Expression of CYP11B2 in Aldosterone-Producing Adrenocortical Adenoma: Regulatory Mechanisms and Clinical Significance

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Author(s)

    • Nakamura Yasuhiro
    • Division of Pathology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University|Department of Pathology, Tohoku University Graduate School of Medicine
    • Yamazaki Yuto
    • Department of Pathology, Tohoku University Graduate School of Medicine
    • Tezuka Yuta
    • Division of Nephrology, Endocrinology, and Vascular Medicine, Department of Medicine, Tohoku University Graduate School of Medicine|Division of Clinical Hypertension, Endocrinology and Metabolism, Tohoku University Graduate School of Medicine
    • Satoh Fumitoshi
    • Division of Nephrology, Endocrinology, and Vascular Medicine, Department of Medicine, Tohoku University Graduate School of Medicine|Division of Clinical Hypertension, Endocrinology and Metabolism, Tohoku University Graduate School of Medicine
    • Sasano Hironobu
    • Department of Pathology, Tohoku University Graduate School of Medicine

Abstract

<p>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. The gain-of-function mutations were reported in <i>KCNJ5</i> that encodes G-protein activated inward rectifier K<sup>+</sup> channel 4 (Kir3.4) and in <i>CACNA1D,</i> encoding calcium channel, voltage-dependent, L type, alpha subunit Cav1.3. The loss-of-function mutations were found in <i>ATP1A1</i> that encodes Na<sup>+</sup>/K<sup>+</sup> ATPase α subunit and in <i>ATP2B3,</i> encoding Ca<sup>2+</sup> ATPase. Furthermore, the aberrant expression of gonadotropin-releasing hormone receptor is associated with the overexpression of CYP11B2 and overproduction of aldosterone in APA with activating mutations in <i>CTNNB1</i> encoding β-catenin. On the other hand, CYP11B2 also catalyzes the conversion of cortisol to 18-hydroxycortisol and subsequently converts 18-hydroxycortisol to 18-oxocortisol. The recent studies have identified 18-oxocortisol as an important and distinct biomarker to diagnose primary aldosteronism. In this review, we summarize the recent findings on CYP11B2 and discuss the molecular pathogenesis of APA and the clinical significance of CYP11B2.</p>

Journal

  • The Tohoku Journal of Experimental Medicine

    The Tohoku Journal of Experimental Medicine 240(3), 183-190, 2016

    Tohoku University Medical Press

Codes

  • NII Article ID (NAID)
    130005281090
  • Text Lang
    ENG
  • ISSN
    0040-8727
  • Data Source
    J-STAGE 
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