Hyperaldosteronism: recent concepts, diagnosis, and management

Abstract
Glucocorticoids and mineralocorticoids are synthesised from cholesterol mainly in the adrenal cortex. The two forms of cytochromeP-450 enzymes, CYP11B1 (aldosynthase) and CYP11B2 (11β-hydroxylase), that catalyse the final step of these synthetic pathways are encoded by two closely related genes on chromosome 8. CYP11B1 synthesises corticosterone from deoxycorticosterone in the zona fasiculata reticularis and is mainly regulated by adrenocorticotrophic hormone (ACTH). CYP11B2 catalyses the synthesis of aldosterone from deoxycorticosterone in the zona glomerulosa and its activity is principally regulated by angiotensin II and potassium; and it is weakly regulated by sodium and ACTH. As mitochondrial enzymes, CYP11B1 and 11B2 are highly sensitive to tissue oxygen concentration.