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Embryology, Anatomy, and Physiology of the Adrenal Glands
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Zona glomerulosa (ZG)Secretes the mineralocorticoid aldosterone and increases sodium reabsorption and potassium excretion.Expresses aldosterone synthase.
Endocrinology and metabolism
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
The adrenal gland consists of the cortex and medulla. Within the cortex there are three zones: zona glomerulosa: produces mineralocorticoids – mainly aldosterone. Renin (from kidney) stimulates conversion of angiotensinogen (from liver) to angiotensin I, which is converted to angio tensin II in the lung by ACE. Angiotensin II stimulates aldosterone productionzona fasciculata: produces glucocorticoids – mainly cortisol. CRF/AVP stimulate ACTH production by the pituitary which stimulates cortisol productionzona reticularis: produces sex steroids The medulla secretes catecholamines (adrenaline, noradrenaline) in response to various stimuli, e.g. stress, fear.
Adrenalectomy
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Mikael Petrosyan, Timothy D. Kane
The adrenal cortex may be divided into three zones: The zona glomerulosa is the outermost zone of the cortex, responsible for the synthesis of aldosterone.The zona fasciculata is the largest zone of the cortex and the site of cortisol production.The zona reticularis is the innermost and smallest zone. Cells here produce adrenal androgens, dihydroepiandrosterone, and androstenedione.
Body mass index predicts aldosterone production in hypertensive postmenopausal women
Published in Clinical and Experimental Hypertension, 2020
Lijun Li, Xiaoling Hou, Xiaowen Geng, Yong Xu
Prior studies suggested that older individuals secrete less aldosterone than younger individuals (14). Nanba et al. (15) revealed that the adrenal gland in older individuals has less normal aldosterone synthase expression in the zona glomerulosa but a greater content of abnormal foci of aldosterone synthase-expressing cells. Interestingly, in this study, PAC and PRA decreased dramatically with ageing in non-obese women, whereas PAC showed no change with older age in obese women, and PRA declined. Regardless of the effect of oestrogen, PAC was significantly higher in obese postmenopausal women than in their non-obese counterparts, while basal PRA was similar between the two groups. Laffin LJ (16) reported that subcutaneous adipocytes produce aldosterone, as evidenced by fat pad biopsies from obese postmenopausal women. Several studies have suggested that adipose tissue secretes adipokines that stimulate aldosterone release from adrenal cells (17,18). The adipocyte-derived hormone leptin serves as a new direct regulator of adrenal aldosterone production, and leptin-mediated aldosterone production potentially contributes to obesity-associated hypertension, particularly in females (19,20). These clinical observations illustrated that obesity is associated with dysregulated aldosterone physiology.
Virilising ovarian tumour in a postmenopausal woman after bilateral oophorectomy
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2020
Ankia Coetzee, Jocelynn Ann Hellig, Candice Sher-Lockitz, Annelize Barnard, Viju Thomas, Magda Conradie
Histopathology remains the gold standard for the diagnosis of steroid cell tumours NOS. Characteristically these tumours are benign, well circumscribed and non-calcified with a lobulated appearance. The tumours are also typically solid with a yellow or orange section surface because of intracytoplasmic lipids. On microscopic examination, the tumour cells typically have a nested arrangement but can be organised into columns or cords resembling adrenal zona glomerulosa and zona fasciculata. Cytologically, cells are polygonal or round with distinctive cell borders, central nuclei and prominent nucleoli. The cytoplasm varies from eosinophilic to clear and vacuolated. The absence of cytoplasmic Reinke’s crystals helps differentiate this tumour from the Leydig cell neoplasm. Immunohistochemical staining helps to distinguish steroid cell tumours from other stromal cell tumours as shown in the index case (see Figures 1 and 2). Based on the limited data available, the recommended management of steroid cell tumour NOS is primarily surgical.
Drug design strategies for Cushing’s syndrome
Published in Expert Opinion on Drug Discovery, 2019
S. A. Usanov, A. V. Kliuchenovich, N. V. Strushkevich
The selective inhibition of CYP11B1 is a novel strategy to block cortisol production. However, the development of selective and potent CYP11B1 inhibitors is particularly challenging due to high homology to the CYP11B2 isoform. Both CYP11B1 and CYP11B2 belong to the cytochrome P450 family and contain a heme group as a cofactor. CYP11B1 catalyzes the 11β-hydroxylation of 11-deoxycortisol to cortisol. CYP11B2 catalyzes a multistep reaction: the 11β-hydroxylation of 11-deoxycorticosterone (DOC) to corticosterone (B) followed by the 18-hydroxylation of B and 18-oxidation of 18-OH-B to aldosterone. CYP11B1 and CYP11B2 are located in the inner membrane of the mitochondria, share 93% amino acid sequence identity and function within an identical redox-chain which consists of ferredoxin reductase and ferredoxin [11]. However, they are expressed in different zones of the adrenal cortex and, as a result, have different gene regulation. CYP11B1 is expressed in the zona fasciculata/reticularis under control of ACTH [25], while expression of CYP11B2 is restricted to the zona glomerulosa and regulated by angiotensin II, K+ and ACTH [26] . Zonal distribution, the absence of CYP17A1 in the zona glomerulosa and centripetal blood flow in the adrenal cortex ensure different sites of production of mineralocorticoids (aldosterone) and glucocorticoids (cortisol) [26].