Modulation of calcium signaling on demand to decipher the molecular mechanisms of primary aldosteronism

Abstract Primary aldosteronism (PA) is the most common form of secondary hypertension. Major advances have been made in our understanding of PA with the identification of germline and somatic mutations in ion pumps and channels. These mutations lead to the activation of calcium signalling, the major trigger of aldosterone biosynthesis. To elucidate the molecular mechanisms underlying the development of PA, we established an adrenocortical cell model in which we can modulate sodium entry into the cells “on demand” leading to calcium signalling activation. These cells recapitulated the major features of KCNJ5 mutations, the most frequent genetic alteration identified in Aldosterone-Producing-Adenoma. Activation of calcium signalling was associated with increased aldosterone biosynthesis and decreased cell proliferation. RNA sequencing and steroidome analyses revealed unique profiles associated with Na + entry. Altogether, this work offers valuable insights into the role of sodium-induced calcium signalling in PA development and paves the way for developing new therapeutic strategies.