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Nature Medicine 13, 189 - 197 (2007)
Published online: 4 February 2007 | doi:10.1038/nm1545



There is a Corrigendum (September 2009) associated with this Article.

Aldosterone impairs vascular reactivity by decreasing glucose-6-phosphate dehydrogenase activity

Jane A Leopold1,4, Aamir Dam1, Bradley A Maron1,4, Anne W Scribner1, Ronglih Liao1,4, Diane E Handy1,4, Robert C Stanton2, Bertram Pitt3 & Joseph Loscalzo1,4


Hyperaldosteronism is associated with impaired vascular reactivity; however, the mechanisms by which aldosterone promotes endothelial dysfunction remain unknown. Glucose-6-phosphate dehydrogenase (G6PD) modulates vascular function by limiting oxidant stress to preserve bioavailable nitric oxide (NOfilled circle). Here we show that aldosterone (10-9–;10-7 mol/l) decreased endothelial G6PD expression and activity in vitro, resulting in increased oxidant stress and decreased NOfilled circle levels—similar to what is observed in G6PD-deficient endothelial cells. Aldosterone decreased G6PD expression by increasing expression of the cyclic AMP-response element modulator (CREM) to inhibit cyclic AMP-response element binding protein (CREB)-mediated G6PD transcription. In vivo, infusion of aldosterone decreased vascular G6PD expression and impaired vascular reactivity. These effects were abrogated by spironolactone or vascular gene transfer of G6pd. These findings demonstrate that aldosterone induces a G6PD-deficient phenotype to impair endothelial function; aldosterone antagonism or gene transfer of G6pd improves vascular reactivity by restoring G6PD activity.


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