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Endocrine Abstracts (2015) 37 GP03.04 | DOI: 10.1530/endoabs.37.GP.03.04

ECE2015 Guided Posters Adrenal (2) (8 abstracts)

Prolactinoma and primary aldosteronism: is there a causal link?

Tracy Ann Williams 1, , Anna Dietz 1 , Felix Beuschlein 1 , Paolo Mulatero 2 & Martin Reincke 1


1Ludwig‐Maximillians‐University‐Munich, Munich, Germany; 2University of Turin, Turin, Italy.


Introduction: We report the largest case series of concomitant prolactinoma and aldosterone-producing adenoma (APA), diagnosed in four patients from the German Conn Registry and in three patients at the Hypertension Unit, University of Torino. A disproportionate number (five out of seven) presented with macro-prolactinomas indicating that elevated prolactin (PRL) concentrations may play a role in APA formation. Further, increased expression of PRLR in the zona glomerulosa could sensitise the adrenal gland to the high circulating levels of PRL in prolactinoma patients.

Methods: PRLR gene expression data was from the GTEx Portal database2 (dbGaP accession number phs000424.vN.pN: www.gtexportal.org). Transcriptional profiles of eight APA and three normal adrenals were compared using an Affymetrix GeneChip HG-U133 Plus 2.0 gene expression platform. Effects of PRL were tested on CYP11B2 gene expression levels and aldosterone production in NCI H295R cells.

Results: The uterus and the adrenal gland expressed the highest levels of the PRLR of the 45 tissues in the GTEx Portal database. Microarray analysis demonstrated a 1.55-fold upregulation of PRLR gene expression in APA compared to normal adrenals. In H295R cells PRL (100 nM) resulted in a 1.35±0.02-fold upregulation in CYP11B2 gene expression and a 1.26±0.07-fold increase in aldosterone production.

Conclusion: High levels of PRL result in CYP11B2 upregulation and an increase in aldosterone production in vitro and may play a role in APA development in cases of concomitant prolactinoma–APA.

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