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September 14, 2026Endocrine Reviews

Single-cell and spatial technologies map adrenal cellular heterogeneity to support precision management of primary aldosteronism.

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Design

Review

Key result

Recent advances in single-cell and spatial technologies enable high-resolution interrogation of adrenal cellular heterogeneity, supporting a shift toward precision management of primary aldosteronism.

Authors

AAAmnani AminuddinEAElena AzizanSOSamuel O’Toole

Discussion

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Overview

May inform precision strategies beyond binary classification in primary aldosteronism; extends molecular spectrum model but leaves open prospective validation.

Key Points

  • To review the pathophysiological mechanisms of primary aldosteronism and evaluate how single-cell and spatial profiling technologies can overcome the limitations of traditional binary classification to advance precision clinical care.
  • Synthesized current clinical, histopathological, and molecular evidence challenging the conventional unilateral versus bilateral management paradigm in primary aldosteronism.
  • Evaluated methodological frameworks using single-cell RNA sequencing and spatial transcriptomics to resolve adrenal development, zonation, and somatic mutation landscapes.
  • Demonstrated that variable surgical cure rates, post-adrenalectomy biochemical recurrence, and CYP11B2 histopathology reflect a continuous disease spectrum driven by cellular plasticity and somatic mutations.
  • Identified that bulk tissue genetics obscures intratumoural heterogeneity, whereas single-cell approaches map distinct cellular microenvironments and developmental trajectories in adrenal tissue.
  • Highlighted translational opportunities for single-cell technologies in identifying pre-operative circulating biomarkers and developing genotype-directed, mechanism-based alternatives to mineralocorticoid receptor antagonists.

PICO

P
Population
Primary aldosteronism

Single-cell and spatial technologies provide high-resolution insights into the cellular heterogeneity of primary aldosteronism, supporting a shift toward precision, genotype-informed therapies.

Cite This Study

Aminuddin et al. (2026) conducted a review in Primary aldosteronism. Recent advances in single-cell and spatial technologies enable high-resolution interrogation of adrenal cellular heterogeneity, supporting a shift toward precision management of primary aldosteronism.

synapsesocial.com/papers/6aa7afef79e9260bc85aad13https://doi.org/10.1210/endrev/bnag034
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Emerging methods for subtype differentiation in primary aldosteronism2025 · 2 citations
  2. 2From bench to bedside: primary aldosteronism revisited2026
  3. 3Beyond aldosterone and renin: emerging biomarkers for diagnosing and subtyping primary aldosteronism2026
  4. 4Transcriptomics, Epigenetics, and Metabolomics of Primary Aldosteronism2021 · 14 citations
  5. 5The importance of novel histopathological classification and its association with outcomes of primary aldosteronism: What you need to know from a urologist’s perspective2024 · 2 citations