Aldosterone and 18-oxocortisol coaccumulation in aldosterone-producing lesions

Yuki Sugiura, Emi Takeo, Shuichi Shimma, Mai Yokota, Tatsuya Higashi, Tsugio Seki, Yosuke Mizuno, Mototsugu Oya, Takeo Kosaka, Masao Omura, Tetsuo Nishikawa, Makoto Suematsu, Koshiro Nishimoto

Research output: Contribution to journalArticlepeer-review

38 Citations (Scopus)


Primary aldosteronism is a secondary hypertensive disease caused by autonomous aldosterone production that often caused by an aldosterone-producing adenoma (APA). Immunohistochemistry of aldosterone synthase (CYP11B2) shows the presence of aldosterone-producing cell clusters (APCCs) even in non-primary aldosteronism adult adrenal cortex. An APCC-like structure also exists as possible APCC-to-APA transitional lesions (a speculative designation) in primary aldosteronism adrenals. However, whether APCCs produce aldosterone or 18-oxocortisol, a potential serum marker of APA, remains unknown because of lack of technology to visualize adrenocorticosteroids on tissue sections. To address this obstacle, in this study, we used highly sensitive Fourier transform ion cyclotron resonance mass spectrometry to image various adrenocorticosteroids, including 18-oxocortisol, in adrenal tissue sections from 8 primary aldosteronism patients with APCC (cases 1-4), possible APCC-to-APA transitional lesions (case 5), and APA (cases 6-8). Further analyses by tandem mass spectrometry imaging allowed us to differentially visualize aldosterone from cortisone, which share identical mass-to-charge ratio value (m/z). In conclusion, these advanced imaging techniques revealed that aldosterone and 18-oxocortisol coaccumulated within CYP11B2-expressing lesions. These imaging outcomes along with a growing body of aldosterone research led us to build a progressive development hypothesis of an aldosterone-producing pathology in the adrenal glands.

Original languageEnglish
Pages (from-to)1345-1354
Number of pages10
Issue number6
Publication statusPublished - 2018 Dec


  • Adenoma
  • Adrenal glands
  • Aldosterone
  • Mass spectrometry
  • Mutation

ASJC Scopus subject areas

  • Internal Medicine


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