Review
Endocrinology & Metabolism
Jun Yang, Morag J. Young, Timothy J. Cole, Peter J. Fuller
Summary: Primary aldosteronism, or Conn syndrome, is the most common endocrine cause of hypertension. It is associated with a higher risk of cardiovascular, metabolic, and renal diseases and leads to a lower quality of life compared to hypertension caused by other reasons. The multi-systemic effects of primary aldosteronism can be attributed to aldosterone-mediated activation of the mineralocorticoid receptor in various tissues. Recognizing primary aldosteronism as a multi-system disease with tissue-specific pathophysiology may result in more vigilant testing and earlier targeted interventions.
JOURNAL OF ENDOCRINOLOGY
(2023)
Review
Endocrinology & Metabolism
Livia Lenzini, Brasilina Caroccia, Teresa Maria Seccia, Gian Paolo Rossi
Summary: Understanding the regulation of adrenal function and the interactions between adrenal cortex and medulla is crucial for studying the mechanisms of various diseases. The modulation of adrenal hormone biosynthesis is a complex process involving multiple factors working together. Tight vascular and neural connections between the adrenal cortex and medulla play a role in physiological autocrine/paracrine interactions involving several peptides.
Review
Peripheral Vascular Disease
Ute Scholl
Summary: Primary aldosteronism is the most common cause of secondary hypertension, largely due to genetic mutations in ion channels and pumps. Somatic mutations are responsible for sporadic cases, while germline mutations cause familial hyperaldosteronism.
Review
Pharmacology & Pharmacy
Piotr Jedrusik, Bartosz Symonides, Jacek Lewandowski, Zbigniew Gaciong
Summary: Primary aldosteronism (PA) is a potentially curable form of secondary hypertension that requires measuring renin and aldosterone, followed by confirmatory tests. Various antihypertensive drug classes interfere with PA evaluation, with calcium antagonists and alpha-blockers being the least interfering drugs.
FRONTIERS IN PHARMACOLOGY
(2021)
Review
Endocrinology & Metabolism
Lucas S. Santana, Augusto G. Guimaraes, Madson Q. Almeida
Summary: Primary aldosteronism (PA) is the most common form of secondary arterial hypertension, and recent advances in understanding its pathogenesis, including genetic mutations and the activation of calcium signaling, have expanded our knowledge of familial hyperaldosteronism. Additionally, the use of CYP11B2 staining to guide genetic investigations of adrenal lesions has had a significant impact on our understanding of PA.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Endocrinology & Metabolism
Fabrizio Buffolo, Jacopo Pieroni, Federico Ponzetto, Vittorio Forestiero, Denis Rossato, Paolo Fonio, Antonello Nonnato, Fabio Settanni, Paolo Mulatero, Giulio Mengozzi, Silvia Monticone
Summary: This study assessed the impact of asymmetrical cortisol secretion on the lateralization index during adrenal venous sampling, and the effectiveness of metanephrines as a normalization factor for aldosterone levels. The results showed that 18% of patients with primary aldosteronism had asymmetrical cortisol secretion, and the use of metanephrines as a normalization factor improved the accuracy of diagnosis compared to aldosterone to cortisol lateralization index.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2023)
Article
Peripheral Vascular Disease
Hiroko Ogata, Yuto Yamazaki, Yuta Tezuka, Xin Gao, Kei Omata, Yoshikiyo Ono, Yoshihide Kawasaki, Tomoaki Tanaka, Hidekazu Nagano, Norio Wada, Yutaka Oki, Akira Ikeya, Kenji Oki, Yoshiyu Takeda, Mitsuhiro Kometani, Kazunori Kageyama, Ken Terui, Celso E. Gomez-Sanchez, Shujun Liu, Ryo Morimoto, Kensuke Joh, Hiroshi Sato, Mariko Miyazaki, Akihiro Ito, Yoichi Arai, Yasuhiro Nakamura, Sadayoshi Ito, Fumitoshi Satoh, Hironobu Sasano
Summary: Research found that patients with hyperaldosteronism have more pronounced renal damage, characterized by global and segmental glomerulosclerosis, interstitial fibrosis, arteriosclerosis, and arteriolar hyalinization. These results suggest the potential clinical significance of early intervention using mineralocorticoid receptor antagonists or blockers.
Review
Biochemistry & Molecular Biology
Kiyotaka Itcho, Kenji Oki, Haruya Ohno, Masayasu Yoneda
Summary: Primary aldosteronism (PA) is the most common form of secondary hypertension, with two main subtypes: aldosterone-producing adenoma (APA) and bilateral idiopathic hyperaldosteronism. Recent advancements in genetic analysis have led to the discovery of mutations in causative genes, contributing to a better understanding of the mechanism of excess aldosterone synthesis.
Article
Endocrinology & Metabolism
Alessio Pecori, Fabrizio Buffolo, Jacopo Burrello, Giulio Mengozzi, Francesca Rumbolo, Valeria Avataneo, Antonio D'Avolio, Franco Rabbia, Chiara Bertello, Franco Veglio, Paolo Mulatero, Silvia Monticone
Summary: In patients with primary aldosteronism, mineralocorticoid receptor antagonists can cause a significant increase in renin and potassium levels, as well as a significant decrease in the aldosterone to renin ratio. This effect becomes more pronounced with higher doses of canrenone and longer treatment periods.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2021)
Article
Endocrinology & Metabolism
Yi-Ju Chen, Kang-Yung Peng, Jeff S. Chueh, Hung-Wei Liao, Tsung-Yi Hsieh, Vin-Cent Wu, Shuo-Meng Wang
Summary: This study reported a PA patient with concomitant ACS, showing that bilateral APM may coexist with histopathologically classical and non-classical PA adenomas with different somatic mutations.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Endocrinology & Metabolism
Alessio Pecori, Fabrizio Buffolo, Jacopo Burrello, Giulio Mengozzi, Francesca Rumbolo, Valeria Avataneo, Antonio D'Avolio, Franco Rabbia, Chiara Bertello, Franco Veglio, Paolo Mulatero, Silvia Monticone
Summary: The study found that mineralocorticoid receptor antagonists significantly impact the screening results of primary aldosteronism, leading to increased false negative rates.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2021)
Article
Peripheral Vascular Disease
Ryo Nakamaru, Koichi Yamamoto, Hiroshi Akasaka, Hiromi Rakugi, Isao Kurihara, Takashi Yoneda, Takamasa Ichijo, Takuyuki Katabami, Mika Tsuiki, Norio Wada, Tetsuya Yamada, Hiroki Kobayashi, Kouichi Tamura, Yoshihiro Ogawa, Junji Kawashima, Nobuya Inagaki, Megumi Fujita, Kenji Oki, Kohei Kamemura, Akiyo Tanabe, Mitsuhide Naruse
Summary: The study found that female patients with bilateral primary aldosteronism have worse renal outcomes compared to male patients after receiving mineralocorticoid receptor antagonist treatment. Despite similar systolic blood pressure levels between the sexes, women experienced a greater decline in estimated glomerular filtration rate, especially during the late phase of 6 to 60 months post-treatment initiation.
Article
Endocrinology & Metabolism
Paolo Mulatero, Chiara Bertello, Franco Veglio, Silvia Monticone
Summary: Primary aldosteronism is an overlooked condition with significant mortality and morbidity. The difficulty of screening patients on antihypertensive therapy has resulted in low testing rates. However, interference with medication may not always be necessary for accurate screening.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2022)
Article
Endocrinology & Metabolism
Yuta Tezuka, Adina F. Turcu
Summary: This study found that only a small percentage of patients with PA and LRH treated with MRAs in an academic outpatient practice were evaluated for target renin, and less than half of them achieved target renin. Lower baseline serum potassium, lower MRA doses, and beta-blocker use were associated with lower odds of achieving target renin in PA, while male sex was associated with target renin in LRH.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Article
Peripheral Vascular Disease
James M. Luther, Dawei S. Wei, Kakali Ghoshal, Dungeng Peng, Gail K. Adler, Adina F. Turcu, Hui Nian, Chang Yu, Carmen C. Solorzano, Ambra Pozzi, Nancy J. Brown
Summary: Epoxyeicosatrienoic acids (EETs) are lipid signaling molecules generated by the action of CYP450s, with vasodilatory, anti-inflammatory, and insulin-enhancing effects. Treatment of primary aldosteronism led to an increase in EET concentrations, particularly 14,15-DHETs.
Article
Endocrinology & Metabolism
Matthieu St-Jean, Isabelle Bourdeau, Eric Therasse, Andre Lacroix
CLINICAL ENDOCRINOLOGY
(2020)
Article
Endocrinology & Metabolism
Nada Younes, Matthieu St-Jean, Isabelle Bourdeau, Andre Lacroix
Summary: Endogenous Cushing's syndrome during pregnancy is rare, commonly caused by adrenal adenomas and pregnancy-induced CS. Diagnosis is challenging due to physiologic hypercortisolism in pregnancy. Careful interpretation of cortisol production tests and limited imaging options are required. Surgical resection of lesions before 24 weeks of gestation is the optimal treatment, with metabolic complications managed in mild cases.
REVIEWS IN ENDOCRINE & METABOLIC DISORDERS
(2023)
Article
Endocrinology & Metabolism
Mitsuhide Naruse, Masanori Murakami, Takuyuki Katabami, Tomaz Kocjan, Mirko Parasiliti-Caprino, Marcus Quinkler, Matthieu St-Jean, Sam O'Toole, Filippo Ceccato, Ivana Kraljevic, Darko Kastelan, Mika Tsuiki, Jaap Deinum, Edelmiro Menendez Torre, Troy Puar, Athina Markou, George Piaditis, Kate Laycock, Norio Wada, Marianne Aardal Grytaas, Hiroki Kobayashi, Akiyo Tanabe, Chin Voon Tong, Nuria Valdes Gallego, Sven Gruber, Felix Beuschlein, Lydia Kuerzinger, Norlela Sukor, Elena A. B. Aisha Azizan, Oskar Ragnarsson, Michiel F. Nijhoff, Giuseppe Maiolino, Guido Di Dalmazi, Valentina Kalugina, Andre Lacroix, Raluca Maria Furnica, Tomoko Suzuki
Summary: This study investigated the diversity of approaches utilized for each diagnostic step in different expert centers regarding primary aldosteronism (PA). The results showed significant variations in blood sampling conditions, assay methods, screening and confirmatory tests among centers. This diversity may lead to inconsistent diagnosis of PA and limit comparison of evidence between centers. Standardization of the diagnostic process and revisiting the concept of mild PA are necessary.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2023)