Aldosterone Synthase ∞ Area

Aldosterone Synthase

Meaning

Aldosterone Synthase, scientifically designated as CYP11B2, is a crucial enzyme primarily in the adrenal cortex. It catalyzes the final three steps in aldosterone biosynthesis, converting 11-deoxycorticosterone into this potent mineralocorticoid hormone. This process is fundamental for physiological regulation.

Context

This enzyme functions as a pivotal component within the adrenal gland’s zona glomerulosa, central to the Renin-Angiotensin-Aldosterone System (RAAS). Aldosterone Synthase activity is tightly regulated by angiotensin II, potassium, and adrenocorticotropic hormone, ensuring precise mineralocorticoid production. It governs blood pressure regulation and electrolyte homeostasis.

Significance

Clinical importance of Aldosterone Synthase is substantial, as its dysregulation leads to significant health concerns. Overactivity causes primary aldosteronism, a common form of secondary hypertension with excessive aldosterone production. Impaired function, though rare, results in aldosterone deficiency, affecting blood pressure and electrolyte balance. Understanding its role aids diagnosis and management.

Mechanism

Aldosterone Synthase executes hydroxylation and oxidation reactions within adrenal cortical cell mitochondria. It converts 11-deoxycorticosterone to corticosterone, then modifies corticosterone to 18-hydroxycorticosterone, finally oxidizing the 18-hydroxyl group to an aldehyde, yielding aldosterone. This sequential enzymatic action is indispensable for active hormone synthesis.

Application

Clinically, Aldosterone Synthase activity is a target for pharmacological intervention, particularly in managing hypertension driven by excessive aldosterone. Aldosterone synthase inhibitors are studied as therapeutic agents to reduce aldosterone production directly. Such interventions aim to normalize blood pressure and correct electrolyte disturbances in patients with primary aldosteronism or resistant hypertension.

Metric

Aldosterone Synthase effects are typically assessed indirectly via plasma aldosterone concentration (PAC) and plasma renin activity (PRA). The PAC/PRA ratio is a key diagnostic tool for screening primary aldosteronism, indicating autonomous aldosterone production. Serum potassium and sodium levels offer essential insights into aldosterone regulation’s downstream impact.

Risk

Aberrant Aldosterone Synthase activity carries distinct clinical risks. Excessive aldosterone production, due to enzyme overactivity, can lead to hypertension, hypokalemia, metabolic alkalosis, and increased cardiovascular and renal damage. Conversely, rare deficiency results in hypotension and potentially life-threatening hyperkalemia. Therapeutic inhibition requires careful monitoring to prevent hyperkalemia or excessive hypotension.

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∞ Aldosterone Synthase
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HRTioJuly 20, 2025