Hypersecretion of a new corticosteroid, 18-hydroxycortisol in two types of adrenocortical hypertension.

Abstract

The most abundant substance in the urinary free steroid fraction of patients with primary aldosteronism has been identified as 18-hydroxycortisol. 18-hydroxycortisol is very likely an adrenocortical secretory product rather than a peripheral metabolite, since it is abundantly synthesized by aldosteronoma tissue slices. The biogenesis of 18-hydroxycortisol takes place from cortisol rather than from 18-hydroxycorticosterone; that is, 17 alpha-precedes 18-hydroxylation. Cortisol 18-hydroxylation appears to be unrelated to the two other types of adrenocortical hydroxylation at this position. The pathway is present to a small extent in the normal human adrenal cortex and is only moderately stimulated by ACTH. Cortisol 18-hydroxylation is markedly accentuated in two circumstances: in the aldosteronoma cell where its presence may serve to distinguish tumor from bilateral hyperplasia and in ACTH-stimulatable hyperaldosteronism where it represents the first qualitative steroid biochemical abnormality to be demonstrated and as such may be useful in diagnosis and genetic studies. The possible contribution of 18-hydroxycortisol to the severity of the clinical manifestations of mineralocorticoid excess in these two types of aldosteronism remains to be explored.

• Authors: S Ulick, M D Chu
• Journal: Clinical and experimental hypertension. Part A, Theory and practice (Clin Exp Hypertens A) Vol. 4 Issue 9-10 Pg. 1771-7 ( 1982) ISSN: 0730-0077 [Print] United States
• PMID: 7139974 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Aldosterone
• 18-hydroxycortisol
• Hydrocortisone

Topics

• Adenoma (metabolism)
• Adrenal Cortex (metabolism)
• Aldosterone (metabolism)
• Humans
• Hydrocortisone (analogs & derivatives, metabolism)
• Hyperaldosteronism (physiopathology)
• Hypertension (etiology)