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2016 ; 23
(3
): 242-8
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Immunohistochemistry of the adrenal in primary aldosteronism
#MMPMID27119751
Gomez-Sanchez CE
; Gomez-Sanchez EP
Curr Opin Endocrinol Diabetes Obes
2016[Jun]; 23
(3
): 242-8
PMID27119751
show ga
PURPOSE OF REVIEW: Primary aldosteronism is a major cause of hypertension;
aldosterone-producing adenomas (APA) cause about half of primary aldosteronism;
idiopathic hyperplasia of adrenal glomerulosa cells are responsible for the rest.
A surprising variety of mutations have recently been identified in ion channels
and pumps in a significant number of APA. The present review addresses
histological and molecular aspects of APA and the surrounding adrenal. RECENT
FINDINGS: Specific antibodies against the CYP11B2 and CYP11B1 enzymes, the last
enzyme in aldosterone and cortisol synthesis, respectively, allow for the first
time study of the steroidogenic capabilities of cells within the APA and adjacent
adrenal. Cells expressing CYP11B2 may be scattered and/or in clusters throughout
the normal adrenal zona glomerulosa. APA differ widely in the number of cells
expressing CYP11B2; some did not express it at all, but were surrounded by cells,
some in clusters or micronodules, that expressed CYP11B2. Some APAs also
comprised cells expressing both CYP11B1 and CYP17A1. In some samples, analysis of
the tissue adjacent to APA detected ion channel and pump mutations heretofore
associated only with APA. SUMMARY: APAs have a complex structure and expression
of steroidogenic enzymes.