Aldosterone biosynthesis in the human adrenal cortex and associated disorders

• Aldosterone is known to regulate extracellular fluid volume and potassium exchange.
• Primary aldosteronism constitutes one of frequent causes of secondary hypertension.
• The expression of various factors are involved in adrenal aldosterone production.
• Several mutations have been reported to be associated with primary aldosteronism.
• New in vitro models of primary aldosteronism should be explored in future studies.

Aldosterone is one of the mineralocorticoids synthesized and secreted by the adrenal glands, and it plays pivotal roles in regulating extracellular fluid volume and blood pressure. Autonomous excessive aldosterone secretion resulting from adrenocortical diseases is known as primary aldosteronism, and it constitutes one of the most frequent causes of secondary hypertension. Therefore, it is important to understand the molecular mechanisms of aldosterone synthesis in both normal and pathological adrenal tissues. Various factors have been suggested to be involved in regulation of aldosterone biosynthesis, and several adrenocortical cell lines have been developed for use as in vitro models of adrenal aldosterone-producing cells, for analysis of the underlying molecular mechanisms. In this review, we summarize the available reports on the regulation of aldosterone biosynthesis in the normal adrenal cortex, in associated disorders, and in in vitro models.