Mast cell hyperplasia is associated with aldosterone hypersecretion in a subset of aldosterone-producing adenomas

J Clin Endocrinol Metab. 2015 Apr;100(4):E550-60. doi: 10.1210/jc.2014-3660. Epub 2015 Jan 19.


Context: Adrenal mast cells can stimulate aldosterone secretion through the local release of serotonin (5-HT) and activation of the 5-HT4 receptor (5-HT4). In aldosterone-producing adenomas (APAs), 5-HT4 receptor is overexpressed and the administration of 5-HT4 receptor agonists to patients with APA increases plasma aldosterone levels. These data and the well-documented role of mast cells in tumorigenesis suggest that mast cells may be involved in the pathophysiology of APA.

Objective: The study aimed at investigating the occurrence of mast cells in a series of APA tissues and to examine the influence of mast cells on aldosterone secretion.

Design: The occurrence of mast cells in APAs was investigated by immunohistochemistry. Mast cell densities were compared with clinical data. The influence of mast cells on aldosterone production was studied by using cultures of human mast cell and adrenocortical cell lines.

Results: In APA tissues, the density of mast cells was found to be increased in comparison with normal adrenals. Mast cells were primarily observed in adrenal cortex adjacent to adenomas or in the adenomas themselves, distinguishing two groups of APAs. A subset of adenomas was found to contain a high density of intratumoral mast cells, which was correlated with aldosterone synthase expression and in vivo aldosterone secretory parameters. Administration of conditioned medium from cultures of human mast cell lines to human adrenocortical cells induced a significant increase in aldosterone synthase (CYP11B2) mRNA expression and aldosterone production.

Conclusion: APA tissues commonly contain numerous mast cells that may influence aldosterone secretion through the local release of regulatory factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoma / genetics
  • Adenoma / metabolism*
  • Adenoma / pathology*
  • Adrenal Cortex Neoplasms / genetics
  • Adrenal Cortex Neoplasms / metabolism*
  • Adrenal Cortex Neoplasms / pathology*
  • Aldosterone / metabolism*
  • Aldosterone / pharmacology
  • Cell Count
  • Cell Proliferation / drug effects
  • Cells, Cultured
  • Gene Expression Profiling
  • Gene Expression Regulation, Neoplastic
  • Humans
  • Hyperaldosteronism / complications
  • Hyperaldosteronism / genetics
  • Hyperaldosteronism / metabolism
  • Hyperaldosteronism / pathology
  • Hyperplasia
  • Mast Cells / drug effects
  • Mast Cells / pathology*
  • Mast Cells / physiology
  • Microarray Analysis
  • Retrospective Studies


  • Aldosterone