In vivo evidence of cortisol secretion by aldosterone-producing adenomas

1984 ◽  
Vol 106 (4) ◽  
pp. 516-520 ◽  
Author(s):  
Kaoru Nomura ◽  
Mitsuhide Naruse ◽  
Kiyoko Naruse ◽  
Hiroshi Demura ◽  
Kazuo Shizume
Keyword(s):  
Primary Aldosteronism ◽  
Plasma Cortisol ◽  
Plasma Concentrations ◽  
Normal Subjects ◽  
Plasma Aldosterone ◽  
Adrenal Vein ◽  
Cortisol Secretion ◽  
Adrenal Vein Sampling ◽  
The Relationship

Abstract. This study was done to confirm that aldosterone-producing adenomas secrete cortisol in vivo. Plasma cortisol and aldosterone concentrations were measured in samples obtained by selective adrenal-vein sampling in 8 patients with primary aldosteronism due to unilateral adenoma. All cases revealed higher adrenal-vein plasma cortisol concentrations on the adenoma side than the opposite, irrespective of adenoma location. These concentrations correlated significantly with plasma aldosterone concentrations (r = 0.972, P < 0.001) in effluents from the adenoma side, but not from the opposite. Plasma concentrations also correlated significantly with estimated adenoma volume (r = 0.918, P < 0.05). These findings strongly suggest that aldosterone-producing adenomas secrete cortisol in vivo. In a second study, we used metyrapone to test 6 patients with adenomas. Their responsiveness to cortisol and corticotrophin was found to be the same as that in normal subjects, suggesting that adenoma-secreted cortisol did not disturb the relationship between corticotrophin and cortisol. We thus concluded that cortisol is secreted concomitantly with aldosterone from aldosterone-producing adenomas under corticotrophin influence.

scholarly journals Optimization of left adrenal vein sampling in primary aldosteronism: Coping with asymmetrical cortisol secretion

2017 ◽  
Vol 64 (3) ◽  
pp. 347-355 ◽  
Author(s):  
Mitsuhiro Kishino ◽  
Takanobu Yoshimoto ◽  
Masashi Nakadate ◽  
Yoshiaki Katada ◽  
Eiichiro Kanda ◽  
...  
Keyword(s):  
Primary Aldosteronism ◽  
Adrenal Vein ◽  
Cortisol Secretion ◽  
Adrenal Vein Sampling

Abstract 277: Mutations in the KCNJ5 Gene Imply a Higher Lateralization Index at Adrenal Vein Sampling for Primary Aldosteronism

Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Teresa M Seccia ◽  
Franco Mantero ◽  
Claudio Letizia ◽  
Maniselvan Kuppusamy ◽  
Marlena Barisa ◽  
...  
Keyword(s):  
Primary Aldosteronism ◽  
Somatic Mutations ◽  
Contralateral Side ◽  
Adrenal Vein ◽  
K Channel ◽  
Coding Region ◽  
Aldosterone Secretion ◽  
Adrenal Vein Sampling ◽  
Lateralization Index

Background. The mutations that affect the selectivity filter of the KCNJ5 K+ channel can play a role in triggering and/or maintaining aldosterone oversecretion in primary aldosteronism (PA). We therefore hypothesized that these somatic mutations can be associated with an increased aldosterone secretion from the APA, thus translating in raised plasma aldosterone concentrations (PAC) in the ipsilateral adrenal vein. Aim. To investigate if the lateralization index (LI) at adrenal vein sampling (AVS) is higher in the patients with an APA carrying the mutation (KCNJ5mut), as compared to those without the mutation (KCNJ5wt). Methods. Ninety-two consecutive PA patients who underwent AVS and received diagnosis of APA based on the four corners criteria were recruited. Unequivocal information on the presence or absence of the KCNJ5 mutations was available for each patient. The selectivity index (SI) was calculated as ratio between the right or left adrenal vein PCC (PCCside) and the infrarenal IVC PCC and a cutoff of 2.00 was used. The lateralization index (LI) was calculated in the bilaterally selective AVS as the ratio of PAC/PCC at the APA side to PAC/PCC at the contralateral side. We sequenced the KCNJ5 coding region spanning aminoacids 122 to 199, which include the selectivity filer. Results. The overall prevalence rate of KCNJ5 somatic mutations was 34%; G151R, L168R and T158A mutations were found in 19, 10 and 1 APA respectively. The G151E mutation was not found. The KCNJ5mut and KCNJ5wt groups were similar for gender, age, sK+ levels, while PAC and ARR were higher, and PRA lower (all p<0.05) in the KCNJ5 mut group. In the latter group the LI was higher than in the KCNJ5wt group (29.3± 6.7 vs 16.7±3.9, p< 0.02). This was due to a PAC/PCC ratio which was higher in the adrenal vein ipsilateral to the APA side and lower contralaterally in the KCNJ5mut group. Conclusions. These results provide direct in vivo evidence for a higher aldosterone secretion from APA carrying the KCNJ5 mutations, which translates into higher values of the LI, compared to the tumors without such mutations. Hence, the presence of these KCNJ5 mutations can affect the accuracy of the AVS-based diagnosis of the subtype of PA.

11C-metomidate PET-CT in primary aldosteronism: five possible indications for a non-invasive alternative to adrenal vein sampling

2015 ◽  
Author(s):  
Andrew S Powlson ◽  
Olympia Koulouri ◽  
Elena Azizan ◽  
Carmela Maniero ◽  
Kevin Taylor ◽  
...  
Keyword(s):  
Primary Aldosteronism ◽  
Adrenal Vein ◽  
Adrenal Vein Sampling ◽  
Non Invasive ◽  
Pet Ct

Is the adrenal vein sampling the gold standard diagnostic test for the subtyping of primary aldosteronism?

2018 ◽  
Author(s):  
Ana Jimenez Portilla ◽  
Elena Mena Ribas ◽  
Antonia Barcelo Bennasar ◽  
Juan Manuel Martinez Ruitort ◽  
Cristina Alvarez Segurola ◽  
...  
Keyword(s):  
Diagnostic Test ◽  
Primary Aldosteronism ◽  
Gold Standard ◽  
Adrenal Vein ◽  
Adrenal Vein Sampling

Partially successful adrenal vein sampling can in some cases reveal the etiology of primary aldosteronism

2019 ◽  
Author(s):  
Karin Zibar Tomšić ◽  
Vilim Molnar ◽  
Tina Dušek ◽  
Ivana Kraljević ◽  
Polovina Tanja Škorić ◽  
...  
Keyword(s):  
Primary Aldosteronism ◽  
Adrenal Vein ◽  
Adrenal Vein Sampling

scholarly journals Non-sequential and non-stimulated bilateral adrenal vein sampling utility in primary aldosteronism: Case inform

2019 ◽  
Vol 12 ◽  
pp. 100049
Author(s):  
José Juan Ceballos-Macías ◽  
Jorge Alberto Flores-Real ◽  
Joel Vargas-Sánchez ◽  
Guillermo Ortega-Gutiérrez ◽  
Ramon Madriz-Prado ◽  
...  
Keyword(s):  
Primary Aldosteronism ◽  
Adrenal Vein ◽  
Adrenal Vein Sampling

scholarly journals Impact of Different Diagnostic Criteria During Adrenal Vein Sampling on Reproducibility of Subtype Diagnosis in Patients With Primary Aldosteronism

Hypertension ◽  
2010 ◽  
Vol 55 (3) ◽  
pp. 667-673 ◽  
Author(s):  
Paolo Mulatero ◽  
Chiara Bertello ◽  
Norlela Sukor ◽  
Richard Gordon ◽  
Denis Rossato ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Primary Aldosteronism ◽  
Adrenal Vein ◽  
Adrenal Vein Sampling

scholarly journals Analysis of free and protein-bound nitrotyrosine in human plasma by a gas chromatography/mass spectrometry method that avoids nitration artifacts

2000 ◽  
Vol 345 (3) ◽  
pp. 453-458 ◽  
Author(s):  
Matthew T. FROST ◽  
Barry HALLIWELL ◽  
Kevin P. MOORE
Keyword(s):  
Reactive Nitrogen Species ◽  
Plasma Proteins ◽  
Biological Fluids ◽  
Plasma Concentrations ◽  
Normal Subjects ◽  
Gas Chromatography Mass Spectrometry ◽  
Highly Sensitive ◽  
Acidic Conditions ◽  
First Time

Measurement of nitrotyrosine in biological fluids and tissues is increasingly being used to monitor the production of reactive nitrogen species in vivo. The detection of nitrotyrosine in vivo has been reported with the use of a variety of methods including immunoassay, HPLC and GLC/MS. The validity of HPLC and immunoassays have been questioned with regard to their selectivity and sensitivity limits. In principle, the measurement of nitrotyrosine by GLC/MS permits a highly specific, highly sensitive and fully quantitative assay. The nitration of tyrosine under acidic conditions in the presence of nitrite is well documented. Derivatization for the full quantification of nitrotyrosine by using GLC/MS can lead to the artifactual nitration of tyrosine if performed under acidic conditions in the presence of nitrite. We describe a novel alkaline method for the hydrolysis and derivatization of nitrotyrosine and tyrosine, and demonstrate its applicability to the measurement of plasma concentrations of both free and protein-bound nitrotyrosine and tyrosine. A detection limit of 1 pg for nitrotyrosine and 100 pg for tyrosine has been achieved. Our method allows, for the first time, the analysis of free and protein-bound nitrotyrosine and tyrosine in biological samples. The plasma concentrations (means±S.E.M.) of free tyrosine and nitrotyrosine in eight normal subjects were 12±0.6 μg/ml and 14±0.7 ng/ml respectively. Plasma proteins contained tyrosine and nitrotyrosine at 60.7±1.7 μg/mg and 2.7±0.4 ng/mg respectively.

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