Format

Send to

Choose Destination
J Clin Endocrinol Metab. 2019 Mar 13. pii: jc.2019-00143. doi: 10.1210/jc.2019-00143. [Epub ahead of print]

PTH Modulation by Aldosterone and Angiotensin II is Blunted in Hyperaldosteronism and Rescued by Adrenalectomy.

Author information

1
Hypertension Unit, Department of Medicine -DIMED, University of Medicine of Padova, Padova, Italy.
2
Endocrine Surgery, Department of Surgical and Oncological Sciences, University of Padua, Padova, Italy.

Abstract

CONTEXT:

Accumulating evidences suggest a link between adrenocortical zona glomerulosa and parathyroid gland through mechanisms that remain unexplored.

OBJECTIVES:

To test the hypothesis that in vivo Angiotensin (Ang) II blockade affects parathyroid hormone (PTH) secretion in hypertensive patients and that aldosterone and Ang II directly stimulate PTH secretion ex vivo.

DESIGN AND SETTING:

We investigated the changes of serum PTH levels induced by oral captopril (50 mg) administration in patients with primary essential hypertension (EH) and with primary aldosteronism (PA) due to bilateral adrenal hyperplasia (BAH) or to aldosterone-producing adenoma (APA), the latter before and after adrenalectomy. We also exposed primary cultures of human parathyroid cells from patients with primary hyperparathyroidism to Ang II [10-7M] and/or aldosterone [10-7M].

RESULTS:

Captopril lowered PTH levels (in ng/L) both in EH (n=63; 25.9±8.3 baseline vs 24.4±8.0 post captopril, p<0.0001) and in APA patients after adrenalectomy (n=27; 26.3±11.6 vs 24.0±9.7 p=0.021). However, it was ineffective in PA patients with full-blown PA due to APA and bilateral adrenal hyperplasia (BAH). In primary culture of human parathyroid cells, both aldosterone (p<0.001) and angiotensin II (p=0.002) markedly increased PTH secretion from baseline, by acting through MR and AT-1R, as these effects were abolished by canrenone and irbesartan, respectively.

CONCLUSION:

These results collectively suggest an implication of the renin-angiotensin-aldosterone system in PTH regulation in humans, at least in PTH-secreting cells obtained from parathyroid tumors. Moreover, they further support the concept that mild hyperparathyroidism is a feature of human PA that is correctable with adrenalectomy.

PMID:
30865228
DOI:
10.1210/jc.2019-00143

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center