Non-adrenal synthesis of aldosterone: A reality check

Advances in the sensitivity of molecular techniques during the 1990s led to a flurry of studies that supported the existence of extra-adrenal sites of aldosterone production in various tissues including the brain and the heart. Subsequent work was often conflicting or ambiguous, leading many to question whether extra-adrenal aldosterone was of any physiological importance, or whether it even existed. In this article, we review these studies and, in light of this evidence, discuss whether the current lack of interest in extra-adrenal aldosterone biosynthesis is justified.

► Technical advances gave partial evidence of extra-adrenal aldosterone biosynthesis.
► The cardiovascular and central nervous systems have attracted most attention.
► Data suggest low and/or incomplete expression of required steroidogenic components.
► Belief in its physiological importance has receded but is not entirely discounted.