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Mineralocorticoids are a class of corticosteroids, which in turn are a class of steroid hormones. Mineralocorticoids are produced in the adrenal cortex and influence salt and water balances (electrolyte balance and fluid balance). The primary mineralocorticoid is aldosterone.

Contents

1 Physiology 2 Mode of action

2.1 Genomic mechanisms

3 Pathophysiology 4 Pharmacology 5 See also 6 References 7 Further reading 8 External links

Physiology[edit] The name mineralocorticoid derives from early observations that these hormones were involved in the retention of sodium, a mineral. The primary endogenous mineralocorticoid is aldosterone, although a number of other endogenous hormones (including progesterone and deoxycorticosterone) have mineralocorticoid function. Aldosterone
Aldosterone
acts on the kidneys to provide active reabsorption of sodium and an associated passive reabsorption of water, as well as the active secretion of potassium in the principal cells of the cortical collecting tubule and active secretion of protons via proton ATPases in the lumenal membrane of the intercalated cells of the collecting tubule. This in turn results in an increase of blood pressure and blood volume. Aldosterone
Aldosterone
is produced in the zona glomerulosa of the cortex of the adrenal gland and its secretion is mediated principally by angiotensin II but also by adrenocorticotrophic hormone (ACTH) and local potassium levels. Mode of action[edit] The effects of mineralocorticoids are mediated by slow genomic mechanisms through nuclear receptors as well as by fast nongenomic mechanisms through membrane-associated receptors and signaling cascades.

Steroidogenesis, showing mineralocorticoids in ellipse at top right.[1] Note that it is not a strictly bounded group, but a continuum of structures with increasing mineralocorticoid effect, with the primary example aldosterone at top.

Genomic mechanisms[edit] Mineralocorticoids bind to the mineralocorticoid receptor in the cell cytosol, and are able to freely cross the lipid bilayer of the cell. This type of receptor becomes activated upon ligand binding. After a hormone binds to the corresponding receptor, the newly formed receptor-ligand complex translocates into the cell nucleus, where it binds to many hormone response elements (HREs) in the promoter region of the target genes in the DNA. The opposite mechanism is called transrepression. The hormone receptor without ligand binding interacts with heat shock proteins and prevents the transcription of targeted genes. Aldosterone
Aldosterone
and cortisol (a glucosteroid) have similar affinity for the mineralocorticoid receptor; however, glucocorticoids circulate at roughly 100 times the level of mineralocorticoids. An enzyme exists in mineralocorticoid target tissues to prevent overstimulation by glucocorticoids. This enzyme, 11-beta hydroxysteroid dehydrogenase type II (Protein:HSD11B2), catalyzes the deactivation of glucocorticoids to 11-dehydro metabolites. Licorice
Licorice
is known to be an inhibitor of this enzyme and chronic consumption can result in a condition known as pseudohyperaldosteronism.[2] Pathophysiology[edit] Hyperaldosteronism
Hyperaldosteronism
(the syndrome caused by elevated aldosterone) is commonly caused by either idiopathic adrenal hyperplasia or by an adrenal adenoma. The two main resulting problems:

Hypertension
Hypertension
and edema due to excessive Na+ and water retention. Accelerated excretion of potassium ions (K+). With extreme K+ loss there is muscle weakness and eventually paralysis.

Hypoaldosteronism
Hypoaldosteronism
(the syndrome caused by underproduction of aldosterone) leads to the salt-wasting state associated with Addison's disease, although classical congenital adrenal hyperplasia and other disease states may also cause this situation. Acute underproduction (hemorrhagic adrenalitis) is often lifethreatening. Pharmacology[edit]

Fludrocortisone, a synthetic mineralocorticoid.

An example of a synthetic mineralocorticoid is fludrocortisone (Florinef). Important antimineralocorticoids are spironolactone and eplerenone. See also[edit]

List of corticosteroids

References[edit]

This article includes a list of references, but its sources remain unclear because it has insufficient inline citations. Please help to improve this article by introducing more precise citations. (November 2013) (Learn how and when to remove this template message)

^ Häggström, Mikael; Richfield, David (2014). "Diagram of the pathways of human steroidogenesis". WikiJournal of Medicine. 1 (1). doi:10.15347/wjm/2014.005. ISSN 2002-4436.  ^ Omar, HR; Komarova, I; El-Ghonemi, M; Fathy, A; Rashad, R; Abdelmalak, HD; Yerramadha, MR; Ali, Y; Helal, E; Camporesi, EM (2012). " Licorice
Licorice
abuse: Time to send a warning message". Therapeutic Advances in Endocrinology and Metabolism. 3 (4): 125–138. doi:10.1177/2042018812454322. PMC 3498851 . PMID 23185686. 

Further reading[edit]

Stewart P (2008): "The Adrenal Cortex " In: Kronenberg, Melmed, Polonsky, Larsen (eds.) Williams Textbook of Endocrinology (11 ed)., Saunders Elsevier, Philadelphia, pp. 445–504. Bennett PN and Brown MJ (2008) "Adrenal corticosteroids, antagonists, corticotropin", in Clinical Pharmacology
Pharmacology
(10ed), Churchill Livingstone Elsevier, Publ. pp. 593–607. Hu X, Funder JW (2006) The evolution of mineralocorticoid receptors. Mol Endocrinol. 20(7):1471-8. McKay L, Renoir JM, Weigel NL, Wilson EM, McDonnell DP, Cidlowski JA. (2006) International Union of Pharmacology. LXV. The pharmacology and classification of the nuclear receptor superfamily: glucocorticoid, mineralocorticoid, progesterone, and androgen receptors. Pharmacol Rev. Dec;58(4):782-97. Pippal JB, Fuller PJ. (2008) Structure-function relationships in the mineralocorticoid receptor. J Mol Endocrinol. 41(6):405-13.

External links[edit]

Mineralocorticoids at the US National Library of Medicine Medical Subject Headings (MeSH)

v t e

Pharmacology: major drug groups

Gastrointestinal tract/ metabolism (A)

stomach acid

Antacids H2 antagonists Proton
Proton
pump inhibitors

Antiemetics Laxatives Antidiarrhoeals/Antipropulsives Anti-obesity drugs Anti-diabetics Vitamins Dietary minerals

Blood
Blood
and blood forming organs (B)

Antithrombotics

Antiplatelets Anticoagulants Thrombolytics/fibrinolytics

Antihemorrhagics

Platelets Coagulants Antifibrinolytics

Cardiovascular system (C)

cardiac therapy/antianginals

Cardiac glycosides Antiarrhythmics Cardiac stimulants

Antihypertensives Diuretics Vasodilators Beta blockers Calcium channel blockers renin–angiotensin system

ACE inhibitors Angiotensin II
Angiotensin II
receptor antagonists Renin inhibitors

Antihyperlipidemics

Statins Fibrates Bile acid sequestrants

Skin (D)

Emollients Cicatrizants Antipruritics Antipsoriatics Medicated dressings

Genitourinary system (G)

Hormonal contraception Fertility agents SERMs Sex hormones

Endocrine system (H)

Hypothalamic–pituitary hormones Corticosteroids

Glucocorticoids Mineralocorticoids

Sex hormones Thyroid hormones/Antithyroid agents

Infections and infestations (J, P, QI)

Antimicrobials: Antibacterials (Antimycobacterials) Antifungals Antivirals Antiparasitics

Antiprotozoals Anthelmintics Ectoparasiticides

IVIG Vaccines

Malignant disease (L01–L02)

Anticancer agents

Antimetabolites Alkylating Spindle poisons Antineoplastic Topoisomerase inhibitors

Immune disease (L03–L04)

Immunomodulators

Immunostimulants Immunosuppressants

Muscles, bones, and joints (M)

Anabolic steroids Anti-inflammatories

NSAIDs

Antirheumatics Corticosteroids Muscle
Muscle
relaxants Bisphosphonates

Brain and nervous system (N)

Analgesics Anesthetics

General Local

Anorectics Anti-ADHD agents Antiaddictives Anticonvulsants Antidementia agents Antidepressants Antimigraine
Antimigraine
agents Antiparkinson
Antiparkinson
agents Antipsychotics Anxiolytics Depressants Entactogens Entheogens Euphoriants Hallucinogens

Psychedelics Dissociatives Deliriants

Hypnotics/Sedatives Mood Stabilizers Neuroprotectives Nootropics Neurotoxins Orexigenics Serenics Stimulants Wakefulness-promoting agents

Respiratory system (R)

Decongestants Bronchodilators Cough medicines H1 antagonists

Sensory organs (S)

Ophthalmologicals Otologicals

Other ATC (V)

Antidotes Contrast media Radiopharmaceuticals Dressings Senotherapeutics

v t e

Mineralocorticoids and antimineralocorticoids (H02)

Mineralocorticoids

Desoxycortone (desoxycorticosterone)

Desoxycortone esters

Hydrocortisone
Hydrocortisone
(cortisol)

Hydrocortisone
Hydrocortisone
esters

Fludrocortisone

Fludrocortisone
Fludrocortisone
acetate

Methylprednisolone

Methylprednisolone
Methylprednisolone
esters

Prednisolone

Prednisolone
Prednisolone
esters

Prednisone

Prednisone
Prednisone
esters

Antimineralocorticoids

Steroidal: Canrenoate potassium (potassium canrenoate) Canrenone Drospirenone Dydrogesterone Eplerenone Gestodene Medrogestone Progesterone Spironolactone Trimegestone

Nonsteroidal: Amlodipine Apararenone§ Benidipine Esaxerenone† Felodipine Finerenone† Nifedipine Nimodipine Nitrendipine

Synthesis modifiers

Acetoxolone Aminoglutethimide Carbenoxolone Enoxolone Ketoconazole Metyrapone Mitotane Trilostane

#WHO-EM ‡Withdrawn from market Clinical trials:

†Phase III §Never to phase III

See also Mineralocorticoid receptor
Mineralocorticoid receptor
modulators Glucocorticoids and antiglucocorticoids List of corticosteroids

v t e

Mineralocorticoid receptor
Mineralocorticoid receptor
modulators

MR

Agonists

11-Dehydrocorticosterone
11-Dehydrocorticosterone
(11-oxocorticosterone, 17-deoxycortisone)

11-Dehydrocorticosterone
11-Dehydrocorticosterone
acetate

11- Deoxycorticosterone (desoxycortone, deoxycortone, desoxycorticosterone)

Desoxycortone esters

11-Deoxycortisol
11-Deoxycortisol
(cortodoxone, cortexolone)

Cortifen
Cortifen
(cortiphen, kortifen) Cortodoxone acetate

11β-Hydroxyprogesterone 16α,18-Dihydroxy-11-deoxycorticosterone 17α-Hydroxyaldosterone 18-Hydroxy-11-deoxycorticosterone 19-Norprogesterone Aldosterone Corticosterone

Corticosterone
Corticosterone
acetate Corticosterone
Corticosterone
benzoate

Cortisol
Cortisol
(hydrocortisone)

Benzodrocortisone
Benzodrocortisone
(hydrocortisone benzoate) Hydrocortamate
Hydrocortamate
(hydrocortisone diethylaminoacetate) Hydrocortisone
Hydrocortisone
esters

Cortisone

Cortisone
Cortisone
acetate

Fludrocortisone
Fludrocortisone
(fludrocortone)

Fludrocortisone
Fludrocortisone
acetate

Mometasone

Mometasone
Mometasone
furoate

Prednisolone

Prednazate Prednazoline Prednicarbate
Prednicarbate
(prednisolone ethylcarbonate propionate) Prednimustine Prednisolamate
Prednisolamate
(prednisolone diethylaminoacetate) Prednisolone
Prednisolone
esters

Prednisone

Prednisone
Prednisone
esters

Antagonists

Steroidal: 6β-Hydroxy-7α-thiomethylspironolactone 7α-Acetylthio-17α-hydroxyprogesterone 7α-Thiomethylspironolactone
7α-Thiomethylspironolactone
(SC-26519) 7α-Thioprogesterone
7α-Thioprogesterone
(SC-8365) 7α-Thiospironolactone
7α-Thiospironolactone
(SC-24813) 16α-Hydroxyprogesterone 17α-Hydroxyprogesterone
17α-Hydroxyprogesterone
(hydroxyprogesterone) 18-Deoxyaldosterone 18,19-Dinorprogesterone Canrenoate potassium (potassium canrenoate) Canrenoic acid
Canrenoic acid
(canrenoate) Canrenone
Canrenone
(canrenoate y-lactone) Dicirenone Dimethisterone Drospirenone Dydrogesterone Eplerenone Gestodene Guggulsterone Hydroxyprogesterone caproate Medrogestone Mespirenone Metribolone Mexrenoate potassium Mexrenoic acid
Mexrenoic acid
(mexrenoate) Mexrenone Oxprenoic acid
Oxprenoic acid
(oxprenoate) Oxprenoate potassium
Oxprenoate potassium
(RU-28318) Pregnenolone Progesterone Prorenoate potassium Prorenoic acid
Prorenoic acid
(prorenoate) Prorenone RO-14-9012 RU-26752 SC-5233
SC-5233
(spirolactone) SC-8109 SC-11927 (CS-1) SC-19886 SC-27169 Spirorenone Spironolactone Spiroxasone Tibolone Trimegestone ZK-91587 ZK-97894

Nonsteroidal: Amlodipine Apararenone Benidipine BR-4628 Esaxerenone Felodipine Finerenone Nifedipine Nimodipine Nitrendipine PF-03882845 SM-368229

See also Receptor/signaling modulators Mineralocorticoids and antimineralocorticoids Glucocorticoid
Glucocorticoid
receptor modulators List

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