Aldosterone has a significant role in the development of hypertension and cardiovascular damage. Primary Aldosteronism, caused by the autonomous and excessive secretion of aldosterone by the adrenal, is the etiology of the high blood pressure in 5-10% of hypertensive patients. Synthesis of aldosterone requires several enzymatic steps, some occurring in the cytosol, others, notably the first and last, in mitochondria. Aldosterone biosynthesis is known to be regulated at two steps in the pathway, an early step requiring the transfer of cholesterol by the StAR protein into the mitochondria where it is hydroxylated and cleaved to produce pregnenolone, and late in the pathway when deoxycorticosterone (DOC) is successively hydroxylated to aldosterone by the product of the CYP11B2 gene, aldosterone synthase, within the mitochondria. Aldosterone synthase is regulated primarily at the transcriptional level. DOC is synthesized from progesterone by the cytosolic enzyme 21-hydroxylase. We present preliminary data indicating that aldosterone biosynthesis is also regulated by the efficient transfer of DOC into the mitochondria by an active process. We proposed to address the following hypotheses: """"""""Regulation of the late pathway of aldosterone biosynthesis involves regulation of the transfer of DOC from the cytosol into the mitochondria"""""""" This is an exploratory proposal to address the specific aims: 1. Characterize the mechanism of the regulation of the facilitated transfer of DOC into the mitochondria for conversion into aldosterone by the CYP11B2 enzyme 2. Identify and clone of the factor responsible for facilitating the transfer of DOC into the mitochondria. Relevance to human health: Hypertension is one of the most common diagnoses in adults and contributes to cardiovascular morbidity and mortality, as well as stroke, the primary causes of morbidity and death in America. Patients with aldosteronism have significantly greater cardiovascular, renal and cerebrovascular pathology than those with equivalent increases in blood pressure. Information about the regulation of aldosterone synthesis will lead to more effective therapy for these patients.

Public Health Relevance

Primary Aldosteronism is the most common form of secondary hypertension, accounting for about 7-10% of unselected patients with hypertension. The regulation of aldosterone biosynthesis is incompletely understood, but it is known that the regulation occurs both early and late in the biosynthetic pathway. The late pathway involves the action of the enzyme aldosterone synthase upon DOC within the mitochondria. We have shown that the transfer of DOC into the mitochondria is regulated and propose to isolate the factor involved.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Exploratory/Developmental Grants (R21)
Project #
Application #
Study Section
Hypertension and Microcirculation Study Section (HM)
Program Officer
Thrasher, Terry N
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Mississippi Medical Center
Internal Medicine/Medicine
Schools of Medicine
United States
Zip Code
Gomez-Sanchez, Elise P (2016) Third-generation Mineralocorticoid Receptor Antagonists: Why Do We Need a Fourth? J Cardiovasc Pharmacol 67:26-38
Kuppusamy, Maniselvan; Caroccia, Brasilina; Stindl, Julia et al. (2014) A novel KCNJ5-insT149 somatic mutation close to, but outside, the selectivity filter causes resistant hypertension by loss of selectivity for potassium. J Clin Endocrinol Metab 99:E1765-73
Gomez-Sanchez, Elise; Gomez-Sanchez, Celso E (2014) The multifaceted mineralocorticoid receptor. Compr Physiol 4:965-94
Gomez-Sanchez, Celso E; Qi, Xin; Velarde-Miranda, Carolina et al. (2014) Development of monoclonal antibodies against human CYP11B1 and CYP11B2. Mol Cell Endocrinol 383:111-7
Gomez-Sanchez, Celso E (2014) Primary aldosteronism: a channelopathy? Hypertension 63:668-9
Chen, Jian; Gomez-Sanchez, Celso E; Penman, Alan et al. (2014) Expression of mineralocorticoid and glucocorticoid receptors in preautonomic neurons of the rat paraventricular nucleus. Am J Physiol Regul Integr Comp Physiol 306:R328-40
Gomez-Sanchez, Celso E; Oki, Kenji (2014) Minireview: potassium channels and aldosterone dysregulation: is primary aldosteronism a potassium channelopathy? Endocrinology 155:47-55
Gomez-Sanchez, Elise P (2014) Brain mineralocorticoid receptors in cognition and cardiovascular homeostasis. Steroids 91:20-31
Oki, Kenji; Kopf, Phillip G; Campbell, William B et al. (2013) Angiotensin II and III metabolism and effects on steroid production in the HAC15 human adrenocortical cell line. Endocrinology 154:214-21
Velarde-Miranda, Carolina; Gomez-Sanchez, Elise P; Gomez-Sanchez, Celso E (2013) Regulation of aldosterone biosynthesis by the Kir3.4 (KCNJ5) potassium channel. Clin Exp Pharmacol Physiol 40:895-901

Showing the most recent 10 out of 13 publications