title: Prevalence of angiotensin II type 1 receptor (AT1R)-activating autoantibodies in primary aldosteronism.
abstract: Autoantibodies to the angiotensin II type 1 receptor (AT1R) have been reported in patients with primary aldosteronism, including aldosterone producing adenoma (APA) and idiopathic adrenal hyperplasia (IAH). Sera from 25 primary aldosteronism subjects (12 with IAH and 13 with APA) and 15 normotensive control subjects were assayed for AT1R autoantibodies by enzyme-linked immunosorbent assay and an AT1R-transfected cell-based bioassay. Nine of 12 IAH subjects (75%) and six of 13 APA subjects (46%) were positive for AT1R autoantibodies in the bioactivity assay. The mean AT1R autoantibody activity for the IAH and APA subjects was significantly greater than controls (P < .001 and P < .01, respectively), and this in vitro activity was suppressed by the AT1R blocker losartan. None of the controls had significant AT1R autoantibody activity. Enzyme-linked immunosorbent assay values were less sensitive but were positive in some subjects with IAH and APA. The mean arterial pressure of these primary aldosteronism subjects correlated modestly with AT1R autoantibody activity. These data confirm the presence of active AT1R autoantibodies in a high percentage of subjects with primary aldosteronism irrespective of their underlying etiology. These observations have both pathophysiological and clinical implications.
authors.affiliation: Endocrinology Section, Department of Medicine, University of Oklahoma Health Sciences Center and VA Medical Center, Oklahoma City, OK, USA; Heart Rhythm Institute, Department of Medicine, University of Oklahoma Health Sciences Center and VA Medical Center, Oklahoma City, OK, USA.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Li
authors.affiliation: Endocrinology Section, Department of Medicine, University of Oklahoma Health Sciences Center and VA Medical Center, Oklahoma City, OK, USA; Heart Rhythm Institute, Department of Medicine, University of Oklahoma Health Sciences Center and VA Medical Center, Oklahoma City, OK, USA.
authors.forename: Xichun
authors.initials: X
authors.lastname: Yu
authors.affiliation: Endocrinology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors.forename: Maria Verena
authors.initials: MV
authors.lastname: Cicala
authors.affiliation: Endocrinology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Mantero
authors.affiliation: Endocrinology Section, Department of Medicine, University of Oklahoma Health Sciences Center and VA Medical Center, Oklahoma City, OK, USA.
authors.forename: Alexandria
authors.initials: A
authors.lastname: Benbrook
authors.affiliation: Endocrinology Section, Department of Medicine, University of Oklahoma Health Sciences Center and VA Medical Center, Oklahoma City, OK, USA.
authors.forename: Vineet
authors.initials: V
authors.lastname: Veitla
authors.affiliation: Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Madeleine W
authors.initials: MW
authors.lastname: Cunningham
authors.affiliation: Endocrinology Section, Department of Medicine, University of Oklahoma Health Sciences Center and VA Medical Center, Oklahoma City, OK, USA; Heart Rhythm Institute, Department of Medicine, University of Oklahoma Health Sciences Center and VA Medical Center, Oklahoma City, OK, USA. Electronic address: david-kem@ouhsc.edu.
authors.forename: David C
authors.initials: DC
authors.lastname: Kem
mesh_terms: D000328:Adult; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology; D001323:Autoantibodies / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000276:immunology*; D007150:Immunohistochemistry; D019808:Losartan / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D044140:Receptor, Angiotensin, Type 1 / Q000378:metabolism*
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001323:Autoantibodies; D044140:Receptor, Angiotensin, Type 1; D019808:Losartan
keywords: Aldosterone–producing adenoma; cell-based bioassay; hypertension; idiopathic adrenal hyperplasia