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 |
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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. |
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ISSN: | 1061-4036 1546-1718 1546-1718 |
DOI: | 10.1038/s41588-023-01498-5 |