Endogenous corticosteroid biosynthesis in subjects after bilateral adrenalectomy

Abstract

Significant levels of adrenal steroids are found in adrenalectomized subjects. We speculate that this occurs at extra-adrenal sites or in residual adrenal cortex tissue in an ACTH-independent manner. Our data suggest that aldosterone synthase, acting on cortisol, is the source of 18-oxoF and 18-OHF in these subjects. Further studies of corticosteroid production within adrenalectomized subjects, looking for evidence of adrenal regrowth or residual adrenal tissue, are justified.

A rare case of juvenile hypertension: coexistence of type 2 multiple endocrine neoplasia -related bilateral pheochromocytoma and reninoma in a young patient with ACE gene polymorphism

“…We can try to explain this particular phenomenon by considering a possible extra-adrenal aldosterone production. In fact, the existence of extra-adrenal sites of aldosterone synthesis, such as heart or brain, has been clearly demonstrated [26] and an endogenous corticosteroid biosynthesis after bilateral adrenalectomy has been described [27], even if the contribution of these sources to the circulating hormone levels is not completely known. In fact, while mRNA levels of aldosterone synthase (CYP11B2) are about 100 to 10,000 times lower in the normal human heart than in the human adrenal gland [28], the aldosterone synthase expression has been found to be elevated in patient with heart failure.…”