototsugu Nagao, Taro Harada, Kyoko Tanimura-Inagaki, Shiro Onozawa, Satoru Murata, Hideki Tamura, Izumi Fukuda, Shinichi Oikawa, Hitoshi Sugihara
The diagnostic steps for primary aldosteronism (PA) include case screening tests, confirmatory tests, and localization. The aim of this study was to identify useful confirmatory tests and their cut-off values for differentiating the subtype of primary aldosteronism, especially in unilateral PA, such as aldosterone-producing adenoma, and bilateral PA, such as idiopathic hyperaldosteronism. Seventy-six patients who underwent all four confirmatory tests, the captopril-challenge test (CCT), furosemide upright test (FUT), saline infusion test (SIT), and ACTH stimulation test (AST), and who were confirmed to have an aldosterone excess by adrenal venous sampling (AVS) were recruited...
October 1, 2016: Endocrine Journal
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