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Expression of Genes Encoding Aldosterone Synthesis Pathway Enzymatic Proteins in Adrenocortical Adenomas in Patients With Conn Syndrome

100%

Ziaja J., Cholewa K., Chudek J., Król R., Kajor M., Więcek A., Mazurek U., Cierpka L.

Polish Journal of Surgery

2010

vol. 82

issue 1

47-52

One of the possibilities of explanation of persistent hypertension after adrenocortical adenoma excision in patients with Conn syndrome could be analysis of transcriptional activity of genes encoding aldosterone synthesis pathway enzymatic proteins within these tumours.The aim of the study was to analyze the expression of mentioned genes in adrenocortical adenomas in patients with primary hiperaldosteronism and to analyse correlations between their expression and results of hormonal tests of blood serum before surgery as well as maximal values of blood pressure before surgery and their decrease after operation.Material and methods. Thirteen patients with Conn syndrome subjected to surgical excision of adrenocortical tumour were analyzed. Expression of CYP 11A1, CYP 21A2, CYP 11B2 and HSD 3B2 genes in tissue of removed tumours was analyzed using RT real-time PCR method. GAPDH was used as reference gene. The results analysis was based on amplification threshold values CT. Analysis of clinical consequences of adrenalectomy was performed after a period of minimum 12 months after surgery.Results. Expression of mRNA, presented as 2-ΔΔCT, of CYP 11A1 gene was 1.58 (1.01-2.48), CYP 21A2-2.74 (1.78-4.24), CYP 11B2- 19.15 (11.28-32.50) and HSD 3B2-2.57 (1.47-4.50). Correlation analysis revealed only negative correlation between CYP 11A1 gene expression and plasma renin activity in upright position (r=-0.604; p=0.049) and positive correlation between HSD 3B2 gene expression and decrease of maximal values of systolic blood pressure in long term follow up (r=0.763; p=0.010).Conclusions. High expression of genes encoding aldosterone synthesis pathway enzymatic proteins is observed in adrenocortical adenomas in patients with Conn syndrome. The transcriptional activity of the genes does not correlate with results of preoperative hormonal tests and is not a prognostic factor of persistent hypertension after adrenal tumour excision.

Arterial blood pressure circadian rhythm in normotensive decompensated cirrhotic patients before and after single paracentesis

84%

Marcisz C., Orzeł A., Kowalik-Kabat A., Kulik H., Balicka J., Olejko A.

Annales Academiae Medicae Silesiensis

2016

vol. 70

265-273

INTRODUCTION: Decompensated liver cirrhosis is associated with hemodynamic changes including arterial blood pressure alterations. The aim of the study was to investigate the circadian rhythm variability of arterial blood pressure in relation to reninemia and aldosteronemia in cirrhotic patients with ascites, before and after paracentesis. MATERIAL AND METHODS: The study was performed in 22 normotensive cirrhotics with ascites and 19 healthy controls. Ambulatory arterial blood pressure monitoring was conducted for 24 hours, cardiac output and systemic vascular resistance were determined and circulating renin and aldosterone concentrations were measured. In cirrhotics, the tests were repeated 24 hours after paracentesis. RESULTS: It was demonstrated that as a consequence of paracentesis, the mesor values of systolic and diastolic blood pressure and heart rate decreased, whereas the amplitudes did not change in the cirrhotics. Moreover, in the cirrhotics' acrophases of blood pressure occurred earlier than in the controls. The day-night differences of mean pressure values were smaller in the cirrhotics than in the controls. The patients before paracentesis demonstrated higher cardiac output and lower systemic vascular resistance than healthy subjects. In cirrhotic patients the renin and aldosterone concentrations were higher and the aldosterone/renin ratio was lower than in the controls. CONCLUSIONS: Arterial blood pressure circadian rhythm in normotensive patients with decompensated cirrhosis of the liver with ascites is characterized by a lowered decrease at nighttime that suggests the occurrence of non-dipping phenomenon. The reduction of ascites in patients with decompensated liver cirrhosis leads to a reduction in arterial blood pressure and does not eliminate the non-dipping phenomenon in its day-night rhythm. In normotensive cirrhotic patients with ascites before and after single paracentesis, a dissociation of the renin-aldosterone nexus occurs.

WSTĘP: Niewyrównana marskość wątroby prowadzi do zaburzeń hemodynamicznych i zmian ciśnienia tętniczego krwi. Celem pracy było badanie zmienności okołodobowego rytmu ciśnienia tętniczego z uwzględnieniem reninemii i aldosteronemii u pacjentów z marskością wątroby z wodobrzuszem, przed i po paracentezie. MATERIAŁ I METODY: Badania obejmowały 22 chorych na marskość wątroby z wodobrzuszem i 19 osób zdrowych stanowiących grupę kontrolną. Przeprowadzono 24-godzinny pomiar ciśnienia tętniczego krwi, określono objętość minutową serca, całkowity opór obwodowy naczyń oraz stężenie reniny i aldosteronu w surowicy. U chorych na marskość wątroby badania powtórzono po 24 godz. od wykonania paracentezy. WYNIKI: W następstwie paracentezy mezory wartości ciśnienia skurczowego i rozkurczowego oraz tętna obniżyły się, amplituda zaś nie uległa zmianie. U chorych akrofazy ciśnienia krwi wystąpiły wcześniej niż w grupie kontrolnej. Różnice dzienno-nocne wartości ciśnienia krwi u chorych na marskość wątroby okazały się mniejsze niż u osób zdrowych. U chorych przed paracentezą objętość minutowa serca była większa, a całkowity opór obwodowy naczyń mniejszy niż u osób z grupy kontrolnej. W porównaniu z grupą kontrolną, reninemia i aldosteronemia były większe, natomiast wskaźnik aldosteron/renina mniejszy u chorych na marskość wątroby. WNIOSKI: U normotensyjnych chorych na marskość wątroby z wodobrzuszem występuje zjawisko non-dipper. Paracenteza prowadzi do zmniejszenia ciśnienia tętniczego, lecz nie znosi zjawiska non-dipper. U chorych na marskość wątroby z wodobrzuszem obserwuje się rozkojarzenie reninowo-aldosteronowe zarówno przed, jak i po paracentezie.

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1 Annales Academiae Medicae Silesiensis

1 Polish Journal of Surgery

1 2016

1 2010

1 Balicka J.

1 Cholewa K.

1 Chudek J.

1 Cierpka L.

1 Kajor M.

1 Kowalik-Kabat A.

1 Król R.

1 Kulik H.

1 Marcisz C.

1 Mazurek U.

1 Olejko A.

1 Orzeł A.

1 Więcek A.

1 Ziaja J.

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Expression of Genes Encoding Aldosterone Synthesis Pathway Enzymatic Proteins in Adrenocortical Adenomas in Patients With Conn Syndrome

Arterial blood pressure circadian rhythm in normotensive decompensated cirrhotic patients before and after single paracentesis