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Pathology and gene mutations of aldosterone-producing lesions

Journal

ENDOCRINE JOURNAL
Volume -, Issue -, Pages -

Publisher

JAPAN ENDOCRINE SOC
DOI: 10.1507/endocrj.EJ22-0492

Keywords

Aldosterone; Aldosterone synthase; Immunohistochemistry; Aldosterone-producing cell clusters (APCC)

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The human adrenal cortex secretes aldosterone and cortisol as major corticosteroids. CYP11B2 and CYP11B1 play crucial roles in their synthesis. This study successfully purified and identified CYP11B2 as aldosterone synthase, allowing for visualization of functional histology and discovering new aldosterone-producing lesions.
The human adrenal cortex secretes aldosterone and cortisol as major corticosteroids. For their production, CYP11B2 and CYP11B1 catalyze the last steps in the syntheses of aldosterone and cortisol, respectively. In our previous study, CYP11B2 was the first successfully purified from rat adrenals and human clinical samples and then was proved to be aldosterone synthase. We demonstrated the immunohistochemistry for CYP11B2 of both rats and humans and applied it clinically to visualize the functional histology of aldosterone-producing adenoma (APA) causing primary aldosteronism (PA). We discovered aldosterone-producing cell clusters (APCCs) and possible APCC-to-APA transitional lesions (pAATLs) and further visualized aldosterone-producing lesions for rare forms of PA including familial hyperaldosteronism type 3 and novel non-familial juvenile PA. Here we review the history of our research on aldosterone-producing lesions.

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