ABSTRACT
Primary aldosteronism (PA) is the most common form of endocrine hypertension and is characterized by inappropriately elevated aldosterone production via a renin-independent mechanism. Driver somatic mutations for aldosterone excess have been found in approximately 90% of aldosterone-producing adenomas (APAs). Other causes of lateralized adrenal PA include aldosterone-producing nodules (APNs). Using next-generation sequencing, we identified recurrent in-frame deletions in SLC30A1 in four APAs and one APN (p.L51_A57del, n = 3; p.L49_L55del, n = 2). SLC30A1 encodes the ubiquitous zinc efflux transporter ZnT1 (zinc transporter 1). The identified SLC30A1 variants are situated close to the zinc-binding site (His43 and Asp47) in transmembrane domain II and probably cause abnormal ion transport. Cases of PA with SLC30A1 mutations showed male dominance and demonstrated increased aldosterone and 18-oxocortisol concentrations. Functional studies of the SLC30A151_57del variant in a doxycycline-inducible adrenal cell system revealed pathological Na+ influx. An aberrant Na+ current led to depolarization of the resting membrane potential and, thus, to the opening of voltage-gated calcium (Ca2+) channels. This resulted in an increase in cytosolic Ca2+ activity, which stimulated CYP11B2 mRNA expression and aldosterone production. Collectively, these data implicate zinc transporter alterations as a dominant driver of aldosterone excess in PA.
Subject(s)
Adenoma , Adrenal Cortex Neoplasms , Adrenocortical Adenoma , Cation Transport Proteins , Hyperaldosteronism , Male , Humans , Aldosterone/genetics , Adrenocortical Adenoma/genetics , Hyperaldosteronism/genetics , Adenoma/genetics , Adenoma/complications , Mutation , Zinc/metabolism , Adrenal Cortex Neoplasms/genetics , G Protein-Coupled Inwardly-Rectifying Potassium Channels/genetics , G Protein-Coupled Inwardly-Rectifying Potassium Channels/metabolism , Cation Transport Proteins/geneticsABSTRACT
Hypertension due to primary aldosteronism poses a risk of severe cardiovascular complications compared to essential hypertension. The discovery of the KCNJ5 somatic mutation in aldosteroene producing adenoma (APA) in 2011 and the development of specific CYP11B2 antibodies in 2012 have greatly advanced our understanding of the pathophysiology of primary aldosteronism. In particular, the presence of CYP11B2-positive aldosterone-producing micronodules (APMs) in the adrenal glands of normotensive individuals and the presence of renin-independent aldosterone excess in normotensive subjects demonstrated the continuum of the pathogenesis of PA. Furthermore, among the aldosterone driver mutations which incur excessive aldosterone secretion, KCNJ5 was a major somatic mutation in APA, while CACNA1D is a leading somatic mutation in APMs and idiopathic hyperaldosteronism (IHA), suggesting a distinctive pathogenesis between APA and IHA. Although the functional detail of APMs has not been still uncovered, its impact on the pathogenesis of PA is gradually being revealed. In this review, we summarize the integrated findings regarding APA, APM or diffuse hyperplasia defined by novel CYP11B2, and aldosterone driver mutations. Following this, we discuss the clinical implications of KCNJ5 mutations to support better cardiovascular outcomes of primary aldosteronism.
Subject(s)
Adenoma , Adrenocortical Adenoma , G Protein-Coupled Inwardly-Rectifying Potassium Channels , Hyperaldosteronism , Adenoma/genetics , Adenoma/pathology , Adrenocortical Adenoma/complications , Adrenocortical Adenoma/genetics , Aldosterone/genetics , Cytochrome P-450 CYP11B2/genetics , Cytochrome P-450 CYP11B2/metabolism , G Protein-Coupled Inwardly-Rectifying Potassium Channels/genetics , Humans , Hyperaldosteronism/etiology , MutationABSTRACT
Despite extensive studies on blood pressure, its genetic risk factors remain uncertain. Even one of the most researched blood pressure-related traits - renin - is not fully understood genetically. Here, we determine the genetic relationship and associated predisposition between blood pressure and baseline renin. In 8840 Korean individuals, we observed a strong negative genome-wide genetic correlation (rg = -0.484) between systolic blood pressure (SBP) and plasma renin activity (PRA), suggesting that antagonistic genetic signals explain the variance in the two traits. We found 51 significant pleiotropic SNPs affecting the two traits, which could contribute to the Renin-Angiotensin-Aldosterone System (RAAS). Our findings provide insight into studies on RAAS by identifying the genome-wide relationship and susceptibility loci of SBP and PRA.
Subject(s)
Aldosterone , Renin , Humans , Renin/genetics , Blood Pressure/genetics , Aldosterone/genetics , Renin-Angiotensin System/genetics , Republic of KoreaABSTRACT
In high-yielding dairy cows, the rapidly increasing milk production after parturition can result in a negative nutrient balance, since feed intake is insufficient to cover the needs for lactation. Mobilizing body reserves, mainly adipose tissue (AT), might affect steroid metabolism. We hypothesized, that cows differing in the extent of periparturient lipomobilization, will have divergent steroid profiles measured in serum and subcutaneous (sc)AT by a targeted metabolomics approach and steroidogenic enzyme profiles in scAT and liver. Fifteen weeks antepartum, 38 multiparous Holstein cows were allocated to a high (HBCS) or normal body condition (NBCS) group fed differently until week 7 antepartum to either increase (HBCS BCS: 3.8 ± 0.1 and BFT: 2.0 ± 0.1 cm; mean ± SEM) or maintain BCS (NBCS BCS: 3.0 ± 0.1 and BFT: 0.9 ± 0.1 cm). Blood samples, liver, and scAT biopsies were collected at week -7, 1, 3, and 12 relative to parturition. Greater serum concentrations of progesterone, androsterone, and aldosterone in HBCS compared to NBCS cows after parturition, might be attributed to the increased mobilization of AT. Greater glucocorticoid concentrations in scAT after parturition in NBCS cows might either influence local lipogenesis by differentiation of preadipocytes into mature adipocytes and/or inflammatory response.
Subject(s)
Adipose Tissue/metabolism , Aldosterone/genetics , Aldosterone/metabolism , Androsterone/genetics , Androsterone/metabolism , Cattle/metabolism , Dairying , Metabolomics , Peripartum Period/blood , Peripartum Period/metabolism , Progesterone/genetics , Progesterone/metabolism , RNA, Messenger/blood , RNA, Messenger/metabolism , Adipocytes/physiology , Aldosterone/blood , Androsterone/blood , Animal Nutritional Physiological Phenomena/physiology , Animals , Cell Differentiation , Eating/physiology , Female , Glucocorticoids/metabolism , Lactation , Lipogenesis , Progesterone/bloodABSTRACT
Cellular senescence is considered a physiological process along with aging and has recently been reported to be involved in the pathogenesis of many age-related disorders. Cellular senescence was first found in human fibroblasts and gradually explored in many other organs, including endocrine organs. The adrenal cortex is essential for the maintenance of blood volume, carbohydrate metabolism, reaction to stress and the development of sexual characteristics. Recently, the adrenal cortex was reported to harbor some obvious age-dependent features. For instance, the circulating levels of aldosterone and adrenal androgen gradually descend, whereas those of cortisol increase with aging. The detailed mechanisms have remained unknown, but cellular senescence was considered to play an essential role in age-related changes of the adrenal cortex. Recent studies have demonstrated that the senescent phenotype of zona glomerulosa (ZG) acts in association with reduced aldosterone production in both physiological and pathological aldosterone-producing cells, whereas senescent cortical-producing cells seemed not to have a suppressed cortisol-producing ability. In addition, accumulated lipofuscin formation, telomere shortening and cellular atrophy in zona reticularis cells during aging may account for the age-dependent decline in adrenal androgen levels. In adrenocortical disorders, including both aldosterone-producing adenoma (APA) and cortisol-producing adenoma (CPA), different cellular subtypes of tumor cells presented divergent senescent phenotypes, whereby compact cells in both APA and CPA harbored more senescent phenotypes than clear cells. Autonomous cortisol production from CPA reinforced a local cellular senescence that was more severe than that in APA. Adrenocortical carcinoma (ACC) was also reported to harbor oncogene-induced senescence, which compensatorily follows carcinogenesis and tumor progress. Adrenocortical steroids can induce not only a local senescence but also a periphery senescence in many other tissues. Therefore, herein, we systemically review the recent advances related to cellular senescence in adrenocortical biology and its associated disorders.
Subject(s)
Adrenal Cortex Neoplasms/genetics , Adrenal Cortex/metabolism , Aldosterone/genetics , Androgens/genetics , Adrenal Cortex/pathology , Adrenal Cortex Neoplasms/pathology , Aging/genetics , Aging/pathology , Cellular Senescence/genetics , Humans , Hydrocortisone/genetics , Hydrocortisone/metabolism , Zona Glomerulosa/metabolism , Zona Glomerulosa/pathologyABSTRACT
The EGF receptor (EGFR) has been extensively studied in tumor biology and recently a role in cardiovascular pathophysiology was suggested. The mineralocorticoid receptor (MR) is an important effector of the renin-angiotensin-aldosterone-system and elicits pathophysiological effects in the cardiovascular system; however, the underlying molecular mechanisms are unclear. Our aim was to investigate the importance of EGFR for MR-mediated cardiovascular pathophysiology because MR is known to induce EGFR expression. We identified a SNP within the EGFR promoter that modulates MR-induced EGFR expression. In RNA-sequencing and qPCR experiments in heart tissue of EGFR KO and WT mice, changes in EGFR abundance led to differential expression of cardiac ion channels, especially of the T-type calcium channel CACNA1H. Accordingly, CACNA1H expression was increased in WT mice after in vivo MR activation by aldosterone but not in respective EGFR KO mice. Aldosterone- and EGF-responsiveness of CACNA1H expression was confirmed in HL-1 cells by Western blot and by measuring peak current density of T-type calcium channels. Aldosterone-induced CACNA1H protein expression could be abrogated by the EGFR inhibitor AG1478. Furthermore, inhibition of T-type calcium channels with mibefradil or ML218 reduced diameter, volume and BNP levels in HL-1 cells. In conclusion the MR regulates EGFR and CACNA1H expression, which has an effect on HL-1 cell diameter, and the extent of this regulation seems to depend on the SNP-216 (G/T) genotype. This suggests that the EGFR may be an intermediate for MR-mediated cardiovascular changes and that SNP analysis can help identify subgroups of patients that will benefit most from MR antagonists.
Subject(s)
Calcium Channels, T-Type/genetics , ErbB Receptors/genetics , Hypertrophy/genetics , Receptors, Mineralocorticoid/genetics , Aldosterone/genetics , Animals , Cardiovascular System/drug effects , Cardiovascular System/pathology , Cell Line , Female , Genotype , HEK293 Cells , Humans , Male , Mice , Mice, Inbred C57BL , Mice, Knockout , Mineralocorticoid Receptor Antagonists/pharmacology , Myocytes, Cardiac/drug effects , Polymorphism, Single Nucleotide/genetics , RatsABSTRACT
We have previously demonstrated that manipulation of the renin angiotensin system (RAS) has large effects on digestive efficiency. However, the effects of aldosterone on body weight, adiposity, and glucose absorption in the intestine remains unknown. We here demonstrated that lack of aldosterone synthase (ASKO) in mice did not affect adiposity. In contrast, mice administered with aldosterone were resistant to diet-induced obesity. This is due to gastrointestinal loss of dietary glucose. As expected, ASKO mice had increased glucose absorption, whereas mice administered with aldosterone had reduced glucose absorption in the small intestine. Furthermore, the level of protein expression of sodium glucose transporter 1 (SGLT1) in the mucosa of the jejunum was higher in ASKO mice, and lower in mice administered with aldosterone than control mice. Our findings indicate that aldosterone plays an important role on SGLT-1-mediated glucose absorption in the small intestine.
Subject(s)
Adiposity/physiology , Aldosterone/metabolism , Aldosterone/pharmacology , Cytochrome P-450 CYP11B2/genetics , Intestine, Small/metabolism , Adiposity/drug effects , Aldosterone/genetics , Animals , Body Composition/drug effects , Body Composition/physiology , Body Weight/physiology , Cytochrome P-450 CYP11B2/metabolism , Epithelial Sodium Channels/metabolism , Feces/chemistry , Glucose/metabolism , Glucose/pharmacokinetics , Intestinal Absorption , Jejunum/metabolism , Male , Mice, Inbred C57BL , Mice, Knockout , Sodium/analysis , Sodium-Glucose Transporter 1/genetics , Sodium-Glucose Transporter 1/metabolismABSTRACT
Aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia are the main cause of primary aldosteronism (PA), the most frequent form of secondary hypertension. Mutations in ion channels and ATPases have been identified in APA and inherited forms of PA, highlighting the central role of calcium signaling in PA development. Different somatic mutations are also found in aldosterone-producing cell clusters in adrenal glands from healthy individuals and from patients with unilateral and bilateral PA, suggesting additional pathogenic mechanisms. Recent mouse models have also contributed to a better understanding of PA. Application of genetic screening in familial PA, development of surrogate biomarkers for somatic mutations in APA, and use of targeted treatment directed at mutated proteins may allow improved management of patients.
Subject(s)
Hyperaldosteronism/genetics , Adrenocortical Adenoma/genetics , Aldosterone/genetics , Animals , Calcium Signaling/genetics , Genetics , Genomics/methods , Humans , Hyperplasia/genetics , Hypertension/genetics , Mutation/geneticsABSTRACT
BACKGROUND AND AIMS: Emerging evidence suggests aldosterone (aldo) and NLRP3 inflammasome are important factors for HSC activation and liver fibrosis. However, the interaction between aldo and NLRP3 inflammasome in HSC activation and liver fibrosis remains largely unknown. The aim of this study is to investigate the relationship between aldo and NLRP3 inflammasome in liver fibrosis. METHODS: Serum and liver specimens collected from 40 patients with or without liver fibrosis were used to test the level of aldo and NLRP3. Primary HSC isolated from C57BL/6 mice were treated with aldo, and the effects of aldo on NLRP3 inflammasome and HSC activation were detected in vitro. Two animal models were used to verify the effect of aldo on liver fibrosis in vivo: hyperaldosteronism model was established in wild-type and NLRP3 knockout (NLRP3-/- ) mice by micro-pump, and liver fibrosis mouse model was built by tetrachloromethane (CCl4 ). RESULTS: Patients with liver fibrosis showed higher aldo levels and increased NLRP3 expression in liver. In vitro, aldo induced the activation of primary mouse HSCs by promoting the expression and assembly of NLRP3 inflammasome. In vivo, NLRP3 knockout could alleviate the liver fibrosis induced by aldo in mice. In addition, treatment with spironolactone (spi) could inhibit the NLRP3 expression, HSC activation, and liver fibrosis induced by CCl4 . CONCLUSIONS: Aldo promotes the activation of HSCs and liver fibrosis through NLRP3 inflammasome relative pathways. Intervention of aldo and NLRP3 inflammasome-related pathways may provide a promising strategy for treatment of liver fibrosis.
Subject(s)
Aldosterone/metabolism , Aldosterone/physiology , Gene Expression Regulation, Developmental/genetics , Gene Expression , Hepatic Stellate Cells/metabolism , Inflammasomes/genetics , Inflammasomes/metabolism , Liver Cirrhosis/genetics , Liver Cirrhosis/pathology , NLR Family, Pyrin Domain-Containing 3 Protein/genetics , NLR Family, Pyrin Domain-Containing 3 Protein/metabolism , Aldosterone/genetics , Animals , Cells, Cultured , Hepatic Stellate Cells/pathology , Humans , Mice , Mice, Inbred C57BL , Molecular Targeted Therapy , Signal Transduction/genetics , Signal Transduction/physiology , Up-Regulation/geneticsABSTRACT
Recent genetic examinations and multisteroid profiles have provided the basis for subclassification of aldosterone-producing adenomas (APAs). The objective of the current study was to produce a comprehensive, high-resolution mass spectrometry imaging (MSI) map of APAs in relation to morphometry, immunohistochemical profiles, mutational status, and clinical outcome. The study cohort comprised 136 patients with unilateral primary aldosteronism. Matrix-assisted laser desorption/ionization-Fourier transform-ion cyclotron resonance MSI was conducted, and metabolite profiles were analyzed with genotype/phenotype information, including digital image analysis from morphometry and IHC of steroidogenic enzymes. Distinct molecular signatures between KCNJ5- and CACNA1D-mutated APAs with significant differences of 137 metabolites, including metabolites of purine metabolism and steroidogenesis, were observed. Intratumor concentration of 18-oxocortisol and 18-hydroxycortisol were inversely correlated with the staining intensity of CYP11B1. Lower staining intensity of CYP11B1 and higher levels of 18-oxocortisol were associated with a higher probability of complete clinical success after surgery. The present study demonstrates distinct metabolomic profiles of APAs in relation to tumor genotype. In addition, we reveal an inverse correlation between cortisol derivatives and CYP11B1 and the impact of 18-oxocortisol and CYP11B1 on clinical outcome, which provides unprecedented insights into the pathophysiology, clinical features, and steroidogenesis of APAs.
Subject(s)
Adenoma/metabolism , Adrenal Cortex Neoplasms/metabolism , Adrenocortical Adenoma/metabolism , Aldosterone/metabolism , Metabolomics/methods , Adenoma/genetics , Adrenal Cortex Neoplasms/genetics , Adrenal Cortex Neoplasms/pathology , Adrenocortical Adenoma/genetics , Adrenocortical Adenoma/pathology , Adult , Aldosterone/genetics , Calcium Channels, L-Type/metabolism , Cohort Studies , Female , G Protein-Coupled Inwardly-Rectifying Potassium Channels/metabolism , Genotype , Humans , Hydrocortisone/analogs & derivatives , Hydrocortisone/metabolism , Hyperaldosteronism/metabolism , Male , Middle Aged , Mutation , Phenotype , Steroid 11-beta-Hydroxylase/metabolismABSTRACT
Aldosterone producing adenomas (APAs) occur in the adrenal glands of around 30% of patients with primary aldosteronism, the most common form of secondary hypertension. Somatic mutations in KCNJ5, ATP1A1, ATP2B3, CACNA1D and CTNNB1 have been described in ~60% of these tumours. We subjected 15 aldosterone producing adenomas (13 with known mutations and two without) to RNA Sequencing and Whole Genome Sequencing (n = 2). All known mutations were detected in the RNA-Seq reads, and mutations in ATP2B3 (G123R) and CACNA1D (S410L) were discovered in the tumours without known mutations. Adenomas with CTNNB1 mutations showed a large number of differentially expressed genes (1360 compared to 106 and 75 for KCNJ5 and ATP1A1/ATP2B3 respectively) and clustered together in a hierarchical clustering analysis. RT-PCR in an extended cohort of 49 APAs confirmed higher expression of AFF3 and ISM1 in APAs with CTNNB1 mutations. Investigation of the expression of genes involved in proliferation and apoptosis revealed subtle differences between tumours with and without CTNNB1 mutations. Together our results consolidate the notion that CTNNB1 mutations characterize a distinct subgroup of APAs.
Subject(s)
Adenoma/genetics , Adrenocortical Adenoma/genetics , Aldosterone/genetics , Transcriptome/genetics , beta Catenin/genetics , Adenoma/pathology , Adrenal Glands/pathology , Adrenocortical Adenoma/pathology , Adult , Aged , Aldosterone/biosynthesis , Calcium Channels, L-Type/genetics , Female , G Protein-Coupled Inwardly-Rectifying Potassium Channels/genetics , Gene Expression Regulation, Neoplastic/genetics , Humans , Hyperaldosteronism/genetics , Hyperaldosteronism/pathology , Male , Middle Aged , Plasma Membrane Calcium-Transporting ATPases/genetics , Sequence Analysis, RNA , Sodium-Potassium-Exchanging ATPase/geneticsABSTRACT
Somatic mutations have been identified in aldosterone-producing adenomas (APAs) in genes that include KCNJ5, ATP1A1, ATP2B3, and CACNA1D. Based on independent studies, there appears to be racial differences in the prevalence of somatic KCNJ5 mutations, particularly between East Asians and Europeans. Despite the high cardiovascular disease mortality of blacks, there have been no studies focusing on somatic mutations in APAs in this population. In the present study, we investigated genetic characteristics of APAs in blacks using a CYP11B2 (aldosterone synthase) immunohistochemistry-guided next-generation sequencing approach. The adrenal glands with adrenocortical adenomas from 79 black patients with primary aldosteronism were studied. Seventy-three tumors from 69 adrenal glands were confirmed to be APAs by CYP11B2 immunohistochemistry. Sixty-five of 73 APAs (89%) had somatic mutations in aldosterone-driver genes. Somatic CACNA1D mutations were the most prevalent genetic alteration (42%), followed by KCNJ5 (34%), ATP1A1 (8%), and ATP2B3 mutations (4%). CACNA1D mutations were more often observed in APAs from males than those from females (55% versus 29%, P=0.033), whereas KCNJ5 mutations were more prevalent in APAs from females compared with those from males (57% versus 13%, P<0.001). No somatic mutations in aldosterone-driver genes were identified in tumors without CYP11B2 expression. In conclusion, 89% of APAs in blacks harbor aldosterone-driving mutations, and unlike Europeans and East Asians, the most frequently mutated aldosterone-driver gene was CACNA1D. Determination of racial differences in the prevalence of aldosterone-driver gene mutations may facilitate the development of personalized medicines for patients with primary aldosteronism.
Subject(s)
Adrenal Cortex Neoplasms/genetics , Adrenocortical Adenoma/genetics , Aldosterone/genetics , Black or African American , Genetic Predisposition to Disease , Mutation , Adrenal Cortex Neoplasms/ethnology , Adrenal Cortex Neoplasms/metabolism , Adrenal Glands/pathology , Adrenocortical Adenoma/ethnology , Adrenocortical Adenoma/metabolism , Aldosterone/metabolism , DNA Mutational Analysis , DNA, Neoplasm/genetics , Humans , Incidence , United States/epidemiologyABSTRACT
The mineralocorticoid receptor (MR) and its kin, the glucocorticoid receptor (GR) evolved from an ancestral corticoid receptor (CR) in a cyclostome (jawless fish) through gene duplication and divergence. Distinct MR and GR orthologs first appear in cartilaginous fishes, such as sharks, skates, rays and chimaeras. Although aldosterone, the main physiological mineralocorticoid in humans and other terrestrial vertebrates, is not synthesized by cyclostomes or cartilaginous fishes, cyclostome CR and cartilaginous fish MR and GR are activated by aldosterone. Aldosterone first appears in lungfish, lobe-finned fish that are forerunners of terrestrial vertebrates. Further sequence divergence of the MR and GR in terrestrial vertebrates led to emergence of aldosterone as a selective ligand for the MR. Interestingly, ray-finned fish do not synthesize aldosterone, leaving the identity of their physiological mineralocorticoid(s) unresolved. Several steroids: cortisol, 11-deoxycortisol, corticosterone, 11-deoxycorticosterone and progesterone activate fish MR and are potential mineralocorticoids in ray-finned fish. Here we review the evolution of the MR in cartilaginous fish, terrestrial vertebrates and ray-finned fish, and discuss new insights into progesterone activation of the MR in ray-finned fish.
Subject(s)
Aldosterone/metabolism , Evolution, Molecular , Receptors, Mineralocorticoid/genetics , Receptors, Mineralocorticoid/metabolism , Vertebrates/physiology , Aldosterone/genetics , Animals , Gene Expression Regulation , Vertebrates/geneticsABSTRACT
Secretion of the major mineralocorticoid aldosterone from the adrenal cortex is a tightly-regulated process enabling this hormone to regulate sodium homeostasis and thereby contribute to blood pressure control. The circulating level of aldosterone is the result of various regulatory mechanisms, the most significant being those controlled by the renin-angiotensin system and plasma potassium levels. The importance of maintaining tight control over aldosterone secretion is demonstrated by cases of dysregulation, which can result in severe hypertension and significantly increased cardiovascular risk. In this article we summarize current knowledge of the major regulatory mechanisms, focusing particularly on the systems operating within the adrenocortical zona glomerulosa cells; we also describe some of the other factors that influence aldosterone production to a lesser but still significant extent. Finally, we discuss the influence of common genetic polymorphisms on aldosterone secretion in large sections of the population and also the emerging role of microRNA as significant regulators of this system.
Subject(s)
Aldosterone/metabolism , Gene Expression Regulation/physiology , Adrenal Cortex/physiology , Aldosterone/genetics , Animals , Humans , Polymorphism, Genetic , Signal TransductionABSTRACT
The prominence of obesity in the clinical population as well as the strong association of cardiovascular risk factors with obesity has prompted the investigation of the adipose tissue and its physiological contribution to cardiovascular health. A notable finding in these investigations was the discovery of the adipocyte-derived hormone leptin. Leptin is secreted from the adipose tissue, increases in linear fashion in the circulation with increased body mass and is implicated in the development of cardiovascular disease in obesity, notably via pro-hypertensive mechanisms. Leptin stimulates the activation of the sympathetic nervous system in male patients and mice, which has been implicated as the pro-hypertensive pathway for leptin in obesity. However, obese premenopausal females do not exhibit increased sympathetic activation in response to hyperleptinemia in obesity, indicating a sex-discrepancy in mechanisms of obesity-associated hypertension. Our lab recently demonstrated that leptin also induces the adrenal production of aldosterone in a direct fashion and that this pathway leads to the hyperaldosteronemia that is characteristic of obesity. We have also published data that indicate that the implications of leptin-induced aldosterone are of particular impact in obese females. Leptin-mediated hypertension and endothelial dysfunction, a significant predictor of hypertension clinically, require activation of the mineralocorticoid receptor in female mice. The clinical potential of this pathway remains under investigation; however, existing data indicate that a sex discrepancy exists in mechanisms of leptin-mediated hypertension between males and females and that leptin-stimulated aldosterone plays a significant role in females.
Subject(s)
Aldosterone/metabolism , Leptin/metabolism , Aldosterone/genetics , Animals , Female , Gene Expression Regulation/physiology , Humans , Hypertension/metabolism , Leptin/genetics , Male , Obesity/metabolism , Sex FactorsABSTRACT
The mineralocorticoid hormone aldosterone is released by the adrenal glands in a homeostatic mechanism to regulate blood volume. Several cues elicit aldosterone release, and the long-term action of the hormone is to restore blood pressure and/or increase the retrieval of sodium from filtered plasma in the kidney. While the signaling cascade that results in aldosterone release is well studied, the impact of this hormone on tissues and cells in various organ systems is pleotropic. Emerging evidence indicates aldosterone may alter non-coding RNAs (ncRNAs) to integrate the hormonal response, and these ncRNAs may contribute to the heterogeneity of signaling outcomes in aldosterone target tissues. The best studied of the ncRNAs in aldosterone action are the small ncRNAs, microRNAs. MicroRNA expression is regulated by aldosterone stimulation, and microRNAs are able to modulate protein expression at all steps in the renin-angiotensin-aldosterone-signaling system. The discovery and synthesis of microRNAs will be briefly covered followed by a discussion of the reciprocal role of aldosterone/microRNA regulation, including misregulation of microRNA signaling in aldosterone-linked disease states.
Subject(s)
Aldosterone/metabolism , MicroRNAs/metabolism , Signal Transduction/physiology , Acute Kidney Injury/metabolism , Aldosterone/genetics , Animals , Gene Expression Regulation/physiology , MicroRNAs/geneticsABSTRACT
Primary aldosteronism affects ≈5% to 10% of hypertensive patients and has unilateral and bilateral forms. Most unilateral primary aldosteronism is caused by computed tomography-detectable aldosterone-producing adenomas, which express CYP11B2 (aldosterone synthase) and frequently harbor somatic mutations in aldosterone-regulating genes. The cause of the most common bilateral form of primary aldosteronism, idiopathic hyperaldosteronism (IHA), is believed to be diffuse hyperplasia of aldosterone-producing cells within the adrenal cortex. Herein, a multi-institution cohort of 15 IHA adrenals was examined with CYP11B2 immunohistochemistry and next-generation sequencing. CYP11B2 immunoreactivity in adrenal glomerulosa harboring non-nodular hyperplasia was only observed in 4/15 IHA adrenals suggesting that hyperplasia of CYP11B2-expressing cells may not be the major cause of IHA. However, the adrenal cortex of all IHA adrenals harbored at least 1 CYP11B2-positive aldosterone-producing cell cluster (APCC) or micro-aldosterone-producing adenomas. The number of APCCs per case (and individual APCC area) in IHA adrenals was significantly larger than in normotensive controls. Next-generation sequencing of DNA from 99 IHA APCCs demonstrated somatic mutations in genes encoding the L-type calcium voltage-gated channel subunit α 1-D ( CACNA1D, n=57; 58%) and potassium voltage-gated channel subfamily J-5 ( KCNJ5, n=1; 1%). These data suggest that IHA may result from not only hyperplasia but also the accumulation or enlargement of computed tomography-undetectable APCC harboring somatic aldosterone-driver gene mutations. The high prevalence of mutations in the CACNA1D L-type calcium channel provides a potential actionable therapeutic target that could complement mineralocorticoid blockade and inhibit aldosterone overproduction in some IHA patients.
Subject(s)
Aldosterone , Calcium Channels, L-Type/genetics , G Protein-Coupled Inwardly-Rectifying Potassium Channels/genetics , Hyperaldosteronism , Hypertension , Zona Glomerulosa , Aldosterone/biosynthesis , Aldosterone/genetics , Cytochrome P-450 CYP11B2/metabolism , Female , Gene Expression Regulation , Humans , Hyperaldosteronism/complications , Hyperaldosteronism/genetics , Hyperaldosteronism/metabolism , Hyperplasia , Hypertension/etiology , Hypertension/metabolism , Immunohistochemistry , Male , Mutation , Zona Glomerulosa/metabolism , Zona Glomerulosa/pathologyABSTRACT
Aldosterone is synthesized in zona glomerulosa of adrenal cortex in response to angiotensin II. This stimulation transcriptionally induces expression of a series of steroidogenic genes such as HSD3B and CYP11B2 via NR4A (nuclear receptor subfamily 4 group A) nuclear receptors and ATF (activating transcription factor) family transcription factors. Nurr1 belongs to the NR4A family and is regarded as an orphan nuclear receptor. The physiological significance of Nurr1 in aldosterone production in adrenal cortex has been well studied. However, coregulators supporting the Nurr1 function still remain elusive. In this study, we performed RIME (rapid immunoprecipitation mass spectrometry of endogenous proteins), a recently developed endogenous coregulator purification method, in human adrenocortical H295R cells and identified PARP1 as one of the top Nurr1-interacting proteins. Nurr1-PARP1 interaction was verified by co-immunoprecipitation. In addition, both siRNA knockdown of PARP1 and treatment of AG14361, a specific PARP1 inhibitor suppressed the angiotensin II-mediated target gene induction in H295R cells. Furthermore, PARP1 inhibitor also suppressed the aldosterone secretion in response to the angiotensin II. Together, these results suggest PARP1 is a prime coregulator for Nurr1.
Subject(s)
Aldosterone/biosynthesis , Nuclear Receptor Subfamily 4, Group A, Member 2/genetics , Poly (ADP-Ribose) Polymerase-1/genetics , Protein Interaction Maps/genetics , Adrenal Cortex/cytology , Adrenal Cortex/metabolism , Aldosterone/genetics , Aldosterone/metabolism , Angiotensin II/metabolism , Cell Line , Gene Knockdown Techniques , Humans , Immunoprecipitation , Mass Spectrometry , Nuclear Receptor Subfamily 4, Group A, Member 2/metabolism , Poly (ADP-Ribose) Polymerase-1/antagonists & inhibitors , Poly (ADP-Ribose) Polymerase-1/metabolism , RNA, Small Interfering/genetics , Zona Glomerulosa/cytology , Zona Glomerulosa/metabolismABSTRACT
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. Somatic mutations are found not only in aldosterone-producing adenoma (APA), leading to primary aldosteronism, but also in aldosterone producing cell clusters of normal and micronodules from image-negative adrenal glands. Genetic knowledge has allowed the discovery of surrogate biomarkers and specific pharmacological inhibitors. Ageing appears to be associated with dysregulated and relatively autonomous aldosterone production. SUMMARY: New biochemical markers and pharmacological approaches may allow preoperative identification of somatic mutation carriers and use of targeted treatments.
Subject(s)
Adrenal Cortex Neoplasms/genetics , Adrenocortical Adenoma/genetics , Aldosterone/biosynthesis , Aldosterone/genetics , Hyperaldosteronism/genetics , Adrenal Cortex Neoplasms/metabolism , Adrenal Glands/metabolism , Adrenocortical Adenoma/metabolism , Age Factors , Aging , Aldosterone/physiology , Cytochrome P-450 CYP11B2/genetics , Female , G Protein-Coupled Inwardly-Rectifying Potassium Channels/genetics , Humans , Hyperaldosteronism/diagnosis , Hyperaldosteronism/therapy , Hypertension/etiology , Male , Mutation , Sex Factors , SyndromeABSTRACT
Urotensin II (UII) contributes to cardiovascular diseases by activating vasoactive peptides. The present study aimed to determine the effect of UII on aldosterone (ALD) and its receptor in cultured adventitial fibroblasts (AFs) and the tunica adventitia of rat vessels to explore the possible mechanisms underlying vascular remodeling. Expression levels of aldosterone and its receptor on tunica adventitia were determined using immunohistochemistry. Growtharrested AFs and tunica adventitia from rat vessels were incubated with UII and inhibitors of various signal transduction pathways. ALD receptor (ALDR) mRNA expression levels and ALD protein exoression levels were determined by reverse transcriptionquantitative polymerase chain reaction and ELISA, respectively. Aldosterone and its receptors were expressed on tunica adventitia. UII promoted ALD protein secretion from cells in a dose and timedependent manner. ALDR mRNA expression in cells was also dysregulated. Furthermore, the effects of UII were substantially inhibited by treatment with the inhibitors PD98059, Y27632, H7, CSA and nicardipine. These results were further verified in the tunica adventitia of rat vessels. The present findings indicated that UII stimulated ALD protein secretion and ALDR mRNA expression in AFs and in the tunica adventitia of rat vessels; moreover, this effect may be mediated by signal transduction pathways involving MAPK, Rho, PKC, calcineurin and Ca2+. UII may also contribute to vascular remodeling by stimulating the production of ALD and its receptor.