title: A case of primary aldosteronism in pregnancy: do LH and GNRH receptors have a potential role in regulating aldosterone secretion?
abstract: OBJECTIVE
  The mechanisms inducing steroidogenesis in primary aldosteronism (PA) remain poorly defined. It was recently demonstrated that some G-protein-coupled receptors are abnormally expressed in aldosterone-producing adenomas (APA). We evaluated the potential role of LH and GNRH receptors (LHR (or LHCGR) and GNRHR) in regulating aldosterone secretion in a patient with APA arising during pregnancy (index case) and in a subset of other patients with PA.
  
  
  METHODS
  GNRH test was performed in the index case, 11 other PA, and 5 controls. GNRHR and LHR expressions were examined in 23 APA and 6 normal tissues.
  
  
  RESULTS
  Aldosterone response increased significantly (114%) in the index case after GNRH test was performed preoperatively, while it was blunted after adrenalectomy. Aldosterone also increased after human chorionic gonadotropin and triptorelin stimulation. A partial aldosterone response to GNRH was observed in other 7/11 PA, while a significant response was observed in two patients. Controls did not respond to GNRH test. GNRHR was overexpressed and LHR expression was moderate in the APA tissue from the index case. Moreover, LHR was found in normal adrenals and overexpressed in 6/22 APA. GNRHR was overexpressed in 6/22 APA, 2 of them with a 95- and 109-fold higher expression than normal. A correlation between the clinical and molecular findings was observed in five out of seven patients.
  
  
  CONCLUSIONS
  We describe a case of PA diagnosed during pregnancy, which appeared to correlate with aberrant LHR and GNRHR expression. Our findings suggest that a subset of patients with PA has aberrant LHR and GNRHR expression, which could modulate aldosterone secretion.
authors.affiliation: Division of Endocrinology, Department of Medical and Surgical Sciences, University of Padua, Via Ospedale 105, 35128 Padua, Italy. nora.albiger@unipd.it
authors.forename: N M
authors.initials: NM
authors.lastname: Albiger
authors.forename: P
authors.initials: P
authors.lastname: Sartorato
authors.forename: B
authors.initials: B
authors.lastname: Mariniello
authors.forename: M
authors.initials: M
authors.lastname: Iacobone
authors.forename: I
authors.initials: I
authors.lastname: Finco
authors.forename: A
authors.initials: A
authors.lastname: Fassina
authors.forename: F
authors.initials: F
authors.lastname: Mantero
mesh_terms: D000328:Adult; D000450:Aldosterone / Q000097:blood* / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006929:Hyperaldosteronism / Q000097:blood* / Q000378:metabolism*; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011974:Receptors, LH / Q000235:genetics / Q000378:metabolism*; D011966:Receptors, LHRH / Q000235:genetics / Q000378:metabolism*; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D011974:Receptors, LH; D011966:Receptors, LHRH; D000450:Aldosterone; D006854:Hydrocortisone