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Aldosterone.

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J T AUGUST, D H NELSON, G W THORN. 1958-11-13. Aldosterone.. https://doi.org/10.1056/nejm195811132592005

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Circadian rhythm of water balance and aldosterone excretion in the whitebellied sunbird Nectarinia talatala.

Nectarivorous whitebellied sunbirds, Nectarinia talatala, demonstrate distinct circadian patterns in osmoregulatory parameters. We recorded intake of a 1 mol/l sucrose solution which enabled calculation of total water gain, and collected cloacal fluid for measurements of volume, osmolality and aldosterone concentration. These variables were assessed hourly over 12 h of photophase, and averaged over the 12-h scotophase period. Overnight, when sunbirds were in negative water balance, aldosterone concentrations and outputs were significantly higher than diurnal levels, reflecting a shut-down of cloacal fluid production. Early morning was marked by a high rate of osmotic excretion, disproportionate to water gain or cloacal fluid output, followed by steady intake and cloacal fluid output during the morning and early afternoon. Reduced water flux (decreased feeding and cloacal fluid output) during mid-afternoon was accompanied by a paradoxical decline in osmotic excretion, whilst a significant increase in the discrepancy between water intake and output was recorded as the birds effectively stored water before the scotophase. These patterns of intake and excretion may be informative in explaining drinking and foraging behaviour in the field.

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Review of aldosterone- and angiotensin II-induced target organ damage and prevention.

Aldosterone is well recognized as a cause of sodium reabsorption, water retention, and potassium and magnesium loss; however, it also produces a variety of other actions that lead to progressive target organ damage in the heart, vasculature, and kidneys. Aldosterone interacts with mineralocorticoid receptors to promote endothelial dysfunction, facilitate thrombosis, reduce vascular compliance, impair baroreceptor function, and cause myocardial and vascular fibrosis. Although angiotensin II has been considered the major mediator of cardiovascular damage, increasing evidence suggests that aldosterone may mediate and exacerbate the damaging effects of angiotensin II. While angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers reduce plasma aldosterone levels initially, aldosterone rebound, or 'escape' may occur during long-term therapy. Therefore, aldosterone blockade is required to reduce the risk of progressive target organ damage in patients with hypertension and heart failure. This may be achieved nonselectively with spironolactone or with use of the selective aldosterone blocker eplerenone. While both agents have been demonstrated to be effective antihypertensive agents, eplerenone may produce improved target organ protection as witnessed in a variety of clinical settings, without the antiandrogenic and progestational effects commonly observed with spironolactone.

Aldosterone↗

Human endothelium: target for aldosterone.

Aldosterone has long been known to control water and electrolyte balance by acting on mineralocorticoid receptors in kidney. However, recent studies demonstrated the presence of these receptors in nonclassical locations, including the cardiovascular system. We tested the hypothesis whether endothelial cells respond to aldosterone with changes in cell volume, a measure for ion-mediated water movement across the cell membrane. By means of atomic force microscopy in fluid, we measured volume of adherent human umbilical venous endothelial cells exposed for 72 hours to 10 nmol/L aldosterone. Over this period of time, cells swell by approximately 18%. Aldosterone-induced swelling is prevented by 100 nmol/L of the mineralocorticoid receptor antagonist spironolactone, added to the primary endothelial cell culture. Aldosterone-treated cells dramatically shrink when 1 micromol/L of the diuretic amiloride is applied. Cells deprived of aldosterone do not respond to amiloride. Our conclusions are: (1) aldosterone leads to sustained cell swelling inhibited by administration of spironolactone or the sodium channel blocker amiloride; (2) cells respond to amiloride after aldosterone exposure; (3) renal diuretics act on endothelial cells; and (4) both amiloride and spironolactone could be useful for medical applications to prevent aldosterone-mediated endothelial dysfunction.

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