Regulation of aldosterone secretion

Abstract

Although angiotensin II and potassium ion play the leading parts in the regulation of aldosterone synthesis and secretion, various factors have recently been shown to act in concert with these two secretagogues, such as neurotransmitters, neurohormones, the intra-adrenal renin-angiotensin system, antioxidant vitamins, and adrenomedullin. Extra-adrenal, vascular production of aldosterone has been proposed as an intriguing, regulated mechanism for the modulation of angiotensin II-induced trophic effects. Much attention has recently been devoted to the intracellular signaling mechanisms leading to both the acute and chronic stimulation of aldosterone biosynthesis: role of voltage-gated calcium channels, of protein phosphorylation by various kinases, regulation of intramitochondrial cholesterol transport, and control of expression of aldosterone synthase, among others. A complex picture of cross-talking, additive, or opposite regulatory mechanisms emerges that may help us understand some disease states of uncontrolled mineralocorticoid secretion.