Somatic SLC30A1 mutations altering zinc transporter ZnT1 cause aldosterone-producing adenomas and primary aldosteronism

Primary aldosteronism (PA) is the most common form of endocrine hypertension and is characterized by inappropriately elevated aldosterone production via a renin-independent mechanism. Driver somatic mutations for aldosterone excess have been found in approximately 90% of aldosterone-producing adenom...

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Veröffentlicht in:Nature genetics 2023-10, Vol.55 (10), p.1623-1631
Hauptverfasser: Rege, Juilee, Bandulik, Sascha, Nanba, Kazutaka, Kosmann, Carla, Blinder, Amy R., Plain, Allein, Vats, Pankaj, Kumar-Sinha, Chandan, Lerario, Antonio M., Else, Tobias, Yamazaki, Yuto, Satoh, Fumitoshi, Sasano, Hironobu, Giordano, Thomas J., Williams, Tracy Ann, Reincke, Martin, Turcu, Adina F., Udager, Aaron M., Warth, Richard, Rainey, William E.
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Sprache:eng
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Zusammenfassung:Primary aldosteronism (PA) is the most common form of endocrine hypertension and is characterized by inappropriately elevated aldosterone production via a renin-independent mechanism. Driver somatic mutations for aldosterone excess have been found in approximately 90% of aldosterone-producing adenomas (APAs). Other causes of lateralized adrenal PA include aldosterone-producing nodules (APNs). Using next-generation sequencing, we identified recurrent in-frame deletions in SLC30A1 in four APAs and one APN (p.L51_A57del, n  = 3; p.L49_L55del, n  = 2). SLC30A1 encodes the ubiquitous zinc efflux transporter ZnT1 (zinc transporter 1). The identified SLC30A1 variants are situated close to the zinc-binding site (His43 and Asp47) in transmembrane domain II and probably cause abnormal ion transport. Cases of PA with SLC30A1 mutations showed male dominance and demonstrated increased aldosterone and 18-oxocortisol concentrations. Functional studies of the SLC30A1 51_57del variant in a doxycycline-inducible adrenal cell system revealed pathological Na + influx. An aberrant Na + current led to depolarization of the resting membrane potential and, thus, to the opening of voltage-gated calcium (Ca 2+ ) channels. This resulted in an increase in cytosolic Ca 2+ activity, which stimulated CYP11B2 mRNA expression and aldosterone production. Collectively, these data implicate zinc transporter alterations as a dominant driver of aldosterone excess in PA. Somatic SLC30A1 mutations altering the zinc efflux transporter ZnT1 cause primary aldosteronism. These mutations result in membrane depolarization and opening of voltage-gated calcium channels, stimulating CYP11B2 expression and aldosterone production.
ISSN:1061-4036
1546-1718
1546-1718
DOI:10.1038/s41588-023-01498-5