Abstract:
:In the 60 years that have passed since the discovery of the mineralocorticoid hormone aldosterone, much has been learned about its synthesis (both adrenal and extra-adrenal), regulation (by renin-angiotensin II, potassium, adrenocorticotrophin, and other factors), and effects (on both epithelial and nonepithelial tissues). Once thought to be rare, primary aldosteronism (PA, in which aldosterone secretion by the adrenal is excessive and autonomous of its principal regulator, angiotensin II) is now known to be the most common specifically treatable and potentially curable form of hypertension, with most patients lacking the clinical feature of hypokalemia, the presence of which was previously considered to be necessary to warrant further efforts towards confirming a diagnosis of PA. This, and the appreciation that aldosterone excess leads to adverse cardiovascular, renal, central nervous, and psychological effects, that are at least partly independent of its effects on blood pressure, have had a profound influence on raising clinical and research interest in PA. Such research on patients with PA has, in turn, furthered knowledge regarding aldosterone synthesis, regulation, and effects. This review summarizes current progress in our understanding of the physiology of aldosterone, and towards defining the causes (including genetic bases), epidemiology, outcomes, and clinical approaches to diagnostic workup (including screening, diagnostic confirmation, and subtype differentiation) and treatment of PA.
journal_name
Physiol Revjournal_title
Physiological reviewsauthors
Stowasser M,Gordon RDdoi
10.1152/physrev.00026.2015subject
Has Abstractpub_date
2016-10-01 00:00:00pages
1327-84issue
4eissn
0031-9333issn
1522-1210pii
96/4/1327journal_volume
96pub_type
杂志文章,评审abstract::Cutaneous melanin pigment plays a critical role in camouflage, mimicry, social communication, and protection against harmful effects of solar radiation. Melanogenesis is under complex regulatory control by multiple agents interacting via pathways activated by receptor-dependent and -independent mechanisms, in hormonal...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.00044.2003
更新日期:2004-10-01 00:00:00
abstract::Intercellular calcium (Ca(2+)) waves (ICWs) represent the propagation of increases in intracellular Ca(2+) through a syncytium of cells and appear to be a fundamental mechanism for coordinating multicellular responses. ICWs occur in a wide diversity of cells and have been extensively studied in vitro. More recent stud...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.00029.2011
更新日期:2012-07-01 00:00:00
abstract::Protein toxins such as ricin and Shiga toxin with intracellular targets have to be endocytosed and translocated to the cytosol to inhibit the protein synthesis and thereby kill the cell. Ricin is internalized by both clathrin-dependent and -independent endocytic mechanisms, whereas Shiga toxin seems to be taken up exc...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.1996.76.4.949
更新日期:1996-10-01 00:00:00
abstract::Oligodendrocytes generate multiple layers of myelin membrane around axons of the central nervous system to enable fast and efficient nerve conduction. Until recently, saltatory nerve conduction was considered the only purpose of myelin, but it is now clear that myelin has more functions. In fact, myelinating oligodend...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.00031.2018
更新日期:2019-07-01 00:00:00
abstract::Prolactin is a protein hormone of the anterior pituitary gland that was originally named for its ability to promote lactation in response to the suckling stimulus of hungry young mammals. We now know that prolactin is not as simple as originally described. Indeed, chemically, prolactin appears in a multiplicity of pos...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.2000.80.4.1523
更新日期:2000-10-01 00:00:00
abstract::The iron hormone hepcidin and its receptor and cellular iron exporter ferroportin control the major fluxes of iron into blood plasma: intestinal iron absorption, the delivery of recycled iron from macrophages, and the release of stored iron from hepatocytes. Because iron losses are comparatively very small, iron absor...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.00008.2013
更新日期:2013-10-01 00:00:00
abstract::The discovery of cannabinoid receptors and subsequent identification of their endogenous ligands (endocannabinoids) in early 1990s have greatly accelerated research on cannabinoid actions in the brain. Then, the discovery in 2001 that endocannabinoids mediate retrograde synaptic signaling has opened up a new era for c...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.00019.2008
更新日期:2009-01-01 00:00:00
abstract::During the last decade, earlier suggestions that insulin acts at the plasma membrane level via combination with receptors have been amply confirmed in studies of 125I-labeled insulin binding kinetics. Efforts have been devoted to the development of homogeneous, stable, and bioactive tracers, and a preparation of monoi...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.1984.64.4.1321
更新日期:1984-10-01 00:00:00
abstract::The neuromuscular junction is the chemical synapse between motor neurons and skeletal muscle fibers. It is designed to reliably convert the action potential from the presynaptic motor neuron into the contraction of the postsynaptic muscle fiber. Diseases that affect the neuromuscular junction may cause failure of this...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.00033.2014
更新日期:2015-07-01 00:00:00
abstract::It has been suggested that highly social mammals, such as naked mole rats and humans, are long-lived due to neoteny (the prolongation of youth). In both species, aging cannot operate as a mechanism facilitating natural selection because the pressure of this selection is strongly reduced due to 1) a specific social str...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.00040.2015
更新日期:2017-04-01 00:00:00
abstract::The aim of this review is to provide basic information on the electrophysiological changes during acute ischemia and reperfusion from the level of ion channels up to the level of multicellular preparations. After an introduction, section II provides a general description of the ion channels and electrogenic transporte...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.1999.79.3.917
更新日期:1999-07-01 00:00:00
abstract::The 1910-1913 Terra Nova Expedition to the Antarctic, led by Captain Robert Falcon Scott, was a venture of science and discovery. It is also a well-known story of heroism and tragedy since his quest to reach the South Pole and conduct research en route, while successful was also fateful. Although Scott and his four co...
journal_title:Physiological reviews
pub_type: 传,历史文章,杂志文章
doi:10.1152/physrev.00031.2011
更新日期:2012-04-01 00:00:00
abstract::The urothelium, which lines the inner surface of the renal pelvis, the ureters, and the urinary bladder, not only forms a high-resistance barrier to ion, solute and water flux, and pathogens, but also functions as an integral part of a sensory web which receives, amplifies, and transmits information about its external...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.00030.2012
更新日期:2013-04-01 00:00:00
abstract::Changes in energy regulation occur during normal aging and contribute to the common phenomenon of weight and fat losses late in life. This review synthesizes data on aging-related changes in energy intake and energy expenditure and on the regulation of energy intake and expenditure. The ability of older adults to accu...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.00019.2005
更新日期:2006-04-01 00:00:00
abstract::The classic concept of gastrointestinal endocrinology is that of a few peptides released to the circulation from endocrine cells, which are interspersed among other mucosal cells in the upper gastrointestinal tract. Today more than 30 peptide hormone genes are known to be expressed throughout the digestive tract, whic...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.1998.78.4.1087
更新日期:1998-10-01 00:00:00
abstract::Polymers of deoxyhemoglobin S deform sickle cell anemia red blood cells into sickle shapes, leading to the formation of dense, dehydrated red blood cells with a markedly shortened life-span. Nearly four decades of intense research in many laboratories has led to a mechanistic understanding of the complex events leadin...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.00052.2003
更新日期:2005-01-01 00:00:00
abstract::Although opioids are highly effective for the treatment of pain, they are also known to be intensely addictive. There has been a massive research investment in the development of opioid analgesics, resulting in a plethora of compounds with varying affinity and efficacy at all the known opioid receptor subtypes. Althou...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.2001.81.1.299
更新日期:2001-01-01 00:00:00
abstract::Given the large amount of genome-wide data that have been collected during the last decades, a good understanding of how and why cells change during development, homeostasis, and disease might be expected. Unfortunately, the opposite is true; triggers that cause cellular state changes remain elusive, and the underlyin...
journal_title:Physiological reviews
pub_type: 杂志文章
doi:10.1152/physrev.00034.2019
更新日期:2021-01-01 00:00:00
abstract::The function and survival of all organisms is dependent on the dynamic control of energy metabolism, when energy demand is matched to energy supply. The AMP-activated protein kinase (AMPK) alphabetagamma heterotrimer has emerged as an important integrator of signals that control energy balance through the regulation o...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.00011.2008
更新日期:2009-07-01 00:00:00
abstract::Although vitamin A was recognized as an "anti-infective vitamin" over 90 years ago, the mechanism of how vitamin A regulates immunity is only beginning to be understood. Early studies which focused on the immune responses in vitamin A-deficient (VAD) animals clearly demonstrated compromised immunity and consequently i...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.00032.2013
更新日期:2015-01-01 00:00:00
abstract::The minK gene encodes a protein of 130 amino acids that has a single transmembrane segment and is expressed in many tissues including heart, uterus, and kidney. When Xenopus oocytes are injected with minK mRNA, a very slowly activating voltage-dependent potassium current is induced in these cells. The induced channels...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.1997.77.3.627
更新日期:1997-07-01 00:00:00
abstract::Afferent signals that guide orienting movements converge in the deeper layers of the SC in a wide variety of animals. The sensory cells are arranged topographically according to their receptive-field locations and, thereby, form maps of sensory space. Maps of visual, somatosensory, and/or auditory space have been obta...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.1986.66.1.118
更新日期:1986-01-01 00:00:00
abstract::Eukaryotes are characterized by endomembranes that are connected by vesicular transport along secretory and endocytic pathways. The compositional differences between the various cellular membranes are maintained by sorting events, and it has long been believed that sorting is based solely on protein-protein interactio...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.2001.81.4.1689
更新日期:2001-10-01 00:00:00
abstract::Impairments of vision and hearing are highly prevalent conditions limiting the quality of life and presenting a major socioeconomic burden. For a long time, retinal and cochlear disorders have remained intractable for causal therapies, with sensory rehabilitation limited to glasses, hearing aids, and electrical cochle...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.00035.2019
更新日期:2020-10-01 00:00:00
abstract::Astrocytes are the most abundant cells in the central nervous system (CNS) that provide nutrients, recycle neurotransmitters, as well as fulfill a wide range of other homeostasis maintaining functions. During the past two decades, astrocytes emerged also as increasingly important regulators of neuronal functions inclu...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.00041.2013
更新日期:2014-10-01 00:00:00
abstract::Hemoglobin (Hb) occurs in all the kingdoms of living organisms. Its distribution is episodic among the nonvertebrate groups in contrast to vertebrates. Nonvertebrate Hbs range from single-chain globins found in bacteria, algae, protozoa, and plants to large, multisubunit, multidomain Hbs found in nematodes, molluscs a...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.2001.81.2.569
更新日期:2001-04-01 00:00:00
abstract::Small GTPases use GDP/GTP alternation to actuate a variety of functional switches that are pivotal for cell dynamics. The GTPase switch is turned on by GEFs, which stimulate dissociation of the tightly bound GDP, and turned off by GAPs, which accelerate the intrinsically sluggish hydrolysis of GTP. For Ras, Rho, and R...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.00003.2012
更新日期:2013-01-01 00:00:00
abstract::Stress induced by accumulation of unfolded proteins at the endoplasmic reticulum (ER) is a classic feature of secretory cells and is observed in many tissues in human diseases including cancer, diabetes, obesity, and neurodegeneration. Cellular adaptation to ER stress is achieved by the activation of the unfolded prot...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.00001.2011
更新日期:2011-10-01 00:00:00
abstract::In electrically nonexcitable cells, Ca(2+) influx is essential for regulating a host of kinetically distinct processes involving exocytosis, enzyme control, gene regulation, cell growth and proliferation, and apoptosis. The major Ca(2+) entry pathway in these cells is the store-operated one, in which the emptying of i...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.00057.2003
更新日期:2005-04-01 00:00:00
abstract::The major areas of normal coronary physiological research since Berne's 1964 review have been the measurement of ventricular transmural blood flow distribution with microspheres, the adenosine hypothesis of local metabolic control of coronary blood flow, and the autonomic control of coronary blood flow. There is an im...
journal_title:Physiological reviews
pub_type: 杂志文章,评审
doi:10.1152/physrev.1983.63.1.1
更新日期:1983-01-01 00:00:00