Patients with pheochromocytoma exhibit low aldosterone renin ratio-preliminary reports
BMC ENDOCRINE DISORDERS
Authors: Yamada, Tomoko; Fukuoka, Hidenori; Hosokawa, Yusei; Odake, Yukiko; Yoshida, Kenichi; Matsumoto, Ryusaku; Bando, Hironori; Okada, Yuko; Hirota, Yushi; Iguchi, Genzo; Ogawa, Wataru; Takahashi, Yutaka
Abstract
Background: Plasma renin activity (PRA) is generally increased in patients with pheochromocytoma (PCC) due to low circulating plasma volume and activation of beta-1 adrenergic receptor signaling. However, there has been no study on the aldosterone renin ratio (ARR) in patients with PCC. To elucidate the issue, this study aimed to determine the PRA, plasma aldosterone concentration (PAC), and ARR in patients with PCC and compare them with those in patients with subclinical Cushing's syndrome (SCS) and non-functioning adrenal adenoma (NFA). Methods: In this retrospective single-center, cross-sectional study, 67 consecutive patients with adrenal tumors (PCC (n = 18), SCS (n = 18), and NFA (n = 31)) diagnosed at Kobe University Hospital between 2008 and 2014 were enrolled. Results: PRA was significantly higher in patients with PCC than in those with SCS and NFA (2.1 (1.3 similar to 2.8) vs. 0.7 (0.5 similar to 1.8) and 0.9 (0.6 similar to 1.4) ng/mL/h;p = 0.018 andp = 0.025). Although PACs were comparable among the three groups, ARR was significantly lower in patients with PCC than in those with SCS and NFA (70.5 (45.5 similar to 79.5) vs. 156.0 (92.9 similar to 194.5) and 114.9 (90.1 similar to 153.4);p = 0.001 andp < 0.001). Receiver operating characteristic curve analysis demonstrated that, in differentiating PCC from NFA, PRA > 1.55 ng/mL/h showed a sensitivity of 70.0% and specificity of 80.6%. Interestingly, ARR < 95.4 showed a sensitivity of 83.3% and specificity of 86.7%, which were higher than those in PRA. Conclusions: ARR decreased in patients with PCC, which was a more sensitive marker than PRA. Further study is necessary to understand the usefulness of this convenient marker in the detection of PCC.
Aldosterone from endometrial glands is benefit for human decidualization
CELL DEATH & DISEASE
Authors: Li, Shu-Yun; Song, Zhuo; Yan, Ya-Ping; Li, Bo; Song, Min-Jie; Liu, Yue-Fang; Yang, Zhen-Shan; Li, Meng-Yuan; Liu, Ai-Xia; Quan, Song; Yang, Zeng-Ming
Abstract
Local renin-angiotensin system (RAS) in female reproductive system is involved in many physiological and pathological processes, such as follicular development, ovarian angiogenesis, ovarian, and endometrial cancer progress. However, studies on the functional relevance of RAS in human endometrium are limited, especially for renin-angiotensin-aldosterone system (RAAS). In this study, we defined the location of RAS components in human endometrium. We found that angiotensin II type-1 receptor (AT(1)R) and aldosterone synthase (CYP11B2), major components of RAAS, are specifically expressed in endometrial gland during mid-secretory phase. Aldosterone receptor, mineralocorticoid receptor (MR), is elevated in stroma in mid-secretory endometrium. In vitro, MR is also activated by aldosterone during decidualization. Activated MR initiates LKB1 expression, followed by phosphorylating of AMPK that stimulates PDK4 expression. The impact of PDK4 on decidualization is independent on PDHE1 alpha inactivation. Based on co-immunoprecipitation, PDK4 interacts with p-CREB to prevent its ubiquitination for facilitating decidualization via FOXO1. Restrain of MR activation interrupts LKB1/p-AMPK/PDK4/p-CREB/FOXO1 pathway induced by aldosterone, indicating that aldosterone action on decidualization is mainly dependent on MR stimulation. Aldosterone biosynthesized in endometrial gland during mid-secretory phase promotes decidualization via activating MR/LKB1/p-AMPK/PDK4/p-CREB/FOXO1 signaling pathway. This study provides the valuable information for understanding the underlying mechanism during decidualization.